The upper class and the upper-middle class in the US probably do OK under republicare because they can afford it. (in some cases -- barely). Once you gt to the lower middle class, though, I'm betting that the US does worse than Canada (which is where I'm from)
I remember a incident, some years ago, when an American friend fell and hit his head. He was a small business owner, which means that health care was beyond his reach. The conversation went pretty much as follows:
Canadians: That's not good. You might have a concussion. We should take you to the hospital.
Paul: Hospital? No way man! How much is it gonna cost me? A hospital visit could bankrupt me!
Paul: The last time I went to the hospital with a headache, I ended up with a $20K second mortgage -- and they didn't even solve the problem!
After a good deal of cajoling we managed to get him to the hospital, where things turned out fine. As a foreigner, the visit was a flat-rate $600 (a good hard hit, but it could have been a lot worse in the US.)
The fact that a simple visit to the hospital could bankrupt an average middle-class american is what makes the US system so dangerous. I have little respect for it. Many Canadian doctors have moved to the US for the money, and then moved back to Canada, where they could actually spend their time taking care of people, rather than worrying about whether or not they could afford to pay for that care.