Obama 2007:

"I happen to be a proponent of a single-payer health care plan. The United States of America--the wealthiest country in the history of the world, spending 14 percent--14 percent of its gross national product on health care and cannot provide basic health insurance to everybody and that's what Jim is talking about when he says, 'Everybody in. Nobody out.' A single payer health care credit--universal healthcare credit. That's what I'd like to see, but as all of you know, we may not get there immediately. Because first we have to take back the White House and we've got to take back the Senate and we've got to take back the House."

No doubt these are his words, but when it came to time in 2008-09 to pass the legislation, he couldn't get the blue dog dems to go along with a single payer system and reverted to the individual mandate. At this point do you really think he would be willing to dismantle his signature legislation just to pull a fast one on the Repub's? Never. It's got his name on it: Obamacare.

No. What I think is that this will go one way or the other. Republicans rip it piece by piece if they take charge or the Liberals will move this to eventually a single payer system. Whatever it is today is not what it will be tomorrow. Obama just set the foundation for a (possible) single payer system.

We do pay more, but worse is subjective. There are many reasons we pay more. Demographcs are a large part of this. As is the fact that Europe's costs are strangled by price controls. These price controls are the reason why the doctor shortages are so much worse in Europe.

An American has an average wait time of three days for standard care and 6 hours for emergency care. In Sweeden the wait time on Emergency care is 3 days.

This is only partially true. Health insurance companies have low profit margins. The industry average is around 3%. Pharma, and medical suppliers make the money.

Dr. Vandenenden, from Sweeden did my foot surgery a few months ago. I stepped on a roofing nail and it implanted into the bone in my heel. He had to go in and clean some stuff up. My dad's cancer doc is also sweedish, and my mom's PCP is from Lybia. My wife's doctor is French.

The point in all this is that America's health system attracts doctor's from all over the world because they can make a great living. That isn't true everywhere.

Well, I tend to find those articles as far from proof of your statement. The first is an opinion of the health care system not an opinion of the quality of health which wouldn't be properly judged by only patients anyway.

The second also refers to both the healthcare system and the quality of healthcare in the same article. Also, they're basing it off of "health at middle age" or "life expectancy" at birth. Those things are hardly trends you can look at when determining quality of healthcare.

Same with the third.

I have none but neither do you. My evidence is strictly observational. I know if I have cancer, no place I'd rather be than MD Anderson. In fact, I can't envision a scenario where I would leave the country for a medical procedure. The point was, it's hard to argue that we don't have the best healthcare. Our system is screwed up bad and will be markedly different in 20 years whether we want it to be or not. That's just a fact. But the quality of our care, for the most part is excellent.

Can we dial this back a little? We are ALL speaking past each other and using statistics and quoting articles and news pieces to win a point here and there.

I think there are several different facets of health care that need to be looked at and in some ways they can conflict with each other.
I see two main ways to look at health care. The first is availability/access/cost. The second is efficiency of service/typical outcome vs best possible out come. Unfortunately both views take insurance and the way medicine is delivered (its availability, cost and terms) as the basis of the determination. IMO that ignores the potential available to change the whole equation in how it is delivered, accounted for and paid for in a way that will provide the efficiency required to cover more people with less cost.

Today I think it can be said that the US delivers the best high end health care available. If you have cancer, heart disease or some chronic problem there are more places here that can help than anywhere in the world. I would expect that for the upper 10-20% of income our life expectancy is at the highest level. However we pay for it through the nose. Look at the figures noted above our spending per capita is the highest in the world by far. That is tilted largely to the higher income brackets. If you look at the lower 10-20% of the population (by income) I bet their healthcare is poorer and life expectancies are significantly lower.

All that said I think our system has the ability to deliver the best health care possible anywhere. Unfortunately what is possible is very expensive the way it is delivered now. Also what is possible isn't realistically available to many. To me what is required is two fold. First to make the delivery of healthcare efficient and cost effective. The second is to make it affordable across a broader range of the population.

As I understand Obamacare, its main tool to reduce costs is to make everyone get insurance there by broadening the pool and spreading the cost across the bigger pool. However it also increases the cost by demanding existing conditions be covered, children under 26 be included in a family plan and there be in essence no cap on coverage. It also doesn't change the basic equation of how costs are measured and charged, by doctors, hospitals insurance and pharma. Finally it adds another layer (or more) of bureaucratic administration. I believe based on the past this will lead to greatly increased costs to us all and maybe catastrophic increases. There are enough neutral economic studies available to make this concern a valid one. That is my prime objection to Obamacare it didn't do the hard things required to set us on a really better path. IMO it ignored the real problem for a politically attractive Band-Aid. BTW while the Rs offered some interesting alternatives their blood lust to do in Obama cancelled any positive offers they had. They have no one to blame but themselves for their current position.

If there is a mandate that all get insurance then the insurance, health care services (hospital & pharma & doctors) should be opened up to real competition. There needs to be competition across state lines for insurance, hospital, doctor & drug charges be made transparent. I believe the real deal changer would be real open competition among the entire industry. Change the fee for service model to a fee for outcome/procedure that covers all charges including unexpected additions due to complications. Take bureaucrats (both public & private) out of the chain. There is much we can do to lower the real cost and broaden the number of people who can access the top level of healthcare that is possible.

All of those can be done under Obama care and should have been its first priority. The Rs should have dropped their absolute opposition and pushed for real compromise. Politics got in the way in 2009 and has ever since.