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Every system of health care has to have some form of rationing health care. Otherwise utilization would be out of control and the cost of any system would make health care unaffordable. In Canada's single payer they "ration" health care by a system of waiting for medical procedures and treatment. The sickest patients get treated first while those who are less sick usually have to endure waits to get their medical care. But everyone eventually gets treated and no one is uninsured.
It is impossible to have health care in any system where everyone can have ready access to medical care whenever they want it and not have to pay anything up front or share in the costs. Even Canada had ti impose deductibles and co-payments as a means of controlling utilization. In Europe it is pretty much the same thing, very often people have to wait for elective surgery or just to get a check up. It is the same thing here in the United States in many places.
But here in the United States we use the cruelest form of rationing. Access to medical care is based on whether or not we can afford health insurance through a private system and where we work. If one is fortunate enough to work for a large employer, very often they have generous employer paid health insurance that requires minimal cost sharing. This is especially true if one works in the public sector where their health insurance benefits are far better than many private employers.
But if one is self employed, they have to use the individual health insurance market. That has been dysfunctional for a long time. Premiums for good health insurance are quite high. Deductibles are also very high and premium increases of 20% or more per year have been commonplace. Of course if you have any medical issues or pre-existing conditions; you are either stuck in your present plan or cannot get health insurance at all. A recent poll among self employed individuals showed that 24% were uninsured and that the majority of those who are insured are covered through their spouse's plan. Among unmarried self employed individuals under age 65, about 60% were uninsured.
The same survey among uninsured self employed individuals asked when was the last time they saw a doctor. Most said that it had been more than five years since they saw a doctor for any reason. Of course many of those self employed people are very healthy, but even a healthy person should at least see their doctor for check ups every now and then.
It has been demonstrated that the most effective health insurance system is a single payer system with some cost sharing required. The cost sharing prevents over utilization and the financing of a single payer system through taxation is the fairest way of financing the program since everyone is paying based on their ability to pay and everyone is covered the same. The risk is spread around among the entire population with no demographic being favored over another.