OK, I think there are some basic definitions that need to be set.
For example, I have refuted your arguments against single payer by explaining that I have lived in countries that have single payer and received treatment under those systems, and the scenarios that you depict (rationed care, care denied, unhappy/underpaid doctors and nurses, shortages of same in the workplace, etc.) have been refuted by the simple fact that in these other countries such problems do not obtain. So we know what a single payer system will look like. We do not have to guess. And to spin doomsday yarns and warnings of disaster is, as I have said, to engage is the dissemination of non-truths in order to pursue a specific political agenda. In other words, PROPAGANDA.
So consider yourself refuted.
We do not need to speculate as to what a single payer system will look like, because we already have one: Medicare. A system that works and works well.
Here is also a fact that you need to consider: Medicare is by far the most popular health insurance program in the country.
And for those who say it’s not just about money, that the private market does a better job overall — guess what? Medicare is better on all counts, according to a major 2002 study by the Commonwealth Fund. The study’s bottom line: “Medicare outperforms private sector plans in terms of patients’ satisfaction with quality of care, access to care, and overall insurance ratings.”
Secondly, we need to define “access.” When you say “Everyone has access to healthcare” you are defining access very broadly. Your definition would mean that we do not need public transit because everyone has access to buying a car. Hell, why not even say everyone has access to Ferraris? Or a private jet?
When I say access to healthcare, I mean having the ability to see a doctor when you are not feeling well; to get treatment for depression or smoking recession or weight management; access to preventative care that ends up saving money and extending lifespans — that is the reason that these other countries spend so much less and have so much better outcomes. By the time an indigent person ends up in the ER they are often already beyond help’ their diabetes or other condition has progressed to the point where they need massive and massively expensive medical intervention. And when they leave the ER they are saddled with a huge bill that they most likely cannot pay. The hospitals then write that off as bad debt and increase all their fees to cover such losses. It is a very, very stupid system, a short term accommodation from the Reagan era that only served to dodge the single payer bullet.
Finally, Vermont DID NOT “try single payer”. That is PROPAGANDA spread by the anti-Bernie and/or anti-single payer propagandists. Single payer was never given a chance. The Governor of Vermont dropped the single payer initiative during the planning stages because he was in a tight race for re-election and he was afraid that the issue could work against him enough to tip the scales (remember, VT is actually very conservative in many respects).
Shumlin, chairman of the Democratic Governors Association, still hasn’t even officially won his own reelection bid: The Legislature will settle the outcome of the November race in January because Shumlin failed to win more than 50 percent of the vote. He’s leading his Republican challenger by just a few thousand ballots.
And one more thing, going back to your reactionary views as to what constitutes access and public services such as mass transit: wanting to be able to take a bus to work is not the same as wanting a private jet. Duh.