Quote from musingmom
I have no experience with single payer systems. However I would advocate neither the current situation, nor a single payer system. I personally think the solution lies in a free market system with an emphasis on coordination of care and management of chronic conditions, instead of our reliance on acute care and the primary care physician. Our current system is more like bringing a screwdriver and a crane to a construction site and expecting to build something (credit Atul Gawande).
I would like to clarify that the current reforms set to roll out have been (perhaps innocently) misrepresented by the previous poster. The initial penalty for not purchasing insurance is capped at 1% of your income. Unless one is making over $100,000 that amount is not in the "thousands." And I would gently suggest an income of that amount should support the purchase of some kind of health insurance. And, like all things tax, the number of dependents in a household affect that figure as well. Further, there are govt subsidies that will cover people who make too much to receive medicaid (I believe that's at 400% of the poverty level), but not enough to afford insurance. The gov't subsidies decrease as one's income increases.
My sources are the Kaiser Family Foundation and Healthcare.gov.
I always suspect, in these conversations, that the individuals proposing "free market" systems and that people who have a problem with paying for insurance just don't want to be responsible probably don't have any experience as an individual customer in our current free market system. You don't really get how bad the system is until you've tried to buy insurance on your own in our wonderful "free market." The last time I was unemployed for a significant amount of time, I went shopping for health insurance as an individual. At the time, I was in my early 50s and in excellent health except for one minor health issue which is stable on no medication/treatment and has been for a long time. The best offer I could find was $500/month premium with a $5,000 deductible -- that's $11,000
out of my pocket (each year) before the insurance would pay a single penny. Now, if I had been working full-time and making a decent salary, I might have been able to afford that (but, in that case, I would have insurance through my work, at a more affordable group rate).
Our system needs serious
changes, much more than the ACA (which is basically just minor tweaking of our current dysfunctional system) will provide. I am another of the many advocates of a single-payer system in the US.