No, private practice is not extinct, but there are fewer engaged in it.

The advent of managed healthcare attracted many Drs. who thought they saw long lines of patients and bags of money bulging their bank accounts. Some quit practice altogether, some went into research, some became consultants, some went to work as case reviewers for insurance companies, some were hired to teach, and some went to work for the VA.

Before long the managed care companies were down writing the physician contracts and by that time the playing field was heavily unlevel in favor of those companies. Physicians were to blame for falling for the con but it was too late for most. Contracts became unreasonable. They controlled the # of patients to be seen, the fee schedules, even where the physician must go for continuing ed.

To combat, hospitals invented the hospitalist. Soon after we saw mass produced healthcare become standard. The Dr. leaving the shift handed his patient load to the Dr. coming on. Continuity out of the window.

Today fewer graduating students go into private practice. PP is not extinct, but it is.wounded.

In 2016 US total health CARE spending was $3.35 TRILLION, or $10,335 for every man, woman and child. Now, not every man, woman and child generated that amount. Of which, government (federal and state) paid for nearly 65% of that. Why is that? About 5% of the population — those most frail or ill — accounts for nearly 50% the costs of health CARE in a given year. Who picks up that tab? You guessed it, government. Meanwhile, 50% of the US population has little or no health CARE costs, accounting for 3% of spending. Who profits from those 50% of people that are for the most part healthy. You guessed it. Big, private, for profit health INSURANCE corporations that are able to extract $500 billion in annual profits from avoiding risk, denying claims, charging ridiculously high premiums the equivalent of 3 house payments with co-pays and deductibles the size of a down payment on a home.

Even with government subsidies to big, private, for profit health INSURANCE corporations under the ACA they could not make enough profit from insuring those with pre-existing conditions and the poor and not enough young, healthy people mandated by the ACA signed up to offset that risk.

And we certainly get our money's worth on military spending? Well at least the MIC does just because it's Constitutional, right.

Do we really need 234 military golf courses around the world, an $80 million military ski resort in the Bavarian Alps and a parade of unnecessary weapons, ships, and planes?

It is increasingly obvious that our enormous untouchable “military” budget is not always being used for our national defense. Is that Constitutional?

But the reason why this overspending has continued unabated is that it enriches powerful special interest groups with entrenched hidden ties to politicians and government bureaucracies.

The same may be said of the private, for profit health INSURANCE industry.

http://www.onlinemilitaryeducation.org/secret-side/

The US could well afford to go to a Medicare for All system paid for with taxes, and still save 95% of taxpayers money!

http://moneyedpoliticians.net/medicare-for-all/

Those who cry "socialism" as an argument against universal or single-payer (government paid) health care for everyone in the country should also opt out of protection by tax payer funded fire protection, tax payer funded mandatory education, tax payer funded streets and highways, tax payer funded parks and recreational facilities, tax payer funded police protection - the list gets longer the more you look without a preconceived notion as to what constitutes "socialism" and base your observations on the one criterion of "if the government pays for it, and those of a lower socio-economic class than you benefit from it to an equal degree as their 'betters', it must be socialism". You must also judge cooperative civil actions as an expression of a social behavior to allow you to judge something done by the representative government for the good of those residing in the nation as " socialism ". I, personally, like having the services the body politic provides, and having first hand experience with "socialized medicine " in England, I believe it would be a great improvement over our current, very expensive, piecemeal system of medical care. And for those who claim the English system is inferior - tiled and other hard surfaced floors which are much more easily kept sanitary than the carpets expected in American medical institutions was the biggest difference I noticed, other than their lack of paranoia when it comes to pain relief. Their cross-infection rates demonstrate their superior sanitation. They value the medical effects of the environment over a need to prove their facilities' supposed superiority over others by installing a more posh environment. There's a reason surgical suites are all hard bare surfaces other than those specific to a particular individual. With surgeons on their feet all day, you can bet they'd prefer soft carpets if it was safe.

Those who cry "socialism" as an argument against universal or single-payer (government paid) health care for everyone in the country should also opt out of protection by tax payer funded fire protection, tax payer funded mandatory education, tax payer funded streets and highways, tax payer funded parks and recreational facilities, tax payer funded police protection - the list gets longer the more you look without a preconceived notion as to what constitutes "socialism" and base your observations on the one criterion of "if the government pays for it, and those of a lower socio-economic class than you benefit from it to an equal degree as their 'betters', it must be socialism". You must also judge cooperative civil actions as an expression of a social behavior to allow you to judge something done by the representative government for the good of those residing in the nation as " socialism ". I, personally, like having the services the body politic provides, and having first hand experience with "socialized medicine " in England, I believe it would be a great improvement over our current, very expensive, piecemeal system of medical care. And for those who claim the English system is inferior - tiled and other hard surfaced floors which are much more easily kept sanitary than the carpets expected in American medical institutions was the biggest difference I noticed, other than their lack of paranoia when it comes to pain relief. Their cross-infection rates demonstrate their superior sanitation. They value the medical effects of the environment over a need to prove their facilities' supposed superiority over others by installing a more posh environment. There's a reason surgical suites are all hard bare surfaces other than those specific to a particular individual. With surgeons on their feet all day, you can bet they'd prefer soft carpets if it was safe.

Some of us have been beating that drum for years, enduring accusations of being a Communist, Socialist, Satan worshiper and other vile monikers, but we continue the crusade anyway. That doesn't make us some kind of hero, saint, or whatever, it makes us Americans who believe in the ideals that made America great.

What does "universal" even mean in this context? Simply put, it means "universal access", where everyone is treated exactly the same way by the healthcare industry - because there is only one pay source. Now, you can be denied treatment by anyone ( or everyone ), because they don't like your source of payment. Some Doctors and facilities require you to pay your co-insurance up front, before treating you. I've even had a hospital do a credit check on me, before scheduling a procedure. This type of behavior is capitalism gone bad.

When did we decide that life giving, life sparing and life saving healthcare was a business? When did we decide that profiting off of people's misfortunes, illnesses and tragedies was perfectly ok? The Constitution says we have rights to life, liberty and the pursuit of happiness, but life comes at a premium cost, we have to pay to keep our liberty - and the pursuit of happiness has a menu and a price tag. Those rights were purchased with the blood of American heroes, the unending heartache of their families, and the vigilance of their descendants - and may NOT be sold for profit!

We need a common sense approach to healthcare, absolutely sans partisan BS, where private enterprise and Gov. work together. There MUST be price controls placed on healthcare itself, because an MRI machine costs the same in NY as it does in Iowa, and prices ranging from $800 - $3500 for a scan is criminal. I don't have a problem with insurance companies bidding to administer our healthcare payments, thus avoiding the usual bureaucratic crap, and it would save billions right out of the gate, because they have the mechanisms in place already. I don't have a problem with payroll deductions for paying premiums, everyone MUST pay for their own healthcare regardless. Everyone must pay, and not just through income taxes, but with universal healthcare, those premiums would be adjusted by income, the more you make, the more you pay. There would still be co-insurance and copays, because if you use the system, you should pay more than those who do not - who will still have it if they need it.

When we get beyond the partisan rhetoric, and just use common sense, we'll all agree that the current healthcare system has gone rogue and is unsustainable. There is simply no excuse for private companies to be making 100's of billions of dollars in PROFIT every year, off of our accidents, illnesses or those of our children.