Canada and the United States are also working at the World Trade Organization and in our own hemisphere with negotiations for a Trade Area of the Americas to try to help countries create a positive climate for investment and trade.
Because you want to have competition to drive down the price. You want innovation. You have the ability to get people to agree that it's worth having a public plan. You could get private insurers to cover this population, but you couldn't without giving the population leverage in the marketplace.