> So assume that the U.S. health system goes away and that no further medical research is ever conducted; we're left with whatever the state of knowledge is no

> So assume that the U.S. health system goes away and that no further medical research is ever conducted; we're left with whatever the state of knowledge is now, and it'll never get better. This is what I was somewhat obliquely referring to as "some people will die because the person who could've saved them has no incentive to". Again, there is no "would you rather". You can't treat these as binary options, and you can't treat these as operating in isolation. They're an array of systems that mutually operate within a global context. There is no answer to that question, because the dichotomy assumes both a binary and isolation. There is indeed a tradeoff between quality and access, and there's a worthwhile and necessary conversation to be had around that. But that's not the same as the difference between the US and the multitudinous systems within Europe (most of which are not single-payer). And it's not the same as the question you opened with.