Pros & Cons

Adopting a national health system in the US has several potential strengths and weaknesses. On the plus side, a national health care system (like the one in Britain) would ensure that everyone has a least a minimum level of health care. At a population level, benefits would be maximized, although at the expense of a minority of individuals (to me it seems reasonable to require someone to be a healthy weight to receive a knee replacement). And do the people receiving costly, experimental end of life care really choose it for themselves? To what extent are they and their families persuaded and pressured by the medical community to further research and profits (e.g. the infant who received a baboon heart)? In the UK, if you have the money you can even choose to buy supplemental insurance to cover the extras or pay out of pocket. In terms of overall cost, it is hard to imagine that such a system could cost more than our current one, but the flow of money would be re-routed. In fact, it would likely cost less when all was said and done because it would eliminate insurance profits, would emphasize primary care, coordinate care, etc. Providing health care for those under 65 wouldn't be that expensive relative to what the government already spends on the elderly, the poor, and the disabled especially when money is diverted from having to pay health insurance, out of pocket fees, etc. Having a national health system is pretty much the largest pool of risk possible. Plus, the government would benefit from an economy of scale and would have much more leverage in terms of regulation and costs.

However, it is doubtful if Americans would ever accept such a system. It would also be difficult to ensure that the system was equal across all states and regions. The US is geographically and culturally diverse that a one-size-fits all approach would not work, but variations might be deemed unfair. There would be huge resistance by the medical community, insurance companies, and pharmaceutical companies who would seek to preserve their interests at all cost. Likely they would try to find some loop-hole to exploit the system. There might initially be a huge demand and strain on services if changes were made overnight and a national health system would have to be phased in gradually.

Overall, a national health system would be preferable to the system currently in place, but a social insurance model would be even better. Although there would be a great deal of resistance at first, I think that once it was in place, people would wonder why they ever favored the old, private, for-profit insurance system.