Every American should live for a while in a country that has a single-payer health system

Here is Jon Shore responding a year ago to someone who asked him the question: “How do countries that have a single payer system handle people with preexisting conditions and special needs specifically?”

Shore’s answer is very simple.

I am an American and have lived in 4 EU countries over the past 19 years. All of them have single payer systems. Most people in countries with single payer systems do not even know what a ‘pre-existing condition’ is or why it would matter. They are shocked when I explain it to them. The only person who needs to know your medical history is your doctor. If you or someone in your family has a special need then they get the special treatment necessary. It is really that simple.

As an American expat, even after all these years I still have a subconscious fear of telling a doctor about a pre-existing condition because it might raise my health insurance premium or cause me to lose my coverage. I have to remind myself that I live in a civilized country now and that my right to high quality healthcare is guaranteed no matter what.

Just because the health insurance industry, pharmaceutical industry and corporate healthcare system want to keep their profits exorbitantly high they spend huge amounts of money on lobbying and propaganda to keep the system exactly how it is now. They buy politicians and bureaucrats to make sure their system remains in place. They hire PR firms to create ubiquitous propaganda to manipulate public opinion. No matter how many people suffer and die they will do anything to retain their hold over our country’s healthcare system.

Very soon Americans are going to have an opportunity to have a real single payer system for everyone in America. You are going to hear those same bought and paid for politicians and PR firms spreading fears of ‘socialism, socialized medicine, Venezuela, death panels’ etc. They are going to be very loud and the media is going to collude with them because they are being paid a great deal of money to do so. You are going to hear these terms over and over again. They are going to try to make you terrified of change.

Shore’s prediction about the dire rhetoric about socialism that we can expect and the forces behind it is coming true when we read the criticisms of Bernie Sanders’s Medicare For All proposal.


  1. sonofrojblake says

    “I have to remind myself that I live in a civilized country now”

    Civilised countries spell it with an “s” 😉

    Why would anyone with a choice want to live in the US? If really baffles me.

  2. jrkrideau says

    Pre-existing conditions? I don’t think we have the concept in the payment system. Under OHIP (the Ontario Health Insurance Plan) your doctor decides you need to be treated for something done. OHIP pays, no questions asked.

    Co-pay? What is that? …….You must be joking.[1]

    Intellectually I understand “pre-existing conditions”. I really do not have a clue what “special needs” means in this context.

    OHIP is, by no means, perfect, it has some big gaps, but compared to the US imbroglio it is Heaven on Earth.

    1. A major complaint about health care in Ontario seems to be the cost of parking at hospitals. I suppose this is a co-payment in some senses.

  3. Holms says

    Perhaps the biggest ‘wtf’ moment in learning about USA’s health system came from the ‘out of network’ concept. I’d never head of that, and had to look it up. USA’s system makes hospitals and GPs a minefield, with some being safe to be treated at, and others being unsafe (where safe/unsafe means whether or not a person will be slugged with bills an order of magnitude worse than expected). Worse, even a safe hospital may contain individual wards, doctors, or diagnoses that are unsafe… meaning nowhere is safe, really.

    In Australia, there is no such thing and the entire concept would be considered outrageous. Here, the ‘network’ is the Australian government, which reaches all hospitals, GPs, doctors, wards, diagnoses, treatments etc. etc. so long as they are within the national borders.

    Those Australians who, foolishly, want Australia to be more like America would be scandalised if such a thing happened to them, yet they persist in wanting their own destruction.

  4. anat says


    Why would anyone with a choice want to live in the US? If really baffles me.

    For my family: Because that’s where a lot of good science jobs are.

  5. sonofrojblake says

    A lot of good engineering jobs are in Saudi Arabia, but I wouldn’t work there for Jeff Bezos’s salary. Some things are more important to me than career and money, like living somewhere that doesn’t murder its own citizens in cold blood. Your mileage may vary.

  6. alanuk says

    One of my hearing aids stopped working on Saturday. On Monday I will walk to the bus stop and take the bus to the hospital; as I am retired, I will just place my free Senior Pass on the card reader and take my seat. I will go to the Audiology Department and take a ticket from the dispenser and wait for my number to be called. I will take my hearing aid to the workshop counter and hopefully they can fix it on the spot.

    Hearing tests are free, hearing aids are free, repairs are free, even batteries are free.

  7. jrkrideau says

    @ 5 Holms
    I had forgotten about ‘out of network’.

    A friend from Rochester NY was on a fishing trip in Canada, probably about 500km from Rochester when he did something to his back and could not even get out of the boat.

    A quick call to the local barber organized a rescue mission but then his wife discovered that his “Gold-Plated” health plan only applied within 50 miles of Rochester! Tabernac.

    New emergency, how to get Mike across the border and back to Rochester !

    Another friend told me that he and his girlfriend drove through two US states because his girlfriend’s health plan did not have anyone in its network!

  8. billseymour says

    sonofrojblake @1

    Why would anyone with a choice want to live in the US?

    Well, I was born and raised in the St. Louis, Missouri area, and I’m comfortable here.

    I also have a pretty good job as a computer programmer that pays enough that I can travel to meetings of an ISO standards committee on which I serve. I can even afford Icelandair’s Saga Class (business class) if I don’t try to afford some other stuff that I don’t really want all that much anyway (e.g., bass boat on the Lake of the Ozarks…no interest).

  9. Who Cares says

    We do have something like networks here. It is the difference between whatever healthcare provider you went to billing your insurer directly or sending the bill to you so you can send it to your insurer.

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