Both in rich and poor countries, universal health care brings huge benefits

At the time I lived in NYC (2007-2013), Me and family had needed urgent care services 3 times. In all three times, we called insurer (Aetna once, United twice), and they told us to go to ER because there is no better option.

Things may be different now, last time I visited manhattan a few months ago indeed there were several walk-in clinics between 8th street and 23th that weren't there 5 years ago, but (at least from the sign on the window), not all accepted all insurances, and none had a chargemaster listed outside, which means there's a nontrivial possibility one would go bankrupt going into them.

> Just because you can use them in the UK or wherever doesn't mean you should, and there is nothing to disincentivise people from this because they're not footing the bill (directly, that is).

That's true. And if people did misuse them significantly, I'm sure the (dis)incentive structure would be put in place. But it turns out that most people in the UK and EU and other places are not jerks, and do not call an ambulance needlessly.

It is a mathematical certainty that there is always a false-positive / false-negative tradeoff; The US system (and your recommendation) prefers false negatives, the EU system and other single payer systems prefer false positives. And .. what do you know? Bang for buck, single payer systems triumph greatly, have lower infant death, and higher life expectancy.

>>You can't start any economic argument by saying that paying any cost is a must. You will get fleeced.

>Paying taxes isn't getting fleeced.

I think it's fair to accurately address the arguments being put forth, rather than reinterpreting them. Taxes are necessary, and I don’t think any serious person would argue otherwise. The problems come when we get into the details:

Conflating local, state, and federal governments with their respective tax regiments only serves to muddy the waters. Additionally, conflating property, income, and capital gains taxes compounds the problem.

Scaling anything from 60M people to 300M is non-trivial (just ask Twitter, which is pretty simple).

Arguing for a collectivist approach in the US (which was partially founded on individualism), seems to betray the entire reason for our independence from Europe (the old country) in the first place.

Let Europe do Europe, and America do America.

Edit: Just to be clear, individual European countries are 20% of the population of the US at best, so it makes more sense to compare them with US states (e.g. The state of CA is the 6th largest economy in the world). Top-down policies do more harm than good in such a large heterogeneous place as the lower 48.

"Economies of scale" isn't a universal idea that you can apply to literally any industry/sector.

Unfortunately, medicine is not retail. Otherwise are lives would be a lot simpler. Would it be more efficient to introduce Amazon-like policies to medicine. For sure. But unlike Amazon fulfillment centres, you can't just close all the hospitals in a city and build a mega hospital 1 hour outside the city and expect anyone to go along with that.

Pretty much everything that can be "economically scaled" in the medical industry already has been -- the drugs you are receiving to treat X condition in NY and WA are probably going to be from the same company. The MR machines you use in TX are the same brand as the ones used in PA. This means those things are cheaper than they would be if they were being produced by "mom and pop" shops. Economies of scale are already in play. It's all about fixed vs. variable costs.

My point was about admin. When the scale of an organization goes up, the admin costs go up, not proportionally to the value that this admin provides. It's necessary if you want to get bigger, but not proportionally useful. With a national health system, the number of doctors you need will not go down. The number of imaging devices you need will not go down. But the amount of centralized bureaucracy you need WILL go up.

I didn't say that the US was larger than the EU...

I said the US is significantly larger than any one country in the EU, and each country in the EU has its own health care system. What is being discussed in this thread is a US-wide health care system, which is definitely not equivalent to what is currently happening in the EU.

You can't definitively conclude anything about example B from the results of example A if the two examples are different.

That's not what I'm saying though. All I'm asking is for you to show me how you will mitigate the problems that will crop up when you try to implement a similar system to the UKs at the scale of the US, because the US has 5x the population of the UK. That's not a negligible difference in scale, and if this can't be shown at all, that is a problem.