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> if I have major surgery, I will only be out a couple thousand

I'll tell that to my buddy who is a general contractor. He put off major ankle trauma surgery for 6 weeks until his insurance kicked in. The alternative was $40,000 out-of-pocket.

Sounds like you really don't like the single-payer system. Let me recommend Paul Starr's "Social Transformation of American Medicine". I'm pretty sure he hates the system more than you do, but his book walks through the history of how we got here while other countries got to other outcomes. It becomes undeniably obvious that opinions like yours were manufactured by agents of the political parties and the medical industry without your realization.

As a skeptical small business owner, I really encourage you to get some more facts, do a lot of homework. Go read that book. Because this system will bankrupt you. It has bankrupted major American corporations. You alone, as busy as you are, cannot win against millions of smart people who have a century of law and public signalling to have crafted the information environment that created the system of thought in your brain right now.

"Hospitals are required to take care of you, even if you have no insurance in the US."

Trouble is, that only applies to emergencies. If you just want to see the doctor about the funny lump you have to pay first.

"We need to get rid of the bloated government-supported insurance companies and let the free market decide the price of everything."

So when I break a leg I should pay the ambulance to drive around different hospitals collecting quotes for the treatment? This doesn't work for a number of reasons:

1: Most obviously, urgent treatment is urgent. Collecting quotes will take time.

2: Hospitals won't give a quotation for medical treatment. They prefer a cost+ situation, partly because they then make money no matter the outcome, and partly because the costs are so variable that you can't estimate the cost. Just how much is that funny lump going to cost? After a few $K of tests you might be able to put a lower bound on it, but not an upper bound.

3: Medical costs for something serious are bankruptingly large for most people. One serious illness and you have to remortgage your house. Insurance is the only option, but then people at serious risk of illness or injury are more likely to take out insurance, and people who are already ill can't get it or change it. Imagine if you have epilepsy: every few months you wake up in ER and they hand you a $5,000 bill. No insurer will touch you.

>Medication is fairly inexpensive and if I have major surgery, I will only be out a couple thousand (the cost of a laptop).

Have you actually ever had a major medical problem? Medication can run in the thousands (or be $5, it varies) and even minor surgery is several thousand dollars out of pocket minimum and certainly more expensive than any laptop. It's also a struggle to afford even the premiums for some people

I don't know how accurate this is but I recall hearing that something like 40% of personal bankruptcies in the US are due ot medical debt.

I'm speaking from experience. If I wasn't high income I dont know how I'd be able to afford my bout of illness.

>Medication is fairly inexpensive and if I have major surgery, I will only be out a couple thousand (the cost of a laptop).

Okay, now what if you don't have a couple thousand lying around? There are many people who can't afford a laptop.

>I have many relatives in Canada and the only reason the system works there is because it borders the US. They get all of their regular care paid for by their taxes and the middle class drive over the border and get major surgery done.

Yeah, this is the shitty part of single-payer, public healthcare. That's why many countries in Europe have a hybrid private/public system. Canada, as you mentioned, effectively has one too.

However, the point of a single-payer system is to ensure that everyone can afford the most crucial, urgent treatment. We're talking about being in an ambulance and being driven down to the ER.

If you live in Canada and suddenly require urgent treatment, you can go to the hospital nearest you, because there's no such thing as "out-of-network" or "in-network". You can get treated by any doctor. And you'll get the same consistent billing everywhere you go, precisely because it's a single payer system.

Having grown up middle class in Canada, I don't know anybody that went to America for "major surgery". Generally speaking where that does happen is with elective surgery, because wait times can be long in some places. Those people are usually not middle class either, I don't know many middle class Canadians with $40k on hand to drive down to the states for surgery.

> the middle class drive over the border and get major surgery done

AFAICT it's pretty rare, and usually done to receive a 'experimental' treatment not approved in Canada.

> The waiting lines are pretty long for most major surgeries and many older people die before they actually get it

Source?

AFAICT the wait times are bad for things like hip replacements and cataract surgery. Not so for things like cancer.

> Medication is fairly inexpensive and if I have major surgery, I will only be out a couple thousand (the cost of a laptop).

I suspect that not everyone would think this is a small amount of money. From this article:

http://www.theatlantic.com/magazine/archive/2016/05/my-secre...

"Nearly half of Americans would have trouble finding $400 to pay for an emergency."

Heh. Be sure not to get in an accident (very often another party's fault) and require multiple surgeries or PT. The person to whom you responded sounds young, like someone who has never seen what cancer or a bad car accident will do to a body. Let alone what walks into a county hospital.

News flash, folks: physicians in the UK and Canada still make a bit above a living wage. It's the insurers that suddenly have to compete, like when a school district finally gets its shit together and parents start wondering why they're paying $40k a year for equal or worse outcomes.

Granted plenty of Canadian plastic surgeons split to practice in the US, but that's a different (and competitive) market.