Source: Vox

October 2, 2024

Health insurance in America is a constellation of brands and acronyms: Medicare, Medicaid, the VA, TriCare, the ACA, CHIP, United Healthcare, BCBS. I got a headache just listing them.

In most rich countries, people don’t have to worry about sifting through a dozen different health plans — and they don’t live in fear of losing their health care after losing a job, and they receive more affordable, higher-quality care than Americans do. The paradox of the world’s wealthiest nation having one of the weakest health systems among developed nations has long been a vexing policy problem — without an easy solution.

Why does it work this way? It was more an accident of history and culture than an intentional plan. Today, the American system works just well enough — which is not to say it works very well — that building a better one just doesn’t rise to the level of political priority.