A majority of coverage in the United states is still private insurance but Obamacare has increased the shift to government covered care. Canada is now illustrating the natural progression many European countries have already experienced. As health care cost continue to rise and more companies fold, the government gains a monopoly and costs continue to rise. While insurance companies have to keep costs down to keep premiums affordable so they don’t lose customers to other providers, they have to pay health care providers enough that they will continue to accept the insurance. They may not pay for services which they don’t feel are necessary but have to approve enough to insure the patient gets the care they need to keep them as a customer. The government doesn’t have to worry about its customers leaving because there is no other affordable policies for their client. We are already seeing many healthcare providers who refuse to accept Medicare and Medicaid because they don’t get reimbursed enough and have high costs for paperwork involved in getting paid. Service providers will often drop out due to the long delays in getting paid. That will result in long delays in getting care from the remaining providers. As costs increase, the government has to restrict services to control escalating costs. Government workers charged with approving payments are pressured to deny services which they don’t feel will be cost effective, which means those who are elderly or mentally challenged, as well as those with severe or life threatening injuries or illnesses. Some patients will die without care while others will be encouraged to accept having their life terminated. Assisted suicides are spiraling out of control in Canada and in European countries. In addition, physicians will be encouraged to terminate the patient’s life without consulting them.