emphasis on realistically. I guess I don’t consider single payer realistic right now for a couple reasons.
Neither political party wants to offend the rich and powerful, and single payer would offend them because it cuts medical costs. This is a major issue, true reform requires cutting medical costs and neither party wants to do that because the medical industry is 3 trillion a year, and that funds a lot of political attack ads.
Because our health care system is so bloated and overpriced, the taxes needed to fund it may be so high that nobody wants to try.
Single payer, right now, seems like a pipe dream. It was defeated in Oregon by 80% of the vote. Vermont passed it, then balked when they saw how much taxes would have to go up to fund it. California talks about it, but that is all they ever do. Talk.
Even in the deep blue states (California & Vermont), single payer is just a talking point.
But anyway, per capita health expenses are now $10,000 a year in the US. Within about 15-20 years they’ll be $20,000. Then $40,000 in ~30-40 years. Meanwhile wages aren’t really budging. Virtually all economic growth goes to the rich and has since the early 70s.
What happens in ~30 years when it is $40,000 a year in per capita health expenses, but median household income is maybe $90,000 (neither figure adjusted for inflation). We are already at the point where even dual income college educated couples are having trouble affording health care.
What happens in 5 year intervals going forward? What are the likely scenarios for 2020, 2025, 2030, 2035, etc?
Will market forces drive prices down somehow (maybe more international travel for care)? Will market forces result in massive investment in robotics? Will some state actually pass single payer? Will massive relocation out of the US become an issue?
how will retirement planning be affected if one day in the hospital can wipe out 30 years of savings and investment? Or when 70% of your retirement savings are eaten up by medical costs not covered by medicare, and the other 30% goes to all other expenses combined (housing, food, luxury items, transportation, etc).
Or will Americans just continue to do what it seems they are doing, avoiding care and looking for alternatives (or just hoping it goes away)?
Or will health care become so overpriced, that it stops growing in price because people stop getting it? Personally if I were elderly and had an expensive illness, I think i’d rather just die so I can leave a nest egg for my children’s generation rather than spend it all in 1 month on health care.