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For an explanation of how the bizarre US system came to be I would recommend the following episode of EconTalk:

http://www.econtalk.org/archives/2017/06/christy_ford_ch.htm...

The guest is an economic historian who details the historical forces which led us to where we are right now. She also describes a few different, more effective and rational models (not just single payer) which could potentially have existed, but which sadly are, for all practical purposes, impossible to get to now.



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