I don't get why the underlying problem is not even being discussed here at all. Any attempt to fix the system will have to increase investment in both training

I don't get why the underlying problem is not even being discussed here at all. Any attempt to fix the system will have to increase investment in both training and drug research. This will be a large investment (if doubling the training budget produced double the graduates that would not be enough), and will NOT bear fruit until those people actually graduate, which is 6 years minimum, and mostly 10 years away. So for 10 years, it means paying through taxes while getting minimum to no improvements in return. Furthermore, such a large increase is not possible at short notice, even if the money is available, so it will take more than 10 years time. For research one might take profit margins of large pharma as an indicator: a fully nationalized, but equally capable, pharma research system would cost some 15% less, assuming nationalizing introduces zero inefficiencies. BUT that money would have to come from taxpayers directly through the government budget. And nobody is looking for 15% reduction in drugs costs. That just won't move the needle enough. So in reality the government would have to increase the drug research budget to make drugs cheap. Failing to do this will mean medicine becomes less accessible to people, regardless of whether we switch to a single payer system or not. So let's get real here: we will fail to do this, and it will get worse.