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Bernie never spoke about banning private healthcare.

I find it amusing you think there is a free market for healthcare in the US.

Bernie's main idea is to destroy all forms of monopoly in various industries in the US - banks,healthcare. It's no different than state capitalism ( in USSR ).

Bernie is not against the free market. He wants single payer to leverage the free market in healthcare which is dominated by big players on the supply side.

You as an individual are free to afford whatever you want. But the govt's concern is improve the standard of living for the average citizen. And all of the world it has been proven time and again that single payer is the best system - empirically. So any arguments you make without any data but on some notion of "choice" will not be as convincing - sorry.

Bernie's whole plan is predicated on eliminating private health insurance. In order to achieve the "savings" that he promises, he needs to be able to go to doctors and hospitals and say "take this, or you get nothing".

Without that bargaining power, he'll just push the entire health care industry private. That's already happening with Obamacare now (reference all of the health insurance companies stating they are considering withdrawing from the exchanges).

Not really. Private health insurance and fully private hospital care exists in most (all?) states with full state-sponsored medical coverage. Ultimately, if people don't have to pay for health insurance any more, a huge proportion won't. Which means the state becomes the single largest buyer of healthcare, probably bigger than all the other players put together, and so should be able to get better value for healthcare than the private companies ever did. Better cheap treatments than a half-empty hospital. And a state health insurer also doesn't need to advertise itself to consumers or pay shareholders, so it should come out ahead even if it's unable to pay any less per treatment than the private companies.

Of course, it's still dire for the health insurers because their customer base shrinks massively when private health insurance becomes a luxury to get people more expensive and faster specialist treatment as opposed to the only way to be able to afford to not die from expensively treatable ailments. But there's no reason to assume that some/most wouldn't continue to provide the option of more expensive and more exclusive healthcare for those that don't trust the publicly funded system or want to beat the queue.

My original comment wasn't about banning private healthcare, it was about a government forcing people to pay for a product or service that isn't acceptable, or actually damages people's lives because it is managed so poorly. The Citizens of Flint still have access to bottle water, thank goodness, but they still have to pay their city water bills unfortunately. The same would go for Bernie Sander's health plan whether or not the service provided was actually worth the price paid.

>>You as an individual are free to afford whatever you want.

That is not actually true. I'm spent the afternoon searching for health insurance for my wife, who is pregnant, and trying to immigrate to the U.S. Thanks to the 2,000 pages of ACA regulation, there is no clause or loophole that allows us to purchase insurance for her. Your argument using 'data' is not sympathetic nor persuasive to me.

> Thanks to the 2,000 pages of ACA regulation, there is no clause or loophole that allows us to purchase insurance for her.

Are you saying that the ACA is the reason your wife can't purchase health insurance?

Yes, because before the ACA, there were at least options available, albeit expensive. Her situation is complicated, but now there is pretty much nothing available that she qualifies for. Or worse, if there is, I am unable to locate and communicate with those people who can help me, and the people in charge of helping me are not properly trained (another example of the situation above). I've talked to our State's Office for Insurance, and they're trying to help, but are also frustrated (and very sympathetic) with the situation.

Bernie's real expectation is that things will get better if people get off their butts and take action. I doubt he believes that government programs will be magically efficient and effective without the right people to make them that way.

Government jobs are available. You can't really complain about something being "managed so poorly" unless you're one of the people in that organization trying to make it better.

Currently the U.S. has a system where doctors' offices need SEVERAL full time staff just to deal with insurance companies, which is insane and nothing like what I have seen elsewhere.

>>Bernie's real expectation is that things will get better if people get off their butts and take action. I doubt he believes that government programs will be magically efficient and effective without the right people to make them that way.

The problem is, with a government program, we're all forced to pay into it, no matter how good or bad the program actually is. When you are forced to pay for services from an organization, you have every right to complain about how poor those services are if you suffer because of them. If you expect that a government program will be great because Bernie hires the right people, what about the next President, and the President after that? The capabilities of individuals is government statistically by a bell curve and normal distribution. Even if you can select the very best person to manage that program for 4 years, the law of regression to the mean dictates that some future hire will be less capable. So how to we prevent mediocre people from eventually filling these positions, and thus wasting the money we are forced to pay in taxes to fund them?

Well one thing to consider is that a great many countries have managed to do it so we aren't exactly charting scary new territory. We've essentially been told that this has succeeded so the real question is why haven’t we at least tried our own version of it?

Every single job or project has the risk of eventually being taken over by less competent people (or at least, people who didn't understand the entire original vision). Every taxpayer has to live with the fact that he or she won't agree with everything the government does with money. I would have personally loved to have contributed no tax money at all on the military wastes of the last decade, for example. Taxpayers don't really get to choose at a low granularity, otherwise everyone would find some way to cherry-pick to the point that nothing big could get done.

The way to fix it is to put skin in the game personally. Quit your job and apply to work for the government; or, write to a congressman and really press on them that you consider this important; or better yet, tell 50 of your friends and get some network effects; or join some larger group that petitions for change (as so many other groups do).

Your points are not completely unreasonable, but there is more to consider. I agree with you about wasting tax dollars on military affairs in foreign countries, but at least those expenditures are (theoretically) temporary.

Consider that many other countries, mainly in Europe, have managed to put in place a single-payer healthcare system over the last 20-30 years. In the time span of governments and the legal system, this is the blink of an eye. Again, consider statistically that eventually someone incompetent is going to be put in place running one of these systems. This happens in government, and it happens in the private sector (how many firms are in the S&P 500 from 20 years ago?). The difference in the private sector is, when failure happens, individuals are free to choose a competing option, and are not forced to continue to pay for the failing one. I'm sure you've heard the lines about how competition in free markets (truly free, not highly regulated insurance) drive down prices too.

Consider also that no benefit system has lasted longer than a generation and been successfully managed by a federal-level government. The closest we have is Social Security, which is well on it's way to bankruptcy here in the U.S.

Furthermore, the great majority of what are considered good single-payer healthcare systems have been implemented in countries with Parliamentary Style Governments. What this means is when the party in power is no longer doing it's job, the citizens or opposing party can vote them out, more or less ASAP. The difference with this and our Constitutional Style Government is that if we elect the wrong person, or they put the wrong person in charge of our healthcare, we have very little power to change the situation for 4 years. In this sense, those Parliamentary Style Governments operate closer to what an actual free-market operates, giving their Citizens much more power over who runs and manages their single-payer healthcare system than we could.

The reason we haven't tried our own version of it is, because once it is implemented, it is very, very hard to change or roll back. Furthermore, as is with all the data coming out about Obamacare, it is very hard to actually judge whether such a program is actually successful.

>The voters had very little recourse like they do in the free market where they can just go to a different healthcare provider, because they are forced to pay taxes for the VA hospitals either way.

The average voter does not have enough income to have an actual choice. The way it goes is that you pick your GP from a list (so you have a little bit of choice there), and when you have a significant issue, your GP works with a specialist and your insurance company to decide if you qualify for any further care. You can get it without the insurance helping you, but you are risking bankruptcy doing such.

As it stands, other countries spend less on health care with better outcomes. So we can definitely improve the system.

That being said, I'll support privatized healthcare if we can get the same done for police care and CPS. If you don't like the people protecting you, then you can get seek out new ones.

Here's a program for market-based healthcare reform:

1. Eliminate incentives for employer-based insurance. Give legal protection to insurance cooperatives, where individual people could come together to buy insurance as a group.

2. Eliminate restrictions on buying insurance across state lines. This will take care of state-level regulations that drive costs up.

3. Eliminate artificial caps on the number of seats in medical schools, currently set by the AMA with government backing.

4. Loosen other requirements for medical licensure, like four years of undergraduate study in a totally unrelated program. Why are the people of America paying for Doctors' underwater basket-weaving courses? This and the previous point are a political minefield, so you can accomplish mostly the same by letting Nurses or Physicians Assistants to do most or all of a doctor's job. People can still choose to spend more on AMA-approved doctors, but it should be their own prerogative with their own money.

5. Institute an (at least initially) government-backed catastrophic insurance program for when people have ridiculous amounts of medical bills that they can't afford. This is probably what the market would have produced over the last century if not for government meddling.

6. High-deductible plans + health savings accounts are actually a pretty good idea. It puts people directly on the hook for their routine medical expenses, so they shop around and find lower prices.

Milton Friedman wrote a great piece with some of these ideas in 2001: http://www.thepublicinterest.com/archives/2001winter/article...

Allow the FDA to recognize drug approvals already approved in other comparable countries.

Eliminate Certificate of Need programs for the establishment of new hospitals.

Along with your #3, you could work to increase the number of fellowships that doctors use to restrict the supply of doctors ready to replace them.

Make HSA dollars be giftable, and/or don't allow them to be use it or lose it.

Make all medical spending be tax-free.

> The voters had very little recourse like they do in the free market where they can just go to a different healthcare provider

Many have no healthcare providers.

> It's not just about how much in taxes you would pay; it's about the risk of you actually getting quality care for what you are forced to pay in taxes.

Americans face the same risk now. Many Americans have no effective access to health care, and, for example, hospital error is a leading cause of death (as of a few years ago, at least).

The rest of the rich world manages to implement national health care systems, pay (very roughly) half of what Americans pay, and get the same results - much better because all of their citizens receive health care. It seems unbelievable to me to suggest that the U.S. couldn't do the same.

Why would anyone insist on paying twice as much for a worse product? It is really a choice of dogmatic ideology over rationality.

Right now there are still 29 million who are not covered and most of them probably never will be because it will be too expensive. And the current system doesn't cover everything for most people who are insured. Single-payer would cover everything from drug addiction to mental issues to cancer. How many families go bankrupt from having to deal with things like cancer?

And prescription drugs are too expensive, and currently Obama is trying to make that a reality all over the world, not just in the US, thanks to TPP and TTIP. Obama was also the one who banned Americans from buying cheaper meds from Canada to maintain Big Pharma's monopoly in the US.

Not sure I understand about going to a different healthcare provider. You can still go to a different hospital if one is too full.

Yeah, but if there is only one insurer - the U.S. Government, if they deny your claim, you can't choose a new insurer next year.