The VA healthcare delivery system is not comparable to the Medicare system. The VA is a socialized system where every person delivering the care is employed by the government. That is why they are under such scrutiny for long waiting lists for care in some regions. A Single payer system with Medicare in the United States could never be compared to a single payer system in another country. In the United States, the vendors such as Physicians, Hospitals, Clinics, Home Health, DME will always be privatized which gives incentive for more vendors to enter the market. The more eligible Patients, the more vendors eager to provide the care. Regarding regulation of private insurance companies, it's minimal. They are taken to task once in a while over high profile cases ,but, for the most part they have found ways to skirt around the regulations. Some are so reluctant or slow to pay claims that entire hospital systems have stopped accepting their insurance. Medicare always pays. I've been in healthcare delivery for 40 years and I have never witnessed one person FIRE Medicare.
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