If, as you seem to advocate, you want a society where hospitals are not in any way obligated to help people who can't afford to pay, and where sick or badly wounded people with no money should be left to die if they don't manage to beg, cajole or steal the money they need for treatment, then I suppose there is indeed no good reason to make insurance obligatory. How you reconcile that stance with a Catholic morality, I have no idea, but then it's none of my business. Knowing you, I'm well aware I have zero chance of convincing you otherwise and so will save my breath (or my fingers, whatever).

Nonsense. People and their labour belong to themselves, but all the same, unless they live somewhere out in the wilderness or on a deserted island, they generally do contribute something to the lives of others - in some cases in a more positive way than in others, but still. Even in the kind of society you describe, where these people who are too sick to work are left to live or die without any help either way, hence not siphoning any resources from society for their treatment, their absence in the workplace is likely to be felt as a loss, and any investments society has already made in their education will not reap the rewards they might have done if they had stayed healthy (or should we get rid of taxpayer-funded primary and secondary education too, while we're at it?).

I have never understood, or agreed with, the Democratic opposition to eliminating the ridiculous excesses of American tort law.

And as mentioned in the title of my post, I'm far from a big Obamacare fan, nor do I think the American health care mess can be solved in some simple, easy way. I disagreed with Jeo on some principle points, I didn't claim to know how to fix the American system and make it work. I definitely agree with you that one of the main problems lies with the insurance companies and their bureaucracies, and another one in flawed regulation, even before Obamacare.

Your public spending is higher mostly because of the utter idiocy that is Medicare, honestly. We don't agree on much in this debate, but I'm sure we agree that the way Medicare pays far too much for many procedures is a gigantic waste of taxpayer money. But yes, the same goes for private insurance - doctors and hospitals get away with charging absurd amounts for basic procedures, because people with insurance don't care about the bill as they won't pay it anyway, while people without insurance probably can't afford to pay whatever is charged, whether it's reasonable or not. I think we definitely agree that health insurance needs to be something people are in charge of themselves, instead of it being linked to their job. The difference is that I would support a "mandate", forcing people to get at least a minimum of insurance, and you would not, largely because you disagree with my basic premise that at the end of the day sick people have to be treated whether they are insured or not (and so for me the choice is merely between having them treated entirely on the taxpayer's dime, or at least partially on their own).

I'm not saying you'd want to increase the degree to which taxpayer money is spent. The primary point of mentioning that statistic, for me, is not to defend Obamacare, or even to advocate universal health insurance, but rather to make clear something very hard for many Americans to accept, which is that at least one thing about America, its health care system, is in fact inferior to its equivalent in some other countries. How you would go about remedying that is an extremely complex question to which I won't pretend to know the answer, but as they say, being aware of the problem is the first step.

Interesting. I wasn't aware of that, do you have a link or reference?

In any case, I definitely admit that life expectancy is only partially linked to quality of health care - certainly factors like nutrition, violence in the society, and even climate play a certain role.

Also interesting, wasn't aware of that either.

Sure, but how is your alternative better? If you aren't rich, you either won't have insurance at all and won't even live to see your "death panel", or you'll have limited insurance that won't get you any better result than the socialized medicine would, and most likely worse. If you're rich, you probably do have better insurance than that (as a side note, you can still have additional insurance in most countries with socialized systems), but even if paying absolutely any price for any extra day of life is worth it for you, the result is ever-increasing insurance premiums for everyone else. And even an insurance company will draw the line somewhere - the only difference is that it'll be a company making the call instead of a "death panel".