# UHC/Single Payer in the US...how would you do it? **URL:** \ **Category:** Great Debates\ **Created:** [July 3, 2017, 3:09pm UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433 "2017-07-03T15:09:46Z")\ **Posts on this page:** 20\ **Page:** 3
**Author:** ![CarnalK](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/carnalk/32/486_2.png) [@CarnalK](https://boards.straightdope.com/u/CarnalK)\ **Post date:** [July 5, 2017, 8:39pm UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/41 "2017-07-05T20:39:38Z")
> [@davida03801](#): > > The administration prowess of the Dept. of Motor Vehicles and the compassion of the Flint Water Control Board. > > Why is the allure of single payer so strong ? I simply do not understand it. And how would you describe the adminisration prowess and compassion of the pre-Obamacare system? And your allure towards it? ---
**Author:** ![PastTense](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/pasttense/32/14550_2.png) [@PastTense](https://boards.straightdope.com/u/PastTense)\ **Post date:** [July 5, 2017, 10:12pm UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/42 "2017-07-05T22:12:27Z")
> [@davida03801](#): > > The administration prowess of the Dept. of Motor Vehicles and the compassion of the Flint Water Control Board. > > Why is the allure of single payer so strong ? I simply do not understand it. It’s not that government paper pushers are more efficient; they are probably less efficient. Instead it’s that you eliminate many types of activity: you no longer need to spend massive sums on advertising saying type X health insurance is better is superior, massive sums on health insurance agents doing the same. Massive sums on bill collection for those who don’t pay. It’s vastly simpler and cheaper for a doctor to deal with one type of health insurance than dozens plus deal with all those lacking health insurance. ---
**Author:** ![Velocity](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/velocity/32/18006_2.png) [@Velocity](https://boards.straightdope.com/u/Velocity)\ **Post date:** [July 5, 2017, 11:56pm UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/43 "2017-07-05T23:56:28Z")
> [@CarnalK](#): > > And how would you describe the adminisration prowess and compassion of the pre-Obamacare system? And your allure towards it? Not quite the answer you’re looking for, but for an example of the “compassion” of the \*\*\*ACA \*\*\*itself, I went to an ER three years ago. The only procedures that were performed were a blood test and some other examinations. Cost: $1,400. As others have said, the Affordable Care Act isn’t very affordable. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [July 6, 2017, 12:19am UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/44 "2017-07-06T00:19:37Z")
Cost control is certainly the next step in improving ACA. It was all the Dems could do to get what it \*is \*passed, but now that it has broader support, it may be politically possible to move forward. Or it may not. ---
**Author:** ![CarnalK](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/carnalk/32/486_2.png) [@CarnalK](https://boards.straightdope.com/u/CarnalK)\ **Post date:** [July 6, 2017, 12:38am UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/45 "2017-07-06T00:38:24Z")
> [@Velocity](#): > > Not quite the answer you’re looking for, but for an example of the “compassion” of the \*\*\*ACA \*\*\*itself, I went to an ER three years ago. The only procedures that were performed were a blood test and some other examinations. Cost: $1,400. > As others have said, the Affordable Care Act isn’t very affordable. Well that sounds pricey but for me to make sense of it I would have to know what a blood test and some other examinations in an emergency room cost before ACA, how typical that price is in different markets and how much of that was your out of pocket. You know, more than a vague anecdote. ---
**Author:** ![I\_Love\_Me\_Vol.I](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/i_love_me_vol.i/32/521_2.png) [@I\_Love\_Me\_Vol.I](https://boards.straightdope.com/u/I_Love_Me_Vol.I)\ **Post date:** [July 6, 2017, 1:37am UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/46 "2017-07-06T01:37:36Z")
I just found an interesting article about the Nevada legislature passing a bill that offers [Medicaid for anyone who wants it](https://www.vox.com/policy-and-politics/2017/6/6/15731622/nevada-medicaid-for-all). Nevada? Who knew? It mentions that already people have suggested “Medi **care** for all” programs but that the Nevada bill considers Medic **aid** a better foundation for a public health insurance plan than Medi **care**. In large part because it’s cheaper (Medicaid pays doctors less than Medicare does). Separately, I also like the idea of easing into a public health care plan by automatically enrolling all newborn babies (Note: that is not a part of the Nevada plan AFAIK). One problem with Medicaid is that so many doctors simply refuse to accept Medicaid patients because it doesn’t pay enough. But if Medicaid was expanded to cover all newborns year-by-year can you imagine the public outcry if doctors refused to treat the little cutie-pies because it didn’t pay enough? ---
**Author:** ![I\_Love\_Me\_Vol.I](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/i_love_me_vol.i/32/521_2.png) [@I\_Love\_Me\_Vol.I](https://boards.straightdope.com/u/I_Love_Me_Vol.I)\ **Post date:** [July 6, 2017, 1:51am UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/47 "2017-07-06T01:51:07Z")
> [@Merneith](#): > > The chief advantage of expanding Medicare to be America’s UHS is that it’s more efficient than starting a whole new healthcare program from the ground up, to be run in tandem. In Medicare (and rolling Medicaid in, as well as military medicine), we already have the infrastructure and the billing and so on. > > Streamline it all into one billing system and drop the age limit. The crossover period is sure to be a vomit comet but once it sorts out, it will save money on efficiency. It needn’t be a harrowing adjustment. Every year a whole new group of Americans become new beneficiaries of Medicare when they turn 65. It wouldn’t be so different if instead of just adding all the new 65 year-olds one year you also added all the 62-64 year-olds. And then next year, the 59-61 year-olds, etc. I like the idea of phasing in a program like this from both ends of the age spectrum. Each year let younger groups of adults join Medicare (as above) and _also_ add every infant born that year. It helps with the political problem of convincing the voting public to support this when you ease into it by starting with the most vulnerable among us. ---
**Author:** ![foolsguinea](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foolsguinea/32/14751_2.png) [@foolsguinea](https://boards.straightdope.com/u/foolsguinea)\ **Post date:** [July 6, 2017, 2:15am UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/48 "2017-07-06T02:15:43Z")
> [@Velocity](#): > > Not quite the answer you’re looking for, but for an example of the “compassion” of the \*\*\*ACA \*\*\*itself, I went to an ER three years ago. The only procedures that were performed were a blood test and some other examinations. Cost: $1,400. > As others have said, the Affordable Care Act isn’t very affordable. Right. The ACA is not socialized medicine, and it was not designed to make emergency room care cheaper, let alone free. That’s why those of us who want socialized medicine find the ACA disappointing, and why we’re not happy with Democrats acting like it was enough reform. ---
**Author:** ![davida03801](https://avatars.discourse-cdn.com/v4/letter/d/b5e925/32.png) [@davida03801](https://boards.straightdope.com/u/davida03801)\ **Post date:** [July 6, 2017, 2:20am UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/49 "2017-07-06T02:20:46Z")
> [@Ravenman](#): > > Because it works quite well in most of the world. Really. What I read about the UK and Canadian systems is quite negative. Please provide the cites with the glowing reviews of either. ---
**Author:** ![CarnalK](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/carnalk/32/486_2.png) [@CarnalK](https://boards.straightdope.com/u/CarnalK)\ **Post date:** [July 6, 2017, 2:46am UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/50 "2017-07-06T02:46:39Z")
> [@davida03801](#): > > Really. What I read about the UK and Canadian systems is quite negative. Please provide the cites with the glowing reviews of either. > [@](#): > > One fourth of American respondents are either “very” or “somewhat” satisfied with “the availability of affordable healthcare in the nation,” (6% very satisfied and 19% somewhat satisfied). This level of satisfaction is significantly lower than in Canada, where 57% are satisfied with the availability of affordable healthcare, including 16% who are very satisfied. Roughly 4 in 10 Britons are satisfied (43%), but only 7% say they are very satisfied (similar to the percentage very satisfied in the United States). > > Looking at the other side of the coin, 44% of Americans are very dissatisfied with the availability of affordable healthcare, and nearly three-fourths (72%) are either somewhat or very dissatisfied. The 44% in the United States who are very dissatisfied with healthcare availability is significantly higher than corresponding figures in either Canada (17%) or Great Britain (25%). > **[Healthcare System Ratings: U.S., Great Britain, Canada](https://news.gallup.com/poll/8056/healthcare-system-ratings-us-great-britain-canada.aspx)** > > The healthcare systems in the United States, Canada, and Great Britain provide interesting comparisons to one another, especially since the U.S. system is considered private and Canada and Great Britain each have national health systems that supply... Of course, that’s just people’s opinion not necessarily a “glowing review”. ---
**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\ **Post date:** [July 6, 2017, 11:28am UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/51 "2017-07-06T11:28:37Z")
> [@davida03801](#): > > Really. What I read about the UK and Canadian systems is quite negative. Please provide the cites with the glowing reviews of either. Can you be more specific about what is quite negative about the UK and Canadian systems? It’s hard to respond to such a general comment. However, consider this: • all Britons and Canadians have guaranteed coverage for medical issues; • the government funding for that guaranteed coverage is a smaller proportion of GDP than is the government funding in the US for healthcare; • although the US government funding for healthcare is a greater proportion of GDP than in either Britain or Canada, not everyone in the United States is covered. So you’re already spending more public dollars, as percentage of GDP, than either Canada or the UK, and you’re getting less coverage. Those are the broad-brush comments. If you have specific comments, I’d be interested to see them. ---
**Author:** ![blindboyard](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/blindboyard/32/2833_2.png) [@blindboyard](https://boards.straightdope.com/u/blindboyard)\ **Post date:** [July 6, 2017, 11:30am UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/52 "2017-07-06T11:30:28Z")
> [@PatrickLondon](#): > > The crucial factor in the UK is that the doctors themselves are the system’s (or at least the principle’s) biggest defenders, with a few exceptions. You need to get them onside and show them how it would make life better for them: get them and the employers together, and you might have a powerful coalition. > > But you’re still going to have to find an agreed way for costs to be controlled. They like it now, but it could only be founded because Nye Bevan “stuffed their mothes with gold”. The British system was also largely founded by nationalising charitable hospitals. The American system is encrusted with profit-making hospitals and profit-making everything else, which is a different matter. ---
**Author:** ![Grim\_Render](https://avatars.discourse-cdn.com/v4/letter/g/a87d85/32.png) [@Grim\_Render](https://boards.straightdope.com/u/Grim_Render)\ **Post date:** [July 6, 2017, 12:04pm UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/53 "2017-07-06T12:04:54Z")
> [@XT](#): > > You are President. Your party, whichever it is, has a small majority in the house and senate. The USSC is what it is. And this is key…our system is what it is. The parties are what they are. The voters are what they are. IOW, this isn’t fantasy America, nor are you god-King of the US, able to use your fiat powers to do whatever you want. You have the same real world limitations as every other US president (well, let’s say you haven’t fucked yourself as Trump, so you have a little political capital…say, Obama early first term levels). > > And what you want to do is get a good, affordable UHC/Single payer healthcare system passed and implemented in such a way that it becomes the new norm. And without a disruption or disconnect in the transition. (if you are completely opposed to the very idea of this then this isn’t a thread for you…move along if you can’t play along. Please). > > So, the question is…how would you do it? How would you get it through your own party AND through the opposition of the other party? How would you sell it to the American people so as to be meaningful to them, especially to the majority who have healthcare through their work and who are used to how it works today and for the last 50 years in the US? How would you sell it to the large number opposed to stuff like this, how would you get it through the opposition lobby groups and entrenched people who don’t think they want such a thing or have a vested interest in the old system? You have to do this within the reality of our system, of the parties and the voters as they actually are. Difficult with the small majority. The insurance companies are going to target any approachable politician, and given their resources and how motivated politicians are by money, they are almost certain to be able to sway enough votes to scupper the whole deal. You’d need to get enough opposition politicians along to block that. Very difficult. Beyond that, a number of countries, including I believe Taiwan, who were latecomers to the UHC issue conducted some very detailed studies on how the various systems work, strong points and weak points of the stuff that is out there, and long-term effects. They are still happy about Trump actually calling them back, so they’d probably translate it and hand it over for the asking. Such studies should be read very carefully before designing a program. As an alternative to expanding Medicare/Medicaid, I would consider passing a federal law that says citizens have a legal right to medically necessary healthcare, and states have a duty to provide for it. Write it so that the states will be sued heavily by citizens if they fail. Basically use the US fascination with lawsuits as an engine, and let the states themselves try out various systems for delivering it. Probably be much more turbulent implementation than expanding the existing programs, which can draw on the experience of a large number of nations that have done this for a long time, but I do feel it would be more American if I may say so. > [@CarnalK](#): > > You have to start really selling the idea that it’s good for business. Right now health care coverage is beyond most small businesses and a big headache for larger ones. Employment based health coverage inhibits labour movement. UHC standardizes a major factor with our European and Canadian trading partners. There needs to be hard push back that it’s a communist idea and present that it’s no different than a public police force or fire service. I suspect businesses are quite happy with the fact that their investment in health care insurance keeps a good chunk of their best workers from going off and starting competing businesses. Healthcare feudalism is best feudalism. > [@davida03801](#): > > Really. What I read about the UK and Canadian systems is quite negative. Please provide the cites with the glowing reviews of either. Its not so much that thy are shining examples of perfection, no one is ever happy with their system. Its just that the perform so much better than the US system. The US system costs 2x more, per citizen or as a percentage of gdp, and are way behind in infant mortality, lifespan, amenable mortality, years lost to ill health, maternal mortality, and the other measures. > [@CarnalK](#): > > You have to start really selling the idea that it’s good for business. Right now health care coverage is beyond most small businesses and a big headache for larger ones. Employment based health coverage inhibits labour movement. UHC standardizes a major factor with our European and Canadian trading partners. There needs to be hard push back that it’s a communist idea and present that it’s no different than a public police force or fire service. > [@tim314](#): > > If universal health care would cause a massive influx of illegal immigrants (I think that’s what you’re saying), then why haven’t the illegal immigrants we have now mostly just continued on to Canada? > > I’m sure Canada has controls in place to prevent non-Canadians from taking advantage of their health care system, but I presume universal health care in the U.S. could be implemented with similar controls. Actually, Americans coming to Canada to filch free health care is an issue. ---
**Author:** ![Ravenman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ravenman/32/2929_2.png) [@Ravenman](https://boards.straightdope.com/u/Ravenman)\ **Post date:** [July 6, 2017, 1:14pm UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/54 "2017-07-06T13:14:16Z")
> [@davida03801](#): > > Really. What I read about the UK and Canadian systems is quite negative. Please provide the cites with the glowing reviews of either. You are reading sources that tell you what you want to hear. It isn’t even with bothering to look for cites that these systems cover more people for less money, generally provide better outcomes, and the idea of making their system more like the US is viewed as preposterous in both countries. ---
**Author:** ![Horatius](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/horatius/32/3572_2.png) [@Horatius](https://boards.straightdope.com/u/Horatius)\ **Post date:** [July 6, 2017, 1:51pm UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/55 "2017-07-06T13:51:24Z")
> [@Northern\_Piper](#): > > Can you be more specific about what is quite negative about the UK and Canadian systems? It’s hard to respond to such a general comment. The single biggest complaint here in Canada is wait times for surgery. However, that issue is largely blown out of proportion by the nay-sayers. For critical, life-saving issues, there is essentially no delay to treatment. The wait times are for non-critical or elective surgeries, and vary quite a bit depending on where you are, since not every city/town has the same resources. I’ve had to wait for surgery a few times, but honestly, a few weeks or months delay for something that isn’t an immediate problem is way better than some of the horror stories I’ve heard about the US, with coverage refusals and the like. I’ve literally never once worried about the cost of health care, or if a procedure or treatment would be covered. My father passed away last year after two years of treatment for cancer. He was on one experimental treatment which reportedly cost $20000 per month, so about a quarter of a million dollars per year. Cost to my parents? Zip. And no forms to fill out, and no insurance busybodies to argue with about it either. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [July 6, 2017, 2:05pm UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/56 "2017-07-06T14:05:30Z")
> [@Grim\_Render](#): > > I suspect businesses are quite happy with the fact that their investment in health care insurance keeps a good chunk of their best workers from going off and starting competing businesses. Healthcare feudalism is best feudalism. Not so sure that’s a factor. You can get similar-quality health care at your new job with any but the smallest employers. I suspect the absence of vested pension rights with almost any new employer has more to do with mobility of employees - that’s saved companies a lot directly, but often costs them a lot indirectly. That said, the smallest, low-benefit employers, including the startups that have a chance to grow, would be in much better shape if they didn’t have to take on the direct costs of medical care for their employees. > [@](#): > > Actually, Americans coming to Canada to filch free health care is an issue. How does that even work? Fake or stolen ID cards? ---
**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\ **Post date:** [July 7, 2017, 1:42pm UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/57 "2017-07-07T13:42:25Z")
> [@Grim\_Render](#): > > As an alternative to expanding Medicare/Medicaid, I would consider passing a federal law that says citizens have a legal right to medically necessary healthcare, and states have a duty to provide for it. Write it so that the states will be sued heavily by citizens if they fail. I’m not sure that the federal government has that power, in light of the case that upheld the ACA generally. The Court ruled that Congress could not compel states to expand Medicare at the risk of losing all funding, as that sort of compulsion was unconstitutional. That analysis would seem to apply even more to a compulsion to provide health care at state expense. > [@Grim\_Render](#): > > Actually, Americans coming to Canada to filch free health care is an issue. > [@ElvisL1ves](#): > > How does that even work? Fake or stolen ID cards? I’ve never heard of this, **Grim Render**. An American would need a provincial health card to get health care in Canada without paying for it. ---
**Author:** ![Grim\_Render](https://avatars.discourse-cdn.com/v4/letter/g/a87d85/32.png) [@Grim\_Render](https://boards.straightdope.com/u/Grim_Render)\ **Post date:** [July 7, 2017, 2:10pm UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/58 "2017-07-07T14:10:36Z")
> [@ElvisL1ves](#): > > Not so sure that’s a factor. You can get similar-quality health care at your new job with any but the smallest employers. I suspect the absence of vested pension rights with almost any new employer has more to do with mobility of employees - that’s saved companies a lot directly, but often costs them a lot indirectly. That said, the smallest, low-benefit employers, including the startups that have a chance to grow, would be in much better shape if they didn’t have to take on the direct costs of medical care for their employees. I was thinking more about starting up for yourself rather than moving to a smaller employer. In my experience, most people who do go into business for themselves are in their thirties or forties and accomplished at their craft. That is however also the age where you start to feel the first frost in your bones and realize you are not indestructible, as well as being the age where you acquire dependents. IT is a notable exception, people who start new businesses here are often younger than in other professions, and single. > [@Northern\_Piper](#): > > I’m not sure that the federal government has that power, in light of the case that upheld the ACA generally. The Court ruled that Congress could not compel states to expand Medicare at the risk of losing all funding, as that sort of compulsion was unconstitutional. That analysis would seem to apply even more to a compulsion to provide health care at state expense. I believed it was the losing of funds that was the compulsion? I would think this would be general welfare. > [@Northern\_Piper](#): > > I’ve never heard of this, **Grim Render**. An American would need a provincial health card to get health care in Canada without paying for it. Its been an issue for some time. However, its not a highly visible one, because people who do that try to stay under the radar, obviously. So it takes a deliberate study to get some numbers. [I believe the last one was done by Ontario.](http://www.nytimes.com/1993/12/20/world/americans-filching-free-health-care-in-canada.html?pagewanted=all) _“many are submitting counterfeit, borrowed or fradulently obtained cards.”_ To me, what is interesting is that the numbers far exceed the number of Canadians going to the US for healthcare, and by a vast margin. However, it is not surprising, seeing that on the side of the border with the greater population, an essential product has been made a resorce of scarcity and an intensely expensive one, whereas it is free on the other side of the border. There will obviously be a massive pressure northwards. ---
**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\ **Post date:** [July 7, 2017, 2:16pm UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/59 "2017-07-07T14:16:22Z")
That’s an article from 24 years ago. With a greater awareness of identity thefts, Canadian governments have been amping up the security features on a lot of government-issued ID. I’d be curious to see if there is still an issue. ---
**Author:** ![Quartz](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/quartz/32/267_2.png) [@Quartz](https://boards.straightdope.com/u/Quartz)\ **Post date:** [July 7, 2017, 2:20pm UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/60 "2017-07-07T14:20:59Z")
> [@Merneith](#): > > The good news is you don’t have to waste a single penny hunting down the people who are trying to sneak onto the service because they can’t afford healthcare without it. Everyone is already on the service. This is not correct. You would have non-citizens trying to get care. Healthcare tourism has long been been an issue in the UK. [Previous page](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433.md?page=2) [Next page](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433.md?page=4)