> I mean the whole conservative argument about the value of the free market for moderating health care costs is completely blown up by the most cursory look at

> I mean the whole conservative argument about the value of the free market for moderating health care costs is completely blown up by the most cursory look at the value you get for private health insurance in the UK due to the fact that they have to compete with free. I disagree that they have to compete with free because they effectively compete with free footing parts of the bill and that is ideal. If you take the UK and you have a private insurance (like Bupa) you don't have private insurance instead of the NHS (the public one) but in addition to the NHS. One the one hand this means that I have the choice as a customer to go with an NSH or Bupa service, but I also know that the NHS will always take me and Bupa knows that I will think like that. Bupa knows that people are very unlikely to charge the private insurance for an ambulance (because why would I? The gov pays). However they know I will use their services when I had a mountaineering accident and need a helicopter. They fundamentally operate in largely different areas that just happen to overlap in some parts. Sometimes people use a private insurance because they don't want to wait. But that often also means they don't have to wait not because they will die because then the state system (unless it's temporarily broken) will prioritize you anyways. I think splitting the problem into two (emergency care vs. 'lifestyle' care) would work in the US but that's not the conversation that is taking place and that is a cultural thing more than it is a problem of politics.