I know it gets frustrating when the weight of evidence and argument seems so overwhelming, but throwingup hands in horror and labelling people who are still unconvinced "idiots" doesn't really move things forward.

It's not really that different from crying out "socialized medicine" instead of arguing the case.

I'm sure there are arguments for the present health system in America, just as there were arguments for the slave system. Not sound arguments perhaps, but arguments that are evidently seen as convoncing by a good many Americans, and deserve to be addressed and unwrapped and dismantled.

Obviously there is a very rational argument from the point of view of the insurance companies who recognise that they would be faced by real pressures to behave better if they are to survive in a new system.   

Evidently there are medical professionals who believe that they will lose out - in the same way as their fellow professionals had similar fears in Britain in 1948, for exampel, and found that these were completely unfounded, turning them into some of the strongest defenders of the NHS.

But the ordinary punters who are against change are harder to understand, and yet they are the ones who matter. Doug is satisfied with his own medical care, provided by the government, but is fearful that if everyone else were able to opt for something analogous things would spiral down to disaster.

It seems to me that the only way to put the puzzle together is to take it that American society is seen by such people as uniquely disqualified from following the example of all other advanced countries in this matter.

Any administration in the USA, it appears, is bound to drive down standards to the lowest possible level, and voters are never going to insist that this does not happen, since public services are necessarily seen as a target for economies to keep taxes as low as possible, which will allow at least some hope of paying for escalating payments for private health insurance...