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The place to look for a model is Singapore. That Southeast Asian city-state is smaller than New York City, but its per-capita gross domestic product and life expectancy are similar to those of the United States. Singaporeans spend much less money on health care (4 percent of their economy) than we do (18 percent).

Goldhill identifies three major differences between the Singaporean health system and ours. In Singapore, individuals contribute much more money at the point of purchase. The payment mechanism varies according to treatment and patient. Government doctors and facilities compete with private health care workers. Singaporeans are required to contribute to health savings accounts and purchase a catastrophic insurance plan. There is an insurance pool for the severely disabled and a fund to pay their bills. There are subsidies to providers based on their level of service.

But the thrust of Singapore's system is individual responsibility for a large portion of direct payment. And the results are positive. "Health care in Singapore is high quality, high-tech, and, by international standards, cheap," writes Goldhill. "Genuinely cheap, not just misleadingly cheap at the point of service."

Singapore has the best healthcare in Asia. Expats fly there even for routine dental appointments, along with anything else up to serious but non-emergency reasons. English-speaking, Western-trained, and even after accounting for flights and hotels, it's much cheaper. Plus, they have access to prescription drugs that have been approved anywhere in Europe, most of Asia, Australia, and the US. It's nirvana for a free-markets guy.

We could have that in the US, too. But too many liberals around who expect to never have to do much thinking at all when it comes to healthcare for themselves and their own families. I've always thought that strange. The same uberlibbies who wear the shirts that say, "Keep your laws off my body!!!" don't mind outsourcing to Obama's health commissar every decision and every snippet of information about their body. Weird.

Not my problem anymore though.

On the individual mandate, I was initially supportive of it, but not anymore. If you're going to require me to buy insurance, don't tell me the kind of insurance the company is required to offer me. If I want to buy a policy that excludes pre-existing conditions, I'm not allowed to. That gets expensive. Or go to a company that only offers coverage to healthy people, or to non-smokers. Can't do that either. So suddenly "if you like your policy you can keep it" turned out to be totally preposterous.

Beyond that, if you look at systems where the government truly does own the delivery network, that would be Military Health, and it's probably the best care delivery system we've got. Will you affirmatively state that you don't like our Military Health System? I doubt it.
Snoofy

I was in the military for 9 years, and it was fine. Two questions though. First, you have a very large population of very healthy people in the military, mostly young. We were running 40 miles a week, doing thousands of pushups and situps, and even when one of us was badly injured or ill, the background made recovery so much easier. You don't have that with the general population, and you never will.

Second, the military healthcare was an important inducement to enlist. Your pay sucked, the hours you worked sucked, being away from loved ones for months at a time sucked. Why should some porker who smokes two packs of cigarettes a day get the same medical treatment as a guy who puts it all on the line every day he puts on a uniform?

All that said, there were a lot of problems with military healthcare delivery, and many of the problems were with dependents. Yes, the results among the healthy, young military personnel were great, just like they would be just about anywhere. But it's a system you can't just say, fine, let's do the same thing for poor people in LA. Doesn't work that way.

Look at the big picture every once in a while. That's another one of the reasons Singapore's system works so well. Frankly, Asians live far healthier, eat healthier, live longer, than almost all of America's blacks, Hispanics, or obese whites. It's literally a shock to the system to go back to the US after spending a few months in Asia. It looks like the whole country were auditioning for those "People of WalMart" videos. Fat everywhere.

The one who gets stuck with the bill is the patient. That'll put all kinds of skin in the game. It encourages the patient to shop around, to be healthy, to be selective in which doctor he goes to.

The US health care system is the worst of all worlds, as far as any of that goes. But Matsop is right: it'll all come crashing down. And we should embrace it, not try to save it. ObamaCare just shoved the day of reckoning that much closer.

Since when? The right wing has always said that the government needs to be out of it completely, that we should be able to shop around for whatever care or policy best suits us, and that unhealthy people should pay far, far more for the same coverage. That's life. Government rules and edicts and mandates and money make everything much more expensive, not less so.

And, frankly, if Singapore imported a large population of blacks and Hispanics who suddenly expected to be taken care of without paying for it, the system would collapse there too. ObamaCare doesn't do anything about that problem.

Again, it's not my concern anymore. Let the libbies in America try to figure it out. They voted for this turd of a law. I've already voted with my feet. Not my problem.

Sure. Slaves built America. Fascinating.

Go away.