I suggest that you are taking a bottom-up approach to your analysis; allow me to provide a top-down analysis. The US now spends $3.5 trillion per year on health care, which amounts to nearly $11,000 per person. This consumes 17.9% of US GDP. Meanwhile, other countries spend a much lower share of their GDP on healthcare, as shown by the graph on this page. Most developed nations spend about half as much per capita as the US. Yet, despite spending twice as much per person, the US has poorer overall healthcare. Here’s another source on that point.
So we’re spending more and getting less. Why? Because so much of that money is going to the shareholders of corporations providing private healthcare. Americans pay more for medications than citizens in other countries. Doctors in America are paid more than in comparable countries.
This top-down view makes it clear that the American healthcare system is a disaster, wasting stupendous amounts of money to get inferior results. If we could obtain the same overall efficiencies that other developed nations achieve, we would have at least a trillion dollars to spend on other things. There’s no question that we need to make major changes.
There’s nothing unique about my comments; people have been saying this for decades now. You’re quite right that the transitional process will be very difficult to manage, but I think that we can break it down into stages that will make the transition smoother.
First, we should extend Medicare coverage to all children. There is no ethical justification for a child to receive inferior medical treatment because of the poverty of the parent. I’m not sure where to draw the line between a child and an adult, because it’s tricky for people between age 18 and 24, many of whom will still be in school.
The next step would be the Medicare buy-in option for adults under 65. We could simply throttle down the price of buying in over the course of several decades, allowing the private insurance companies to smoothly wind down their operations.
Lastly, a small plaint about your point regarding the number of people working in private health insurance. You cite the observation that private health insurance employs half a million people. But there are two powerful counterarguments.
First, if we implement Medicare for all, we’ll need plenty of people to administer the program — meaning more jobs. Of course, there would still be fewer than half a million jobs, so there would still be a lot of unemployed people. But:
Second, suppose that we had half a million people digging ditches with shovels, and somebody invented bulldozers. Would you argue that we shouldn’t use bulldozers because we’d put all those ditchdiggers out of work?