In the commentary, and in thinking about the various positions on what needs to be done with the system, I was reminded of a useful metaphor I learned about in project management: the triple constraints.
If you're not familiar with the triple constraints, imagine an equilateral triangle. At each corner of the triangle is a constraint: cost, time, and quality. The concept is simple: pick any point within the triangle and you'll see what the trade-offs in your project will be at your chosen point. For example, if your spot is precisely between "cost" and "time", implying that you want the perfect balance of the lowest cost and fastest time possible, then you will be the farthest away from "quality" possible.
Applying this to healthcare, I would argue that the constraints in our current situation are:
1) Quality (receiving the best care from the best professionals with the best outcomes)
2) Accessibility (how many people can get the care)
3) Financial Sustainability (how long we can afford to pay for the care)
The picture looks like this (image just below):
So for example, if you were to pick a point that was on the line between "Quality" and "Accessibility", meaning we want the perfect balance of the highest quality possible and the most accessibility possible, we are the farthest away from "Financial Sustainability" possible.
In my opinion, another dimension of the debate is: who gets to choose where your particular point within the triangle is? In our pseudo-free market system, we consumers have our own ability to select where in the triangle we are. In single-payer, well-meaning Federal agencies would make the decision for you.
How confident are you that the point they pick and the one you would pick for yourself would be in the same place?
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