The Affordable Care Act is a legalistic mess - a compromise between having private healthcare providers, being as little disruptive to existing health care plans, while allowing the worst problems to be corrected (allegedly) and providing healthcare for the uninsured.
Canadian Health Care is real simple. Each province has its own health care provider. they pay all bills (sort of) for all covered residents of that province. When you move into a province, IIRC once you’ve been there 90 days, and are a legal Canadian resident (citizen, landed immigrant, etc.) you are covered. You get a card, and a number, and the doctor who sees you bills the provincial provider.
It works great if you are in need of emergency service. If the procedure can be put off, there are waiting lists. They can get long. My wife’s grandfather fell, broke his hip (at 87 years old) and had a new hip that same night. My boss had chronic hip pain due to mismatched leg length (a snowmobile accident 30 years before - how Canadian cliche can you get?). He waited 16 months. First they scheduled him for the consultation, 4 months. the consult found he had screws in his leg. (Duh!) Then he went off the hip list, and onto the “remove the screws” waiting list. 8 months later, the screws were out of his thigh, ow they can put him back on the hip list, and 6 months later, tada! New hip. Sounds annoying, but guess how much it cost him? (Hint -zero!)
It’s hard to find a doctor here. It’s hard to get an appointment. To see a specialist, you must be referred by a GP. Surgery tends to have wait lists. Things that are not covered, electives like plastic surgery, are quicker and probably cheaper than the USA. Drugs are not covered unless administered in a hospital setting.
For doctors - they are paid according to the fee schedule. it i low. Not too many filthy rich doctors here compared to the USA. If you want to charge more than the fee schedule (“extra billing”), you opt out completely and try to find people who can pay your fees out of their pocket. The Plans will not pay a portion of your fee - it’s all or nothing, and virtually nobody has private health care plans, so your only option is to be a doctor to the very very rich.
The plan is not tied to employment, or income, or anything, it’s funded out of taxes. So, employers do not count it as an expense, people are not tied to jobs with these golden handcuffs. (Those tend to be prescription drug pans and such benefits). Our taxes are higher (somewhat) but then, we don’t pay $5000 to $15000 in health insurance…
But doctors generally bill one system, they know what is covered by that one plan, they simply need to see your health card, there is no complex billing administration to deal with a hundred insurance compaies and a hundred different criteria for each procedure.
I know if I walk into a hospital (or are carried in) I stand to lose wages, but not much more. they won’t turn me away because of money, they won’t give me second class treatment, I won’t get a bill (except maybe for the TV rental in the room if I want a TV).
Also, there are very few of these convoluted things in Canada like you find in the USA. In the USA, you have problems like “pre-existing conditions”, lifetime maximums, or the newest one - if your employer plan is too high, you can join the government plans; but that’s only if the personal, not the family plan is too high. So the incentive is to make the employee plan cheap, and the family plan exorbitant, and the family man is screwed. In another case, the “Pre existing Condition Plans” are way over budget and stopped signing up new patients.
(According to one op-ed piece - normally, this sort of problem with legislation would be tidied up by congress over the next few years; the Obamacare thing is going to blow up in peoples faces because teh Republicans REFUSE to make any changes to it except to demand it be repealed. The house keeps trying to repeal it and rfuses to make changes from Democratic senate bills that would tidy up the mess; each side hopes the other will be blamed when things finally mess up completely.)