I don't think per-dollar outcomes are a good metric to optimize for. That will get you high quality care at low prices today, but the future quality of health care will be lower than it would've been otherwise.

If there's too much surgery going on, that can be fixed without a single-payer system. My point about the value we place on health care is that even if we fixed all the problems with health care in America, we'd end up paying more than countries with single-payer systems because those systems force the price down below what people would be willing to pay on their own. That is a bad thing.

>because those systems force the price down below what people would be willing to pay on their own

This is very far from the truth. Worry not, rich people can spend to their hearts content in single payer countries. They still spend less and have better outcomes.

In the abstract maybe we do want to spend a lot of money for health care. However, medical costs have been growing at double digit rates. Hopefully that pattern does not continue for too much longer.

Yes, I know that one can still purchase supplemental care in single-payer countries. However, there are plenty of people in the middle who are paying full price for health care in America who wouldn't purchase supplemental care in a single-payer system. That will lead to less funding for advances in health care that people are willing to pay for. That is a bad thing.

Medical costs are rising because people have more and more disposable income, and they're choosing to spend it on the things they value most, like health care and education. Instead of letting that price signal serve as motivation for more people to supply the goods and services that people value most, single-payer systems force prices down and result in less investment in the products that people want to purchase. Forcing people to buy a product from a single vendor hinders competition. Forcing prices down by hindering competition is bad for the future of any market. It's a bad idea.

I'd love to see you produce so data for any of these claims. People in Japan get access to MRIs for much cheaper than Americans. How is that a bad thing?

The median real income has been hardly been growing at a fast rate. You'd need it to get growing at an incredible 10% a year for your explanation to be at all credible.

MRIs are cheap in Japan because the Japanese government will only pay so much for them. As a result, there is less of an incentive for people to develop new imaging technologies since the government will similarly limit the profit that can be made from them. That doesn't mean that innovation in that field will stop, especially since more profit can still be made in other countries. The pace of innovation is just likely to be slower.

I didn't say incomes were rising. I said disposable incomes are rising. I can't find data to back that up, especially since the economic definition is different from the colloquial meaning of "disposable income." However, it's clear that technology has made both the necessities and luxuries of life far cheaper over time, which leaves more money for us to spend on other things even with a stagnant income.