This episode examine contrasting approaches to healthcare funding and patient cost exposure in the United States and Canada. Multiple sources highlight the immediate financial threats facing the U.S. system, particularly noting that the expiration of Enhanced Premium Tax Credits is projected to more than double annual premiums for millions of subsidized Marketplace enrollees. Further complicating U.S. costs, an investigation reveals that major insurers use third-party data firms to aggressively slash out-of-network provider payments, maximizing their own fees but leaving patients vulnerable to massive surprise balance billing for the unpaid remainder, despite limited protections from the No Surprises Act. Crucial to navigating American plans are the financial terms that govern patient liability, specifically the definitions of co-pays and annual deductibles. In contrast, the Canadian system is tax-funded and universal for medically necessary hospital and physician services, eliminating surprise bills and deductibles for core treatment. However, Canadian residents typically rely on separate private insurance or out-of-pocket payments to cover essential needs like dental, vision, and prescription drugs.