Just a quick comment about the “managed care”/for profit system vs alternatives.

Not sure what you would propose as a replacement but I do want to mention that having previously lived in Canada where healthcare is publicly funded, I would choose the current US system without hesitation.

As frustrating as it may be here, I have choices and access to services. Prior to moving to the US the wait list for a PCP in my area was apx 2 years. I don’t recall ever seeing a specialist without waiting at least 3-4 months, and you saw the provider they gave you. Preventative care is limited there and screening for common conditions is restricted.

An example of this is mammograms for breast cancer screening. Typically screening here starts at age 40 and occurs annually. In some circumstances initial screening will be recommended sooner, based on hormone usage history, genetic factors, etc.
When I left Canada an initial mammogram was not permitted until age 50 and then repeats were every 2 years.
I recall a coworker’s wife was diagnosed with breast cancer at the age of 47. She was dead within the year. I cannot say that screening would have prevented her death, but it may have allowed her a fighting chance, who knows? If she had been receiving annual exams from age 40 that is 7 years of opportunity to detect the illness that she was denied.

There was this general sense of health care being something that was given or gifted and not a service that the patient is paying to receive. It’s true that the user is not paying for that specific visit, but ultimately the taxes taken for the system have pre-paid for said service and there should be some accountability.

I’ve gone way off-topic here but did want to point out that the public funded systems have many problems that actually make them worse in my experience, and this reality is rarely reflected in the media by those who promote these systems as an alternative to what we currently have in place in the US today. Profit is not always a bad thing within reason, there needs to be a certain amount of financial motivation to continue developing new talent and solutions. Within reason and without corruption and political influence.

Yes what we have here is certainly flawed but we must be careful not to believe false utopian promises of better solutions that would make things worse. Any future solution will need to be carefully crafted with consideration for all stakeholders and objectives and hopefully without political interference/influence but instead with a common purpose of providing world class healthcare solutions.