the most convincing piece of evidence that americans are incapable of thinking sensibly about health-care reform is their continued focus on "health insurance" instead of "health care". only this obsessive focus on "insurance" leads to the lunacy of secondary talk about "marketing costs" and "overhead".

"insurance" is about the mitigation of risk, and "risk" implies uncertainty.

having someone else pay for your regular 4 times a year visit to your own personal favorite dentist to have your teeth cleaned, and to have your children fitted for braces is not "risk" since there is nothing uncertain about it.

if americans are worried about being uninsured, they need to first understand why "out of the pocket" health care costs so much in this country, especially when compared to the quality of care in other countries vis-a-vis their per-capita spending.

without a proper, evidence-based answer to that question (doctors paid too much, hospitals are greedy, malpractice costs are high, drugs are needlessly expensive, patients demanding unnecessary diagnostics, whatever), trying to sweep the cost problem under the proverbial rug by claiming to provide "insurance to everyone" is just a waste of money.

if the government really had as its ultimate goal the good-health and well-being of all its citizenry, and wanted to achieve this goal most efficiently, all it is has to do is this:

• start a bunch of government-owned, government-run hospitals.
• these hospitals are funded through general tax revenue.
• they are located in all major metropolitan areas in country, thereby ensuring that they are within the reach of an overwhelming majority of the citizenry (just start with every place in the country that has some sort of "federal building" and build a hospital in that city/town).
• staff the hospital with doctors, nurses, technicians that you hire and pay reasonable market wages---if market wages are really reasonable, you should have no problem staffing the hospitals.
• equip the hospitals with the best medicines and diagnostic tools you have at your disposal---the fda and nih will happy tell you all about the latest medical research.
  
• provide treatment to any and all comers at subsidized, or means-tested, or zero-cost.
• there is no talk of insurance or hmo or any other bullshit.
• a citizen walks into the hospital, asks to see a doctor, gets a diagnosis, possibly medicines/therapy/surgery, etc.

people are free to go to the "government hospital" or to a private hospital, based on the quality of care provided by these two institutions.

at private hospitals, they get to see their personal favorite doctor but they pay whatever amount (and through whatever agency) the private hospital administrators demand.

at government hospitals, they pay nothing or write a check or swipe their credit card when leaving the premises. however, they get to see a doctor that has already worked on their case or someone who happens to be working at the hospital.

do this, and you will find out that either (a) you have solved the supposed "health care crisis" in the country without any bullshit talk of insurance, or (b) figure out that running a hospital and providing inexpensive care to whiny fatty american fuckers is ultimately a thankless and wretched job, and breaks the treasury.

what about the american dumfucks who want to make frequent visits to their favorite personal doctor in their favorite private hospital but have someone else pick up the tab---these dumfucks can pay for this privilege by themselves.

what about rethuglicans who will claim that this turns the u.s. into cuba. well, if you have already started down the road of deciding long-term public policy based on the rantings of rethuglicans, you deserve the hell you get.