FUCK THIS COMMERCIAL <| sep |> As an American who used to live in Canada , I can tell you that they don ' t . Largely because Canada is a confederation of provinces , and the power of the federal government is somewhat limited , the provinces hold more power in most regards than the states do with the exception of being able to levy unfunded mandates . Here ' s an example The American impression is that Canada has universal national health care . This is a half truth . Canada has nationally mandated provincial health care . So your health coverage in British Columbia will vary from that in Quebec , Ontario , etc . But the federal government has the power to say You have to do this , figure out how and then the provinces go to work . But they also don ' t have the same federal government economic powers that the US government has . We have a supremacy clause and an interstate commerce clause . So say for example , someone wants to build an oil pipeline through Texas , Oklahoma , and Missouri . The federal government regulates and works out all the details of that . But in Canada , if you wanted to build a pipeline from Alberta to Quebec , going through Manitoba , Saskatchewan , and Ontario , all those provinces have to come to terms of the agreement and make it work . Any of them could effectively block the pipeline . Also , you often don ' t hear about negative outlooks on Canadian programs because they keep their mouths shut and say It could be worse , we could be in the US . Quebec has some of the longest ER wait times in the developed world , around 12 hours on average . Do they complain other than their weekly protest about whatever ? Not really , because from their perspective , people an hour away are going bankrupt and living as wage slaves for the rest of their lives because no state access to healthcare is provided .