You used Canada as an example to fault all universal health systems. Fact is in almost every measure we are anywhere from 15th to 21st in terms of our healthcare system compared to other developed nations. We are solidly in 1st in one measure: cost, especially to the individual. Availability, as in how many people are covered, we are dead last. Wait times are very difficult to quantify, but even by this measure the WHO put out a report a few years back that has us below middle of the pack, like 15th I believe it was. Patient to doctor ratio we are something like 18th (a lower ratio being better - 18th place means doctors have less time to spend with patients). And worse, in terms of outcomes, like mortality rates, life expectancy, infant mortality rates, we are anywhere from last to within a few spots of last. It is no joke, our system of medicine in this country is broken and is costing lives. Everyone wants you skim over that fact and good straight to inconvenience and money. More people, per capita, die earlier in our system than most any other developed nation on the planet, including Canada. It might seem minor, but only if you believe corporate profits are more important than human life. And yes it really is that simple. We have commoditized healthcare, and made it a luxury good. People that for whatever reason have no health insurance are very often driven to bankruptcy because they have no choice if something comes up. I had a friend who was one of those guys vocal about "I shouldn't pay for everybody's healthcare if I'm healthy" and being self-employed, young, and healthy he carried the minimum he could. Until his car accident. Fell asleep on a long drive. Months in the hospital. Nearly destroyed him financially. Ended up in bankruptcy. But many others are in worse situations where they have to choose between paying bills or buying food and seeking necessary medical care.
As far as your German friends and their tax rate they are inflating the number for sure. I made 140k euros while I lived there and my tax rate was right around 35%, however that includes the medical premium.
Here is a fun exercise. Take everything you spent on medical care in the last full year, you know, pre-covid, so it isn't jacked up by a wonky economy. That means everything, premiums, deductibles, prescriptions, the works. Now subtract about 5% to account for the fact that in Germany you do pay copays for a lot of stuff out of pocket. Like for 3 nights in a specialty hospital for my son we played a 10 euro copay per night. Now, take that number and add it to your taxes paid. How much does your tax rate go up? See, ALL of that is part of the tax rate in Germany. It is income driven, on a sliding scale.
We did exactly this exercise and compared the year before we went to Germany to the year we were there. Overall we paid almost double on healthcare in the US, INCLUDING our higher taxes in Germany due to the healthcare portion.
Almost all of these arguments are borne our by real-world research and reports, too. People try to make it sound like everyone in countries like Germany just want out so their taxes come down and they don't have to wait 87 months to see a doctor and that's all a load of ********. My German friends, including 3 physicians and a dentist, and a guy from the US who went there to get his medically degree as tuition was cheaper and stayed there because he likes the system far better than in the US, all were amazed how terrible it is here in the US by comparison, including the tax rate. Germans complain about it, like everyone does everywhere, but they also recognize that everyone benefits through increased productivity and fewer health concerns. Same reason every German company gives, and often enforces, 4 weeks of vacation every year. They recognize they get that back with happier and healthier employees.
In this regard, America is broken, by developed nation standards. Now if you want to complete with like Iran, well then...we are behind them in infant mortality. So maybe it's not as great as you think.