Bigger government mean more legislation. If the government had it’s way, supplements would only be administered through a physician, and no preventative health care would even be allowed (Chiropractors fought for years to get what small amount of coverage they receive now). I doubt we would have access to Mark’s supplements either. These are only accessible because of persons like myself who actively fight against government regulation and control of natural health care. As it is now, the real cancer clinics who offer real cures are forced to operate outside our borders in Mexico. The problem with quality health care in this country has always been the limited access to it, not the cost of it. It’s not the government waging campaigns to get and keep raw milk on the selves. The longest living people on the planet live in villages with virtually no health care or health care facilities. Good health is all about taking responsibility for one’s own health. Medicine, socialized or not, should not be the solution to our health woes. Sorry for any errors as I typed this up quickly.

Here we do sort of have a two-tiered approach. Everybody has access to the NHS(National Health Service)and, if you want to pay extra to someone like BUPA, you can opt to have private cover… the main benefits of which are that you can leapfrog waiting lists and private clinics are nicer to look at (the surgeon you see will do private and NHS work so quality of care is no different, although you will probably be treated to a one-bed room).

Everybody who works in the UK obviously pays PAYE tax which (in addition to council tax, VAT and various stealth taxes) covers the stuff that tax generally covers (plus our politicians ridiculous expense claims). We also pay National Insurance at a fixed percentage of gross income on a monthly basis which covers the NHS.
So, it’s not really free – I pay around £250 a month towards it currently. If it made people feel better, we could privatise the NHS and we could all pay that £115 to a non-government body… but the problem then is that people would get blase about it, stop paying and then be up a creek when they fell over or developed cancer.
My view is that by having it as a government body which we basically pay another, separate tax on, we are protected from ourselves (the human tendency to say “it’ll never happen to me” and therefore try to save a few quid by not paying).
People who are out of work get their NI paid by their dole money – I do however, think that the scum in this country who are long-term dole-ites (by which I mean the lazy sods who won’t work, not those who can’t due to medical/mental problems or caring responsibilities) shouldn’t have access to the “free” service for anything other than emergency treatment.
As I said, growing up in a place where this has always been the case (under 18’s go free by the way), it seems strange to me that people do not want their governments to provide this safety net. I remember watching the movie John Q a few years back and, not knowing any health system other than ours, I could hardly believe the predicament they were in. I have always seen the US as a bit of a trail-blazer and the ultimate modern country but on this issue it seemed miles behind! As I said earlier, this is by no means meant as offence – just the view of an outsider looking in. Our NHS is by no means perfect (it’s always being bitched about over here) but when there is an emergency you can not knock it.
Incidentally, our healthcare workers (surgeons through to nurses) have their training paid for by the NHS and work for the NHS on qualification for a set period of time before making the decision to go private, stay as they are or combine the two. A lot of private clinics have an NHS contract where they commit to seeing a certain amount of “free” cases (which they are paid to do by the NHS, which is paid for by us, through the NI).
A couple of people above made the comment that you should not expect professionals to give their time and skills away for free which I agree with to an extent… but I have always felt that if someone was embarking on a career in healthcare, then you’d like to think they didn’t have money as their primary motivation. Everyone deserves to be compensated for their time/services but if the system Obama is proposing is anything like ours, they will be!

“A government big enough to give you everything you want
Is a government big enough to take away everything you have.”

Gerald Ford

1)Shorter Training times for doctors. I feel you are wrong here. One of my attendings once said that he could teach a monkey to do surgery. This is true. The problem is not the mechanics but everything leading up to and after the surgery.
Sure I could order an MRI and determine that a tendon is ruptured, but what then… Which of the numerous procedures would be most appropriate for that patient. Following the surgery an infection develops (accepted rate in orthopedic surgery is 1%). Which antibiotic should you use. Should you go back to the OR and do an incission and drainage? These are just a few of the questions that can and often do arise. Only doctors who have seen these complications in the course of a rigorous residency training program will be able to handle them properly.
You do see providers such as Nurse Practicioners and Physician Assistants who have generally shorter courses of training who do an excellent job, most of the time. But its when the you know what hits the fan that you want a doc who has seen it all and is comfortable with his skills.
2) You mentioned a system where people were discouraged from elective surgeries. This sounds nice on paper. “Great no more of those silly elective surgeries to gobble up our healthcare dollars”. But when it is you who has chronic and unrelenting pain from a severly arthritic ankle, or hip you may feel differently. I could easily envision a scenario where the “single payer” doesn’t outright say no but rather strings the process along so long that people live with crippling pain. I’m not even saying this is wrong per se. At the end of the day you only have so much money to go around. But I gaurantee that those who have mone will have that bad ankle or hip fixed. They may pay out of pocket, but it will still be done. In a way this almost seems worse to me. I have a friend who practices in Spain he told me that in the morning he sees his state sponsered health care patients and in the afternoon the self pay or private insurance patients. Wait to be seen in the AM 6 months, wait for the PM 6 days. Oh and if you live in England dont bother getting Renal Failure after age 60. The nationalized health insurance doesn’t pay for Kidney dialyisis for the old or infirm. (in other words you die) This might sound ok on paper, and ultimately that is what you have to do if you only have so much money, but when it is your mother, father, brother, wife you may feel differently.

In conclusion I dont know the right answer. The path we are on isn’t great but proposed plans dont inspire much confidence in me either. HMO’s and managed care were supposed to reign in health care in the 80’s and 90’s but worked too good. Doctor’s didn’t want to participate anymore and people didn’t want to either. I fear a state sponsered system wont do any better.