We all have frustrating stories about our private insurance plans. Having no experience with government administered plans I can't make the comparison. But, generally speaking, government agencies are forced to operate with bare bones budgets that are continually under attack so it's almost expected that there would be issues. So the comparison is not really private vs. government because one side is forced to work understaffed and with outdated systems.
There are other nations where people are generally satisfied with their government administered plans. The basic difference is those governments believe in investing in their people.
I can only speak from the provider end of the things. MassHealth (Mass Medicaid) is administered by 3rd parties (several different companies patients can choose from) to run a lot smoother than my experience with Husky (CT Medicaid), CarePath (NH Medicaid), and NY and RI Medicaid. Most surprising is CT given a huge market of insurance employees (Hartford, CT is considered the insurance capital of the world). I have a bit of experience with Tricare (military insurance) having worked at the VA, and that insurance was a mess- as is reported in the media from time to time.
That said, there’s also some very bad private providers. Cigna and United Healthcare/Optum are companies I routinely find difficult to deal with. I also had the misfortune of have a UHC-Optum plan at one point. They were riddled with problems, like being charged copays that were not on my plan.
Obviously there are variations in plans even among private insurers and even among public plans. And public plans vary considerably state to state. But private plans have different incentives than public plans. As do their employees.
Given the nature of our politics I honestly would not trust the government too much power over the healthcare system. Under one party it might be fine, but then get benefits stripped out under the next party. And when you look at how stripped out and expensive Medicare has become, the diminishing returns of social security, all the problems with Tricare/the VA, down to things like how poorly government agencies handled COVID, let’s just say I have significant concerns.
It’s not to say it can’t be run well, but it’s not guaranteed. In the private world at least there is some degree of choice. In reality there is no perfect health plan or health system- except maybe for those who can afford to be self-insured with virtually endless resources.
I would also point out satisfaction isn’t a great metric. While you may say you are unsatisfied with your healthcare, it doesn’t mean you’ll be satisfied with the plan someone else is satisfied with. Cost is obviously going to be a large driver of satisfaction. If you pay little-nothing, you will tolerate more issues, especially if you only require routine healthcare as most people do. But if you need imminent care and are on a waiting list, especially if you’re not used to that, you won’t be happy.
The grass is always greener on the other side, but if you look that the UK’s NHS, they currently have 6.2m patients on waiting lists and almost 25k patients have been waiting for over 2 years. Hospital admission wait time is almost 4hrs now, with some waiting as long as 12hrs. They are considering this a crisis, not surprisingly. And most European healthcare systems are experiencing serious at the moment. Take a look at Spain, Sweden, and France. Canada too is in trouble too.
Much of the accessibility issues stem from the self imposed limits on the number of physicians and the disincentives of being a general practitioner. And in Non-American healthcare workers earn far, far less money than the US.
But I don’t have any answers. At the end of the day though, I believe everyone should have accessible, affordable healthcare- regardless of how it’s paid for. I am merely stating the pros and cons and risks and benefits.