Whilst the health service in the USA seems to be of a decent standard, it sure does sound complicated. Our nhs is slow and you have to be persistent, but there's no worry about payment this or insurence that. That's an upside. My wife's 2 brain operations to treat her tumour have run into the tens of thousands if we had to pay for it, probably more like over £100,000 if you include all of the Mri and cat scans. We would have lost our house most likely if we had insurence and they wouldn't pay out or we had to find the money ourselves. I dare say a similar system over such a large country with different states and laws would be much more difficult to implement.