Hi wavydog,
I try always to begin with the facts as I find them and to avoid the trap of addressing issues with preconceptions.
At the same time, I think there can be a false equivalence between sides of an argument. Sometimes, there's a much stronger position and a weaker one.
For instance, the idea that a government is bound to be worse at running healthcare is a very weak assumption. There's massive evidence that government involvement is not just important. It is necessary. And efficient. With better health outcomes.
That's where I begin.
This doesn't mean that governments must offer a health service. But funding healthcare with private insurance in public markets is - intrinsically - an exclusive system. And exclusion cannot be the goal of a health system, for a variety of reasons.
Separate from this, there's also a reason for this in economic principle, as enshrined in Kenneth Arrow's work. And the facts demonstrate it. So I find I cannot really easily behave in a "bit of this, bit of that" kind of way.
I am not making up the facts. They are astonishingly one-sided when you look into them. On almost every broad measure. There are some things the US system does well. But they don't add up to a system that measures up to those elsewhere. It's not even close.
At some level, McConnell's position is like saying you prefer a car that is slower, smaller, less gas efficient, uglier and more expensive than all others. It just needs a spot of polish and everything will be okay.
Anyone with eyes knows relatively-speaking it's a crap car. The question is, which are the most important major things to change first if it is to start to be remotely comparable to the systems elsewhere.
Obamacare is about the most humble change imaginable, while still making some kind of serious change.
If I was doing the work and I didn't have to function like the US political system, I'd study which countries do health systems well. And I'd copy the best one available. From what I have read, countries like France and Canada have systems that are relatively well liked with reasonably efficient economics and with successful health measures. So I'd probably want to do something like one or the other of them.
On the other hand, I wouldn't want a national health service, as per the UK. All government doesn't always work too well, either. And to be fair to the UK, it also operates private health care in parallel.
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