This isn't Canada, this isn't Europe, and neither Canadians nor Europeans will be running the Affordable Care Act. They have no say, so any comparison is wishful thinking. Before anyone says, "You can't compare it with the for-profit medical system in current use, either," you are right; if only because I have only second-hand knowledge of the system, so I automatically expect bias. I HAVE had experience with socialized medicine in the United States: TRICARE and the VA. You want to see an example of the federal government running health care? Ask a military spouse, or a vet. As long as increase of the bureaucray at the expense of resources, with an equal emphasis on 'triage,' is policy, there will be cost overages, there will be degredation of care, and there will be well meaning but clueless demagogues who will insist they 'know a better way' if we just make them our controller.