Capitalism, nepotism, public, private, insurance, nationalised healthcare ... the GP is saying that these are methods of dividing up available care, not methods for creating more available care.
X is the amount of medical care available
Y is the amount of medical care wanted
If Y < X there is no problem with any of the systems. And, obviously, a certain amount of inefficiency doesn't affect patient care. Plus, perhaps relevant today: when shit hits the fan we can scale up available care quickly.
If X > Y it doesn't matter which system you choose, someone will go without. You can change who goes without but you cannot fix the system by changing the method of dividing care.
Can things be somewhat improved with better organisation? Sure. Probably. But let's not overestimate it either. Let's take a dream scenario: optimal organisation can make 20% more care available. How much more care is wanted? I think we can safely say the US population wants 200% or more than the current system provides. Whilst nobody's opposed to improving organisations, it cannot fix the problem.
Fixing the problem is something you can only do by doubling the medical training available. That'll be a lot of extra dollars, none of which go anywhere near patient care for at least 10 years, so I would expect a lot of strong opposition from a lot of sides. But it's the only way to fix things.
Looking at spending per capita it's clear that American problems aren't caused by lack of money in the system.
They are caused by high barriers of entry, which in turn are caused by entrenched elites gatekeeping jobs through absurdly high tuition fees, expecting everybody to take lots of student debt and a very litigation-friendly environment. These costs are then passed on to the general population through a byzantine system of health insurance that leaves a lot of people uninsured.
> Let's take a dream scenario: optimal organisation can make 20% more care available.
In 2020 UK spent 3278 GBP (~4400 USD) per capita on healthcare [1]. USA: 12,530 USD. That's about 3 times less or a difference of 200% [2].
In UK life expectancy is 81.2 years. In USA it is 78.79 years.
3 times more spent to get a worse outcome doesn't seem like "20% difference" to me. Of course there are other factors, but are they enough to overcome 3x difference? I don't think so.
You cannot compare healthcare systems on X doctors per Y patients basis, because the outcomes aren't linear. It's orders of magnitude more expansive to treat many health problems if you go to the doctor 2 years too late. And the outcomes are worse despite the higher costs. Guess what happens when people have to pay a lot for each visit - often they go too late.
X is the amount of medical care available
Y is the amount of medical care wanted
If Y < X there is no problem with any of the systems. And, obviously, a certain amount of inefficiency doesn't affect patient care. Plus, perhaps relevant today: when shit hits the fan we can scale up available care quickly.
If X > Y it doesn't matter which system you choose, someone will go without. You can change who goes without but you cannot fix the system by changing the method of dividing care.
Can things be somewhat improved with better organisation? Sure. Probably. But let's not overestimate it either. Let's take a dream scenario: optimal organisation can make 20% more care available. How much more care is wanted? I think we can safely say the US population wants 200% or more than the current system provides. Whilst nobody's opposed to improving organisations, it cannot fix the problem.
Fixing the problem is something you can only do by doubling the medical training available. That'll be a lot of extra dollars, none of which go anywhere near patient care for at least 10 years, so I would expect a lot of strong opposition from a lot of sides. But it's the only way to fix things.