> Most Americans experience first hand how horrible health care here is
I mean, no, most Americans are just upset about cost-sharing, most providers in the United States are pretty good and have pretty good facilities and equipments.
You can have systems that are mostly privatized (cough, France) that are better regulated than the United States, but that'd mean doctors would get paid less money & upper class folks would likely get worse care
I agree that upper-class folks' experience would change in ways that would generate loud protests. But the biggest anger points likely wouldn't involve quality of care. Instead, we'd hear shouting about:
providers' increased emphasis on cost-effective care. (You don't need an MRI because there's nothing in your symptoms that warrants it.) Right now, there's a lot of overtreatment in the U.S. medical system, catering to patients' desire to get big workups.
scaling back of today's concierge-level ambiance, with fancy chairs, skyline views, etc.
> there's a lot of overtreatment in the U.S. medical system, catering to patients' desire to get big workups.
It’s not just happening in the US. What goes on in the US is very influential elsewhere, and both patients and staff get pulled into the vortex of over-testing. And then to top it off, sometimes they are correct and they did need the test.
Partly. Let's also talk about the ugly world of Certificates of Need and diagnostic imaging and how they collide.
CoNs are something lobbied for by hospitals. If you want to open a new hospital or healthcare facility in an area, you need to apply for a certificate of need, which allows/asks existing hospitals if they think there is a need for your facility, to avoid "overservice" (lol, okay) of an area.
Diagnostic imaging companies - each of the big ones (Siemens, GE, Philips) offer in house financing for MRI, CT, etc., that they advertise to physicians. They also all offer specialist consulting help to facilitate you getting a CoN for your facility. Hell, they all also well help you find other physicians in your area who'd like to go in on setting up a DI facility (and will assist with spinning up the practice).
And then we find that physicians who own a DI practice (or a share in one) refer their patients to diagnostic imaging at rates several standard deviations above other physicians, and at rates that are "statistically improbable" when correlated to underlying ICD-10 diagnostic codes.
Upton Sinclair comes to mind ("It is difficult to get a man to understand something, when his salary depends on his not understanding it").
It's the same in San Francisco, where we support returns to investors in residential real estate by banning new development since the 1960s and therefore doctor salaries don't afford a luxury lifestyle [https://www.nytimes.com/2017/06/03/business/economy/high-end...] and therefore we have a shortage of physicians.
This is because congress wont expand residencies so there arent enough doctors. Doctors make a bunch of money and can live anywhere they want, almost none of them want to live in bumfuck.
Remove the residency cap, allow foreign doctors to immigrate and quickly certify their skills, allow nurses to attend night school to become doctors, etc.
I mean, no, most Americans are just upset about cost-sharing, most providers in the United States are pretty good and have pretty good facilities and equipments.
You can have systems that are mostly privatized (cough, France) that are better regulated than the United States, but that'd mean doctors would get paid less money & upper class folks would likely get worse care