It's a well enough recorded fact by now that the U.S. overspends on healthcare. That its funding to public healthcare initiatives is now pressing in on countries that are overseeing aging crises, and in terms of the public kitty that percentage of GDP spent on Medicare, Vet Affairs HC, and other government initiatives outspends by capita any other Western nation with applicable public health service models.
So we already know the answer, single-payer is more successful. Master price lists with an understanding of acceptable profit margins that are collectively bargained for by governments rather than individuals, precisely because none of us can be expected to employ bargaining when we're already ill or injured, and no one will listen to you individually before you're sick. And heaven forbid if you're sick, uncovered, and thus have no capacity to negotiate ... your arse is firmly in the hands of debt collectors then.
The real question I want to ask is whether it is already too late for single-payer? ...
Now none of us want to think of the medical industry as self-obsessed, narcissistic and purely self-interested ... but it is. We know by now that simply having less state monopoly private healthcare isn't really the answer because each private healthcare fund has to do its own bargaining with its own hospitals, doctors and specialists.
Everyone, from 18th century economists to anyone with more than one neuron that has even caught a whiff of the exploding health budget of the U.S. understands allowing professionals to form labour unions and lobbyist firms in things like medicine is a bad idea...
That healthcare funds pass the costs of their corporate officer paycheques, the dividends they pay on shares, the medical sales reps they employ, the lobbyists and lawyers they have on retainer, the cost of negative-revenue on individual healthcare claims ... straight onto the people that get less out of their HCF than they pay into it. Essentially you're not only paying for other people, but also paying for corporations to turn a profit. It's insurance, and insurance companies will get money out of other safer/less costly patrons to cover their books.
A doctor isn't going to cut what they charge to just see a patient solely because a new healthcare fund starts up. Through proactive lobbying between medical institutions doctors already know just how much their colleagues in similar fields will charge, and lobbies aren't going to cut deals with or for bleeding hearts that might find this idea of medical hostage-taking morally wrong.
The ball is firmly with hospitals and medics, and singlepayer systems get around this through making demands as an industry whole ... so if doctors and hospitals don't want to play ball? Fine. They just miss out on upwards of 90% of their traffic. Which might be in their favour, but not exactly a stable foundation for which to build a thriving longterm business with aspirations to grow new clinics or run larger medical institutions that actually see returns on their efforts.
The question is rather ... is it too late for single-payer ... and what are you expecting singlepayer to do?
Ridiculous volumes of taxpayer money go to funding private HCFs in the U.S. in order to make HCFs even half cover their fund holders ... the game is rigged. After decades of this rigging, the lobbyists for medical institutions and doctors already have this political power and they won't back down fighting hair, tooth and nail for every item that government ever puts down on what is known as a 'master price list'.
Is the push for single-payer actually the hill that the 'evil liberals' want to die on, and has the ship already sailed? The question of single-payer being better has already sailed, but is by comparing single-payer solutions in the U.S. to other nations that have had it for decades already a venture doomed to disappoint people?
For all those people that want to see single-payer be a reality (where you actually get what you pay for and can negotiate costs BEFORE you get sick, which should be a given) ... what do you want to see in terms of the inevitable medical lobby battle that will likely paralyze single-payer initiatives for years to come?