How I can respond to this discussion?

How I can respond to this discussion? In comparison to other countries, the US medical industry is more lucrative and enterprising. Collective discussions with public payers, which suggest more than merely tacit approval of a state-run social enterprise known as (or moving toward) national health insurance, have long been frowned upon by American providers. In order to survive politically, the United States has developed a split system of payer and provider relations. Medicare, the largest government program, changed from a payment model that mirrored the private sector (retrospective payment of actual hospital costs and usual and customary physician charges) to prospective payment models, guided by commissions in which providers have a voice and by Congress, which they directly lobby. Although it may be ahead of the curve internationally, the United States confronts its own integration issues despite being the renowned source of much of the theory and practice of the services integration that other countries strive to imitate. Reform advocates occasionally disagree on issues such as whether achieving universal coverage is a necessary and sufficient policy goal and whether to demand that such coverage be contained inside an appropriately designed delivery system.

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