I mean, sure, that's fair.

But... The amount of money I spent on medical care in Hong Kong, per year, was probably 1/10th of what I'd have to spend on medical insurance alone if I were in the US. Because patients and practitioners have more agency, and because pricing is transparent, there's actual competition in the market.

Sure, you need money, but it's less than you think, and there are fewer hoops to jump through, fewer roadblocks to treatment.

The optimal system is probably something like that. A public system for emergencies, child delivery, and absolutely necessary treatments -- and a transparent, open, private system for everything else.

Surprisingly, in the U.S. it’s people with means who can’t afford healthcare. Poor people are covered under various state and charity programs.

By definition, when talking about access to healthcare a person of means is someone who can afford it. What is true is that there are lots of people who think they are “middle class” who can’t afford access to the system.

13% of the people don’t have a usual place to get healthcare in the U.S.

https://www.cdc.gov/nchs/fastats/access-to-health-care.htm

> By definition, when talking about access to healthcare a person of means is someone who can afford it.

Correct. Either a person has the dollars to pay or they don’t.

> What is true is that there are lots of people who think they are “middle class” who can’t afford access to the system.

What people think doesn’t really matter when the bill arrives. We might be better off thinking in terms of “qualifies for financial assistance”. Those who have just enough income to disqualify them from assistance will have more trouble paying, obviously. Some of those will forgo or delay treatment due to cost concerns.

If you agree with the first quoted statement of mine then I gather you retract this statement:

it’s people with means who can’t afford healthcare