Then tell me why the U.S., which doesn’t have a single-payer system, has the most expensive healthcare system in the world and one that’s far from the best. Those countries that have a single-payer system have healthcare systems that are both less expensive and less dysfunctional than our own. I am sure there are other salient differences there (for example, Scandinavia generally has a high standard of living, and you don’t have as many of our all-too-familiar obese inner-city welfare queens spending all day eating themselves into an early grave, preceded by every medical problem in the book), and this is part of why I don’t claim I have all the answers here, but I’m also not at all sure your claim that the cost of our system would go up in a single-payer world is true. I just don’t see sufficient evidence that that’s the case. I see many reasons to think that a single-payer system would go a long way toward cleaning up the messy, inefficient, overly complicated system we live in.
I also think that if my choice is between talented people + screwed up incentives that make those talented people harm patients to line their own pocketbooks vs. slightly less talented people working within a system that creates incentives for them to care for patients rather than to line their pockets, I’d choose the latter any day of the week. Using your military/foxhole analogy, it’s like, do you want the dumb fit guy having to navigate his way through a labyrinth full of traps for the unwary, or do you want a slightly less fit version of the same guy having to navigate his way through an obstacle course with step-by-step instructions about how to get to the end?
Finally, as far as the idea of a purely privatized system where there’s no insurance at all, I agree with you that the result would be that prices would come down dramatically but not enough for the poorest of the poor to afford many services, but that’s why I said that we’d maybe still want basic emergency services in place in such a system (and maybe one physical per year or something like that). The idea would be that, yeah, if you’re poor, you’re going to suffer as far as healthcare goes, just like you’ll suffer in every other aspect of life, and that’s just an incentive for you to better your lot. In the single-payer system, of course, you wouldn’t have this issue.
