Shouldn't a country as wealthy as the United States have a healthcare system that enables coverage for all of its citizens?  Most would say yes.  Unfortunately, how to get there is the root of a wide ideological divide.  Reflexively, Republicans fret about the inefficiencies of bureaucracies, while Democrats warn about inequality, lack of access, and the need for government action.  It's easy to dig in along party lines, but that isn't going to help us solve a very complex and daunting problem.

As I've opined in numerous posts, government excess is the single biggest threat to our liberty.  Of course, I've also stated that there are many legitimate roles for government.  Is publically-funded healthcare (beyond Medicare, Medicaid, Veterans Administration) one such role?  The gross wastefulness alone of the current system should at least require us to explore other options.

Rougly sixteen percent of our Gross Domestic Product goes toward medical care.  That is substantially more than any other country.  Despite the enormous expenditure, the U.S. lags many nations in overall health.  According to various sources, we are 45th in life expectancy; 29th in infant mortality; and 19th out of 19 industrialized nations in preventable deaths.  Not a great return on our $2.3 trillion annual spend ($7,439 per person).  Clearly, much is wasted.  A mere 10% savings would shave $230 billion from the total—$100 billion more than the purported yearly cost of Obama's healthcare plan starting in 2018.  7.3% of the total U.S. healthcare outlay is for administration—compared to 2.1% in Finland and 3.3% in the United Kingdom.  Over $100 billion could be saved by matching Finland's administrative cost ratio.

The absence of a universal Electronic Medical Record (EMR) is the root of much of the administrative inefficiency.  Remarkably, as of 2006, fewer than 10% of American hospitals have implemented health information technology (HIT), and only 16% of primary care physicians use EMRs.  Amazingly, paper is still the dominant vehicle for healthcare transactions in the U.S.  Only 2% of healthcare industry gross revenue is spent on HIT.  By comparison, the finance industry spends 10%

Another primary source of healthcare overspend is the proliferation of chronic diseases, particularly heart disease and diabetes, that account for upwards of 75% of healthcare costs.  Logically, a much more substantial and targeted investment in prevention would likely carve hundreds of billions out of the total annual cost.

So, before we make the move to a government-funded system, might it not make more sense to solve the problems that are the source of the United States' disproportionate costs?  After all, government funding is not a free lunch.  The money has to come from somewhere.  Should we take it from education, or infrastructure, or defense, or green initiatives, or research, etc.?  Or, should we properly regulate, incent, and backstop the private sector?

Personally, I'd prefer to see a government-sponsored Manhattan-Project-type effort aimed at defining and implementing a universal Electronic Medical Record and also at putting into operation a major preventative care regime.  Those are foundational elements for any efficient healthcare system.  It would seem folly to attempt to renovate a house that sits on top of a structurally unsound base.  By eliminating most of the waste, costs should be materially reduced; thereby resulting in affordable healthcare for the masses, and a system more easily eradicated of inequalities.