Hi there, MD/PhD country doc here who's hobbies are rocket science and Japanese.

I do optimization analysis (we all do, e.g. shopping for low gas prices). You find the key things you care about. You find numbers for them. Maybe you see how the things influence each other and all the numbers.

If you have a bunch of different situations, you don't come out with the same answers for all of them. Generally.

So.... having ONE health care system for the majority of us who are not elderly and would try not to be sick AND FOR comatose elderly nursing home people AND FOR people living in the emergency room as their primary narcotics source AND FOR this one guy in the Midwest that some Republican hack is going to cite ? No, whatever ONE health care system is made is going to be wrong for most groups. And yet, whatever system someone invents is going to be optimal for some group. It will be a horsetrade to see which set of plans get the most resources allocated to which subset.

My vote: I would like to lend my support to inner-city indigent children, and I don't even have any of them as my patients. We get the most societal benefit at the least cost in this group. I'm looking into how I can place bets that this is a group that gets shafted by the new healthcare system.

Dr. Matt