> Wait which is it. We have a "private" system where we save "the pesky" poor and regulate licensing, insurance, provide medicare/medicaid, have a quasi-public system for ER where private payers fund those who won't pay, or we don't?
You have the fully private provision you insist is more efficient. It costs more for worse outcomes than every other developed country, who also have regulations. If your original claim that the private sector is so efficient it could deliver everything for a third of the tax cost of the current system, it's remarkable that you're actually paying a large multiple the cost of the fully socialised systems for many people to have no care or crippling copays.
Sure, you can move the goalposts by claiming that true private provision requires there to be no medical regulations. But in order for that claim to be remotely credible you'd have to be able to point to all the countries that have great outcomes from having no medical regulations or public healthcare at all (the Philippines where the government is the main provider of healthcare but it doesn't have the time or inclination to enforce regulations on OTC antibiotics doesn't count, even if its health outcomes were excellent, which they're unsurprisingly not). Not gonna lie, if I'm suffering from the symptoms of a heart attack, I don't think antibiotics for half a day's pay are going to help, and literally the only efficiency argument for restrictions on ER rooms being allowed to employ extra admin staff to check insurance paperwork before deciding to administer treatment being an efficiency loss is that it's more efficient to let me die if I can't pay. As I've said, common argument but the complete opposite of your original setup where everyone gets the same outcomes for a third of the cost.
It's an extremely strong indication you've no experience with the US ER system that you think the efficiency issues are checking insurance at the door of a MI patient vs the fact they're required to at least entertain the hordes of people coming in with self reported "STD" or "doctor note for flu" when that kind of stuff shouldn't be appearing at the ER unless a lower acuity clinic has suspicion it might actually require emergent care. But of course why go to a clinic that is much cheaper when you can just show up at the ER and claim the pseudonym Pedro Sanchez with no ID and let the clinic bill it to all the other patients (which you insanely claim makes our system 'private' despite the fact all this happens at the behest of government), whom of course won't show up unless they're about dead because they not only will have to pay for these abuses but actually having something to lose. [Oh and how would I know this, only working ~1 yr in an inner city ER and seeing all the cases]
And you can argue that it would be better if those patients could get free urgent care instead of free ER to do the same thing at way higher cost, and I would agree that would be better than what we have now. But either way we're at an entirely different starting point.
What you can't argue is we actually have a private system in the US (and somehow miss the elephant in the room that over 1/3 of healthcare spending in the US is public Medicare/Medicaid, then add VA on top that) and then allude it's no true Scotsman or a moved goalpost if I point this out. In fact every time I do point it out, you just go back to morally proselytizing about dead poor people because it's a great way to distract from the fact you've lied and knowingly lied.
I mean, if we're in agreement that it'd be more efficient to have socialized healthcare than the non-socialized healthcare the US has, I'm not sure why you started off with the insistence that the private and charitable sector made everything so much more efficient it could provide all the actual benefits of the US government for a third of the cost.
Correct me if I'm wrong, but aren't private hospitals entirely free not to accept EMTALA patients if they also choose not to accept Medicare funding? And that some do, and remarkably still manage to be significantly more expensive than the rest of the world. Weird all these profit making companies opting in to accepting the regulation though, if it's that big a burden.
Like I said, if it was easy to do so much better than socialized healthcare simply by abolishing regulations on the private sector (which itself is a different discussion entirely from whether private companies are intrinsically more efficient), it's surprising nobody seems to have achieved this, anywhere. The true purely private healthcare system that delivers the same or better health outcomes at lower cost doesn't exist.
I've never claimed I thought totally private healthcare might be 1/3 the cost of universal healthcare. I postulated the functions of our government as currently implemented might be able to achieve for 1/3 the cost if privatized. You invented some straw-man that argued I was arguing vs something else, something our government isn't even offering, so I'm unsure how you even got to the point you got to.
If you truly thought our health care was privatized it's all a moot point, because it wouldn't have been included in our original argument. In either case your point is moot because I never compared to hypothetical socialized healthcare but rather our current entire government system.
It blows my mind you would even use the "1/3" statement if you thought it was private because if it was private it wouldn't have even been in the subset of stuff I was comparing relative cost to. I never claimed private things would cost 1/3 the price of things already "private."
Paying for the inefficiencies of private healthcare is about half of US govt spend on providing services (the only larger spend is transfer payments, and you can't pay $4b in annuities to senior citizens from a private insurance scheme that takes in significantly less than that. So probably you need to cut healthcare by more than a third...). I actually believe the US could stay safe on a much lower military budget (though god knows what a private donor funded military would look like) but that's not getting the overall budget cut by a third even if you zero it out.
Mathematically impossible to achieve the functions of the US government for a third of the cost without cutting healthcare spend. Which has been demonstrated to be entirely possible by other countries, but only by choosing to let more people die or, ironically, removing some of the dependence on inefficient private companies for provision...