And…. there we have it: the last desperate faux-argument from the reactionary Right: I am “naive” because I think that the US can afford to have a world class healthcare system in which everyone gets all the care that they need. You say, essentially, that this cannot happen. Why do you hate America? Why do you think that while we can spend $1 million on each Tomahawk, or $169 million on each F-35, while we can maintain 800+ military bases in 120 countries, we cannot provide the necessary health services to all people?
You have been bamboozled by the Reaganite view that the Government is your enemy; that Government can do no good; that the Government is not “we the people” but rather some dark and sinister overclass taht is totally unresponsive to the people.
That is only as true as we allow it to be. The Republicans HATE Government, and, sure enough, when they get in power they do everything they can to ensure that Government does nothing, thereby proving their mantra correct. This is bullshit, and it is only believed because Bill Clinton and his DLC accepted this ethos when they transformed the Democratic Party into the Party of Big Business and declared “the era of big government is over.”
It does not have to be that way.
At the risk of stating what should be the obvious, when you have an insurance “pool” of 320 million people, and when that “buyer” is the only game in town, then you can dictate prices. The burden shifts to the suppliers of the products and services. This is not rocket science. It simply takes political will to stand up to the for-profit providers.
To use your framing, if the “payer” decides what treatments are available, and which treatments will be provided, then it simply makes sense to have the “payer” be the patients themselves.
Look at the current debate in the UK. The NHS is under-funded because the Conservatives have been defunding it for decades. This is the typical neoliberal strategy: defund a public service to the point where it fails, then use that artificially induced “failure” as an excuse to privatise. But the Brits aren’t having it. The appeal to fully fund the NHS is one of the factors driving the resurgence of the Labour Party.
We progressives are sick and tired of being told that we are naive for wanting to have what every other industrialised country has, or that we have a never-ending supply of money to wage war and provide tax cuts to billionaires, but nothing to finance things that actually help people. Those dogs won’t hunt anymore.
And finally, please do not presume to tell me how the world works. How many years have you lived outside the US? Have you ever lived in a country with single payer? If the answers to those questions are what I suspect them to be (i.e., no and never), then it is pretty comical for you to be telling me how “the world” does and does not work.