I generally agree with what you’ve said, but, and maybe I’m missing something here, how does the quality of health care automatically decrease under a UHC system? I think it’s fairly easy to prevent medical doctors who have questionable foreign educations from practicing in the US. Simply don’t recognize the foreign qualification, only US approved qualifications. You might even allow a system where the foreign-trained doctor can apply for an exemption to that rule, provided they are well-regarded in their field or their education and training are deemed of a high enough standard.
On the issue of lowering the profitability of the medical profession, and thus losing the best and brightest to other, more profitable, jobs, I can only speak from my own Australian experience and say that the people who score the highest results at high school in Australia go on to become doctors (or vets), almost without exception. Sure, the guys that went into stockbroking might be earning more, but being a doctor is a prestige thing.
On the issue of there being good GPs vs not-so-good GPs, I think it works the same way in the US as it does under UHC systems. Word of mouth is a powerful tool, and the good GPs build very nice lives for themselves (and their patients). The bad ones, not so much. And if you ever need specialist care, and you want the very best, then that’s what opt-in private health care insurance covers.
Make a doctors appointment or worse a an appointment with a specialist and then tell me we do not have waiting times in America.
The profit system is counterproductive to health care. Profits are increased by denying heath care not providing it. Preventive care is just another cost to an insurance company. While most see it as healthy for the populace, insurance companies see it as a drain on short term profits. Our system is flawed.
I don’t doubt that may be true, but regulation is also a protective shield for people. For example Cobra can keep people’s healthcare going after they lose their job. Now Cobra arguably has some problems in implementation but it’s basic idea is sound.
For comparison what regulation makes the US system inefficient?
The flip side of that is that they have less of an incentive to do their jobs too.
Many people who’ve compared the efficiency and motivation of workers at the DMV & post office with that of private sector employees are wary of turning more sections of the economy into government bureaucracies for this reason.
I would think the opposite will be true. If health care is provided by the government, it will automatically be rationed by virtue of government spending levels. This could take the form of the waiting times for non-emergency care that is being discussed.
Government employees are not just end of the working world drones. They can work their way up into supervisory positions. They can get promoted or moved into other government jobs. They have incentive to improve themselves and move up the ladder.