You need to dig deeper on that "worst rated service" aspect. Here's a hint. There's not much the medical system can do for inner city people who are bound and determined to kill each other in gang turf wars, pass along debilitating conditions like HIV through unsafe sexual behaviors or eat themselves into chronic conditions like diabetes. Take those people out of the equation and the US system stacks up great against any other. 20% of the population causes 80% of health care spending (excluding end of life spending). It's just that our 20% of the population here in the US is far more decadent than the 20% of any other OECD country, as a result of the fact that we have a far less homogenous population with far fewer restrictions on just how stupid they can be.
Hey, don't forget that it's about 20% of Americans who self-identify as "liberal", too. Damn skippy they cause 80% of the problems with their infernal yappin' about something or other. Get rid of that 20%, there go 80% of the "problems". Now that's what I call "problem solving".
The reason I exclude it is because it isn't someone's fault they need a lot of care right at the end, it is just the natural consequence of old age, should one reach it. Personally, I would prefer that, rather than Medicare, that care be privately financed by individuals and families, but that view, although logical, is the minority view in a country where the majority often has its views enacted into law. What I called for looking at is the rest of the spending, which is driven by lifestyle choices made by people who are irresponsible. When you exclude that spending, the US does just fine. Basically, calls for "universal health care" that aren't accompanied by calls for "universal rational behavior" are moronic. Since you'll never get "universal rational behavior", there's no sense in "universal health care". The alternative is to have people's lives micromanaged like Bloomberg is trying to do in NYC. Since that level of micromanagement is unsustainable, I prefer to just not have "universal health care".
A lack of competition is the key. And that will only get worse under Obamacare. Before it became law, I thought HSA-type plans might grow enough to foster more competition. Hundreds of thousands of people "shopping around" with limited savings accounts was just what the proverbial doctor ordered. That was about the only trend that offered a glimmer of hope. Despite myriad regulations and rampant crony capitalism, there are still a few places that actually compete on price and quality. The second link (their blog) is quite good. http://www.surgerycenterok.com/ http://surgerycenterofoklahoma.tumblr.com/
I will never understand the reason why Obama went to Olso to receive the Nobel Peace Prize at the beginning of his term. I guess he thought he achieved what L Martin King did, therefore...