The problem with the Canadian systems (they’re slightly different by province) is that there is TOO LITTLE management and rationing.

Single payer, but insufficient efforts to manage demand and access lead to overutilization.

So, the copay is good not because the amount will make a substantial difference, but rather because it will make people be more judicious about their use of the system.

I am, however, surprised at the $25 amount.

In any case, some type of copay, combined with community case management and disease management strategies will make a significant impact in their system.

(FYI…I’ve consulted with one provincial government on strategies to manage costs and quality. There’s opportunity, and they also start from a better place than we do in the US.)