It’s important to recognize that the system in the US is more convoluted than you believe. It’s not like we have totally separate drug manufacturers versus distributors versus hospitals versus insurers. There’s a fair amount of overlap, and a lot of it is relatively secretive, so you don’t know where the kickbacks are. You don’t know who’s jacking up prices in general knowing that they’re going to lower prices for the company that they are partners with. All of which is to say, this is not a fair market, this is not a market where you can reasonably compete if you play by the rules, but even if they actually bothered to follow the rules, you’re already screwed because they have market dominance.

The only path forward is through government run single payer healthcare. You can call it NHS, you can call it whatever you want, but it has to be run by the government. You need the government to set price ranges for drugs and treatments so that the drug companies and the hospitals don’t f*** over everyone.

But I don’t think Americans are ready for that yet. Obviously Trump winning the election makes it incredibly unlikely, but I think even large numbers of Democrat voters are still trapped in American exceptionalism. They know they’re getting fleeced, but they aren’t yet willing to say that they should probably copy what’s happening north of the border or across either ocean. They have good stories, things about super long wait times or lack of doctor choice, pretending that those things don’t happen in the US, and then pretending that those things do happen in every other country that has universal health care, which is laughable. But it’s hard, because so many people are desperate to believe that the US is the greatest country in the world, and they are desperate to avoid recognizing that they’ve been getting f***** right in the ear for the last few decades.