Americans begging for money to pay for basic healthcare

No, it's not free, but as per one of the posts above, the average US household pays over $3,700 in taxes towards healthcare programs each year, and they still have to spend thousands each year on health insurance and deductibles.
 
In comparison, I earn an average salary in the UK and I pay only about £1,500 in tax towards the NHS each year... and I get all my healthcare included in that (bar the odd £8 prescription). I'm single, but if I had a family too and we were living on just my wage, my whole family's healthcare would still only cost just £1,500 per year.

Exactly.

For 2015 I calculated what my UK taxes would have been and we would have paid $3,500 more than we did that year in the USA but we spent almost $15,000 on healthcare that year. ($10k in premiums plus $5k in copays and deductibles)

Exactly.

For 2015 I calculated what my UK taxes would have been and we would have paid $3,500 more than we did that year in the USA but we spent almost $15,000 on healthcare that year. ($10k in premiums plus $5k in copays and deductibles)

Holy sh*t... you guys must really make bank then and have a high level of insurance.

Husband and I make about 50k GBP together and we didn't even pay close to that.

Holy sh*t... you guys must really make bank then and have a high level of insurance.

Husband and I make about 50k GBP together and we didn't even pay close to that.

If your income is more than 3 times the poverty level then you have to pay full price for health insurance, no subsidies under the ACA. The best I could find was $500/month with an HMO with very few doctors and hospitals in the network so since we travel a lot we had to stay with our unsubsidised PPO retiree plan at over $800/ month.

No, it's not free, but as per one of the posts above, the average US household pays over $3,700 in taxes towards healthcare programs each year, and they still have to spend thousands each year on health insurance and deductibles.

In comparison, I earn an average salary in the UK and I pay only about £1,500 in tax towards the NHS each year... and I get all my healthcare included in that (bar the odd £8 prescription). I'm single, but if I had a family too and we were living on just my wage, my whole family's healthcare would still only cost just £1,500 per year.

No they don't. The avg household income is 45-48k. Medicare/Medicaid is 1.45%. You're including social security, which has nothing to do with healthcare. Actual Medicare tax adds up to about $700. And that pays for healthcare premiums after you retire (obviously it really pays for current retirees and nothing is saved for you, but it is essentially you paying for your own future, not present, healthcare).

I understand how the U.K. system works. It's just like anything in a progressive tax structure. You pay a low amount no matter how much healthcare you need and someone making more money but needing a lot less care has to make up the difference. You might see that as an advantage to you, and it is, but someone else has to be punished with more than their fair share to give you more than you're actually paying for. That's a societal choice about cost sharing and has nothing whatsoever to do with cost, quality, or access to healthcare.


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If your income is more than 3 times the poverty level then you have to pay full price for health insurance, no subsidies under the ACA. The best I could find was $500/month with an HMO with very few doctors and hospitals in the network so since we travel a lot we had to stay with our unsubsidised PPO retiree plan at over $800/ month.

I'm not sure your age, but 500/mo is about double the baseline cost of an HMO plan. If you're retired or nearing retirement and making 48 grand more or less, then yeah that's what you pay.

That is exactly the band of people being punished most by the structure of ACA. Those cost should come down a whole lot if/when a replacement ever gets passed. You start giving more options on what to cover and to what extent then you can customize the thing to pay for what you need rather than paying extra for stuff you don't need or want.


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Actual Medicare tax adds up to about $700. And that pays for healthcare premiums after you retire (obviously it really pays for current retirees and nothing is saved for you, but it is essentially you paying for your own future, not present, healthcare).

I understand how the U.K. system works. It's just like anything in a progressive tax structure. You pay a low amount no matter how much healthcare you need and someone making more money but needing a lot less care has to make up the difference. You might see that as an advantage to you, and it is, but someone else has to be punished with more than their fair share to give you more than you're actually paying for. That's a societal choice about cost sharing and has nothing whatsoever to do with cost, quality, or access to healthcare.


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Medicare tax does not pay for Medicare premiums, the individual pays $134/ person per month, and that's only covers Part B leaving the individual to pay for 20% of costs and it does not cover prescriptions at all which is why most retirees also have additional insurance to cover that 20% gap plus prescription coverage. We had good friends where we lived in Texas in their early 70's who paid $500/month for a combined medical and prescription coverage Medicare Advantage plan in an HMO with a very narrow network of providers, and were pleased to get it that cheap.

No they don't. The avg household income is 45-48k. Medicare/Medicaid is 1.45%. You're including social security, which has nothing to do with healthcare. Actual Medicare tax adds up to about $700. And that pays for healthcare premiums after you retire (obviously it really pays for current retirees and nothing is saved for you, but it is essentially you paying for your own future, not present, healthcare).

I just quoted the amount from the post further up, which says:
$3,728.92 (or 28.7%) on health programs
I didn't investigate further to see what 'health programs' meant.

You pay a low amount no matter how much healthcare you need and someone making more money but needing a lot less care has to make up the difference. You might see that as an advantage to you, and it is, but someone else has to be punished with more than their fair share to give you more than you're actually paying for

Um, that's not exactly fair - you seem to be assuming I have a low income and expect other people to pay for my healthcare. I don't.

I work for the UK government as a civil servant. My base salary is close to the national average and so I used that figure to give an 'average UK salary' example of how much I pay in taxes at that salary. In actual fact, since I work 24/7 shift patterns and I work overseas 3-5 months a year, for the last 4 years my total earnings have been above the national average and not far off the highest tax band.

I also rarely get sick - I have no medical conditions, I have never spent a night in hospital, I have never had an operation, and I only usually see the GP once, maybe twice a year (usually just for a repeat prescription). The only medical things that has ever happened to me (so far) is a fractured ankle when I was 12. So, if anything, my taxes are supporting other people's healthcare much more so than my own... and that's perfectly fine with me. I believe that's how it should be - we all chip in to support each other.

I've learned that since I can barely navigate the insurance systems in the us as a patient, trying to explain them to anyone not living there is impossible. To change things though would be drastic, cost a lot of jobs and likely cause a recession even though it's in the interest of all people to have universal healthcare. They've been trying to pass a bill for it in my state for many years but it always dies in the conservative assembly.  Insurance and the medical system are a huge business, with very few controls on costs. The thing I find odd is that their profits keep going up but their provider reimbursement rates are flat or going down; so the actual doctors caring for us are being paid less. The amount of paperwork and bureaucracy is driving away young doctors I am sick, I need the system, I pay for it because I do earn enough, and I strongly feel like my health should not be part of a for-profit business. 


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I just quoted the amount from the post further up, which says:
$3,728.92 (or 28.7%) on health programs
I didn't investigate further to see what 'health programs' meant.

Um, that's not exactly fair - you seem to be assuming I have a low income and expect other people to pay for my healthcare. I don't.

I work for the UK government as a civil servant. My base salary is close to the national average and so I used that figure to give an 'average UK salary' example of how much I pay in taxes at that salary. In actual fact, since I work 24/7 shift patterns and I work overseas 3-5 months a year, for the last 4 years my total earnings have been above the national average and not far off the highest tax band.

I also rarely get sick - I have no medical conditions, I have never spent a night in hospital, I have never had an operation, and I only usually see the GP once, maybe twice a year (usually just for a repeat prescription). The only medical things that has ever happened to me (so far) is a fractured ankle when I was 12. So, if anything, my taxes are supporting other people's healthcare much more so than my own... and that's perfectly fine with me. I believe that's how it should be - we all chip in to support each other.

National average by definition means relative low income. In the US the lower 50% essentially have a negative tax rate. That is they pay nothing and we give them money back. That's less fica, state taxes, etc so they still pay a tiny bit, but essentially they are dependents of the state for tax purposes and that's up to the national avg income level.

You aren't chipping in together to help each other out. You're paying significantly less than the cost of the coverage you get and the difference is being made up by someone else who makes a lot more money.

I understand you aren't consuming as much coverage as you have, and others consume far more. You probably are getting ripped off for what you actually consume, but it's not pre-payment of consumed care that you're paying for. It is insurance against needing massive amounts of care if something were to happen.

Again, this is just how a progressive tax system and risk shifting works. It has nothing to do with healthcare. It's just a societal choice on do you want to force people to have healthcare coverage at the cost of their other vital expenses, or do you want to give them the choice to assume more personal risk in order to put food on the table and a roof over their head.

That's for each society to choose. The UK has chosen to force people to have a set level of care at the cost of holding more people in poverty and less economic growth. That's fine. The US has chosen to let people assume greater risk if they decide - or more correctly to tailor a plan to their needs rather than pay for stuff they don't need. Again, that's fine. It's not better or worse, it's just different.




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Huh, has the median household income in the US dropped since I last checked it? Where are you getting your figures texas2uk?

In 2013 it was over $52k.
https://www.google.co.uk/url?sa=t&source=web&rct=j&url=https://www.census.gov/content/dam/Census/library/publications/2014/acs/acsbr13-02.pdf&ved=0ahUKEwipxr-WoMDSAhWbOsAKHSR_BxkQFggsMAM&usg=AFQjCNH4nS2RnuAykIAQpRWYErqASsb0WQ&sig2=v5SG72I4_6TXNdAwgYGmCg

It was over $55k in 2015.
http://www.deptofnumbers.com/income/us/

And the below is just hogwash:
 

The US has chosen to let people assume greater risk if they decide - or more correctly to tailor a plan to their needs rather than pay for stuff they don't need. Again, that's fine. It's not better or worse, it's just different.
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Are you kidding me? You have obviously always had a bit of a privileged upbringing.

It's not about "allowing people to take a risk and to choose the kind of healthcare they want." It's always been about what kind of healthcare you can afford!

Most people want full coverage healthcare, one without a ridiculous premium, and affordable deductibles. But that has always been out of so many people's reach.

I can tell you I know dozens of people who simply couldn't afford health insurance (myself included) in the years before the ACA was put into effect. And honestly, that number hasn't changed since the ACA was put into effect either! It just helps more people who are closer to the poverty line.

It is pathetic that so many Americans are going into medical bankruptcy over longterm healthcare issues, cancer, and care after serious accidents. Are those people ones who simply gambled, and "chose poor insurance?" What about the people who were dropped by their insurance companies for having expensive illnesses like cancer or developing MS or Crohn's disease? Did they simply gamble on a poor insurance company?

When the previous Vice President of the US was going to sell his home to pay for his son's cancer treatments, don't you think that says something negative about the US healthcare system?

Actually you're probably going to say something snarky about him cause he's a Democratic, so that's probably not the best choice there.

Basically, I find your premise intolerable. It's a poor justification for the state of the US healthcare system. Saying that people have a choice in what healthcare they can afford. It's laughable.

Huh, has the median household income in the US dropped since I last checked it? Where are you getting your figures texas2uk?

In 2013 it was over $52k.
https://www.google.co.uk/url?sa=t&source=web&rct=j&url=https://www.census.gov/content/dam/Census/library/publications/2014/acs/acsbr13-02.pdf&ved=0ahUKEwipxr-WoMDSAhWbOsAKHSR_BxkQFggsMAM&usg=AFQjCNH4nS2RnuAykIAQpRWYErqASsb0WQ&sig2=v5SG72I4_6TXNdAwgYGmCg

It was over $55k in 2015.
http://www.deptofnumbers.com/income/us/

And the below is just hogwash:
 
Are you kidding me? You have obviously always had a bit of a privileged upbringing.

It's not about "allowing people to take a risk and to choose the kind of healthcare they want." It's always been about what kind of healthcare you can afford!

Most people want full coverage healthcare, one without a ridiculous premium, and affordable deductibles. But that has always been out of so many people's reach.

I can tell you I know dozens of people who simply couldn't afford health insurance (myself included) in the years before the ACA was put into effect. And honestly, that number hasn't changed since the ACA was put into effect either! It just helps more people who are closer to the poverty line.

It is pathetic that so many Americans are going into medical bankruptcy over longterm healthcare issues, cancer, and care after serious accidents. Are those people ones who simply gambled, and "chose poor insurance?" What about the people who were dropped by their insurance companies for having expensive illnesses like cancer or developing MS or Crohn's disease? Did they simply gamble on a poor insurance company?

When the previous Vice President of the US was going to sell his home to pay for his son's cancer treatments, don't you think that says something negative about the US healthcare system?

Actually you're probably going to say something snarky about him cause he's a Democratic, so that's probably not the best choice there.

Basically, I find your premise intolerable. It's a poor justification for the state of the US healthcare system. Saying that people have a choice in what healthcare they can afford. It's laughable.

I know it is what you can afford. I don't have health insurance now. I haven't for most of my adult life and avoided like the plague using it when I did have it because unlike the rest of you, my doctor had to report my condition to my employer and I could be fired if I developed a medical problem that might be an issue. Cause that's how the military works.

But, if you cannot afford both food and healthcare coverage, would you rather have a system where you can choose food over health coverage, or would you rather be forced to have health coverage even if having it means you can't feed yourself or your kids properly. Both of those are bad choices, but which one in your view is less bad?

Historically the US chose to let people choose food & other necessities over healthcare. If something catastrophic happened then they'd still have access to critical care, but in the meantime they could accept some more risk and get by.

The UK system chooses society over the individual. It forces people to have healthcare coverage even if they cannot afford other necessities because of it. There is not so much of a critical care for the uninsured cost borne by the community and more are held on n poverty at the same time the economy is restrained. That's fine too.

I'm not making a value judgement for one or the other. Both make tough choices on how to allocate precious resources when there is not enough for all the necessities.

Mathematically, full coverage healthcare with low premiums and low deductibles for everyone that also has easy access to quality care and covers things like preexisting conditions, preventative care, catastrophic, and long term... that is not possible. There are people for which that coverage should cost hundreds of thousands per year because they are guaranteed to consume that much. You can either cover them and pass the cost off on others or not cover them in order to give the masses what they want.

ACA attempted to split the difference, which gives no one what they want by making care for most people cost more while becoming less accessible.

For sure it is a tough problem, and I understand you want ACA to be a solution, but as you said it hasn't helped. It has slightly helped a few people at the cost of a lot of other people paying higher fees for coverage that doesn't give them access. And still it hasn't worked financially.

I don't care what someone's politics are. They're human beings and deserve to be respected as such. I also did not at any point advocate for one system or the other. I simply explained they are two different choices about how to allocate finite resources when there are not enough to support all the necessities for some people - either because they are poor or unhealthy or both. Whichever choice is made has nothing to do with healthcare and everything to do with the priorities a given society chooses in making their terrible lifeboat-style choice.

If anything, I may be confronting you with an uncomfortable explanation that says the US is indeed wrong but you shouldn't be so hard on them because the UK is equally wrong in another direction which you've not recognized as clearly before. Citing anecdotal tragedies doesn't change anything. I can spend years on the tragedies of poverty in the UK & it's just as bad.

This isn't politics. It should be the least political set of choices a society can be asked to make. It is just that all available options are equally bad in their own different ways.


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I'd rather not have to make the decision between food and healthcare... and in the UK I don't have to.

I may not always be in a position to afford food, but I will always have UK healthcare.

I don't get how you think the UK system 'forces' you to have healthcare coverage over food... because you will ALWAYS have healthcare coverage anyway, regardless of whether or not you have money for food.

If you never work and never pay taxes, you will still have healthcare... you are not forced to pay anything for it and therefore you can put any money you do have towards food instead, because you don't have to choose between the two.

If you do work, then you do contribute towards healthcare, but you never see that money anyway, since it's part of your income tax and is taken out of your wages before you get paid, so you just budget accordingly for food based on your take-home pay... just like you would in the US - except you don't have high health insurance premiums to worry about too.

UK healthcare isn't insurance coverage... there's no such thing as being 'uninsured' in the UK. There are no premiums, no deductibles... healthcare is considered a right and everyone is entitled to the same standard of treatment, regardless of whether you can pay or not. If you have extra money, you can choose to
pay extra for private treatment, but if not, you will still be treated anyway - often by the same doctors/surgeons who would have treated you privately.

I don't see what's wrong with that. The only real thing I see wrong with the UK system is that it's overstretched... it's in a lot of debt and is struggling to cope with demand and so it can't always offer all treatments/medications because they are too expensive for the budget.


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I know it is what you can afford. I don't have health insurance now. I haven't for most of my adult life and avoided like the plague using it when I did have it because unlike the rest of you, my doctor had to report my condition to my employer and I could be fired if I developed a medical problem that might be an issue. Cause that's how the military works.

But, if you cannot afford both food and healthcare coverage, would you rather have a system where you can choose food over health coverage, or would you rather be forced to have health coverage even if having it means you can't feed yourself or your kids properly. Both of those are bad choices, but which one in your view is less bad?

Historically the US chose to let people choose food & other necessities over healthcare. If something catastrophic happened then they'd still have access to critical care, but in the meantime they could accept some more risk and get by.

The UK system chooses society over the individual. It forces people to have healthcare coverage even if they cannot afford other necessities because of it. There is not so much of a critical care for the uninsured cost borne by the community and more are held on n poverty at the same time the economy is restrained. That's fine too.

I'm not making a value judgement for one or the other. Both make tough choices on how to allocate precious resources when there is not enough for all the necessities.

Mathematically, full coverage healthcare with low premiums and low deductibles for everyone that also has easy access to quality care and covers things like preexisting conditions, preventative care, catastrophic, and long term... that is not possible. There are people for which that coverage should cost hundreds of thousands per year because they are guaranteed to consume that much. You can either cover them and pass the cost off on others or not cover them in order to give the masses what they want.

ACA attempted to split the difference, which gives no one what they want by making care for most people cost more while becoming less accessible.

For sure it is a tough problem, and I understand you want ACA to be a solution, but as you said it hasn't helped. It has slightly helped a few people at the cost of a lot of other people paying higher fees for coverage that doesn't give them access. And still it hasn't worked financially.

I don't care what someone's politics are. They're human beings and deserve to be respected as such. I also did not at any point advocate for one system or the other. I simply explained they are two different choices about how to allocate finite resources when there are not enough to support all the necessities for some people - either because they are poor or unhealthy or both. Whichever choice is made has nothing to do with healthcare and everything to do with the priorities a given society chooses in making their terrible lifeboat-style choice.

If anything, I may be confronting you with an uncomfortable explanation that says the US is indeed wrong but you shouldn't be so hard on them because the UK is equally wrong in another direction which you've not recognized as clearly before. Citing anecdotal tragedies doesn't change anything. I can spend years on the tragedies of poverty in the UK & it's just as bad.

This isn't politics. It should be the least political set of choices a society can be asked to make. It is just that all available options are equally bad in their own different ways.


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Just, no. The US doesn't help you if something catastrophic happens, where are you getting that idea? That's why so many people go bankrupt from healthcare, there is no help.

The UK always gives you care, even if you aren't from here, you get free A&E care. Anything beyond that you have to pay for, but the A&E is free or if the UK has an agreement with your country it's free because the UK will be reimbursed for your care.

Are you seriously trying to say that Medicare and Medicaid are for catastrophic illnesses and injuries or are you taking about people becoming eligible for Social Security due to major injury/disability? If its not that, what help are you claiming that people get in 'catastrophic times?' Because that is NOT what any of those programs are for. They do not help you during the initial time periods until you fall under their very strict rules.

If you are in a terrible accident and you are taken to the ER, you had better hope they take you somewhere that accepts patients if they don't have insurance. My town had two hospitals, one took and treated everyone, the other only treated you if you had insurance or a valid CC.

And who didn't want the ACA to do what it promised? But insurance companies still want to make and beat their previous profits. So that worked out well for no one.

I wanted to see universal healthcare not this attempt to meet in the middle crap. The US is the only first world country that doesn't have universal healthcare. And why is that?

And by your logic people who have a longterm or autoimmune diseases don't deserve the same healthcare as everyone else because they would be priced out of being able to afford their care or simply not covered because insurance companies could choose not to cover them. What are these people to do for their care then?

Sorry, dude. I'm an American and I can see how flawed the American healthcare system is because I am no longer a part of it. It is a cash cow and it is being milked for all it's worth so the rich can get richer.

Yep, the UK system has some issues. Mostly what Ksand said, it's oversubscribed and underfunded. And the current government wants to cut NHS spending even further.

But the thing to take away is if you are legally living in the UK, you always have coverage.

Not so in the US. Not even close.

I'd rather not have to make the decision between food and healthcare... and in the UK I don't have to.

I may not always be in a position to afford food, but I will always have UK healthcare.

I don't get how you think the UK system 'forces' you to have healthcare coverage over food... because you will ALWAYS have healthcare coverage anyway, regardless of whether or not you have money for food.

If you never work and never pay taxes, you will still have healthcare... you are not forced to pay anything for it and therefore you can put any money you do have towards food instead, because you don't have to choose between the two.

If you do work, then you do contribute towards healthcare, but you never see that money anyway, since it's part of your income tax and is taken out of your wages before you get paid, so you just budget accordingly for food based on your take-home pay... just like you would in the US - except you don't have high health insurance premiums to worry about too.

UK healthcare isn't insurance coverage... there's no such thing as being 'uninsured' in the UK. There are no premiums, no deductibles... healthcare is considered a right and everyone is entitled to the same standard of treatment, regardless of whether you can pay or not. If you have extra money, you can choose to
pay extra for private treatment, but if not, you will still be treated anyway - often by the same doctors/surgeons who would have treated you privately.

I don't see what's wrong with that. The only real thing I see wrong with the UK system is that it's overstretched... it's in a lot of debt and is struggling to cope with demand and so it can't always offer all treatments/medications because they are too expensive for the budget.


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You may not have to, but people do. In the UK you're right, people do not have to make that decision. The govt makes it for them and chooses healthcare over food or child care or heat or whatever other necessity. That's fine. A society is free to make that choice. I'm not even saying it's a bad choice. The only thing I'm saying is recognize it is a policy choice that the UK has chosen to make, that the US traditionally left for individuals to make (at some public cost), and that the US under ACA is doing a bad job of trying to straddle the fence.

It doesn't matter if you recognize it as insurance or not. When you balance risk over a large pool of people and extract enough money from the pool to pay for the care consumed by the pool, that is insurance even when operated by the govt (note social security is actually called social security insurance).

The real question you might be looking for is if that's better operated in a competitive free market that drives down prices and increases efficiency but that also needs to make profits; or, by a disinterested bureaucracy that pretty universally everywhere in the world tends to be inefficient and not sufficiently responsive to customers. There's pros & cons to either choice. I'm not advocating one way or the other.

But you can call healthcare a right if you want. That's fine. But it is a societal choice to prioritize that over all other necessities. There's not the same kind of right for housing or food or other necessities. There is a public cost to having uninsured people. The UK govt chooses avoiding that cost as a priority over the consequences of not providing for other necessities. And that's fine. It is a sound economic decision. As an American I see it as the govt choosing to serve their rational self-interests (which they impute to collective society - though they sometimes should not), over the more American philosophy of government taking a hit to provide for individual choice (and counting on individuals to find the choices that are most efficient for them).

Still it isn't free. If someone is making very low wages in the U.K. then they're contributing less than the avg cost of covering an individual and some rich person is paying to cover a dozen people. If you take all of that money contributed towards healthcare and divide it out over the number of people covered, that number isn't so insanely different from one developed country to another, regardless of their method of paying for it.

If you want to make a choice about paying for it with a progressive tax structure such that people contribute based on their income, rather than a system where people pay for their consumption of a service based on their demand for the service, then that's fine. It's socialist, but the math works so it is a sound option a society can pick. But, that has nothing to do with healthcare.

I'm not really taking sides here. I'm just breaking down the choices these two societies have made. Both perfectly valid choices. Both with great success stories and with tragic terrible anecdotes about the unintended consequences of those choices.

We all make choices in our lives and ask our govts to make policy choices that we might try to influence. We have to make sure those choices actually add up before we make them or things will be much worse later. But after that we have to accept the negatives that come with the positives.

If you want to attack the US system then the way you do that is not talking about the tragic story of an uninsured person. Of course that's a terrible situation, but no one on earth decided to inflict those things on that person or allow them to happen. They made a rational good intentioned choice to have the system paid for through a competitive market and allow a small portion of the costs to be levied on those who demand the product but also try to maximize individual choice. If you want to attack the US system then just say you're against individual choice, favor bureaucracy over competitive markets, and want things paid for on the basis of the payer's income rather than their demand for the product. I might disagree with some of those choices, but that is an intellectually honest conversation about a choice between equivalent alternatives. It is good to take notice of the unintended side effects, but if you make them the basis of your argument or belief about a system then that's simply creating the other side as a straw man you can equate to being an evil heartless greedy bastard doing malicious harm to the folks in those sad stories. I can guarantee you that no sound policy decision can be made in the face of rhetoric like that. It can only make the world worse off.

THAT is what I'm trying to deviate from. If you like the UK or US system whatever other alternative, then great, good for you. But if we're going to talk about policy then let's have an intellectually honest conversation that recognizes everyone on all sides are smart good people trying to make rational choices, and that the choices they've made are valid functional choices that do far more good than harm.


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I'm not advocating one way or the other.

Well you certainly are:

"competitive free market that drives down prices and increases efficiency"

v

"a disinterested bureaucracy that pretty universally everywhere in the world tends to be inefficient and not sufficiently responsive to customers"

I find two problems. First, as much as we would like to believe the positivist stance that morals can be removed from a system...they can't be. How we work with morality is a quagmire, but it is there.

But also, we do have a tendency to look at these things through the eyes of the individual....healthcare is a very personal topic, but if you draw back a bit you begin to realise, like Beveridge, that society itself suffers and is inefficient without good health. Health, and you can apply this personally as well as universally, is the foundation on which everything else sits. Health care is very much a societal concern, and without quality care and a healthy population, any society, including America, will not function to optimal levels.