>And with the wilful blindness to how exactly those gatekeeping referrals are present in most every single healthcare plan in the US.

This is only required by HMO plans which cover around 40% of the US population. PPO plans don't have such a requirement.

So please don't call other people willfully blind when you yourself make broad factually incorrect statements. Pot please meet kettle.

edit: Also my statements about Germany are based on comments Germans have made on hacker news regarding their own health plans. So you should really go yell at those Germans for not knowing how their own health system works.