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I think the average middle class person you're trying to get this message to is also aware that American single-payer is far more likely to look like Universal Medicaid rather than Medicare-for-all. And also that Medicaid is known for being, for lack of a better word, "cheaper" [1] [2] [3] [4] than Medicare. Few of the good doctors take Medicaid (more, but not all, take regular Medicare), or there's frequently a waiting list unless you have private insurance or pay cash (I've literally overheard a receptionist having this conversation while waiting for an appointment before). Even within Medicare, Part C private-insurer-run ("Advantage") plans are more popular than vanilla single-payer Medicare (A and B) these days.
Ultimately, I think the biggest part of the problem is that even once cooler heads prevail (we're pretty good at throwing out ideas here, at least), the American Healthcare ship is huge and can't be steered on a dime. We need not just a valid concept and details of a final system, but also how we get there from here. Simplify the complexity of medical billing and procedure payouts (IMO the easiest starting point)? What do we do with the 200k odd medical billing specialists (plus whomever at the health care networks and insurers negotiate prices annually), and who's going to be checking for fraud? Cut doctor salaries? Not going to be popular and the AMA has huge power, plus many really do have student loans for med school to pay for. Someone's (or many's) oxen will have to get gored, and most politicians don't seem willing to make the sorts of enemies-for-life we're talking about here.
Universal Medicaid does seem the most viable option, and it's not that different from what I hear is done in Germany, which I understand is a two-ish tier system, and it's much easier to get appointments with private insurance. That isn't to say that I like it, it just seems easiest. Gradually reducing the Medicare eligibility age at least sounds promising as well, but probably has pitfalls I'm not considering at the moment.
[4] Correlation does not imply causation, but I've also heard plenty of
horror storiesanecdotes of Medicaid providers doing worse/old-style and maybe-unnecessary procedures.More options
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