No one seems happy with their healthcare. How come there is not more common consensus across the aisle to move to a better coverage, lower cost solution like single payer? Other than the ceos of health nsurance companies, who is for for-profit health insurers controlling access to healthcare?
The overhead created/needed for administration of the inefficient insurance method of doing health care is significant and employs millions of people. Useless and net negatives for society though they may be, a lot of people would be out of jobs if health care in the US was fixed.
This is the gist of the problem in a country where dollars buy voters.
Once an inefficient or destructive activity becomes an industry, government policy is unable to affect it. Instead, the industry affects government policy, perpetuating itself and its harms. Tobacco, fossil fuels, automobiles, and fast food all did their damage, in the same way as the insurance lobby works today.
Many of the millions of people employed to squabble over who pays for whose healthcare (including the portion of time spent by healthcare providers) might as well be employed digging holes and filling them back in. Hole digging/filling started as a humorous suggestion by John Maynard Keynes for how to increase employment and GDP during the Great Depression, but it is essentially what we are doing now with all the futile activity around healthcare payments.
"Healthcare" is now the
3rd largest sector in the S&P500, comprising 12.6% of market cap. Some of that would be necessary even in a single-payer system with private providers, like REITs, pharmaceuticals, and service provision. Proponents of single-payer are essentially talking about deleting the business models for a large chunk of the stock market - perhaps 2-5% of it? And as efficiencies were realized that reduced healthcare spending, GDP would go down. Add a possible recession to the political costs! Everyone would be mad about the job losses, recession, and stock market losses, even if we were able to eradicate most rent-seeking from the insurance world, unleash small business formation from the requirement to offer expensive benefits plans, and save thousands of lives.
It all returns to the American consensus that GDP and stock market growth are to be maximized at any cost. We can't agree to pay the costs described above, but we can generally agree to make the numbers go up. Whoever dies in the process just dies. It's really hard to balance the risks of being extorted by exorbitant insurance rates or denied care, versus the risk of losing one's job and having one's stock investments decline. Those in ex-US countries who are not paralyzed by this debate should feel lucky not to have even started down this pathway.
The root problem, as with all problems in a prosperous democracy, is that money can buy our votes. We're too plugged into media/social media, and not thinking clearly enough about our own interests.