A good summary of the issues facing competing health care schemes at Poligazette:
What are the implications for these observations on the eternal debate over health care in the U.S.? Mostly that advocates should dispense with the illusion of easy solutions or romanticized models from other countries. Any increase in access funded by the government will either require a massive increase in costs paid or a significant decrease in availability. There is no free lunch at the cutting edge of technological health care and slogans about social justice won’t produce MRI machines to feed demand in the absence of profitability. Yet, refusal to increase access makes those wonders merely theoretical for a huge proportion of the population, probably more than two-thirds. The miracle of high-tech capitalist health care has a dark side in the neglected masses who die needlessly within sight of its unrivaled glamor.
European systems have largely chosen the option or prioritizing access to primary care over access to advanced care while the U.S. has heretofore chosen to prioritize advanced care over broadening primary care. Modifying the U.S. choice while avoiding the killing of the golden technological goose is a challenge with which no health care plan I am aware of has yet seriously grappled.