The US also spends frankly absurd amounts on drugs and devices. In my country, generic drugs are the norm and you essentially need special permission to be pres

The US also spends frankly absurd amounts on drugs and devices. In my country, generic drugs are the norm and you essentially need special permission to be prescribed most drugs that are still on patent. I see a lot of Americans grumbling about their high out-of-pocket costs for drugs, but a lot of the drugs they're paying for simply wouldn't be routinely prescribed in my country on cost grounds. I think it's basically a fantasy to imagine that the US could have affordable healthcare if only the system was reformed. Rationing of various kinds is the norm in single-payer systems, because everyone wants the insanely expensive new drug when it's their health and someone else is paying; I don't think that America can do much to control their healthcare spending if they aren't willing to engage in a serious conversation about what they don't want to pay for. Even Medicare covers tons of stuff that I wouldn't get from my universal single-payer system.