Health care also isn't like writing software. I know how to write software. I don't know how to select health care plans, and I when I had my own US company I was always afraid that I had made the wrong choice.

> "Can you imagine your entire hospital and insurance system being in blocks of 800 000"

I now live in Sweden, so I'm not unfamiliar with how single payer works in a country of 9 million people. Do note that it's not so isolated as you think. If I were to travel to France, and fall ill, I am entitled to any medical treatment that a resident would receive. This includes Switzerland, so your statement isn't quite a match to how the system works.

And let me say that it's a big relief to not worry about those details anymore. With our first kid on the way, I didn't have to wonder if my insurance would cover everything, or if I was feeding into the cost machine that has caused the price of giving birth to triple over the last 20 years in the US.

> "Successful countries that do it are tiny"

icebraining pointed out the 63 million people living in the UK with its NHS.

Even in the US, there are about 9 million people in the VA system and 55 million people in the Medicare system. Is there some fundamental reason which explains why Medicare cannot scale by a factor of 6?

> "the guy who snuck across the border illegally gets the exact same healthcare as you"

First, in the US everyone, no matter their immigration status, has the right to emergency care. See http://www.medscape.com/viewarticle/590328 for how the ethics are clear. So you end up with pregnant women coming to ER to give birth, which is expensive. And you have people coming to ER for things that could have been handled at a clinic more cheaply, and before any complications might have come up.

To make things more complicated, how does this hypothetical border crosser live in the US without a job? Because if he had a job enough to live on, then either the US employer is paying under the table, or he has a falsely acquired SSN and is paying into Medicare, even if he can't use it. The same works for universal healthcare - the money comes from payroll tax/automatic salary deductions, so even if someone snuck across the border, as long as they have a job they are paying for healthcare.

Second, people visiting (say) France from a country outside Europe are not covered under the French system. They are supposed to pay. Indeed, they do pay. Medical tourism is a thing. People will travel to France for treatment, and they pay for the treatment. It is not free to all comers. When my then-girlfriend visited me in Sweden for a couple of weeks, she needed an emergency root canal. She had to pay, and she did, even though she isn't a dutiful Swedish citizen.

But sure, there are people who are in the country but aren't eligible for health care and can't afford to pay or refuse to pay. There are two options 1) treat them, 2) don't treat them and wait until they appear in the ER once the problem gets more serious. (Option 3 is let them die, but I'm not inhumane enough to want that.)

Which is why the following happened in Spain. "Under a reform that came into place in September 2012, foreigners without residency papers lost their national health cards which allowed them free treatment in local public health clinics." Then in 2015, "Spain's conservative government said ... it would restore free healthcare for illegal immigrants, overturning a controversial decision taken three years ago." - https://www.thelocal.es/20150331/spain-to-restore-free-healt...

And they did it to take the load off of expensive ER care, which even the non-single-payer US does.