Last week’s CSG/ERC annual meeting in Halifax, NS featured a plenary session comparing health systems across the border. Despite distinct financing mechanisms there were many common challenges including skyrocketing costs, struggles to improve quality and ensuring adequate workforce. Speakers included Rep. Laurie Harding (NH), Asm. Richard Gottfried (NY), Paula Roy (DE Health Care Commission), MLA Bill Fraser (NB), and Minister of Health Maureen MacDonald (NS). Anya Rader Wallack (now health policy advisor in the VT Governor’s Office, but SustiNet members will remember Anya’s excellent work helping us develop CT’s plan) rounded out the panel describing VT’s single player plan. Canadians spend just over half what we do per person on health care on average. Despite a government-funded single payer system, just in average government funding they spend 18% less than we do per person. Canadians also spend about one third less than we do out of pocket on average. They also live two years longer than we do, have fewer low birth weight babies, and are half as likely to go without health care due to cost, on average. We have a lot to learn.