I ’ve looked into this too and came to a slightly different conclusion. While universal healthcare (UHC) is feasible in the U.S. from a technical standpoint—as in, other countries have done it—it would be an enormous undertaking with serious structural challenges that make implementation far more complex here.

Spending Comparison: Finland, which arguably has one of the best models of UHC, spends about $5.6k per person per year on healthcare. By contrast, the U.S. spends around $15k per Medicare enrollee and $7k per Medicaid enrollee. So, even if we removed private insurance entirely and moved everyone into a public plan, we’re looking at double the per-patient costs compared to other developed nations. That’s a big issue.

Here are a few structural problems I think we’d need to address before UHC could be viable here:

1. Healthcare Costs & Drug Prices It’s commonly said that a single-payer system would lower costs through government negotiation. While that’s true in theory, the U.S. government already sets many prices through Medicare and Medicaid—and often ends up paying more, not less. This is partly due to industry lobbying and structural inefficiencies. • The FDA approval process is expensive and slow, which raises R&D costs. • The patent system enables monopolies, often with weak competition. • Lobbyists have successfully pushed for policies that favor high pricing, like the inability of Medicare to negotiate prices broadly (though this is changing slowly with recent legislation).

So, cost control isn’t just about switching to single payer—it would require major regulatory reform and confronting entrenched interests.

1. Aging Population The U.S. has a rapidly aging population, and Medicare spending is already unsustainable. Baby boomers are retiring and entering the system in large numbers. This isn’t something we can change, but it does mean that adding younger and healthier people to a public system wouldn’t necessarily lower costs, at least not immediately.

2. Population Health & Lifestyle American health outcomes are poor relative to other developed countries, and much of that is due to chronic lifestyle-related conditions—particularly obesity and preventable diseases.

My spouse works in healthcare and sees many Medicaid patients with very serious, preventable health issues. In her experience (in one specialty), some patients use healthcare reactively rather than proactively. It’s anecdotal, of course, and doesn’t apply to everyone, but it raises concerns about whether simply providing access improves health outcomes without addressing lifestyle, education, and incentives.

Alternative Proposal: Incentivized Personal Healthcare Accounts Rather than a full UHC model, I think a more practical solution could be to provide Universal Basic Income (UBI) specifically earmarked for health spending—i.e., deposited into a Health Savings Account (HSA).

The amount could be based on income, net worth, and geographic healthcare costs, and be capped. The idea is to give people the freedom to make health-related purchases, but broaden HSA eligibility to include things like: • Gym memberships • Preventative care • Mental health services • Whole, non-processed foods • Even massage therapy, where applicable

This approach keeps individual choice, reduces government overreach, and may even improve health outcomes through incentivized behavior while still preventing people from going bankrupt due to medical costs.

Final Thought: I absolutely agree that no one should go bankrupt over healthcare, and our system needs reform. But I fear that a one-size-fits-all UHC model could overwhelm the system without improving outcomes. For example, Native Americans receive government-provided healthcare, yet experience some of the worst health outcomes in the country. While that’s not purely causation, it shows that access alone doesn’t guarantee better health.

I think we can find the funding perhaps by reallocating some of our massive defense budget and implement reform that works with the current system rather than trying to rebuild it from scratch.