How Does Republican Platform Help Middle Class?

In the NHS everyone who requires a hip and knee operation will get one, and under normal circumstances hospitals should provide this service within 18 weeks. But this issue of delays has only recently surfaced as part of budget cuts, resulting in doctors and surgeons having to prioritise those who are most in need.
Of course in the US this situation will not arise since not everyone who has a need for a hip or knee operation will have the opportunity to get one. This situation will not be decided by doctors or surgeons but by the insurance companies, either directly by whether the operation is covered by the policy, or indirectly by the patient/customer looking at the affordability of the policy excess or hike in premiums.I also work for the NHS, although for me it is in a hospital microbiology department. From my experience a national health service is more than just patching up an individual when they are ill. At my work, amongst other things, we screen for MRSA and C.difficile carriage for patients admitted to hospital as well as in the community, which are important infection control issues and could affect the outcome of any surgical intervention. The routine testing of patient samples also allows us to track other health issues, like food poisoning outbreaks or STD's or new bacterial resistance patterns.
My point of this is that even if you don't accept that universal health provision isn't a basic human right, you should at least recognise that withholding it from a section of the population means could still affect you. For example, you go to a doctor in the UK with an illness, they take a sample and we can tell you the causative organism and what antibiotics to treat with. The bacteria is eradicated and that's the end of the story. In America an uninsured person walks into the emergency room with an illness, and the doctor gives them some generic broad-spectrum antibiotic and fulfils their contractual obligations. It may not be the best antibiotic for the illness, the illness may not even be bacterial, and the patient may not be able to afford a full course of treatment. The upshot is that the bacteria is not eradicated and may go on to develop novel antibiotic resistances.Edited by Malcolm, : No reason given.

Well of course medical treatment will vary depending on the patient and their symptoms and what is 'required' will be determined by the examining doctor. I simply cited knee and hip operations as that was the example in the article.
As others have already pointed out, nothing is compulsory. You can still when or if you go to a doctor if you are feeling unwell, and choose whether to follow the advise the doctor gives. However I would say that the general public is not qualified to determine if symptoms they are experiencing can be lived with. It could be the start of something more serious, even potentially life-threatening, so the sooner you choose to see the doctor the better the outcome. Of course over here doctor visits are free. I did not realise that you even have to pay to just see the doctor in the US system. Illness is not something you can control and even living a healthier lifestyle provides no guarantees. To go back to the example of hip operations, that is the result of gradual wear and tear on the joint, so is generally age related but can also be exacerbated by a job which is physically demanding. The risk of heart disease can be increased by stress. Other diseases like many cancers can happen spontaneously. A person may have unknown genetic predispositions to certain diseases, or have a child with a genetic disorder like cystic fibrosis requiring long term care. The point is illness is not always a choice.As a non-American I admit I don't fully comprehend the 'American Dream' but it seems to be the idea that if you work hard you can improve your lot in life. But this doesn't appear to be what happens. You work harder to not fall behind, so your busy running on the spot until a health issue comes along to trip you up. I realise a public health service is open to knee-jerk accusations of freeloading or abusing the system (not so sure about unnecessary elective surgery ) but really it's a safety net for when things go wrong. There are a huge number of services involved in a national health service, and they do not all have to come under a public healthcare system at one time. For example you already have Medicare and Medicaid services which could be expanded. As less services are required to be covered by the insurance companies, the premiums will go down, including for employers. With more money the employers can invest it in the business, providing more jobs. This will in turn drive up salaries as businesses compete for staff, and the increase in salaries will be offset by an increase in taxes as more services are added. Anyway that's how I see it.

Just to say that in the UK the average cost of a heart transplant is about 30,000 ($50,000) which is still quite a lot, but is a fraction of what you have to pay. Is this the marvels of the free market you talk of? Over here the medications that companies provide are assessed by national committees which drive prices down as the companies are competing directly with each other, and know that if they're successful will be supplying their products to whole countries. As far as I can see this can't happen in the US as separate hospitals are responsible for their own budgets, and the specific medications will vary depending on individual patients and what their policies cover.