I’ve riffed on this a few times various places, so I felt it necessary to put down my essential two cents in one place. To wit: we’ve got a compelling interest in state healthcare even by the debased standards of modern politics and management.

Why? Because the current system - and any system even close to it - is abusive beyond belief.

My father’s a doctor. He makes two hundred thousand a year - and he wants socialized medicine. He’s not a soggy lefty - a pretty centrist Democrat, actually - but the plain and simple fact is that it’d be better for him and for his patients. (And considering he works trauma in a tourist town, that latter part is really important.)

As a doctor, you go through a decade of specialized, mind-bogglingly intense training and make scads of money. Scads. Doctors and lawyers are the two professions whose fairly large incomes don’t scandalize me; they require a lot of education, field work, devotion - and personal efficiency is directly proportional to how well society benefits. Doctors and lawyers are exactly who ought to be making hundreds of thousands. (Along with many workers who do not - like hazmat workers, engineers, and most importantly, pedagogues.)

As a hospital administrator, you spend a few years getting your MBA and, if you know the right people in college, you can wind up making tens of millions. Doctors and nurses aren’t the ones benefiting from the absurd excess expense of American medicine; almost all of it is funneled at a breakneck pace into the yawning maws of the American profiteer class. The people who profit are the insurers, the administrators, and other private bureaucrats. (I will return to private bureaucrats in a later article - how abusive they tend to be in an economic system is seriously important to many topics.) They’re the source of the red tape, the reason that the hospital fleeces people blind for simple procedures; they’re who fucks you in the hospital. Pretty much everything an experienced physician in a quasi-public system does is an elaborate effort to keep them from putting it inside you hard and deep until you hand them your credit cards and cry.

Most doctors are in the business of improving human life, not battling red tape. But just doing the day-to-day tasks of a hospital can put them within the power of the business-school assholes running the place. Take a burn victim, for instance.

They need their skin grafts, so you’ve got that once they’ve healed. (It’s expensive - but that’s a given.) In the meanwhile, you wrap them up in gauze. Then you have to come back the next day. You take off the old gauze, inspect the wound, debride (scrape off dead skin to keep it clean) as necessary (or don’t if not), apply disinfectant, give it a final once-over, and then dress it with new gauze. The procedure takes between five minutes and an hour.
The hospital breaks it down into six procedures - and charges more than $250 for each. Eighty cents of each dollar of that go to administration - which gets most of its supplies dirt cheap, so hey! Bonuses aplenty.

The insurers keep this system alive, because if people actually had to pay $2500 to $3000 for a wound dressing, they’d quickly decide to do it themselves, infection be damned. But the insurance company pays a fraction of that.

And then bills the client as if it paid every cent - and often, the hospital appeals to (and gets!) subsidies from the state for taking the reduced (but still insane) payment.

This basically makes medical insurance vital to good health (where in an even vaguely functional system it’d only be necessary for people in poor health or prone to accidents), ensures it’ll stay expensive, and makes sure that anyone who doesn’t have insurance will basically be in debt for the rest of their lives whenever anything goes wrong.

And if the patient dies, goes into a coma, or eventually goes bankrupt? Why, of course, the taxpayers pick up the tab. Can’t have the hospital going without their $3000 Band-Aids and Bacitracin, after all. There’s the repugnant irony of all the corporate shills screaming about how awful and expensive socialist medicine would be: if it weren’t for assholes like them, we’d be getting better healthcare for less money and the people delivering it to us would be paid better for it. Even those who don’t need healthcare would be paying less for it, for Christ’s sake.

The only ‘positive’ they’ve managed to hammer into the general public is actually a hideous negative: the stalwart defenders of the capitalist parasites ruining our medical system seem to honestly believe that the fact that private healthcare keeps people from seeking treatment outside of emergencies a good thing. One of my dad’s favorite anecdotes is about the guy who left a wrench clamped on his dick for two days (stuck there by a persistent, mechanically forced erection, known in medicine as priapsm); he refused to go to the clinic out of embarrassment until it became a crisis, and wound up losing it. If only he’d been willing to swallow his pride, stop withering at the shame of it all, and actually go into the clinic when he needed to, he’d still have that wrench.

Similarly, the public is best served by a population receiving regular checkups, getting care early and often, and generally being taken care of by the mechanisms designed to take care of them. You can’t tough out infectious disease, and trying to do so when you have other options makes you an asshole; in addition to being stupid and counterproductive, it gets everyone around you sick. It’s how epidemics and flus and shit like that work. The discredited Reagan-era Rand study glibbies like to bat around pretending that free healthcare = people using healthcare more and getting less out of it would be preposterous even if it weren’t a profoundly disingenuous and methodologically bankrupt fraud perpetrated by shameless intellectual prostitutes. The idea that using more healthcare can be bad would confuse most doctors, because they almost never see a case where they don’t wonder if things wouldn’t be better if the patient were in the office sooner.

We are the mightiest economy on Earth, and our medical profession is the planet’s best. That makes the staggeringly intense effort by money-grubbing assholes to put that to waste in the interest of their own pocketbooks all the more shameful, and the willingness of capitalist whores to defend that effort all the more irritating. You really get the sense some of those partisan idiots would sell their own children to get a white man rich. It’s the principle that matters, evidently.