實際上各國實質上都差不多，比如大家拿的公共醫療是預付在稅裏麵了；具體執行係統不一樣；大美加了個資本市場

Canada’s public health care system is fundamentally “pre-paid” through taxes, whereas in the United States it is not universally prepaid via taxes. Here’s a clear comparison of how public financing works in both countries:

Canada — Tax-Funded Universal Health Care

How It Works

• Public health care is funded primarily through taxes (federal and especially provincial/territorial taxes).

• Everyone who is a resident of a province/territory is covered for medically necessary hospital and physician services.

• Coverage is universal and single-payer — the government pays providers directly.

• You don’t pay at the point of service for covered services.

Key Features

Funded through income and other taxes
Universal eligibility (for medically necessary services)
No direct billing to patients for covered services
Provinces administer plans within national standards

What Taxes Pay For

Primarily:

• Physicians’ fees

• Hospital services

• Diagnostic tests

Some services may require private payment or supplemental insurance (e.g., dental, vision, prescriptions outside hospitals).

---

United States — Mixed Public/Private System

How It Works

• No universal tax-funded health care for all residents.

• Public coverage exists for specific groups:

  • Medicare — primarily for those 65+ and certain disabled individuals (funded by payroll taxes, premiums, general revenues).

  • Medicaid — for low-income individuals (funded by federal/state dollars).

  • CHIP — for children in families with too much income for Medicaid.

• Most working-age adults get insurance through employers or buy private plans, funded by premiums, cost-sharing, and out-of-pocket payments.

Key Features

Some public programs are tax-funded for eligible groups
No universal, tax-funded coverage for everyone
Many people rely on employer or private insurance
Patients may pay premiums, deductibles, copays