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November 2026

Provincial Rules, American States

The government cost of Canadian-style health coverage in the United States

Canada is often held up as a model for American health care, but Canada runs ten provincial health systems, not one. This study applies each province's public-coverage rules to the health spending of the US states that most resemble it.

If each state adopted the rules of the province it most resembles, US government health spending would rise by an expected $806.7 billion a year in 2020 dollars. Total health spending would fall, because administrative costs would drop to Canada's level.

$807Bextra government spending a year
$2,454per person
40% → 71%government share of health spending

Sensitivity checks put the estimate between about $725 billion and $1.06 trillion a year. All figures cover the 50 states, in 2020 US dollars.

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