Your original article did not explain the Bismark system very well (at least to me). But there was a link to a website that provided a better explanation (even better than the Wikipedia article). I took a quick read and became more knowledgeable than before.

I would say that for the USA, the Bismark model is preferable to the byzantine health care system currently in place. I have to agree that it would be more politically acceptable than a single user system. But I have to wonder how the current insurance companies would manipulate this new Bismark system for their own profits. In essence, a Bismark in the USA just might leave the insurance companies in charge as to who gets health care or not.

As for Canada to change to Bismark, this one quote summed things up quite nicely:

the Bismarck nations accept greater costs and less efficiency.

I think economists have deemed single-payer as the most efficient provider of health care. For Canada, Bismark would be a step backwards.

According to the Wikipedia article, Germany has 130 insurance companies operating in the health insurance business. And all these companies are tightly regulated by the government, which the American mindset might not like. This leaves consumers in charge of deciding their own health care coverage. And many consumers are not just that knowledgeable about the better companies and better deals.

If health coverage varies from employer to employer or depends on economic class, people will be making decisions to change jobs based on health care coverage. Companies make be stuck with employees who really don’t want to be working there just because they don’t want to leave the current coverage.

In Canada, this is so simple. If I change a job, I am still covered the same as before. If I decide go on a sabbatical from the workforce, I am still covered. If I get an illness and can’t work, I am still covered. In other words, the labor force is more fluid in Canada than the USA. And that is good for the economy.