Both Canada and the United States are historically and practically steeped in fee-for-service medicine, and much of the power to control prices rests in the hands of the medical establishment. While provincial governments have periodic negotiations with medical and hospital groups, and there are global budgets for hospitals that try to constrain costs, the system is relatively expensive.

We know that the U.S. has the most expensive health care in the world. But beyond noting that dubious achievement, we seldom ask why. On my recent visit to Canada as a Fulbright scholar, I stopped by to pose that question to one of their leading health care experts, David Dodge, an economist who has served as federal deputy health minister and seven terms as governor of the Bank of Canada.

Here’s a fact most Canadians probably don’t know: Canadians live longer than people in the United States. Specifically, women in Canada live an average of 83 years, compared to 80 in the United States; men live over 78 years on average compared to 75 in the United States. Why is this the case? There are clear links between mortality rates and the way countries invest in healthcare and improving social conditions.

One thing Americans and Canadians can agree on is that we don’t want each other’s health care systems. In truth, most Americans don’t know how Canada’s system works and Canadians don’t know much about the U.S. system.