I mean, yes but also no. A bureaucracy already exists, but it is largely structured so that privately owned caregivers can get money from semi-public insurance firms. Very little of that would survive the transition to publicly owned caregivers paid by federal or state programs.Seanchaidh said:The Medicare/medicaid bureaucracy already exists, and single-payer, though applicable to more people, is much simpler than a means-tested program.
As someone who works in a healthcare bureaucracy that's nominally single payer I can tell you that there are a ton of hurdles you need to clear and the US would face the same problem that Sweden does now if it transitioned: Who pays? Is it the federal government and if so, do they pass the money to the states or do they operate federal hospitals in the states? If the states pay, how do you ensure that the poorer states aren't shafted by much higher healthcare costs? These aren't trivial issues and none of the existing bureaucracy can be transitioned to work them out, because the current bureaucracy is designed to keep the state and federal government out of healthcare as much as possible, by letting private caregivers do their thing irregardless of if it gives consistent healthcare coverage.
Just because the system is single payer it is not much simpler, because it isn't just as easy as handing a hospital a bag of tax-payer money and telling them to treat everyone. You need some way to decide which level of government is paying, for what they are paying and how to ensure that individual hospitals aren't getting shafted or enriching themselves. I could go on about this if you'd like, seeing as how it is one of my pet peeves in healthcare, but I feel it is only slightly tangential to the actual discussion about Sanders. If you want to continue though, let me know.
I know and I'm not really sure it disproves anything I wrote. Whether the voters themselves hold power or are merely pawns moved around by lobbyists with deep pockets is sort of inconsequential to the idea that the "powers that be" (be it voters or lobbyists) are quite averse to sweeping, drastic progressive change and will resist it.Seanchaidh said:The United States was close to passing national health insurance in 1948. It's a popular idea now. What obscures your perception of American politics is that we absolutely do not have in any sense a political system that could accurately be called democratic. Your country, I'm sure, comes much closer to a democratic ideal. We are utterly dominated by money. It is easy to assign policy outcomes to voters if you think they're the ones calling the shots but in this country they just are not.