I will post some links to things I’ve written elsewhere. My views on a lot of this range from skeptical to cynical. Noone should take these as comments on what “should be”, rather they are sad observations on what I think “actually is”:
We are actually talking about three different things (all legit):
1. Why does the US not actually cover 'everybody' the way, say, the NHS does? Short answer - the vast majority of citizens don't want to, or don't want to if they have to pay anything at all.
The numerical majority in the US gets a very good deal. Changing that deal in a way that the numerical majority would have to pay more or get less (which due to scale would have to be) is very hard indeed.
See:
EconoMonitor : Ed Dolan's Econ Blog >> CNN’s Sanders-Cruz Healthcare Debate: A Scorecard
And in particular the comments I wrote at the end (Bryan Willman)
Keep in mind that Medicaid covers 70million people, more than the total populations of France or Germany or the UK. It's not considered a great success.
Medicare covers another 50million if memory serves.
Which means the two largest programs cover about as many people as the population of Japan. Also keep in mind that because of how the tax system works, ALMOST everybody is eligible for medicare, but most assuredly NOT actually everybody. Medicare is as close to “universal” as the US has ever come.
This should give great pause to anyone arguing "the US 'can' and 'should' do what X does" – we might actually be socially or politically incapable of doing it. "The US is too stupid to do it right" might actually be true.
2. OK, but does it really have to cost so much? A system that doesn't cover some (smallish) parts of the population ought to be cheap, right?
There are lots of arguments about this, but as of this month I now think it comes to these two:
A. The US spends vast sums on lots of things, because we can. In fields where it's not clear how much is enough, and the stakes are very high, people will spend as much as they can "just to be sure." Healthcare and Education are the prime targets in the US. In fact, for someone living "the good life" in the US (which is *very good*) you could argue the rational thing to do is to spend 100% of their excess income on healthcare, in an attempt to extend the length of that goodness.
B. The US has a form of AxBxC cost disease, even worse than the say the UK. AxBxC is the case where A is consuming output from B which appears to be paid for by C. If you have health insurance from, say, MSFT (when I was there) all healthcare appeared to be free. No deductibles. No out of pocket. B (the healthcare industry) would be stupid not to take the money. C, employers, insurers, government, struggle to pay the bill. A (you and I) is actually paying the bill, but in opaque ways - you do not see it deducted from your paycheck, rather, you just get a lower paycheck. You don't see cost shifting, rather, you see higher bills from an inscruitable source.
Any 3rd party payer system, even one that runs its own providers (the NHS) will have pressures like this. (The US has such a system, called the VA. Go read about it at length before you decide that "VA for everybody" is the solution.)
C. Life expectency. The statistics for large groups can be very hard to interpret. Various reasonably credible sources claim that *my* life expectency (57yo white male) is at least 83. (We're talking about sources like the social security administration which have VAST statistical databases to work from - but which don't break down by race, etc.) Calculators adjusted for race, smoking history, etc. suggest the number is more like 90.
The chart PeteM started with is showing 78. Is it lying? Probably not. Probably a different datase, or from a different year, or not adjusted for date of birth.
(Life expectency for somebody BORN TODAY versus remaining life expectency for somebody at some particular age today are different.....)
Of course, this also means that the true life expectency of my mirror in France might really be 85, or 78, or 95. It’s hard to know.
Worse, for relatively small groups relatively confined scourages can make statistical life expectency look shorter than it is, by just a little bit. This appears to explain the drop in life expectency for non-rich middle aged white women. General health hasn't changed, but an alarming number of them are dying from alcohol and opioid scourages, and it changes the numbers.
Blogs I suggest its worth your time to look through and at least sometimes read.
Articles by Megan McArdle - Bloomberg View
EconoMonitor : Ed Dolan's Econ Blog >> CNN’s Sanders-Cruz Healthcare Debate: A Scorecard
Skip the woo-woo stuff for the analytic stuff, eye popping on:
Slate Star Codex
EDIT: this took so long to write I overlapped some posts above that raise similar points.