Pain and medicine

I have had two medically needy people in my home over the last several years. The nature of need is that it tends to hijack all other functions of the household, especially when it is not effectively treated. Treatment can be difficult and sometimes rejected by the people who need it. Sometimes we don’t know how to help. Sometimes we do.
It is maddening and hurtful when that treatment is withheld, especially because of system failure. When effective treatment is known and available but withheld administratively. I also work in medicine; I see this from both sides of a cone with a dozen or more sides. Our system will leave a person in moderate to saver pain, for lack of insurance, gap in insurance, or hope that expensive needs can be delayed until someone else will have to pay, the list is exhaustive.
I don’t have an answer to all of it. Right now, I am helping a friend through a painful episode that has been mismanaged, poorly explained and at times treatment has been simply refused. Some of this has been a lack of capacity that leads to long waiting lists to get treatment. Some of this has been in the hope this patient will just go away. Some of this is because this person hurt themselves preparing to move between states and jobs and they must wait until it is convenient for the new insurance to take effect.
Delaying treatment hoping the care will be deferred until someone else can pay for it is simply malicious. Refusing to take the patient seriously is bigotry. The gap is a system failure unique to the USA, Mexico, and I think Argentina. Most other nations have systems of care, that do not have the gaps we do, and do not provide an incentive to delay care. we did not.
The way we pay for healthcare allows us in the USA to pay for the most expensive health care on earth. For that we get less than the best outcomes and leave many people with no coverage at all. The fragmented way we try to provide care is confusing at best and malicious at worst. This is not a failing of individual caregivers or providers it is a failing of the system.
Single Payor is not THE answer, but it is AN answer for some of it. Medicare for all is not THE way to achieve that but it is A way to achieve it. When there is one payor there is no incentive to delay treatment until some one else will have to pay for it. That saves money and gives better care. When there is one payor there is no gap when people move or change jobs. There may be other ways to do the same thing, but single payor is one of the ways. Another might to have consistent rules in how bills are paid so that a system with insurers can look like a single payer system yet retain aspects of competition.
Our way of providing health care is broken and we argue about if there is something to fix. People want your vote and your money insist they work on this. Insist that the people who want to lead our country stay engaged in solving this problem. If we don’t they won’t and it will stay broken.