I agree - a lot of the issue in the US is that there isn´t any effective competition (or control of) the drug companies and price gouging. A single payer will h

I agree - a lot of the issue in the US is that there isn´t any effective competition (or control of) the drug companies and price gouging. A single payer will help tackle that. But the key question is, why is American healthcare so expensive, and for such poor outcomes - measured by life expectancy at least? You can lop off a few percent as the cost of running the insurance company infrastructure, but it still doesn´t explain all of it. Nor is it the case that US patients are subsidising other patients drug costs - not all drugs are researched or manufactured by US drug companies. There is a supply element to all this as well, and it´s not just drugs. Let me give you one example from the UK, since I don´t know the US figures. One of the problems in the UK is that doctors are very expensive, and there aren´t enough of them - this isn´t because of their student loans, it´s because there´s a shortage of doctors. The NHS imports a lot of doctors from abroad to cover this (causing issues in their home countries), the US does the same. (If you´re a doctor from a country with low cost medical training the markup for working in the US is insane. I digress.) Dig into the statistics for medical training in the UK, and it becomes clear that the number of places has been held more or less constant, while the base population has increased significantly, and you can put whatever fudge factor you like on the population needs more healthcare because of obesity/ageing/excessive tea drinking, etc. http://dera.ioe.ac.uk/16155/1/medical-and-dental-school-intakes.pdf http://dera.ioe.ac.uk/16155/1/medical-and-dental-school-inta... (p11) Finally - this year: https://www.gov.uk/government/news/up-to-1500-extra-medical-training-places-announced https://www.gov.uk/government/news/up-to-1500-extra-medical-... Which unfortunately won´t have any real impact for at least 6 years or so. To solve the american health care problem requires essentially a large scale attack on the cost of the health provisions, and that has to be across the board, and it´s going to take years just because of the lag times involved. Personally I would start with simply doubling the number of medical school places - maintain standards on admission - and work on dropping the salary levels. Provide scholarships so students don´t need big loans. Attack the anti-competitive practices of the drug companies directly, etc. In other words, remove artificial supply bottlenecks, let the market sort it out... and have some kind of bailout ready for the existing medical professionals, and medical providers, who then can´t repay their loans. Making the rest of the world pay US prices...isn´t going to happen. Sir Alexander Fleming was Scottish.