In Canada, a much higher percentage of the population lives in remote areas whereas covered healthcare services are often concentrated in large cities (Reid, 2009).
Medicare Expansion and Mandatory Health Insurance Issues and Concerns
From the perspective of middle and upper middle income families in the U.S., the expansion of Medicare and the mandatory provision of healthcare by employers would be a tremendous benefit. From the employers perspective, the associated costs could be prohibitive. Mandatory requirements for individuals could be problematic for those at the lower end of the group income spectrum; however, it would be no less fair than the current situation that forces everyone who pays for healthcare to (in effect) subsidize those who choose not to (Kennedy, 2006). In all likelihood, the only way to make mandatory health insurance work would include expanding Medicare, at least to compete with private health insurers.
Naturally, this interferes with their profits, but there is no fundamental right to profit excessively from providing basic healthcare and public agencies could perform the same function as private insurers at approximately a tenth of the cost charged by private insurers (Kennedy, 2006).
Privatized Healthcare with Government Subsidization
Some hybridized version of healthcare that included elements of both privatization and government subsidies (such as through a voucher program) might be the most beneficial to middle and upper middle income families. It would severely reduce the profitability of private health insurance companies, but only because that industry has established an unreasonable and unjustifiable profit margin that has made healthcare unaffordable in the U.S. (Kennedy, 2006).
Kennedy, E. (2006). America: Back on Track. Viking: New York.
Reid, T. (2009). The Healing of America:.