The business case for a national health plan in the US of some kind has been overlooked; but the numbers are conclusive. There are two reforms needed: universal coverage and cost controls.
You cannot control costs as long as you have a private-sector dominated medical system based on profitability, conflicts of interest (doctors ordering services from hospitals or clinics they own pieces of) and medical-lobby-protectionist and featherbedding legislation. This ranges from criminalizing volume discounts from pharmaceutical companies to ensure obscene profits all the way to not licensing midwives or others to do procedures overpaid American doctors do exclusively.
That aside, the doctors went crazy in Canada in the late 1960s when our universal medical coverage was imposed for the benefit of Canadians. What happened was a nasty, lengthy doctors' strike in Saskatchewan -- causing people to die for lack of care (so much for the Hippocrates' oath when money's involved -- which turned the public tide against the gouging profession finally.
Now two generations of physicians later, doctors in Canada know what's best for them and here's the business/ethical case in favor of the medical profession:
1. The Canadian (and European) systems allowed them as physicians to take on all patients, not just the ones that could afford diagnosis and treatment.
2. They no longer had to chase down bills, argue with insurers or worry about payment. They now had guaranteed payment from the government.
3. They were also exempt from frivolous lawsuits over medical bills and, conversely, did not have to sue to get paid by people, sometimes putting them into bankruptcy or hardship.
4. American physicians must pay exorbitant malpractice insurance premiums, and face de-licensing if successfully or often sued. This can amount to US$100,000 or more annually. Canadians pay a fraction of that amount for coverage.
Next, Canada's hospitals -- all run by the provincial governments -- are administratively more efficient than US hospitals by far for three reasons:
1. They bear no expensive marketing department to draw patients into their facility, instead of the competition.
2. They do not have a large accounting firm, processing insurance claims and chasing down Accounts Receivable.
3. They do not have to spend millions on legal fees defending themselves and medical staffs against people who are suing because they cannot pay bills or, conversely, who must be sued for collection purposes.
C'mon America. You can figure this out. You're better at most things than most countries but not on this file. Washington is thoroughly corrupted by special-interest lobbies who deprive Americans of the health care rights that the rest of the rich world enjoys.