This tablet is amazing, I have zero complaints so far - the drawing area is close to the size of drawing on an 8x10 sheet of paper. I haven't tried a Wacom, but I can't see what one would offer that the monoprice doesn't (this has hotkeys, pressure sensitivity, battery for the pen and an led blink to let you know when its in range). Also many applications (GNU Image Manipulation Program, mtpaint, aseprite and other animation tools) work out of the box with it (at least under GNU/Linux - which I'd guess for sure they do on Windows/OSX) as far as having great defaults for the pen's two buttons (open menu/zoom in and out etc.).
I highly recommend this tablet.
The drivers are a mess to install. http://draw2much.deviantart.com/journal/Monoprice-Tablet-FAQ-for-Windows-7-342426446 is a helpful guide. Basically keep trying the steps listed and mash your face on the keyboard until it works. There are a few cases of bad pens or tablets but the vast majority of the time the drivers haven't been installed correctly.
There isn't an on/off switch as far as I remember. Once you plug it in (and have drivers installed) the light on the tablet should turn on. If you're using the included battery, I do remember that it was ninja-wrapped in plastic and a lot of people don't realize it. So just check that the battery in the stylus is unwrapped as well.
As I said, I use that tablet in some of my computers, though not the associated software, which I didn't intend to use anyway, but the hotkeys would have been welcomed. One of my co-workers has a far more expensive ($ 400) Wacom and of course, his tablet functions perfectly. So said, if you want to try tablet drawing (not an easy thing to get used to) spending only a few bucks, I reccomend it. Previously I tried a Genious 4x5" and the Monoprice is far mor sensitive. As per software, I use Photoshop CS3-5 because it is the software I use for working the photographs and I know it better than others, but some of my friends reccomend Corel Paint, which is supposed to be the specific software for drawing-painting, etc.