It's simply that the current system doesn't fit the model which is to heal people. Medical insurance companies who we've entrusted to make the medical decisions have the exact wrong motive for the goal of healing people. Their bottom line is profit and the insurance model is all about denying claims or minimizing their payment.

When you take it out to its logical conclusion their best business model is to actually let all the patients die instead of giving them care that will cause their lives to go on and expose the company to more financial risk.

So it's not that people are advocating the government because they feel they're efficient. It's only because if not them then who? If everyone is going to be given care for their health, (and we already do this in emergency situations. That's an important point) some central authority must coordinate it all and provide compensation for the services rendered. We can clearly see that economic disparity within our country would leave out huge swaths of individuals from health care if we keep it in the free market. Only the wealthy would have access to individual doctors as expensive as care has gotten.

I'm in the income bracket where I could afford a few hundred dollars for a routine office visit if we reverted to some pay-as-you-go system. Things would be dicier if catastrophe struck and I was saddled with hundreds of thousands of dollars of medical bills but I'd certainly try to do it without filing for bankruptcy. People living on the edge though, barely making their mortgage or rent payments each month couldn't even afford the simple office visit and would immediately default on the huge bills. Guess who ends up paying the difference?

You use the word rationing and yet I just don't see that as a huge problem in the countries that have adopted universal single-payer systems. Even the horror stories people dredge up about long wait times really aren't any worse than the horror stories you see every day in this country about denial of care or fights over claim payments. Wait times to see a specialist here using the crappy insurance our employers can barely afford to pay for are often just as excessive or worse.

We just finally resolved a $900 bill for the lab work after a colonoscopy because the lab wasn't on the approved list for our insurance. The colonoscopy itself was fully covered as was the facility it was done in. Of course we had no control over where they sent the results. It took over 6 months to resolve this issue with all the threats of collection and ruined credit that goes along with it. In the end it was fully paid. These things simply should never happen. I'm certain the insurance company knows full well they are responsible for the costs but also know how easy it is to intimidate patients. We don't give up fighting the absurd. Many people would have quickly and paid it or suffered the bad credit when they fell behind.

What's ironic is that the insurance company should be making it attractive and easy for people to go out and get colonoscopies because the money spent there if something is found early is so much less than if something goes undetected and drastic measures have to be done later. Yet, when you think about it, in this case, people are likely to die and all claims stop if things go undiscovered so it's probably best for them not to encourage the preventative work.

This is the system private enterprise has devised and it's hopelessly broken. Government is all we have left to fix it. I'm open for alternatives but I just don't see any.

Art