The American healthcare discussion is such a complex one, because it is not about health outcomes. It is about insurance and access at this point. Only when everyone has both of those can we begin to take on the outcomes challenges. Trying to get past those two concerns is virtually impossible because of the number of well financed lobbies who influence discussions on the issue. It is a catch-22. Until there is a single payer system to remove the power of the lobbyists, the potential for a single payer system is DOA. Without that, health outcomes are irrelevant and it remains driven by the profit motive.
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