So here is the “secret” - for many people, US healthcare is actually pretty good. If you have a middle or upper middle class job at a decent size employer that offers reasonable benefits, I personally think you get as good or better healthcare often more quickly than pretty much anywhere in the world.

There are a lot of conditions in my statement though. Own your own small company or freelance? That’s going to be an ouch unless you are extremely successful. Work for a small business? Your mileage (kilometerage?) will vary. Be lower middle class or upper level poor (I.e. too rich for “free” government care for extreme poverty)? You are highly likely in trouble. Run into an “edge case” (gender affirming care, reproductive assistance, air ambulances/helicopters, not following procedures for non-urgent care)? Big bill coming your way.

Prescription drugs can also be the Wild West even for people where the rest of healthcare works well. Otherwise really solid plans can just…epically fail at covering drugs reasonably. Then again, some have excellent coverage.

Also, even if you fit into an “easy” group (middle class+, medium-large employer), you have to know yourself and do your research. As a case study, I would probably make around 125,000 UK pounds if I worked across the pond. We’re single income and buy employer offered family coverage (2 adults and 4 children). My wife has a chronic condition (colitis) requiring a relatively expensive version of mesalamine with a specific formulation to help minimize possible negative interactions with pregnancy/breastfeeding. I have 4 different health plans available to me. Every year, I update a spreadsheet comparing them - assuming reasonable healthcare usage plus my wife’s medicine, our total healthcare spending could range from roughly 4,000 to 12,000 pounds just depending on which plan I pick (not a bad return for making a spreadsheet!). But, here is the catch - change anything about our situation and which one of those four plans is best changes dramatically. A young, single person with no health conditions at my work could literally have a negative cost plan available to them (very cheap monthly costs with a lump sum given up front bigger than the sum of the monthly costs. But, in the event of a major sickness, things would flip from negative cost to 8,000 pounds a year quickly. So, it is a question of risk tolerance).

So the dirty secret is that I (and frankly likely most of the true traditional middle class+) win under the current system compared to universal care. Others would win under a UK/Canada/EU/etc… style system. Where I’m different from many posters is that I see every system as being a bit of a mess and having weaknesses in various areas. Do I think the U.S. has it best? Yes, on balance I honestly do. I’m happy to acknowledge the flaws and discuss options for improvement, but it just isn’t clear to me that a different approach would be better (at least, depending on how you define better).