@avalmez—as I recall, if you looked at studies about satisfaction with the Canadian health system back in the 90s, you’d find the vast majority of Canadians were very happy with it. You were hanging out with a very unusual demographic group, and that may be why they didn’t like it. And, of course, if you have a progressive tax system, those making a lot more money, will pay taxes at a higher marginal rate.
As to the issue of wealth driving health care costs; you could be right. In any case, that’s why I didn’t look at total spending per capita, but health spending as a portion of GDP. The US people apparently believe that health is an extremely important commodity, since they spend almost a fifth of their income on it, and that may go up to close to a third by 2030, if the projections turn out to be true.
Now, if you are wealthy, then you can spend a larger portion of you income on health, and still have plenty of money for other things you need and want. Still, studies about satisfaction with health systems show that Americans are pretty unhappy with their system, despite spending more money on it than any other country. This is probably because of the disparity in access. However, the other point is that you can spend much less than we do, and make the overall population much happier.
All the analyses I did showed that we could have more health care, and cover everyone, and actually reduce costs if we went to a single payer system. Of course, that would be tax financed, which is anathema to Americans. Such a system would significantly reduce the costs of businesses which provide insurance to their employees. Presumably they would pass at least some of those savings onto their employees in the form of raises. It would make those businesses more competitive, while not affecting the competitiveness of small businesses, at least, if you funded it through an income tax. Even if you used a payroll tax, the money still comes from individuals, ultimately.
Anyway, single payer would not stop the incentives for research and improvements in health. Far from it. There would be far more money going into actual health services (as opposed to paperwork), resulting in a larger demand for research and development. But we need only look at other nations with universal coverage systems to see that there are thriving pharmaceutical firms.
Also, they seem to get along fine without private health insurers, although they do have some coverage to cover gaps. I believe that Germany uses the private sector, but I’m not sure. In any case, even with a single payer system, you could hire the insurers to administer the system, and to do the actuarial analyses. They’d be smaller, but they wouldn’t go away.