I have yet to see an efficient nationalized medical service. They are usually MUCH better than the U.S. model (in that everyone has basic healthcare and nobody

I have yet to see an efficient nationalized medical service. They are usually MUCH better than the U.S. model (in that everyone has basic healthcare and nobody gets bankrupt), but I wouldn't use words like "efficient" and "cost effective" to describe them. At least within a democracy, they don't get "that" ossified, but you do get a massive, powerful and somewhat corrupt bureaucracy (at least in my country). I find it incredible that the waste generated is less than the waste from the U.S. insurance system, yet it is so.