Life expectancy is more than just healthcare policy and I've a source to back it up. More Americans are likely to die from car accidents and violent crimes than a hospital or a prescription drug bill but more the matter is how are you guys getting decimated by the likes of Singapore with your so called "efficient" universal healthcare system ?

What's more is to add insult to the injury is that Europe has a relatively ethnically homogeneous population which means most countries with "universal healthcare" don't face similar challenges with having to treat a diverse population like you would see with an ethnically varying demographic from America or Singapore yet where is your justification that you guys are somehow getting "value" for your money when Singapore on the other hand massively undercuts you guys by a fraction of the cost yet they earn MORE per capita ?! (they also enjoy longer "lifespans" than most of you Europeans on average that you guys like to cite so much as a metric for judging the "quality" of a healthcare system)

Publications and citations aren't everything but what matters most is VALUABLE DATA! Experts will tell you that China often has bad data most of the time and that America has the highest quality data produced by all nations and we can observe the results. In a little under 5 years ago, the US brought a Hepatitis C cure to the market which continues to ravage millions of people with the condition to this day but with China we can see just how disastrous their results were when they suffered from a nationwide medicine scandal a couple of months ago on top of the many other health scandals they've experience in the past decades ... 

Take it from a scholar here who specializes (although not in medicine) in an applied science that pushing out papers is cheap but the hardest part being is conducting the experiments and collecting good data to back them up but most importantly take it from the man who was instrumental to the development of a Hepatitis C cure ... (science is more than just the papers of which having good data is more important) 

Finally, what advice might you give to young scientists today or those considering a career in science ?    

"When I started my first undergrad research in a real lab at Cornell, I was working for a senior grad student, and he says to me “Mike, you know, I want to tell you this first: Eighty percent of what you do will fail. Twenty percent of what you do will succeed in research. If you are not happy with that 20 percent success rate, you don’t belong here.” It stuck with me forever because science is an endeavor where there is a tremendous amount of failure along the way. But the successes—especially in the field of medical research—are tremendously gratifying. You really do have the ability to impact people’s lives throughout the world, and there are very few endeavors I think that will afford you that opportunity." - Michael J. Sofia

Not sure why Singapore keeps getting brought up, but it's an example of extremely efficient government regulated healthcare. The government controls all pricing and subsidizes 80-90% of all medical costs for everyone. It is government controlled universal healthcare, which is something that think you're supposed to be arguing against fatslob, so Singapore is just yet another example of how much better the US healthcare system could be with government controlled cost measures instead of allowing corporations to grossly profit off of sick and dying people.

Of course, other first world countries also have great hospitals, but it's usually a single one that specializes in a certain area. Even the specialization of Princess Margaret, there is still a US based hospital that bests it on the metrics PMCC judges itself on (although, it's still excellent, so you're splitting hairs for this direct comparison). As for the Canadian billionaire question, it's a case by case thing. They'll go to whatever hospital the specialist or surgeon operates out of. That works in the US's favor as they pay more on average and are more willing to spend on R&D.

Of course, "Best in the world" can be hard to measure. It was more of a general statement meaning that US based hospitals and surgeons would have the most representation in the top 10 of every major care category than any other country.

Well wouldn't that mean that those million people don't see the value in having health insurance ? Insurance can only work on the basis that the unfortunate few is subsidized by the larger customer pool ...

Disregarding all of that I still wonder why democratic strongholds like California and New York which are one of the 3 most populous states haven't tried passing a motion for state subsidized healthcare program yet when these are the states with the most ideal conditions for attempting a policy experiment that are consistently stated to have numerous multiple ideal conditions such as a large patient pool and the fact that they are one of the higher income states per capita so what's the hold up ? I can maybe understand New York since democrats don't have a majority in the state senate but California on the other hand they have a clear super majority in both of it's state legislative chambers to do nearly whatever they want yet it's so intriguing that they also won't try since out of the two states California is the more important state to experiment with the idea which would send a bigger message ... 

Not true, the state only funds one fourth of the medical costs per capita. The rest is paid for by the citizens themselves but do try explaining yourself why somehow countries with "universal healthcare" has yet to catch up in value with the likes of Singapore which is mainly privately funded ... 

Of course, I don't deny that Singapore does regulate the health market such as most of their citizens prescription plans don't involve covering very expensive specialty drugs which cuts costs appreciably that you would see everywhere in America so there's one point to get you started ... (monoclonal antibodies or biologics isn't cheap to mass produce) 

Try harder next time though ... 

I'm not sure why you put universal healthcare in quotation marks. Healthcare is universal in Singapore. It's just not a nationalized system (like nearly all countries with universal healthcare). The main objective is to get the government to control healthcare costs instead of private interests. In Singapore all prices are controlled directly by the government, whether it's a public or private medical practice, both are entirely regulated by the government, which keeps costs low and the care efficient.

I'm not sure what to make of your NY example... so I'm just gonna move past that.

People moving in and working would pay high taxes to cover their government provided healthcare, which should be most. Private insurance tends to exist in countries with single payer healthcare. There would inevitably be price controls for public and private options I assume.

Its a mess if you push this at a state level or country wide. It will not be a smooth transition where everybody is happy either way. So lets try making people unhappy at a state level first.

It's "accessible" almost like a regular household utility such as water and electricity but by no means is it "universal" since citizens have to privately fund most of it themselves ... 

At this point "universal healthcare" like we see in the vast majority of western liberal democracies today is synonymous with a nationalized system when we constantly see tons of advocates recommending America to emulate the European model ... 

I have no doubt that the government has a hand in keeping costs low but is that supposed to be the right model for Americans where extreme rationing happens under Singapore and while being several years behind pharmaceutical technology ? (Singapore shortchanges pharma companies really hard despite the fact that they can most easily pay for the exorbitant prices but I guess they're happy being just a trading hub where they have no intention to have a competitive pharmaceutical industry unlike Switzerland who has shit ton invested to the point where Roche and Novartis is a corporate national pride to them and that 30% of their exports are pharmaceutical products) 

Each and every system or model has their own downsides and upsides so it's impossible for them to outright supersede each other. Most europeans seem to think that they have good balance between value and innovation ratio per cost even though their nowhere near as good as Singapore in the former and admittedly in the latter where they aren't quite upto American standards with an uncontested lead in biologics (b) which is the most innovative field in medicine ... 

If we all really wanted to be as cutthroat in savings we'd be copying Singapore by sun setting the pharmaceutical industry, prioritizing preventative care, overworking our medical staff, and heavily taxing many causes of mortality ... (a lot of freedoms to give up such as owning a car, resisting the drug war when most illicit substances are harmful effects and of course less treatment/doctor options too) 

I mean, there is quite a bit of precedent of universal/single payer healthcare starting off in just one part of a country. Take the Canadian healthcare system for instance, which started in just one relatively tiny province of Sasketcheawan.

The issue with doing it in a single state is that there isn't a single state which doesn't have its politicians completely bribed and at the beck and call of Corporate America, who will fight tooth and nail for its blood money profits rather than having a cheaper more efficient system set up.

Vermont tried single-payer, the proposed taxes were too high for the population.  

https://www.politico.com/story/2014/12/single-payer-vermont-113711

The problem is that the federal government takes the bulk of the taxes, and any increased state taxes scare away even strong economic leftists (which Vermont definitely has.) 

Really, the U.S is probably going to have universal healthcare eventually, but it will probably be a multipayer Bismarckian system like Switzerland's, Germany's, France's, The Netherlands', etc.