[anigbrowl]

1. Oh please, this is just a truism expressing your general political views. Government does lots of things well. Every time there's a relevant accident, the NTSB is on the spot within 24 hours. The FAA does an amazing job. I could go on with many other examples; and where government is slow to respond, it's often because the rules require government to engage in a lengthy public consultation process or make it easy for third parties to litigate against the government (see: any case involving environmental review). It's not like waste, inefficiency, and so on are absent from the private sector.

2. The more your choices impact the lives of others (making yourself chronically ill and sucking up expensive medical resources, driving at 100mph in the rain), the more costs your bad choices impose on other people. Government is the agency we delegate some of our individual autonomy to in order to deal with such systemic problems. The alternative is everyone suing everyone else all the time.

3. I'll tell you the downsides: there are waiting lists for some procedures that are in high demand. There are about as many industrial disputes as before. Everybody blames the government for everything (like a tiny country hospital shutting down, nurses' pay, availability of some experimental treatment of unknown efficacy). A commonly-voiced fear is that if healthcare is cheap then everyone will crowd up doctor's waiting rooms all the time. This doesn't happen, because other than a tiny number of hypochondriacs nobody likes going to the doctor unnecessarily, for the same reason that most people don't engage in recreational dentistry.

The fact is that healthcare can't clear like a normal market for three reasons: a) there are genetic factors that you have no ability to control or predict that can make you sick unexpectedly; b) you typically don't have a choice about when you get sick so you can't defer your healthcare spending accordingly; c) most participants in the market are woefully under-informed because they don't have any kind of medical degree, and price theory demands market transparency for all participants in order for equilibrium to emerge and vendors to be price takers. What we have instead is a monstrously inefficient and unresponsive form of monopolistic competition, in which part of your healthcare costs go towards billboards and TV commercials for goods and services whose efficacy you are incapable of judging properly, massive layers of incomprehensible administration, and heads-I-win-tails-you-lose pricing that royally shafts the individual consumer in insurance and care markets.

[tptacek]

It is especially amusing to see people suggest that the government can't competently administer health care given that Medicare customer satisfaction exceeds that of private health insurers. It's weird how easily people "forget" that the federal government is already an extremely accomplished health management administrator.

But I take issue with your argument about the health market not clearing. In fact, consumers have important options for how they finance the cost of care. One obvious one: they can pay higher premiums for a low-deductible policy that gives them less control over their outlays but eliminates risks, or they can opt for nosebleed deductibles offset by rolling health savings accounts.

[anigbrowl]

I see your point, but I think it's very hard to gauge what the appropriate level of insurance is, because the risk factors are opaque and the likely cost of treatment unpredictable.

The other reason I'm strongly in favor of socialized healthcare is because of the insane administrative burdens it imposes on patients, whether or not they have insurance. Every medical decision a person makes about their own health in the US suddenly takes on administrative and financial dimensions that are quite poorly correlated with the clinical considerations.

[jbooth]

Don't forget the VA, too.

Our government only insures the absolute worst customers (old people, poor people, veterans), and STILL does it cheaper than the vaunted private sector. It's absolutely mind blowing how bad a job the insurance system does.