I don't know how universal healthcare might work in the US, but that is far from the way that it works in Europe. A government doctor does not decide if you need an operation. If a GP has doubts they will refer you to a specialist who will probably order further tests and then, if necessary, outline the treatment options available to you. If one of them is an operation then you (the patient) decides whether you want to go ahead with that option or not. I'm sure that it's a truism to say that there are good and bad doctors everywhere just as there are good and bad engineers, transport planners, decorators, etc. Just because you are paying for a doctor out of your own pocket doesn't guarantee that you will receive good service and advice. In a similar way, government doctors are not necessarily worse than their private counterparts as you imply. My experience of the medical professional in Belgium and the UK is that the level of expertise is good. Moreover, the two questions that I have never had to ask a doctor in either Belgium or the UK is, 'How much is this going to cost?' and 'Will my health insurance cover this?'.
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