That's a hyperbolic misstatement of the situation on the ground. Poor people use free emergency rooms as primary care instead of paying for primary care physicians. That's a cost disaster no matter what you think should be done about health care. We'd be much better off with actually free primary care for the poor, and it would at least make sense to prevent the emergency room misuse since it's so wasteful. But it's politically untenable in the US to fix a broken system in any direction people don't like, even when it's Pareto optimal.

This is the story in Canada as well, but way more than the very poor, because there are not enough primary care physicians where needed, and not enough people pursue family medicine. Why would you? What med student looks at the prospect of administering a dinky small business on top of actually practicing medicine, pay well but not great, and have zero equity when they retire? So we land in a similar position because the change might be publicly funded group practices instead of pay per service which has better optics.

> But it's politically untenable in the US to fix a broken system in any direction people don't like

It’s not even obvious to me that people don’t like the notion of sane, socialized healthcare. They’ve just been trained not to like the name.

See "We've got you covered" for an analysis of reallocating current US healthcare spending into a general healthcare program that aligns with your thinking.

https://www.penguinrandomhouse.com/books/690632/weve-got-you...