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I Lived in Spain for a couple of decades, and I much prefer their government run hospitals to the way the US works. However, I do not believe that the US could just flip a switch and go to a public hospital system, so I would be happy with a more transparent, more competitive hospital system. The question here is not what system to create in a vacuum, but the road in the middle. I live surrounded by a whole lot of ultra-expensive, luxurious hospitals, staffed by extremely well paid professionals (and not so well paid residents), which, in many cases, have six figures worth of debt for the privilege. To move to a public system, all of those things would have to change: Those luxurious, privately owned hospitals are never going to give great prices to a single payer system. The doctors are not going to be happy with lower wages. Medical schools would have to change drastically, so they can actually provide a number of doctors that resembles the rest of the western world. This level of disruption is what makes major changes like that in a system that employs so many people unpopular: It's a bit like how the US military can't take big cuts, as they are political suicide. So overall, the change would be huge, and would be hard to make slowly. Therefore, I'd much rather solve it in the US through markets. Once the system has a whole lot less rent seeking behaviors, and the incentives are better aligned, a public option would actually be easier than from the catastrophe we live on now, where prices are secret, and yet, a hospitalization will often involve 10 to 20% coinsurance. |