mid-1980s, particularly cobra and hipaa, has been aimed at reducing job lock. however, providers of group health insurance in many states are permitted to use experience rating and it remains legal in the united states for prospective employers to investigate a job candidate's health and past health claims as part of a hiring decision. someone who has recently been diagnosed with cancer, for example, may face job lock not out of fear of losing their health insurance, but based on prospective employers not wanting to add the cost of treating that illness to their own health insurance pool, for fear of future insurance rate increases. thus, being diagnosed with an illness can cause someone to be forced to stay in their current job. politics of health canada in canada, the right-wing and now defunct reform party and its successor, the conservative party of canada considered increasing the role of the private sector in the canadian system. public backlash caused these plans to be abandoned, and the conservative government that followed re-affirmed its commitment to universal public medicine. in canada, it was alberta under the conservative government that had experimented most with increasing the role of the private sector in healthcare. measures included the introduction of private clinics allowed to bill patients for some of the cost of a procedure, as well as 'boutique' clinics offering tailored personal care for a fixed preliminary annual fee. united states in the u.s., president bill clinton attempted a significant restructuring of health care, but the effort collapsed under political pressure against it despite tremendous public support. the 2000 u.s. election saw prescription drugs become a central issue, although the system did not fundamentally change. in the 2004 u.s. election healthcare proved to be an important issue to some voters, though not a primary one. in 2006, massachusetts adopted a plan that vastly reduced the number of uninsured making it the state with the lowest percentage of non-insured residents in the union. it requires everyone to buy insurance and subsidizes insurance costs for lower income people on a sliding scale. some have claimed that the state's program is unaffordable, which the state itself says is "a commonly repeated myth". in 2009, in a minor amendment, the plan did eliminate dental, hospice and skilled nursing care for certain categories of noncitizens covering 30,000 people (victims of human trafficking and domestic violence, applicants for asylum and refugees) who do pay taxes. in july 2009, connecticut passed into law a plan called sustinet, with the goal of achieving health care coverage of 98% of its residents by 2014. us president donald trump had declared his intent to repeal the affordable care act, but was unsuccessful. private care the canada health act of 1984 "does not directly bar private delivery or private insurance for publicly insured services," but provides financial disincentives for doing so. "although there are laws prohibiting or curtailing private health care in some provinces, they can be changed," according to a report in the new england journal of medicine. governments attempt to control health care costs by being the sole purchasers and thus they do not allow private patients to bid up prices. those with non-emergency illnesses such as cancer cannot pay out of pocket for time-sensitive surgeries and must wait their turn on waiting lists. according to the canadian supreme court in its 2005 ruling in chaoulli v. quebec, waiting list delays "increase the patient's risk of mortality or the risk that his or her injuries will become irreparable." the ruling found that a quebec provincial ban on private health insurance was unlawful, because it was contrary to quebec's own legislative act, the 1975 charter of human rights and freedoms. consumer-driven healthcare in the united states, congress has enacted laws to promote consumer-driven healthcare with health savings accounts (hsas), which were created by the medicare bill signed by president george w. bush on december 8, 2003. hsas are designed to provide tax incentives for individuals to save for future qualified medical and retiree health expenses. money placed in such accounts is tax-free. to qualify for hsas, individuals must carry a high-deductible health plan (hdhp). the higher deductible shifts some of the financial responsibility for health care from insurance providers to the consumer. this shift towards a market-based system with greater individual responsibility increased the differences between the us and canadian systems. some economists who have studied proposals for universal healthcare worry that the consumer driven healthcare movement will reduce the social redistributive effects of insurance that pools high-risk and low-risk people together. this concern was one of the driving factors behind a provision of the patient protection and affordable care act, informally known as obamacare, which limited the types of purchases which could be made with hsa funds. for example, as of january 1, 2011, these funds can no longer be used to buy over-the-counter drugs without a medical prescription.