> It isn’t a shit show for me.

Nobody is talking about people who earn enough to have great health insurance when talking about the state of the US system. We're talking about the system overall.

> Those “great” systems come at a huge cost.

Last I checked, the per capita cost of the NHS is about the same as Medicare + Medicaid. But the NHS provides universal coverage.

> Nobody is going to the U.K. for advanced cancer treatment if they have a choice.

Well, yes, they do. The UK has a number of world-class private hospitals, some of which purposefully market themselves to international patients. Many of these are staffed by people who also work for the NHS, and some of them rent NHS facilities, including equipment and operating theatres to provide services, as part of the reason the NHS is as cost effective as it is, is that NHS trusts are allowed to supplement their budgets by leasing out excess capacity.

But worth considering when reading about the state of the NHS is that UK has private healthcare insurance plans available, at a tiny fraction of most US insurance as it's offered as a "when the NHS is too slow/not good enough" type "top up" insurance where you see your (NHS) GP first, and tell them to refer you privately if you can't get straight in to an NHS specialist and/or the NHS does not provide the best service available. And because the NHS usually does provide service fast enough and well enough, that tends to cost quite little to provide.

Despite all the complaints, only ~10% of people in the UK take up private insurance, mostly when it is offered as a perk by employers.

In other words: people complain about the NHS because we think it could be even better, and because a lot of us would like to see it receive more funding. Very, very few people in the UK would like to see "US conditions" in the healthcare, to the point where the threat of the involvement of US healthcare providers in provisioning of NHS services is being used as a scare tactic in the current election campaign.

> The US system is fine

Every single discussion I see about healthcare where Americans describe their experiences with the US system tells me it is not fine. It tends to read like horror stories from third world countries.

> The NHS is a shit show — try to get mental health care. Try to get advanced treatment and diagnostics. Try not to be too old or they’ll just deny your care. Be careful if you are young too — if your parents want to take you out of the U.K. because the NHS has no more options, the government will stop you.

It's pretty clear you're getting your "information" about the NHS from sources that are unreliable at best and outright lying at worst.

The NHS is not perfect, but it provides better services for most people than what they would be able to afford somewhere like the US, and does it while spending far less money than US providers. For those who are not satisfied with that, there are plenty of private providers to choose from.

A lot of the criticism of the NHS seems to be on the assumption that it is the only alternative. It is not. It is set up to provide universal service on as cost effective basis as possible to ensure everyone is guaranteed access. Those who can afford to pay more than people are prepared to fund the NHS for are free to pay more, just like in the US. The difference is that unlike in the US most people can realistically choose not to without a risk of going without treatment.

> And how many revolutionary drugs have ever come out of the NHS? Very few. That isn’t a coincidence.

Well, yes, because the NHS is not a pharma company or an R&D outfit. It's literally not its job. The UK has plenty of government funding of R&D, and plenty of pharma companies. It could do more. But it'd still not be the job of the NHS.