I find it hard to understand why y'all object so strongly to socialised healthcare. (I mean, it's been explained to me, but I still don't get it.)
Because as an employed white collar worker with an employed white collar worker spouse, I feel like my healthcare is the best in the world. My insurance company is not unreasonable, I've got plenty of coverage, and if I have a problem I can go see some of the best doctors on the planet for not a ton of money.
I consider the government pretty much entirely incompetent at about everything they do, and I don't see how inserting themselves into the good deal I've got going can make it better for me. For other people, yes, I'm aware they have shitty circumstances, but for me they can ONLY cock it up.
Do you make all your decisions from a "* everyone else, I want mine" perspective? That's what this post sounds like, at least.
I am genuinely curious.
Here's how I see it: Either way we land (socialized medicine or not), somebody gets screwed.
Socialized medicine => those of us who have a good thing going right now get screwed and could die waiting for services we didn't have to wait long for before.
Non-socialized medicine => people at the lowest socioeconomic levels get screwed, but there are programs in place to serve them.
I don't think our government is capable of running an efficient healthcare system that's a win for everyone. If this is the direction we're heading (and I believe it is), I see it as a downward spiral. Doctors end up leaving a system that doesn't work even remotely in their favor, so patients have fewer and fewer doctors/specialists/surgeons we can see, so we wait longer and longer for the services we need. That's not a win for anybody.
I've lived under both a socialized and non-socialized system, and fully agree that the US government is not capable of running any sort of healthcare system at the federal level. This isn't (just) an indictment of the US federal government, it's an observation about balancing flexibility with functionality. The USA has too many people distributed over too large of an area, with too many regional variations for a health care system to function effectively at a federal level.
One thing most of my fellow Americans sometimes haven't been told is that, of the countries that have socialized medicine, no large nation ever attempts to regulate socialized medicine at the federal level. (The ones who try generally fail.) ALL the administrative details, including spending authority, is delegated to the state, province, or territory level. The portion of taxes that goes to health care might be collected at the federal level and distributed to each region in a per-capita fashion, with an occasional federally funded infrastructure initiative to build a hospital in an under-served or rural area, but if a region decides it needs to spend more on hospitals and, say, less on staff or administration it has to balance its own budget and perhaps raise taxes, charge fees, or limit services within that region by not paying for certain procedures or products. This is due to economy of scale: a socialized medicine system simply has to be flexible, and 200+ million people distributed over a large area is the exact opposite of flexible. Trying to run a socialized medical program at the federal level is like using a Cadillac to swat a fly. But there's no way Americans will ever accept anything except a federally run program.
In the United States there's a gigantic demand for homogeneity and for an extremely dominant federal government. People don't even like the idea of having local shops, industries, or foods: it all has to be McProcessed or Wal-uniform so that the same flimsy clothing made by overseas slave or child labor is for sale in every city, while the same concoctions of grease, salt, starch, and high fructose corn syrup are on every plate in the nation. In the United States, that kind of obeisance to corporate dominance isn't considered a gross-out, nor is the near-deification of whoever sits in the Oval Office. In terms of a health care system, unless everyone gets the exact same misdiagnosis, lengthy but irrelevant questionnaire containing information completely ignored by all the medical practitioners, gamut of unnecessary tests, and package of OxyCrap at every visit no matter what state you're in, no American will be satisfied.
In countries with socialized medicine, the federal government is willing to delegate authority to its regions or states. But in the USA there is abso-freaking-lutely no way the federal government will give up an iota of power or authority unless it is forced to do so. States in the USA don't have much in terms of rights or autonomy, because in the USA federal money always comes with strings attached. You want money for highways? Fine... raise the minimum drinking age to 21 and deal with a sudden and ongoing upsurge in binge drinking and drunk driving behavior among teens and adults. Otherwise, no highway money.
In countries with socialized medicine, there are very few big privately owned medical corporations. Much of the infrastructure, such as hospitals, ambulances, and emergency rooms, will be owned by the city, province, or region. The people who work directly with the infrastructure items (such as people employed in an emergency room) are employed by the hospital or by some group that gets its money from the provincial or local system. But individual clinics, doctors, physiotherapists, surgeons with admitting or hospital privileges, and outpatient service providers are for the most part entrepreneurs. They mostly bill the single-payer state or provincial system for each service they provide, and extra-billing is frequently capped. This keeps costs down for the consumer, and it works because it operates in the context of a legal system that limits tort claims.
Torts, in parts of the United States, are so out of control that most doctors pay through the nose for malpractice insurance and have no choice but to pass the cost on to the consumer. In order for a single-payer system to work in the United States, many states would have to completely reform their legal systems so as to get rid of civil prosecution for malpractice and limit malpractice payouts to fines imposed after a criminal conviction for negligence, gross negligence, or malpractice. Realistically, Americans aren't going to be willing to do that.
In the United States, it's acceptable for a state-level government to be utterly corrupt or incompetent. When such a government tries to run anything complicated, disaster is the only predictable result. A state government that routinely balances its budget, avoids major scandals, kicks out corrupt people, and has a proven track record of running functional universities, road systems, and other state facilities will do OK running a health care system. All the other states are pretty much fucked.
The last reason why socialized medicine will never work in the United States is because Americans, like most people in developing countries where there's vast wealth inequality, have a cultural aversion to paying for anything they don't personally expect to use. They shriek over the thought of subsidizing someone else's prenatal care or C-section, for example, forgetting that they themselves once benefited from similar services when they were born, and set up the insurance and billing system in a way that forces the nearest person (in this case, the gestation box) to pay for all the baby's expenses prior to the birth. The behavior comes across as being very self-absorbed, but in reality it's a survival based behavior. With so many people struggling to get by (due in part to extremely spendypants behavior), people in a bad financial position have enough worries about providing for themselves and their families. They can't spare the money, energy, or time to worry about someone else's problems. If more American families were debt free with a large emergency fund, socialized (or non-socialized) medicine might actually be optimal.