I recently got into a brief Twitter spat with a stranger. I know, I know. It’s a waste of energy, but even so I felt inspired to correct a misperception. The discussion was about single-payer health care, and last year I was a patient in both the US and Canadian health care systems so I have an insight that not everyone has. I got very good medical care in both places, but the differences in the administration of my treatment were huge. The outcome has been that I will forever be a defender of the Canadian health care system.

In the Twitter exchange, I wondered why the US would consider buying affordable medications from Canada when it could create its own single-payer system to cut costs. Apparently, I don’t understand how the world works. My antagonist insisted that this would be too expensive to operate and anyway the federal government is incapable of running any service efficiently.

So, for the benefit of anyone who is wondering about these things, here are some key issues as I understand them.

1. The Feds Don’t Run the Show

In Canada, the health care system is administered by the provinces. Both the federal and provincial governments contribute funding, but each province decides how the money will be spent.

2. The Province Is the Insurer

The provinces provide health care insurance to all residents. Doctors bill the province, not the patient. Keeping the patient out of billing and reclaiming costs simplifies the system and saves a lot of money.

3. Medicare Doesn’t Cover Everything

Not included in the national health care system are, most notably, dentistry, home care, long-term care, and prescription drugs. For this reason, many Canadians have private health care insurance to cover those needs.

4. Prescription Drug Prices are Controlled

Provincial review boards negotiate drug prices for everyone and have established a formula for negotiating with pharmaceutical companies. Essentially, they can say “take it or leave it” to the drug companies. Existing drug prices cannot increase more than the rate of inflation. New drugs cannot cost more than similar drugs for the same illness.

5. Standards are Maintained

The government ensures the quality of care through federal standards and everyone is treated equally.

Once you have shown your health care card to the admissions clerk at a Canadian clinic or hospital, all your paperwork is done. When you are in pain and scared, that is a huge burden to have lifted. Then, when the health practitioners do their work, it isn’t necessary for every detail of treatment or medication to be tracked for each patient for insurance purposes. That saves both time and expense.

The system has a structure that is much less complex than the US system and the simplicity saves a lot of money by minimizing the use of private insurance. It is not perfect and is much more involved than I have suggested here, but it works extremely well.