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To be quite honest, most of it is sold by the media, who have mutually beneficial arrangements with the for-profit healthcare/insurance industry. If you’ve ever seen how many advertisements on American TV about prescriptions, health plans, etc, you know what I’m getting at. The debate is kept tightly constrained to make the capitalist system seem more robust and successful than it actually is. So: media propaganda, more or less.

Also want to add: my child’s birth cost $20,000 (with insurance). When I would tell other Americans about this, the response was (usually) “you know you can get on a payment plan, right?”