I recently had a successful experimental surgery in this countries nationalised health service. Interestingly the idea had come from a study where the surgery I had was a control group and the 'real' group had a stem cell therapy as well. My problem was resolved, the single payer system didn't waste $100,000 on stem cell therapy. Good result. In the privatised system that carried out the original study the additional stem cell therapy is being done. It seems like optimising for profit optimises for cost.

I just wanted to add a story as well - my dad was diagnosed with a very rare type of stomach cancer called GIST about 15 years ago in Poland. At the time, he was one of ~6 other people in the entire country with this diagnosis, and the diagnosis was....bleak to say the least, I think the doctors were cautiously giving him 6-12 months max. However, company Novartis has just certified their "Glivec" drug specifically to use against GIST, since it targets the same cell pathways. Now, the problem - Poland does have nationalized healthcare, but Glivec was insanely expensive - basically a box of Glivec cost around as much as an annual pay for many people in Poland at the time....and my dad had to take two boxes per month. And no, because it hasn't been proven to work against GIST yet, it was not on the list of refunded drugs - so my dad was placed on a controlled trial conducted by the largest oncological hospital in Warsaw, where the study funded the drug for him. Long story short - the drug worked miracles, my dad not only recovered, he lived another decade after that(died of another cancer that sadly didn't have a miracle cure this time).

But - other people in this study didn't get the drug. I don't know if they were given placebo or just something else instead. My point being - they didn't survive, my dad did. After the study was concluded, the drug is now paid for by the national health service and anyone who needs Glivec can get it.

So why isn't this a critique of the nationalized system? Well, because the way I see it - in a private health care system, no one in this group would survive, because no one in Poland could ever afford this treatment. At least some of the people were still given a chance because the system has enough flexibility to at least try new and experimental treatments.

You're omitting that it's only a single digit % of the population that gets access to these expensive, specialized treatments.

The US has the best healthcare system in the world--if you're a millionaire.

Anecdotes and all that, but a friend of mine had Deep Brain Stimulation surgery for his essential tremor. The surgery was performed at Stanford and the total bill was in the hundreds of thousands of dollars. His out of pocket charge? ~$1200.

I have a hard time rationalizing his recent experience with the assertion that you have to be a millionaire to receive top-flight care.

Your friend must have outstanding insurance. Our out-of-pocket for a standard run-of-the-mill baby delivery with no complications was several thousand dollars--after what I thought was pretty good tech-company provided health insurance. I'll never forget my wife's reaction (who is not from the USA) at how absurd it is that someone would have to pay any money, let alone thousands of dollars, to have a baby.

I'm against the concept of privatised healthcare completely but within the privatised paradigm insurance only works properly to share risk across a population. A normal birth is not really an insurable event. Normal births are not a risk (in the sense of risk being a semi random events) since on average each women an America has about 2 in their life. In a privatised system insurance make sense as something to cover the risk of complications during a birth. So in a functioning privatised system with insurance working as it theoretically should any birth whether simple or with huge complications should cost the same amount of money. This is similar to dental most people spend X±Y amount of money over their life on dental work where X is high and Y is low. Insurance only works properly where X is lower and Y is higher (for example getting a rare cancer that costs $1million to treat is a very insurable event). Where dental is covered by 'insurance' the person paying for the insurance policy would be better just paying the dentist directly.

Meanwhile I am glad I live in a society with a nationalized health system where births cost nothing.

I have never figured out what "outstanding" insurance is, and my late father was a physician.

I just go with a PPO because that seems less crappy than the alternative. If anyone knows what metric leads to outcomes like my friend's (I'm not being facetious here), I would like to know.