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I think the global problem is that medicine has improved so much that, unlike a hundred years ago, it's impossible to provide the full extent of modern medicine (which is huge!) to everyone, so some form of rationing/filtering is inevitable and necessary.

You can do the rationing through market forces, where people who can't afford it get less care; you can do the rationing through some other allocation system (e.g. priority systems, or long queues, or lottery, or committee allocation) which in effect still mean that not all people get everything.

If you want to say "In our society, everyone gets healthcare" then you have do define "healthcare" narrowly, which includes some services but not everything technically possible - I mean, if we have services that take more than a man-month of labor for each month of prolonged life (and there are some) then that's not possible to provide for everyone always even from a purely mathematical standpoint.



This is the crux of the matter, and the solution at some point is to either have people deny themselves "extraordinary care" or have someone else do so.

There's a "motte and bailey" that goes on with healthcare - emergency services like handling broken legs and illness and such is actually relatively cheap; it's the prolonged costs of all the various things we die of that really puts a burden on things.

Sure we spend $5 million now and then to save premie infants, etc, but that's such a small portion of total healthcare spending as to be a rounding error.

https://www.cdc.gov/nchs/data/hus/2020-2021/HExpType.pdf breaks some of it down, but not in detail; I suspect that a huge amount of healthcare expenses can be directly tied to obesity and its consequences.




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