"carriers refuse to negotiate or offer rates greater than 125% of Medicare" ... "This is not the intent of the law and fundamentally is acting as a wage-cap." Having lived in both Canada and the USA, I think this is great. The doctors in the USA are vastly overpaid (that is why it is/was so hard to find a primary care doctor in Vancouver, they all moved south for the money), and the healthcare, both statistically and in my personal experience, is not better for it.