I don't really disagree with you either. Basically it's just I have seen no metric whatsoever that tells me that our average is better than other first world countries' average. Or that our very good are any better than their very good. I have no doubt that we have more of the very elite, but it was also my experience that they don't take any insurance often. My experience was with oncologists, and I had a great policy. Didn't matter, they took no insurance. The caveat is I did have an extremely rare cancer, but as you said, it's a big country, and if someone who is the best takes insurance, long waits will occur there also if it's a more common cancer. If someone is elite, he'll eventually have no need to deal with insurance. Considering how much better they are at hard sciences, logic would dictate they might be better in the median, and most metrics seem to point to that. It's hard to filter how many of our issues are lifestyle, and how much is worse healthcare. Either way, I think you'd agree that the increasing cost of our health care is unsustainable, and we spend more per capita than anyone in the world, with no evidence it's money well spent. Don't get me wrong, I don't doubt we very well may fuck up the implementation of this. We fuck up most stuff when it comes to bureaucracy. To me, the best argument against Obamacare is that we'll fuck it up with bureaucracy and corruption during implementation. That is believable, and maybe even likely. That we are risking some gold standard of care is a far less convincing argument imo. And that's the argument I see getting made most often, because it's easier to get emotional about your mom and death panels.