We have “versions” of every health care system in the world in the US, so before people think other systems are better… we should ask why are version of those systems are not or even if the other systems are better.

James Methvin… we have the system you are advocating. It is called the VA system and it has a very mixed reputation. Since Trump was elected it has improved but largely because Trump passed legislation allowing Vets to go “outside the system”. So why would we want a system like that?

We have a system similar to France’s system in the US, it is called Medicare. But with Medicare for all being the leading driver of budget deficits going into the future, shouldn’t we figure out how to make it financially sound before we put the rest of the country on it… Wouldn’t Medicare for All be like putting passengers on the Titanic after it hit the iceberg, seems you would want to patch the ship before putting more passengers on it.

We also have a system similar to Taiwan, its called Medicaid. Like in Taiwan our government has forced the medical community to absorb most of the cost increases in order to keep premiums down, but unlike Taiwan our medical community has the ability to shift that lost revenue to private insurance in many cases. However in predominant Medicaid communities provider behavior looks similar to that in Taiwan, where per encounter revenues are offset by very high utilization rates.

https://international.thenewslens.com/article/63425

In other words, the grass appears greener elsewhere, but rarely is when you examine the various systems up close.

The answer is not Medicare for All in the US or even Medicaid for All or a VA system. The answer lies in logically addressing four issues….

1. fair pricing for health care products and services where the “free market” does not function to hold down prices due to a lack of competition… government has a major role to play here to make the health care system work… Medicare does this already, why not simply extend this to include pharmaceuticals and expand access to Medicare pricing for every product and service to every American buyer of health products and services…
2. effective utilization practices… this is almost impossible in a government driven health care system and instead is replaced with various “rationing” mechanisms. Private health care systems do this better than the government, because the government is in a position to look over their shoulder and prevent abuse… who protects citizens when the government is the abuser?
3. access to care for those that cannot afford health care… This is clearly an area where the government has a role to play to make health are affordable to all through subsidies.

4. access to health care for those with pre existing conditions… More than any other single group of people this group would benefit from medical management skills the private sector has developed over time designed to maximize outcomes while controlling costs. Again almost impossible for a government entity to do this properly. On the other hand, this group is uninsurable and needs subsidies.

So as a nation, let’s not embrace the weaknesses of other systems to access their strengths… let’s embrace our strengths and access the strengths of other systems to build a uniquely American health care system… that works…