Um, Canada is significantly MORE invested, at the federal government level, in "advancing social agendas" than the US has ever been. What Canada does not have is one major political party that sees demonizing government as their royal road to power. Canadians see value in using public resources for the public good- they may disagree about what that good should be, but the basic principle holds- as it did in the US until recently.
Before you wax too poetical about the glories of unfettered free markets and how government screws everything up, please reflect that there are many things we do through government exactly because it is the most efficient way to accomplish the task. Not perfect, surely, but most efficient. Police and fire protection, most emergency services, public works like water and sewer, roads and bridges, public safety agencies like the FAA, and the courts come to mind. Those are actually pretty good analogs to the heath care system because they are either not everyday needs of most people or exist in the background and are taken for granted, and most of us are not expert enough to chose from "free market" alternatives. So we collectively- through our government- provide for important public needs. Think having everyone hire their own private police would be more efficient?
Health insurance and health care are examples of markets that don't work well, because of fundamental problems of asymmetry of information, and because when consumers opt to save money on health care they often do so in ways that cost the overall system more and create worse outcomes (not getting that mole checked). On the flip side the push to consume excessive services it not that great ("think I'll just go have another colonoscopy, after all it's free"). Health care is just not the same sort of commodity as groceries or computer hardware. The health insurance market is a market that has failed to deliver what "free market" fundamentalists promised, because we don't consume health care the way we do other consumer goods.
I am a very "productive person", as you put it, but I am screwed by the health insurance system in the US. As an independent entrepreneur designing technology products that will employ many people in US manufacturing, I am acutely aware that the monolithic health insurance companies do not want my business, that as an individual I must pay far more than large companies pay and receive worse coverage, that I could be shut out altogether at any time, and that I have zero leverage as a consumer. That is a huge disincentive to the kind of risk taking entrepreneurship we need more of. The original poster is up against a real dilemma- probably solvable if he is young and healthy, but if he has a child or spouse with health problems, or is over 40, forget it.
In the real world public health insurance is a policy experiment that has been carried out many times. Other industrialized countries cover everyone, spend a fraction of what we do, and have, by any rational measure, better overall outcomes.
Even F.A. Hayek used health insurance as an example of an area where government should intervene- because it is genuine insurance against individual catastrophe, NOT managing an industry or determining outcomes:
“Nor is there any reason why the state should not assist the individuals in providing for those common hazards of life against which, because of their uncertainty, few individuals can make adequate provision. Where, as in the case of sickness and accident, neither the desire to avoid such calamities nor the efforts to overcome their consequences are as a rule weakened by the provision of assistance – where, in short, we deal with genuinely insurable risks – the case for the state’s helping to organize a comprehensive system of social insurance is very strong Wherever communal action can mitigate disasters against which the individual can neither attempt to guard himself nor make the provision for the consequences, such communal action should undoubtedly be taken,” – The Road To Serfdom (Chapter 9).
