Will America ever have a universal healthcare system?

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    I suspect the question means to ask whether the US will ever get taxpayer-funded universal health insurance, not universal healthcare.

    The US already has universal healthcare – any American can walk into an ER, and by law, the hospital can’t refuse to treat that person, even if they can’t afford to pay for their treatment. This is true even for illegal aliens in the US…the problems isn’t access to healthcare – the problem is who pays for it. This has been the law – and the debate – in the US for decades.

    Today, when most people say “universal health insurance”, they really mean a taxpayer-funded single-payer system where the Federal government acts as a giant health insurance system. Instead of paying insurance premiums and so on, you pay higher taxes to fund the system. With government as the only source of payment, the government is free to control prices and wages, as well as to ration access to various medical procedures in order to meet its own goals and preferences. The free market, already nearly gone in US healthcare, meets its final demise under this type of system.

    In fact, we already have several examples of government-run health insurance systems. The VA provides universal health insurance for veterans. Medicare covers the elderly. Medicaid covers the poorest Americans, although the specifics of the program vary a bit state by state. When you add the 85% of Americans that are happy with the insurance they receive through their employers, you see that the US is actually providing insurance to about 95% of citizens that want insurance.

    The “that want insurance” part is interesting to consider as well. Of today’s 20 million or so that are uninsured, a substantial number are uninsured “on purpose”. Truth is, Obamacare and other government regulations destroyed competition and implemented radical wealth redistribution from affluent to poor, and from young and healthy to sick. As a result, government’s ongoing erosion of the free market radically inflated the cost of health insurance for millions of Americans…I know, I am one of them – Obamacare outlawed my policy, forced four out of five of the insurers in my county to abandon us, and caused my premiums to jump from $400/month to almost $2000/month.

    I have no choice but to opt out. I average $1000/year in medical expenses – to pay the $33,000 a year in premiums and deductibles Obamacare demands of me is economic suicide.

    To be clear, it’s not some evil insurance company, it’s not some expensive pre-existing condition, and it’s not greedy doctors, hospitals or other caregivers – the fault is entirely the government. As a result, a healthy and relatively young thirty-something with no serious medical conditions like me has seen my government guarantee that my insurance is not affordable.

    When you look at the pool of uninsured in America today, the majority are folks just like me…government made insurance so expensive, we intentionally choose to opt out. Many Americans simply prefer to have a place to live and ample food, rather than pay 2–3 times more for insurance so that the government can give the excess to everyone from government bureaucrats to illegal aliens.

    Returning to the original question asked here, in a nutshell, the obstacle to achieving universal health insurance is that government has proven itself to be incapable of doing anything other than causing cost to skyrocket, and this should give every American pause.

    Government has an insatiable thirst for power and control over the people, and healthcare is in the crosshairs right now. Despite any evidence whatsoever that government can actually provide higher quality healthcare at lower cost, it steams on unaffected by the facts. The current disastrous plan, Medicare for All – as evidenced by Bernie Sanders 2017 proposed legislation – would increase administrative cost, empower the bureaucracy, outlaw private insurance and use the heavy hand of government monopoly power to cut doctor and hospital revenues by about 40%.

    As one economist that reviewed Bernie’s legislation observed, when you pay doctors and hospitals 40% less, the most immediate impact is that over 80% of doctors and hospitals go from being profitable businesses to being unprofitable, overnight. We would add about 11% more demand for healthcare into the system, even as we drive nearly every doctor and hospital to downsize or become bankrupt. So great would be the calamity, Congress would have no choice but to appropriate hundreds of billions of dollars a year in extra funding, just to keep the nation’s healthcare system alive.

    There are plenty of examples of government failures. Remember all the big Obama lies: “if you like your health insurance, you can keep your health insurance” – then they outlawed nearly half of all the policies in America. “We’ll save the average American family $2500 a year” – then they proceeded to trigger insurance premiums to double or triple. You get the picture.

    And yet strangely, many Americans – possibly including the author of this question – are sitting in eager anticipation of government-controlled single-payer universal health insurance system. The laws of economics, simple facts, and the experience under Obamacare and other attempts don’t seem to matter – it’s full-speed ahead into the national suicide of socialized medicine, no matter what the cost.

    If American can’t resist the urge to go down this path, there will be dark days ahead – and it’s hard to say that we won’t deserve what we get.

    When you say universal healthcare, you probably mean some/any form of government-controlled healthcare. Assuming that is what you mean, I don’t want it, both as a patient and a physician.

    Government-controlled healthcare means Washington decides:

    · What care I get, not me;

    · When I get it, if ever – note the death-by-queueing of our veterans (proven by their own internal audit) in the current U.S. government-controlled VA healthcare system.

    · How much (actually how little) providers are paid: Medicare-for-All (H.R. 1384) cuts MD payments by ≈40 percent.

    · How many (again really how few) burn beds, operating rooms, cancer facilities will be available,

    · And most fundamental to any American, it takes away our freedom and with it, any personal responsibility.

    Some corrections of Mr. Holbrook’s answer are necessary:

    · “No pre-approval process” ­– quite the opposite with federal healthcare. Ask anyone who has to deal with Medicaid, as I have for 40 years.

    · “Show your card, get the procedure” – no, get in line and maybe you will get your procedure before you die. Maybe not. Please note how Great Britain’s government-controlled system simply cancelled 50,000 cataract surgeries leaving those Britons to go or stay blind.

    · “income tax will go up. A little bit.” According to best estimate (by Professor Blahous) our tax bills will double, yes I wrote DOUBLE.

    · “reversal of the ridiculous tax cut for the super-wealthy done in 2017 that added $1.5 trillion to the budget deficit and did nothing for you and me.” Apparently, you don’t believe any of the data showing how much the middle class benefited by higher pay, more/higher bonuses, and most important, more JOBS. Did you not notice that unemployment was driven down to its lowest number since 1969, directly attributable to the 2017 Tax Cut?!

    · Possibly the most wrong-headed statement is, “The government pays for everything, just like Medicare.”

    o The government has no money, except the tax money WE give it or money that it borrows, putting heavier shackles–more debt–on our children.

    o Medicare does not spend this fantastical “government money.” The Medicare Trust disburses contributions working Americans made for 40+ years. And in case you missed this tidbit …

    o According to the CBO, the Medicare Trust will be broke, insolvent, unable to pay for hospital care, within seven years. So much for good stewardship by Washington of the trillions we all contributed to Medicare over the years

    Dr. Deane Waldman, MD MBA, Professor Emeritus of Pediatrics, Pathology, and Decision Science, and author of “Curing the Cancer in U.S. Healthcare.” To download a free Healthcare Decoder go to www.deanewaldman.com.

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    Yes. We will get universal healthcare.

    Americans can not forever ignore the fact that we are literally backward.

    Every perspective that argues universal healthcare is a fantasy that is ultimately fated to collapse is just a lie. Stories about how it takes months to get elective surgery in other wealthy nations are red herrings. Elective surgery is by definition non-urgent. Not to mention it routinely takes 2 months or more to get an intake appointment with a specialist in NYC, so I fail to even see a distinction.

    The right to see a doctor is nothing like a vacation home. I am sick of this assinine comparison. I would gladly live in a country where no one owned a vacation home if that was the cost of universal healthcare. Justice is a virtue, affluence is not. No established body of ethics or morality I have ever heard of contests that claim.

    The proof we are moving in the right direction, is the rampant level of right-wing lying in the latest mid-term elections, were everyone who a decade ago argued that access to medical care by the poor was immoral lied on a stack of bibles that they had always been for the prohibition of denial of healthcare coverage for those with pre-existing conditions.

    I did not imagine that I a decade ago I lived in a country were half the population supported the argument that had I been a more responsible one-year old, I would have foreseen the risk of being diagnosed as asthmatic at the age of two and would have secured healthcare coverage and maintained it in unbroken coverage for the following half-century leaving me with nothing to complain of in middle age.

    I remember all those lyin’ Republicans who now say they had my back. They did not. They wanted to condemn me to an early grave. I will never forget or forgive their unchristian attitude. Christ never inquired of the blind if they had brought it on themselves before bestowing a cure upon them.

    The US is not the nation the nationalists think it is. We have unusually high infant mortality and a starvation rate 45 times that found in Austria!

    We need to return to sane politics and social policies driven by facts, not dogma. And that means we must have universal healthcare or accept that the world stops recognizing us as civilized.

    Then we need to move on to universal college education. Meaning, free access for those who gain admittance joined with funding dedicated to providing enough seats to admit all who are qualified. We should be ashamed that California charges more for a public university education than many Ivy League schools ask.

    America’s “greatest generation” built our nation up to an unprecedented level of well being owing to the GI bill and their unprecedented access to higher education. Americans should not have to go to Germany or war to be educated. If you don’t know, Germany offers Americans who gain admission to their colleges and universities free education in English (indeed, German higher education is free to all Earthlings).

    Did you know progress toward free higher education was a promise America made (and is still a party to) when we signed the Universal Declaration of Human Rights?

    But that was when the US was a liberal democracy leading the world toward a future built on international cooperation. But now we have literally reversed ourselves on the entirety of the Mid-20th Century Revolution that ended fascism in the world. Republicans are leading the way with ever-expanding voter suppression and election malfeasance and their unprecedented support for the Orange fascist.

    Hopefully, the Republicans will fail and the US will get back on board with the otherwise universally accepted agenda of 21st-century civilization.

    PS – There exists an interesting linkage between universal healthcare and free higher education. Europe, has lower healthcare costs in no small part because of the fact that many nations’ doctors graduate school debt free. In the US doctors graduate school with a debt larger than most American’s first mortgages. This is absurd.

    The initial salary expectations of people are premised on the difficulty of entry into the profession (referring to the relative scarcity of raw talent), the length of study, and the cost thereof. And initially high income expectations leads to career long high income expectations. No announces, “hey boss, I just paid off my student loans, you can cut my salary dramatically therefore.” The average income of doctors in Europe is a fraction of that of US physicians. Meanwhile, US physicians have higher salaries than any other equally large profession.

    A similar phenomenon has resulted in the average American having no meaningful access to most legal services. How perverse that access to enforcing the rules of society should be prevented by social policy itself. And it is only getting worse.

    For example, California underwrites the cost of public higher education of those who will eventually become highly compensated less than it does those seeking average degrees. This acts as a wedge further driving high wage discrepancies between people who provide essential medical and legal services relative to their potential clients making those services less widely available and serving to further widen gaps in social mobility as increasing numbers of Americans find themselves with insufficient access to law and medicine.

    I don’t think there is any reasonable chance that the United States will adopt any kind of universal healthcare or Medicare for All system at the federal level any time within the next forty years at the very least. I’m currently twenty-one years old and I frankly don’t think there’s a strong likelihood that the United States will adopt any kind of Medicare for All system at the federal level within my lifetime.

    Everything about the United States government is designed to give disproportionate power to conservatives. In order to implement Medicare for All, Democrats who support it would have to have the majority in both the House and the Senate and there would have to be a progressive Democratic president in office to approve it and there would have to be a liberal majority on the Supreme Court to prevent the court from striking it down.

    Right now, Republican politicians are universally opposed to Medicare for All and even many moderate and conservative Democrats are opposed to it as well. There is an election coming up in November, but there is still a very strong likelihood that Republicans will retain control of the Senate. Even if Democrats do take back the Senate in this coming election, it will only be by an extremely tiny margin—probably only by one or two Senators at the very most.

    Conservative Democrats like Joe Manchin will certainly not be willing to vote in favor of Medicare for All, meaning that, even if Democrats successfully take control of the Senate and abolish the filibuster, there’s probably no realistic chance of the Senate approving Medicare for All. Moreover, Joe Biden, the Democratic nominee for president, does not support Medicare for All either, so, even if Medicare for All did somehow make it through the Senate, Biden would probably veto it.

    The Constitution is designed in a way that automatically gives Republicans a massive advantage in the Senate, meaning we can expect that Democrats will only occasionally manage to take control; the vast majority of the time, Republicans will have control of the Senate. If Democrats do take control of the Senate this year, they will almost certainly lose control in the next election. Once they lose control, they probably won’t regain control for another decade or so.

    ABOVE: Photograph of Joe Manchin, a conservative Democratic Senator who would almost certainly vote against Medicare for All, even if Democrats controlled the Senate and there was a Democratic president

    Then there’s the problem of the Supreme Court. Amy Coney Barrett will soon be confirmed by the Republican-controlled Senate to fill Ruth Bader Ginsberg’s former seat on the Supreme Court. This will give conservatives a six-to-three majority on the Supreme Court for the foreseeable future.

    Right after the November election, the Supreme Court is set to hear a case being pushed by the Trump administration to overturn the Affordable Care Act (i.e., “Obamacare”). The Supreme Court upheld the constitutionality of the Affordable Care Act in a similar previous case while Ruth Bader Ginsberg was still alive, but it was upheld by only one vote and only because Chief Justice John Roberts sided with the liberals.

    While Ginsberg was still alive, it looked like this upcoming case would go the same way. Now that she is dead and she is about to be replaced by Barrett, however, this means that conservatives will have the majority on the court, even without Roberts. Furthermore, Roberts will most likely side with the conservatives this time so he will be able to write the majority opinion. It is therefore extremely likely that the Supreme Court will rule the Affordable Care Act unconstitutional—either in whole or in part—by a six-to-three margin.

    ABOVE: Image of Amy Coney Barrett, who will almost certainly be Ruth Bader Ginsberg’s replacement on the Supreme Court

    In other words, at this point, we will be extremely lucky if the Supreme Court leaves any part of the Affordable Care Act intact. This is how the Supreme Court will be for at least the next several decades. If anyone attempts to implement Medicare for All at the federal level, the conservative court will just rule it unconstitutional and it will go in the scrap heap.

    Democrats could try to pack the Supreme Court with liberal justices, but then Republicans will just pack it again with conservative justices when they retake power. It will turn into an unending cycle of relentless court-packing and, because the system is designed so that Republicans will have control of the Senate most of the time, even in this new world of court-packing, Republicans will still have control of the Supreme Court most of the time.

    Meanwhile, it would be extremely difficult—bordering on impossible—to enact Medicare for All at the state level due to the Employee Retirement Income Security Act of 1974 (ERISA), which preempts all state legislation pertaining to employer-sponsored medical benefits.

    I think that Medicare for All is a good idea, but, unfortunately, it’s not going to happen anytime in the foreseeable future. Again, I think we’ll be extremely lucky if we even get to keep any part of the Affordable Care Act. If you are like me and you think our healthcare system is broken, well, then, all I can say is that you’d better get used to it.

    ABOVE: Stock photo of a book with “ERISA: Employee Retirement Income Security Act” on the cover. ERISA would most likely prevent state legislatures from implementing Medicare for All at the state level.

    Well, for sure it will work, because it worked everywhere. The question is what sacrifices to be made in order to do so. America has the best quality of the healthcare in the world. Not affordability, not effectiveness, not life expectancy. Quality.

    So you have to accept:

    • Dramatically lowering standards and availability of healthcare services. Such as:
      • No same-week appointment for specialist doctors. 2–3 month waiting period will be the norm.
      • Complex exams such as CT or MRI will be available within 3–4 month delay and only if doctor decided it is absolutely nessesary. And if it is not by doctor, there is no appeal to be made.
      • Be ready to wait surgery, such as hip replacement for 1+ year
      • No medical liability, not at all. Doctors are not liable for the services they are performing. Best case if you can prove criminal neglect, but virtually no compensations.
    • So you may heard governments servises are not cheap, you have to pay for this:
      • In Germany which has one of the lowest marginal tax rates in EU, rich have to pay their fair share, so 42% total tax on eranings ~$60k for single/$120k family. Almost no tax deductions, a.k.a “loopholes”
      • Okay you paid your taxes, right? Not so fast – there are consumption taxes come to play. Value added tax (VAT) of 18–22% for all purchases within European Union. You even have to pay VAT and tariffs on purchases via Internet retailers from outside E.U.
      • Gas tax is the third largest source of tax revenue in the E.U. The usual cost of gas somewhere between $6–7 for one gallon, and taxes and duties responsible for more than half of this amount.
    • In conclusion:
      • If you are sick and you want to get the best healthcare and fast – America is a way to go. You have to understand that the only reason other countries do not run American style healthcare because they cannot afford it.

    This is why many European countries slightly moving toward American system. Introducing supplemental private health insurance and privatize ambulance and hospital services.

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    Probably not if you want to possibly tax almost everything from sugary foods to fast food restaurants to alcohol. Why did I say this?

    1. Universal Healthcare is paid by everyone and as great, it looks on paper, it can be poorly executed rather quickly depending on the number of obesity or unhealthy people are in a country.
    2. What will make Universal Healthcare great with only 10% of GDP or even 5% is a healthy population? If the population is healthy then it’s easily affordable but if you look USA statistics back in 2018:

    It’s a concept where it’ll be too much of a burden a lot of the population is unhealthy or obese since everyone will be paying for everyone’s responsibility to be healthy or lack of responsibility to be healthy.

    Another way is also possibly the USA stop helping NATO countries to fill up the military being 2% of GDP agreement since only 7(including the USA) is meeting that 2% of their GDP to defense while others like France, Germany, Sweden, and others failed and rely on the US to fill up their lack of commitment of the 2% GDP to defense.

    Will the USA get universal healthcare? Maybe by state but not the entire country as it will be discussed:

    • How would it be taxed or paid for?
    • Are Americans willing to pay for others?
    • What gets taxed? Examples such as:
      • French healthcare was great due to progressive tax but it was also the willingness to pay the tax but the majority of the revenue to pay for the healthcare was due to them taxing citizens on gambling and casinos. Americans that love gambling would most likely not going to tolerate having to pay taxes just to trying to win more money.
      • Europe also regulates sugar which example being that you wanted to drink coke in Europe, you’re going to ask, ‘Why is this coke taste so weird?’ until realising that coke in Europe doesn’t use as much sugar as in the United States.
      • United Kingdom tried to pay for their healthcare by taxing on sugar.
      • Denmark tax is possibly one of the least popular in my opinion unless you’re a vegan or vegetarian. The tax on meats, dairy, and other animal products.
      • Most Europeans have high tobacco tax which most Americans would probably not be too fond of if it applies to their country.
      • Sweden… High alcohol tax which will go very unpopular amongst Americans generation since the US tried to ban alcohol or tax it before and it failed as citizens were too discontent with the ban/tax.
      • Europe has very strict regulations in food quality and tells what to eat or not to eat which Americans will just say ‘Foff’.
    • Will Americans tolerate being told to change their diets to a more ‘healthy’ diet so they can implement something like a Japan healthcare which is:

    The reason being Japan has possibly the healthiest population in the world which is why their healthcare is pretty good and affordable that they spend the very least money on it in comparison to European countries.

    In order for America to implement this universal healthcare, it’ll be like:

    Now down to the population is the burden of society:

    Now you are wondering about the average obese American. Let’s switch to a Swedish obese person:

    Better and now Sweden has universal healthcare which tax on certain areas that Americans will never want to have taxed. Now… What happens now:

    People see you and knows that you’re not only paying for yourself and others, but they are also paying for you as well which can turn to this:

    Now I’m an obese person in Sweden or France or anywhere else, I’ll be the burden of European society as I basically forced others to pay more for my healthcare.

    Now for America:

    Nobody pays for their own insurance anymore, they’re paying for every American and cost determine on health and others as military spending is questionable but unlikely as maintenance of base is rather high but are stuck there due to international agreements and alliances that our bases have to stay as well as help protecting trade with the United States Navy, fighting terrorism, anti-piracy missions, paying soldiers, maintaining equipment, civilian worker salary(Some if not most Civilian workers in military bases are 50k – 120k+).

    Universal healthcare in America depends on if Americans wants to share the burden of paying for everyone which like several that I explained are unwilling to pay more for others.

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    I suspect not, because there are already too many distortions in the system. By that, I mean established layers upon which any government fund would but add one more, thus increasing, not decreasing, costs.

    In overview, the health care system can be broken into three big pieces: health care delivery, health care administration, and health care financing.

    Health care delivery in the US and in countries with tax-funded universal health care, are relatively comparable. In the US market driven system, it is a sellers’ market, resulting in excess capacity and higher remuneration which increases barriers to access due to cost. In the others, it is a regulated market, resulting in lower capacity (longer waits) but lower (regulated) remuneration and greater access due to lower cost barriers. But people working in the health care fields in both systems generally have secure livings, and occupy a respected niche in society. But they get rich only in the US system. In some countries, the health providers are employees, in others private contractors, who negotiate through unions or directly with the government. As the government represents the users, the user-provider negotiations are on a much more even footing that the US market, where all the power is with the larger provider entities over individual users. The contracting out to private service providers allows the incentivization and efficiencies of a free market delivery system to be largely maintained. The main difference is that the bottom line is negotiated and regulated, rather than set to what the (seller’s) market will bear.

    The administrative level is one with much potential for cost savings. Rather than the US system of multiple levels in multiple jurisdictions, each of which involved profit being skimmed off at each level that has the same effect as compound interest, other countries have one level of administration that pays at cost with no profit margin being necessary. Without remaking the system to get rid of the current administrative duplication and waste, no savings are ever likely to happen, rather as many have commented, costs are likely to increase with one more level added.

    Finally, it should be remembered that the private insurance industry is not a pillar of health care, it is a pillar of the financial industry. The actual primary goal is to create a vast pool of money that can be reinvested for profit, not to ensure that everyone gets good health care. As such, only “good risks” get covered (ie) ones in which the rate of payout does not cause profit margin to fall. The reason that payments to private plans increase is because they only covered the low cost people, in fact actively looked for ways to avoid covering high cost people. One of the problems with universal tax funded schemes is that the high actual tax payments that each taxpayer makes are not explicitly publicized, which would give people a better appreciation of what health care actually costs.

    But it is hard to ignore the bottom line that most other western economies with universal tax funded systems pay a far smaller proportion of their GDP for health care at a level equal or superior to what Americans as a group receive.

    Don’t count on it. America has been in a death spiral of decline since January 20th, 1981. The decline was so slow that most of us didn’t realize there was a problem until the last few years. The vast majority of our ruling class is completely corrupt and suborned to the will of our oligarch masters. Said oligarchs have America pretty much the way they want it. I personally don’t believe America has the potential to pull out of the death spiral. I did before Election Day 2016, but all my hope for the future died that day.

    The only presidential candidate who supposed Medicare for All, the best, least expensive and most sensible healthcare system, is Bernie Sanders. But as we saw in Iowa and will certainly see in New Hampshire the corporate democrats will resort to all kinds of shenanigans to deny him the nomination. Not other candidate can rally enough progressive, liberal, and independent voters to overcome the Electoral College’s built in pro-Republican slant. But the corporate democrats would rather lose with Biden or Buttigieg then upset their donors by winning with Bernie.

    I’m going to caucus for Bernie and vote for the democratic candidate IF THEY WIN CLEANLY WITHOUT 2016 STYLE RIGGING, but I have no faith that a candidate other than Bernie can beat Trump or that Trump will leave office at the end of his term.

    My plan is to hopefully get enough work experience that I can expatriate to a good country before Trump declares himself “SCROTUS for Life” in a few years. If you think Congress, the courts, the SS, federal marshals, or especially the military will actually do their duty and remove Trump from office, you are at best adorably naive and clearly haven’t been paying attention.

    It’s inevitable. As Congress has discovered, any kind of hybrid plan is just not manageable. For instance, if you guarantee coverage for pre-existing conditions, what’s the incentive to have health insurance? Suppose you have no health insurance and develop some high cost condition. Because the right to buy insurance is guaranteed, you just get insurance then. The basis for actuarial science is that the people with a low need for health care subsidize the people with high needs. Medicare for everyone is the idea. The cost of medical care thru Medicare is half what it is with private insurance, and that’s half the retail price. With a single payer, costs can be controlled.

    The U.S. is the only First World country that doesn’t have something in place to take care of everyone. Why? Look to the American Medical Association and the Drug Lobby, both of which have a vested interest in keeping the cost of medical care high.

    Why not make medical school free, with the proviso that every graduate spend some time working for a stipend in inner city clinics. When the Ebola crisis hit Africa, from where did the most physicians who responded come? Cuba. When you go to medical school in Cuba, it’s not IF you are going to do service, but WHERE. Physicians there are trained to serve, not to get rich.

    I’m no fan of big government, but in the most technically advanced, most wealthy nation on earth, good health should be a civil right, a Federal matter.

    Yes, of course we will, it’s only a matter of time. Hard time.

    • The rest of the wealthy world has studied this and determined it to be the best most moral solution – and the cheapest.
    • USA is rich, but backward and poorly educated, the rest of the world is moving on. The below were invented elsewhere but they have now invested in better systems – not the US.
      • The US still uses pounds and ounces – I am not joking they really do.
      • The US still uses inches and miles – I am not joking they really do.
      • The US still uses Fahrenheit – I am not joking they really do.
      • The US still allows its citizens to die of easily curable diseases – this would never be a joke – it’s just true.
      • The US allows it’s citizens to go bankrupt trying to pay for routine life saving medical treatment. True, OMG true.
    • The problem is poor education and isolationism, and a palpable arrogance. In particular because the education system fails to deliver people capable of scientific analysis (in general) then it’s easy to persuade them with silly lies.
    • They want to feel better than other groups of people so racism, religious hatred and immigrant bashing are all the rage – at great expense to the USA.
    • So one day the USA will wake up, probably just as China takes over as the richest country with the most respect and following in the world, and then the US will join the team of rich, democratic, cooperating countries.
    • I know that right now the USA is heading in exactly the opposite direction, people voting to give money to the rich while Social programs are heading for insolvency. Turkeys voting for an early Thanksgiving, when at last they realize that, then it will change – but not before. Hard time yet to be served.

    The question is, Will the USA have universal health care some day?

    The situation in the U.S. at present indicates that, no, we will not have single payer health insurance that is affordable for everyone soon and possibly ever.

    First because there is no way any longer to exert cost controls. Second is because the idea of “rational self interest” has been successfully mangled to the point where true greed at the expense of everyone else has become a virtue and the basis for celebrity. (This is how we in the US have developed a liking for “billionaire celebrities” as well as the equally mythical “billionaire villains.” ) The two are obviously connected.

    The reason we have no cost controls on health care and the reason we’ve become delusional about celebrities is that we’ve let the wealthy buy themselves political immunity and at the same time given them political control of our legislatures, both federal and state. And they know they can count on both the entertainment and news media to make them look glamorous while they’re grabbing all the money they can in any way they can. In this case the grabbers are insurance companies and the people who run them.

    It would take the organization of a national movement to slowly regain control of Congress (which now operates solely as a pet ferret belonging to the wealthy) and get the new independent Congress to enact a health insurance plan which contained the same kinds of cost controls which work for both the producers and consumers of healthcare technologies and services in so many other countries.

    A “war on greed” at the grassroots level is what’s needed. Whether we ever get to that point is 100% speculative. But first we have to define what greed means in real world terms.

    Earning the equivalent of the national median income isn’t greedy. Earning twice that provides many comforts and advantages unavailable to most people. Somewhere between twice and twenty times median income there is a level anyone will think of as “enough” and “adequate.” Only when everyone agrees on a given level will we see a return to anything resembling practical, fair and reasonable.

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