> don't you have already in USA public schools,roads, parks, firemen, police

Sure. That has nothing to do with Socialism. There's nothing wrong with paying reasonable taxes to build and support an infrastructure that is of benefit to all involved.

The healthcare problem in the US is grotesquely misunderstood. It has NOTHING to do with insurance (private and otherwise) and everything to do with stuff politicians have done to us over the years.

Look, I work in aerospace. If I don't analyze things down to the real root causes of failures things go boom or worse, people die. And so I tend to look at problems with this perspective.

If you analyze the healthcare problem in the US to identify root causes the last thing you are going to have on your list (if at all) is insurance. It is as irrelevant as can be.

What's on the list?

I'll list three, in no particular order of importance:

- Government involvement in student loans

- Tort reform

- Federal and State regulatory burden

The US government is involved in guaranteeing student loans, which creates a situation where universities can charge insane amounts of money for their product. Even worse, universities make these loans accessible to kids without consideration to what it will mean for their lives and society in general.

If a doctor graduates with a nice new degree and $300K or more in debt, he or she is not going to be able to work for what I will term a "reasonable wage". Starting life with that much debt pretty locks people in to having to charge large amounts of money for their time and services.

No imagine an operating room where each person has student debt in the range of $300K and more. That surgery, I don't care what it is, is going to be very expensive. Add to that the debt every single person in that hospital has to face and you'll get the picture.

At a first level of inspection, the involvement of government in student loans has created a situation where the cost of medical care has increased to ridiculous levels over time.

The solution isn't to spend unobtainable amounts of money to offer free education. The solution is for government to get out of that business and allow the free market to force universities to compete.

If a doctor graduates with $100K or less in debt they, in theory, medical care costs would drop by 66%. They would be able to have a similar standard of living and charge 2/3 less for their services at the same time. That is a HUGE improvement all by itself.

Tort reform is another huge issue. This one affects the entire chain of participants in the healthcare industry. In the US you can sue anyone and everyone for anything that might happen in the course of receiving medical care. In fact, if, as an example, there's problem with care and a lawsuit is filed, they will sue everyone from the doctor to the hospital, equipment providers, suppliers, etc. They will go as far and wide as they can.

This means everyone in the chain has to have very expensive insurance to protect themselves. I know doctors who pay tens of thousands of dollars per year for this kind of insurance. My wife is a doctor, so we get to experience these realities first hand.

Once again, this imposes minimum costs that have to be covered by what you charge for your services. And the cost is high. Not just in terms of what you have to charge but what you have to do.

It is very common for US doctors to run a bunch of unnecessary tests. One of the fears is that if you don't and, for whatever reasons, a lawsuit is filed, you could be exposed to career-ending liability because you did not run the patient through every possible test in the universe.

These things increase the cost of healthcare by an unknowable factor. Let's just say it is not insignificant. If we fixed this problem healthcare costs would come down. Drug companies are exposed to multi-billion dollar liability. Again, someone has to pay for these costs, and that someone are the patients.

Finally, regulatory burden. I wanted to develop a simple medical device to help people with what's known as "Single Side Deafness" SSD. This is a case where a person can only hear from one side and is deaf on the opposite side. From a technical perspective, giving them the ability to hear something from the deaf side is easy: microphone on one side, earpiece in the other ear, bring some of the sound across, done.

Well, I very quickly discovered that the cost to get such a device through regulatory testing and approvals was very easily in the tens of millions of dollars, if not a hundred million+. This is why hearing aids cost thousands of dollars and other medical supplies and equipment can be so expensive. Drug makers spend billions of dollars on the regulatory burden.

Once again, these costs have to be paid by someone, that that someone are the patients.

Nobody is proposing we eliminate all regulation but, if we truly care about universally available healthcare we have to look for ways to make these costs a rounding error rather than something that has an entrepreneur like me say "forget it, I'd rather put my money in to making websites people click for money". That's just reality my friend.

And so, if you read all of this, got here and stop to think a bit, you should come to the conclusion that insurance isn't on that list because it likely does not belong there, at least not as a major cost driver. It is almost irrelevant. Address the above three (and there are more, of course) and the cost of healthcare in the US (as well as private insurance) will absolutely plummet.

The people pushing stuff like "Medicare for all" are pushing a fantasy not rooted in reality and one that has truly evil side effects (read my other answer on the subject). They push this fantasy because the lie is far easier to sell than speaking about the truth and the hard work we have to do in order to solve the problems I listed here as well as other issues.

A politician's objective is to gain votes, not to solve problem. In order to do that they have to win a beauty contest, not an intellectually sound argument. They use every trick in the book they lie, they misrepresent and they propose crazy stuff that no informed voter would ever support. And they do this because they know that the vast majority of voters operate at a basal level and virtually none of them are going to engage in this kind of analysis or the thought require in order to understand if what they are saying aligns with any objective reality.

I hope you got this far and actually stop to think. Don't attack the messenger, address the argument. What I said above is based on root cause analysis of the US healthcare system and it is as near to irrefutable as I can get given the resources available to me.