Everyone is born and at some point will die. The costs associated with this vary hugely but the certainty of those two end points are inescapable. Almost every other developed country in the world recognises that and shares both the risks and the costs recognising that health is a golden crown worn by (and invisible to) those who have it. As someone with a spinal injury who would be most likely bankrupt and unemployed in the US I just don't understand why you don't get a proper, profit-free healthcare system. You spend the most on it in the world and don't get the greatest outcomes!
> don't understand why you don't get a proper, profit-free healthcare system. You spend the most on it in the world and don't get the greatest outcomes
American healthcare for the top 10 to 15% (about $150k+) is the best in the world. By a long shot. (The bottom ninety-something percent of the world's top 1% get their care here for a reason.)
Another 40% are covered by Medicare or Medicaid [1] which, while nothing to brag about, exceeds the median OECD healthcare experience.
That leaves half of the population with crappy employer-provided healthcare, the VA, scams or no insurance at all. For most of them, until they have an accident, this coverage is fine.
In summary, you have a system that works terrifically for the rich, well for the poor and old, and well enough for the rest that reform is challenging.
"In summary, you have a system that works ... well for the poor".
You don't actually know any poor people, do you? Their lives are not governed by your theoretical models.
And as the GP said, our healthcare - not the best of the best of our healthcare, as you cherrypicked, but the kind ordinary people have - is appalling overpriced for its mediocre quality.
I don't disagree with anything you said, but the simple answer to your question is that most American households are happy with their current health insurance and don't want it to change, so we keep patching the current (severely flawed) system as "needed" rather than starting over with a new one or making what would be seen as radical changes.
That poll doesn't say they're happy with their health insurance, it says they're at least somewhat satisfied with the coverage. You'd see very different results if you asked about health insurance prices.
I believe most people would incorporate the value received into their satisfaction rating.
Most people also don't have any idea how much their insurance costs in total or how it compares to alternatives, so that would be a challenging question to write with any reasonable expectation of getting a coherent response.
> The problem is the cost.
You could say this about almost anything that isn't free, and could still say it about a number of things even if they were free.
Feel free to look at the many, many, many alternative polls over the years. This is well known to anyone who has done any research into the topic at all.
Take the poll in 2026 after ACA subsides evaporate and Medicaid cuts. Highest satisfaction is for government run insurance (Medicare, Medicaid, Tricare).
https://www.nbcnews.com/politics/politics-news/poll-are-sati... ("Overall, 82% of Americans said they’re satisfied with their health care coverage, including a third who said they are very satisfied with their current coverage. The group that reported being the most satisfied were older adults, with 9 in 10 Americans over 65 years old saying they were satisfied. And 42% in that age group reported being “very satisfied.”. Roughly 9 in 10 of those who have public health insurance coverage through Medicare or Medicaid also reported being satisfied with coverage, compared to 77% of those with private health care coverage.")
https://www.citizen.org/article/public-support-for-medicare-... ("Support for Medicare-for-All continues to rise, whether in Congress, state legislatures, or among the American people. Recent polls indicate that six in ten Americans support Medicare-for-All. In addition, more than 60 percent believe that government is responsible for ensuring health coverage for all Americans. And nearly 70 percent of all voters, including battleground voters, identify health care as an important issue in upcoming elections.")
Yes, it's noted in the poll I linked (which is the same one as your first link) that the highest satisfaction is with government run insurance.
Not enough people are on ACA with subsidies to move the poll results that much, and Medicaid cuts aren't going to make people less satisfied with their private insurance.
I have no idea why you and so many other people seem to be taking my explanation as to why the US doesn't adopt universal socialized medicine as some sort of endorsement of the status quo.
Recently, friends and family in other countries have asked about health care in the US and I've been very surprised by what they imagine is going on here.
Let's compare notes? If I go to a hospital (emergency) for any reason, I will be seen within an hour at worst. If I'm bleeding or something I'll be seen immediately. A clinic for surgery might be same day or up to a couple of weeks, depends on severity. More specialized surgery could be 5-6 weeks. American average monthly cost for health insurance is around $600 for a family. Individuals without a family are around $450 so they kind of get screwed. The expenditures for health care, including the $600/mo are tax deductible. This number can go as high as $1200 in places like New York where income is significantly higher as is cost of living.
Overall, averaging co-payment and deductible with accidents, you should expect to spend around $3,000 / yr on average per person in total for health care as part of a family in the US. This number varies greatly by age, and both income and health care in the US is socialized so your wages determine your healthcare liability. (Make more money? Get less social services.)
This should cover everyone, but you have issues where poor people don't file taxes, and don't file for health care. Those people will still be seen in an emergency room.
Conversely, my friends and family in other countries with "free" healthcare pay roughly the same total for their medical portion of tax liability as I pay for health care in total. But their wait times are astronomically greater when it comes to receiving care.
I've often helped financially because their wait time for something like shoulder surgery might be 10 to 12 months or even longer, but the same doctor will see them in a week if it's paid privately. So I've worked out payment plans where I contribute $1k/mo for their "add-on" private care so that they can be seen in a reasonable amount of time. That's in addition to what they already paid in medical tax.
Maybe that helps to understand. From my perspective, in a lot of countries you are told that you have free healthcare, but in fact you're paying for it in taxes, and then someone in the US will still have to pay for it when you actually need it anyway. Double payment. Hope you've got friends. (Maybe that's not true for everyone, I'm just going by what I've seen and paid for myself for my own family.)
I personally think that Europe and other countries don't have better health care, it's much worse. I've lived in several countries for 1-2 months to years in each and I've never seen health care remotely on the level that I see in the US. I would venture to guess it's the best in the world.
If it's hard to understand how people live in a modern high tech country without healthcare, it's because they don't. It's just about which rich person is paying for it. Health care is very expensive, and that's true around the world. And around the world, if you don't file/register for health care, your outcomes are generally much worse. The US is no different in that regard.
I believe you need to compare notes on a societal level, of course that richer Americans will have great healthcare. The quality of care is not the problem, it's the accessibility of it.
Waitlists do mean this is not as comparable as you make it out to be. With a 1-year waitlist for heart surgery ... you effectively do not have heart surgery cover, because you'll be dead before it happens.
Now of course, mostly people just lose a few years of life and have a number of very painful months due to delays, that it is the direct cause of death is fortunately rare.
Oh and before you say it, most of the difference in life expectancy is due to the the difference in overweight people, not medical care.
But of course people have voted everyone has care and can claim everything's great and they've done everything needed. That it doesn't translate into reality ... "is not their fault". Meanwhile you read there is such a doctor shortage in for example Southern Italy that seeing a doctor in under and hour is outright impossible ... because there isn't a doctor less than an hour's drive away from some villages, even without waitlists. And the doctor shortage is getting worse, not better.
You need to compare Southern Italy to a similar impoverished area of the USA which might have the exact same doctor shortage. Of course different parts of a country will have different availability, seeing a doctor in Torino will be much faster than in a village like Saliano...
A 1-year waitlist for a necessary heart surgery where? Every country in Europe has their own healthcare system, each one of those have their strengths and weaknesses, exactly as it would be in the USA.
Notwithstanding there are private facilities you can pay insurance or out of pocket, the difference is no matter what you have decent coverage somehow, the richer the country the better it is, the richer the region of the country the better quality it is, exactly as in the USA...
So if we're comparing, I personally know only two people here without healthcare. They don't have jobs, and won't get them because they just don't want them. They live by buying and selling trash on eBay or similar. They could get free healthcare, but they don't want to file their taxes or fill out forms. I've offered to help them.
And I've known at least as many living the same way in Europe.
You can lead the horse to water, but you can't stop bureaucrats from discouraging it with paperwork.
Same, same.
To be fair, the paperwork is annoying enough that I'm actually paying a dentist $5k for one of them to get work done, just because I'd rather do that than fight this person to file their taxes and fill out the healthcare forms before their teeth rot out of their head. And it would cost at least as much to get an attorney do it for them.
It's just not worth it to fight with them, and the reality is that if it was easy to fill out the forms, then my healthcare costs would just go up anyway to cover all those additional people.
Either way, someone has to pay. There is no free lunch.
No, all parts of Italy (and frankly all of Europe) have a doctor shortage. It just goes from "2 months waitlist for primary care physician if it's not urgent" all the way up to "over a year even for critical care". And yes, richer areas have more doctors though the country is by far the biggest factor.
And this all gets confused by the fact that countries have regulations and make their own situation, making everything complicated. So, for instance, despite bad primary care in Southern Italy, the mental care is actually supposed to be pretty good. By contrast, Eastern Europe, specifically Romania, has terrible mental care but good primary care, including areas that aren't so wealthy.
