You clearly don’t even know what a medicare advantage plan is or that privatized medicare exists.

Medicare advantage: the member pays an additional amount, the insurance company gets a stipend from the government per member per month so they are heavily incentivized to get members off of government controlled insurance. This insurance, to be clear, is only government funded, it is not government controlled. Rates for Aetna medicare advantage are brokered by Aetna, not the CMS (do you even know what this is?). These rates are also completely opaque: as a provider I am contractually obligated to not tell you that Aetna pays $98 for 45 minute psychotherapy (yay anonymity) but the cms has a lookup tool for full transparency that shows you they pay $104 for the same (Aetna MA underpays in my area, in some areas they pay as much as 140 for this service and the “contractually obligated to not disclose rates” is basically “don’t talk about your salary” tied to an service contract)

Again I work in healthcare, I run a practice. Medicare advantage plans, which Harris’ plan enables because she (and/or her colleagues in the dnc) is in the pocket of the insurance industry and absolutely will not rock the boat. Her system ultimately serves to shovel them more tax money again without fixing any systemic issues.

When you speak of European countries that have similar systems you must be referring to countries like Norway, Germany, and Switzerland with Germany being the most similar. The key differences? They have extremely tight regulation that keeps waste down and insurers reigned in. This goes back to my initial point: she proposes nothing to reign in the absurd administrative waste that makes up almost 1/3rd of our spending. Secondly while these systems are demonstrably and objectively better than what the US that does not eliminate them from criticism as they are still classist and prioritize care to the more affluent regardless of need.

My role in this thread was to never promote an alternative though I believe solutions were implied by my pointing out specific issues. I mention this only because I think it is another weasel tactic to discredit valid criticism by trying to defuse it when it is not attached to a solution. Valid criticism is valid criticism, and while moving forward with an imperfect system is often necessary one should not embrace a deeply flawed system solely because it is attached to buzzwords that make you feel nice.

That said to be abundantly clear: If I did so it would be medicare expansion with the eradication of private insurers. This is the most realistic path forward. A single tier system that treats all people regardless of social class, though there will of course be private practitioners who work cash only with the extremely wealthy oligarchs.

This would not necessarily fix all administrative waste overnight but it would address a significant portion of it (over half), create billing consistency, and allow practitioners to focus more on patient care freeing time for patients. This would give a true negotiation mechanism for patients and the government/cms as now collective bargaining would include essentially every American.

This would push hospital networks to address the other administrative overhead because reimbursement rates and budgets would go down.

Therein lies the other issue: a true solution to the problem means putting many people out of work. This means hundreds of thousands, maybe millions, of middle managers, administrators, medical billers, etc all lose their job overnight. What do we do about this? America has an absolutely shit welfare state as well so unless we plan for this we will never see this progress occur. People within and adjacent to the industry will be very susceptible to propaganda and will actively vote and advocate against progress for self preservation, similar to those in the fossil fuel industry who vote to destroy the planet and themselves so they can continue working in a coal mine because it’s not like the failed US state will take care of them. So welfare reform must occur concurrently.

This is a secondary issue though to getting leadership away from slaving for corporate dollars in exchange for favorable treatment. You can’t even begin to address the issue of voters if the voters don’t have any proper options placed in front of them. If all they get is the illusion of choice yet again don’t be surprised when they become disillusioned, do better.