> KP and Geisinger are the closest things I've seen in the US to European-style private healthcare, albeit more vertically integrated, yet why isn't it so popul

> KP and Geisinger are the closest things I've seen in the US to European-style private healthcare, albeit more vertically integrated, yet why isn't it so popular in the US? Kaiser has a reputation for being incredibly inflexible and rationing care to a degree that makes it a non-starter for anyone who has any healthcare needs beyond routine care (assuming they have an alternative to choose from). They have incredibly restrictive network rules, and they make it much harder to access non-routine care (additional hoops to jump through, etc). It's a very frustrating experience unless your care needs happen to align exactly with what their actuaries have determined is optimal. This is not really surprising - it's exactly what you'd expect would happen when an insurer is directly responsible for clinical care (as much as integrated capitated healthcare systems pretend otherwise by using different terms to describe themselves, at the end of the day, that's exactly what they are: medical practices run by health insurance companies).