You argument is that single payer only works in countries with a small population. How come it manages to work with the British NHS and the US Medicare? Why can't those systems scale up by a factor of 10 to work for the entire US population?

Or, let's agree that it only works for a UK-sized population of 80 million or smaller. That's fine. Even California only has a population of 40 million. Let each state run its own medical system, and some of the smaller states can form a interstate compact to share costs.

I had no idea what you are talking about with knee surgery. I believe that a decade ago the queue for non-emergency knee replacement surgery in the UK could be 18 months, but it's 18 weeks now. https://www.theguardian.com/society/2015/jul/24/nhs-waiting-...

Nor was delay caused by non-UK people getting priority. A non-resident does not somehow have priority over all citizens. It's the same queue. Unless coincidentally every single non-resident needed immediate knee surgery, while the resident need wasn't so critical, what you describe (17 months added to wait time because non-emergency health care is extended to people not in the health system) cannot happen.

FWIW, in the 1980s, "The median waiting time for an initial consultation was two weeks in the United States and four weeks in Ontario ... The median waiting time for knee replacement from the time surgery was planned was three weeks in the United States and eight weeks in Ontario. ... Overall satisfaction with surgery (85.3 percent of U.S. respondents and 83.5 percent of Ontario respondents were “very or somewhat satisfied”) was not associated with the duration of the wait for surgery" - http://www.nejm.org/doi/full/10.1056/NEJM199410203311607#t=a...

Sure, that was the 1980s, but it shows that single payer even in Canada doesn't intrinsically end up with 18 months of wait time for knee replacement surgery.

Those comparison numbers are biased. They only include people who had knee surgery. In the US, the uninsured, or those who switch jobs only to find out that it's a "preexisting condition" under their new plan, may not be able to afford it. (And yes, the fear of losing coverage keeps some people working at otherwise horrible jobs.)

Their years of extra pain aren't included in the average or maximum queue times.

> "If people want to pay for healthcare, they can pay for the service to have it in two weeks."

Sure. But single payer doesn't require that there cannot be private doctors as well. The UK has private health care in addition to single payer universal health care. Here's a price list for private knee replacement surgery in the UK: http://www.privatehealth.co.uk/conditions-and-treatments/kne...

I already mentioned health tourism where people go to France for surgery that is cheaper than the US. Back when the wait time was long in the UK, the NHS even sent people to France for treatment - http://news.bbc.co.uk/2/hi/health/1510522.stm . Here's a price list for private knee replacement surgery in France: http://www.treatmentabroad.com/surgery-abroad/france/surgery... .

As that BBC article points out, "The move follows a European court ruling which broadens the circumstances under which countries can carry out reciprocal treatment. ... Mr Milburn's statement follows a ruling by the European Court of Justice (ECJ) that patients facing "undue delay" in their home countries could seek treatment in other EU states."

Tell me again how the other medical systems in EU are "absolutely isolated from the French system"?