I live under singlepayer health care. I like it, but it does have its downsides. For example, let's say you have something really severe going on, and you'd like to try a hail Mary. Well, you can't, as the only treatments that are available to you are whatever treatments have been deemed effective and reasonably safe by the regulatory agency. Experimentation, in lack of a better word, is a no-go.

I never experienced this as a problem myself, but I can easily imagine that someone could.

So I think the best is to have single payer available to everyone, but with private for profit doctors available if you need or want something a little more unorthodox and you have the means to pay for it.

EDIT: Seeing as I may have come off as a bit gloomy, I think I should list why I wouldn't want it any other way.

• My dad had cancer. Chemo and everything covered.
• My kid broke his arm this spring. The only expense was me buying a sandwich while they inserted a titanium rod into his arm.
• Same kid has ADHD. I can show up to any pharmacy in the country and fetch his meds (stock pending) without paying anything.
• His brother also has ADHD and poor eyesight on one eye. Meds and glasses covered.
• All of my kids were born in a hospital at no expense.
• I didn't learn until last year what the hell "copay" is, and the more I learn about it, the more thankful I am that it's not something I have to think about.

In the US. My partner has health insurance through her job, but she works remotely and the company is based in a different state so the insurance is, too. Partner severed her Achilles tendon about two months ago. Because of confusion about her insurance, every appointment related to the initial injury took an extra hour or more while the office staff tried to get in touch with the insurance company. Her MRI was cancelled because the provider of the MRI thought she was uninsured. She had to reschedule and ended up paying out of pocket for it to ensure it got done. Getting reimbursed out of her HSA took several hours of compiling receipts and filing out forms. After all that, and being insured, she still paid $4000 out of pocket. There's also a very low limit to the amount of physical therapy sessions insurance will cover plus there's a copay for every session, so that's an ongoing cost as well.

I'm in the US. For my early adult life, I had no sort of medical insurance, no job that offered any, and not enough money to pay for much. I don't know if that is typical. Midwife offered sliding scale for delivering the kids, there was a state kidcare plan so they could get the regular doctor visits, eventually I got a better job.

Now I have the most American style plan of all, the high deductible with an HSA.

So, most of my bad experience with our system here relates more to cost than quality. The care I have received has been fine, when I could pay for it, but I do live in a city with a whole lot of medical offices, so many doctors, seven hospitals, I don't think it's like that everywhere.

In terms of cost - I get about half of my gross pay as net pay after deductions for tax, (family) benefits, retirement, and the HSA, and with that I do have enough now in the HSA to cover that high deductible (that took years) but not enough to be confident in retirement, I did payroll for our other offices and it looks pretty similar all over, (in terms of amount , not where it goes, most places run most of all through taxes) but other places get more guaranteed benefits for their 50%.

My personal horror story is that I took the time to make sure I went to an in-network hospital before I went to the ER for what ended up being an emergency appendectomy. The surgeon was in-network...for scheduled appendectomies. Emergencies were contracted out to a different organization who he was working for at the time, and that organization was not in network. So I got balance billed for it. I took the payment my insurance company gave me and sent it to him and said "look, I did all this research ahead of time and at no point did anyone ever tell me this would be out of network, so this is all you're getting out of me." They left it at that.

In most developed countries, health care is rationed by need. In the US we ration by ability to pay. I would gladly pay more for worse service so long as care was rationed by need.

In Australia we have fully socialised medical care, but you can have private health care if you want.

I paid $0 for my kidney transplant and cancer treatment.

We also get no-interest loans that only increase with CPI from the government to go to university, which is paid back via a percentage of our income once we earn over a certain threshold.

This allows people to actually raise their social status, such as our current Prime Minister, who grew up working class in a single parent family in a poor part of Sydney, before going to university and succeeding.

If I was in the US I would definitely be bankrupt and most likely dead already.

I also earn more (as a teacher) and pay less tax overall than in most US states.

We pay about $300 a month in premiums for healthcare policy provided by the employer. We’re limited to 4.2k out of pocket but nothing at all is covered but the annual physician before that (medications are seperate and always have at least a copay).

Good years it’s fine, but a few years ago I had a skin growth they scraped to test for cancer and got billed $2,000 after insurance’s “negotiated” price that took a nice chunk of savings to cover. I’d gladly switch to any other system than the one we have here in the US…

Just recently filled some prescriptions: was told they’d be $100 each if using insurance, $50 and $75 if not using insurance. Our system is deranged. In the US.

I don't live in Costa Rica, but I have family there and they have combined. They complain that the private healthcare systems lobby to underfund the public heathcare system in order to turn people away from public healthcare, and off to their services where they make more money.

So combined systems cannot exist, if you want public healthcare then it should quickly phase our private.

I live in the US and was born here. This is true of my wife as well.

I hate to say it because I know how bad many people have it here, but our health care experiences have been excellent. IVF? We paid a few grand by the end of everything, but that's it - most of the cost was one hormone in particular. My cancer that almost killed me? We paid $15 co-pays for doctor appointments and physical therapy appointments, nothing for any treatments (radiation, chemo, surgeries, hydration, etc.), and about $15 co-pays for each prescription medication. My upcoming rotator cuff surgery? I'll pay similar to the cancer. Regular in-home therapy services for our children with special needs? Free.

This was not by accident or dumb luck. My wife and I have always chosen jobs in large part based on benefits in general and health insurance in particular. We may not make as much money on paper as job hoppers and those who chase the highest number on their paychecks. Do you know what we do have? No medical debt. Great parental leave. More vacation time than most. A legal plan that paid to set us up with every estate planning and life management document one could need.

So it's hard. Our system is fucking broken - too many people cannot get the care they need, or they go into debt to get it. It needs to be fixed. That said, I also have friends who just made shitty choices. They actively chose direct income over benefits. They gambled and some of them lost.

We need to fix US healthcare in or much every way. In the meantime? My wife and I choose to play the game by the rules as they are currently written, and we play with intent to win.

So stuff works out pretty well in my European country. Personally I never got anything broken, my friend had their hand re-broken because they never realized it was broken in the first place, only noticed that the pain lasted many months. They did not pay a single thing, but had to move to go through all the surgeries (to their parents). That kinda broke them.

Personally, I had a minor health surgery, that kinda left an ugly scar, which I feel like could have been avoided with better surgeon.

Also we have health insurance, and there it gets tricky. Like state owns one, there are more private ones, as some groups try to privatize the healthcare, and then you have to pay the insurance, you can choose which insurance it is, and in some specific cases, some insurers can order different regimes of treatment. Which may not be ideal in every case.

In Malaysia, we have private and public healthcare. We also have public hospital and clinic, where the first one will have specialist and bed and operating theatre and all those equipment, while clinic is a smaller medical center used to give medical attention for smaller issue(flu, vaccination, treat minor wound, pediatric checkup, that sort of thing).

While it's not free, it's super cheap and affordable by basically everyone. The downside of it is it's always full and the waiting list for non-urgent operation is rather long. Last i went for dentist, i paid rm3(rm2 for registration and rm1 for the work, add up to not even a dollar) for both registration and patching my teeth, where private dentist will charge upward of rm80 to rm120 just for a simple tooth filling. That's at least 26 times more expensive! The downside though, i'm only allowed to do one hole per visit, i got two slightly chipped teeth and one tooth causing me pain, so i have to pick the important one. which is understandable since it will take forever for a single patient if they want to do it at once, making the long line even longer.

I'm always glad public healthcare exists in my developing country, even when it's underfunded and overcrowded and not the best of experience and i barely use it, but visiting once convinced me that all country need it, it's a universal basic human right. I've heard countless stories that treatment that will normally cost rm10k and above is slashed down to rm1, though i also heard a lot of stories that sometimes it takes an upward of 6 months for simple operation because the doctors just can't keep up with the amount of works they have to do. It's a solvable issue though, and one can also use private healthcare for their need if they have the money.

On top of that, in Malaysia the government also have mandatory employees health insurance that employer need to pay for, so if anything happened at work place or when an employees traveling for work and something happened, they are eligible for getting insurance payout on top of free medical treatment.

As someone doing systemic healthcare management for a living (and for research purposes) I might be a bit biased, but basically there is no other way than socialized healthcare. Healthcare is not a market that is open - a patient that needs healthcare is in almost all cases not able to shop freely - unlike a regular economic market you are unable to hold back your healthcare needs (normally).

Additionally society pays massively when healthcare needs are not met - crime goes up, long term healthcare costs rise, the pressure on emergency services increases.