Canada would be better off being America’s 51st state because Canadians would have “much better health coverage,” Donald Trump said last week.

There are probably some Canadians who would concede the point, having travelled to the States and found themselves able to pay for necessary treatment not available at home.

But by almost every objective measure, America’s health-care system is a disaster. The U.S. spends more than any of its peers: 16.5 per cent of GDP, or more than US$15,000 per person in 2022. Yet, U.S. life expectancy is more than four years lower than the average of 10 of its high-income peer countries and it has the highest rate of preventable, treatable deaths. If you were drawing up a national health-care system from scratch, you wouldn’t touch the American model with a 10-foot pole.