[cylinder]

You do a public system for all and then a private system for whomever wants to buy in. You incentivize the private option by levying a tax on those in upper incomes who do not buy private health cover. This is the Australian system and it's the most reasonable option for the US but I guess in America we can never admit to looking to other countries and have to pretend nobody else has figured out healthcare.

[splintercell]

> I guess in America we can never admit to looking to other countries and have to pretend nobody else has figured out healthcare.

There are some problems which exist in America which don't exist in other countries.

Take for instance, when the rest of the world talks about how they ban guns and therefore they have no gun crimes, giving that advice to America is like if Chinese people were giving advice to Australia that they banned Kangaroos, and now they don't have a Kangaroo problem, so why can't Australia do the same?

America will not have universal healthcare like all these other countries for many reasons, which are very American in nature:

* Americans won't accept the huge tax rates which will follow it, calculations show that there would be a 20% tax increase across all income groups to fund it.

* Universal Healthcare would be the single biggest issue on which Democrats and Republicans will fight, win/lose elections, on whether to cut its funding, whether to expand it.

* America is ethnographically different than other countries. Currently our biggest 'universal' service is Courts and Police. Add Healthcare to it, and next thing we know there is an added accusation of systematic racism against certain minorities.

[limeyx]

I dont believe there would need to be a 20% tax rate increase because we already pay far more per person in the US than anywhere else in the world (mostly)

I think it's mostly not going to work here because a lot of people will have to take paycuts (not just doctors / nurses but "administrators" "billing co-ordinators" drug companies and drug resellers, etc etc ...) always follow the $$$

[aianus]

Wouldn't all of the best doctors only treat rich people? Why would you expect them to do the same work for less money over at the public hospital?

[arcticbull]

Two-tier systems work well in a lot of places, for instance in France.

Doctors everywhere else are public servants. They do their jobs because the love it, because it's their calling and because they still get paid very, very well. Canada pays their doctors $232,000 to $676,000 gross (speciality averages, low to high).

Then because malpractice insurance is also socialized (Canadian Medical Protective Association), their costs are significantly lower too. OB/GYNs usually pay the most, and in Manhattan their annual malpractice insurance premium is $125,000. $176,000 in Long Island. [1] The highest in Canada is Ontario, at $44,000 CAD ($34,000 USD).

[1] https://www.excellusbcbs.com/wps/wcm/connect/b7cdbf66-dd6b-4...

[2] http://www.amednews.com/article/20100503/profession/30503993...

[cylinder]

The public hospitals in Australia are often really good and prestigious institutions used for teaching as well. So, while you don't get a private room and luxurious amenities you do see top doctors. I can't comment as to why they stick around the public hospitals. I don't know that they make less money doing that.

Procedures under the public system are scheduled by urgency, so for example you might have a 9 month wait for a torn ACL surgery. That's why most will carry private insurance. Private cover starts around $70 a month so it's much more affordable than US insurance and importantly much simpler to navigate.