ABSTRACT
The United States and Canada share a border, but there are stark differences in the two countries’ healthcare systems and cultural attitudes towards ethically complex medical practices. A country’s health insurance system speaks volumes about how its culture prioritises egalitarian access to healthcare. A number of other federal insurance programmes, including Medicaid and the Veterans Affairs Tricare programme, also cover various populations, but there is no government-sponsored guaranteed coverage of individuals aged 18–64. President Obama’s 2010 Patient Protection and Affordable Care Act (ACA) sought to extend coverage to uninsured individuals via expansion of the Medicaid programme and to make the individual purchase of insurance more affordable. A country’s health insurance system is not the only influence on access to care and quality of care. The heterogeneity of American culture and the divisiveness of its politics make issues at the intersection of life, death, and medicine particularly challenging.
