dr2chase:

"there will definitely be a trade-off" Why are you so sure of this? There's 20-some countries with universal care, obtained in 3 or 4 different ways (national insurance, national health service, regulated mandated insurance, who knows what else), and they all spend less, measured either per capita or as % of GDP, and they all have better life expectancy and better infant mortality.

They aren't the same country we are. For example, a colleague was an advisor for chemotherapy drugs. He went to England and they agreed said drug was effective but would only give it to people with X life expectancy based on some worth of a year of life calculation. Can you imagine that here? "Sorry, that's too expensive, here's your morphine, go home and die". It may be coming, but it'll take a mindset change for the public.

What I think will happen is that when somehting needs to be cut there'll be a big outcry and it will get "temporarily" approved anyway, over and over.