Unless you remove people out of the equation, universal healthcare will never work. There's no incentive for anyone to be efficient, more frugal, work harder, provide a better service in universal healthcare. Humans arent wired for this.
Every OECD nation except the US has universal healthcare; many have generally comparable outcomes and all have lower costs (both per capita and as a share of GDP) when compared to the US.
So, I'm not sure what your binary standard of "work/not work" is, but universal healthcare can and often does work better than what we have in the US.
I spent over a year backpacking after being out of the US for four years. I never worried too much about health care, because the few times I needed to go to a doctor, they'd tell me prices up front for uninsured foreigners. In one country, even though I wasn't a resident, my work visa did give me a discount.
I've been back in the US for a year and want to go a big road trip. I have a ton of savings, but my health care is terrible. I got a contract job with a $19/week "minimal effective coverage" plan (preventative only; the 'legal for less' type car insurance plan that is ACA approved).
After three months they gave me the PPO plan options which started at $400/month. Thankfully I haven't broken an arm, but in the 12 months working and not getting on that overpriced PPO plan, I've saved enough money even after tax that I could probably pay for a broken arm out of pocket.
I looked at ACA plans, but they were $200+/month with $6k deductibles. By not going that route, I've saved enough to actually pay that deductible.
When I quit my job this spring, I might be able to get a real plan by saying my yearly income was what I earned up to that point. But I don't plan on staying in this state at all, or any state for more than 2 ~ 3 weeks after. Since so many of these plans are tied to states/networks, what good is that anyway?
In the US you have to work .. work work work just to have basic health care. Either that or just be desperately poor. No other high income country requires this. They take care of all their people.
The USA stands out horribly. I can't even imagine why anyone would choose to live in a country that did not offer universal health care.
Or wait- other people already have!
Skim through this paper and let me know what you think.
https://www.oecd.org/els/health-systems/Universal-Health-Cov...
Every time healthcare is discussed on reddit, slashdot, etc, most of the people commenting on us healthcare debate it in the form of : "not with my hard earned money, you lazy commies, why don't you start working".
What's interesting is that it isn't their fault.
From the outside, the system looks a bit rigged against the common person, and the dog eat dog mentality is propagandized heavily.
I sometimes wish that our fellow Americans experience better, see that it actually works, and engage more against the corrupt system that milks them, instead of the rest of the fellow human beings.
What amazes me though, is that HN seems a decent place today for a discussion like this one.
So it's not even saving your tax money to avoid universal coverage.
http://visual.ons.gov.uk/how-does-uk-healthcare-spending-com...
> Despite less than half of the USA’s total healthcare expenditure coming from government expenditure or compulsory insurance schemes, it still spends more per person on these financing schemes than the UK- £3,111 in the USA in 2014, compared with £2,210 in the UK. In the USA spending on privately-funded healthcare is over five times more per person than in the UK.
Heck, it's so overdone that even the burden of finding the counter arguments lies with you.
I'm just tired of seeing this conversation turn in circles.
Calling all universal healthcare non-competitive is like calling building roads non-competitive. We have government roads and private toll roads. The same goes for many services we take for granted.
A more advanced basic level of healthcare is something we are able to achieve because of our wealth and success. We already have sanitary toilets, housing, heating, clean water. Every generation has built upon what we can join together as a society to provide in order to promote our health.
In my opinion, Buffet, Gates etc. are the heroes of our time for standing up as rich folks to advocate giving back more to society. They don't view government as the enemy; rather, it is the result of our working together.
Roads are a major one-time investment with occasional upkeep. Everyone can use the road without the permission or assistance of anyone else. If we develop fully robotic medical treatment, this analogy may work, but as long as medicine requires direct, many:one human interaction to be worth anything to anyone, it's not a piece of infrastructure.
>A more advanced basic level of healthcare is something we are able to achieve because of our wealth and success. We already have sanitary toilets, housing, heating, clean water. Every generation has built upon what we can join together as a society to provide in order to promote our health.
We have sanitary toilets, housing, heating, and water without nationalizing home builders, plumbers, or utility companies. All of these things are subject to sensible regulations like municipal building and zoning codes, licensing, and local utility oversight boards that have arguably done a lot to keep the little guy from getting fleeced. Maybe we could take that approach, which is a bit short of writing a blank check or setting fixed prices for all medical providers nationwide?
>In my opinion, Buffet, Gates etc. are the heroes of our time for standing up as rich folks to advocate giving back more to society. They don't view government as the enemy; rather, it is the result of our working together.
Look under the veneer on Buffet, Gates, etc. They like government because it furthers their business interests (this is especially true in the case of Buffet) and because it's easier to exercise control over money sitting in a bureaucrat's coffers, especially when you're a big name like Gates or Buffet, than money that is dispersed among the private citizenry, who really don't have any special reason to care about your opinions.
It's also very useful PR to go on TV as the richest man in the world and say "I need to give the government more of my money". What would the backlash be if he said the opposite?
While Gates and Buffet surely have legitimately laudable humanitarian interests, it's misleading to pretend that they're saints. They are free to donate to the government as they wish. Suggesting that everyone else be forced to match them percentage-wise is a different story.
Do you have any citations from (competent, peer reviewed) journals?
I don't know how anyone can with a straight face argue that the US healthcare system is efficient with regards to money, time, or outcome compared to most single payer systems.
Currently wait times are too long. This is because i) Social care has been chronically underfunded for many years ii) The NHS has been chronically underfunded for many years.
Here's the wait times for IAPT (short form talking therapy for mild to moderate mental health problems -- usually CBT).
http://www.content.digital.nhs.uk/catalogue/PUB22842/IAPT-mo...
> 87.8% waited less than 6 weeks and
> 98.3% waited less than 18 weeks to enter treatment
That's too long, and considerable pressure is being put on trusts to reduce those times.
There's a wealth of data just about IAPT here: http://content.digital.nhs.uk/iaptreports
Have a look at the English NHS. You have a national organisation providing best current practice guidance (NICE.org). You have the Department of Health that funds NHS England, who fund the Clinical Commissioning Groups. The CCGs buy services from health trusts. The CCGs don't have to buy from NHS providers, they could buy from private providers. (See some inpatient eating disorder services; some forensic units; for examples of private providers commissioned by the NHS).
English health care workers are dedicated, skilled, hard working people.
The US is also pretty much the world capital for a number of drug development and medical research areas simply because it's much more profitable to do there - taking away that profitability may have a negative impact on Healthcare advancement - not just in the US but world wide.
Some kind of balance needs to be reached here. I thought Obamacare went a lot in the right direction, but it seems that's a big mess of its own.
If you want to skip the queue you pay for it.
An argument from my side would be that basic income and health may give a person means to give a dignified life, but are not going to let him buy a Ferrari.
I have heard from friends that in Northern European countries, there are people who live their whole lives on welfare. But, we also have very productive people from these societies.
Maybe you only care about money so that clouds your understanding of human behavior.
This is obviously not a sustainable or mature solution to the problem, but it's a band-aid that appears to relieve much of the burden involved for patients.
I broke it out once and my net salary would be about $1k less than what I receive now if I lived in Canada instead of the U.S. I know that those extra taxes aren't all directly attributable to the health care apparatus, but the unverified impression is that a lot of it goes to that.
There have been periods when I've had to pay more than $1000/mo on medical bills on an ongoing basis, and there's pretty much always at least $500/mo going out to medical payments of some type or another in our family of 7. Our credit has also been routinely hounded by the medical industry's inability to figure out its own billing. Is avoiding all of that worth a net loss of $500/mo? Probably.
The polarization in America is really sad. We need to acknowledge that these are legitimate issues. Republicans need to take their heads out of the sand and quit just shrieking that "we have the best health care in the world!!!! We're America, bitch!", and Democrats need to respect that Republicans don't think "Just have the government pay for it and increase taxation commensurately" is an acceptable solution. Let's get away from each others' throats and try to figure this out constructively.
IMO the best option is to outlaw non-catastrophic medical insurance, set up new, temporary medical device and pharmaceutical suppliers who sell brand-name products at a loss, make serious revisions to the terms of drug patents, remove any applicable governmental subsidies that encourage reckless, unsustainable expansion of medical facilities, and make a law that says medical bills cannot be included in any credit worthiness determination.
This converts everyone to self-pay, which means medical providers will have to charge prices that real people can actually pay, it will end the absurd pricing showdowns and billing shenanigans between providers and insurers that often leave patients as collateral damage, it will undercut the supply chain that ratchets up the costs for everyone on the way down to the patient, it will discourage hospitals from building extravagant campuses that rival universities and instead focus on affordable, utilitarian designs, and so on.
I can hardly think of a worse solution than "just make everyone get an insurance policy and leave everything else essentially the same", aka Obamacare/Romneycare.
That should take us a long way to a sustainable, market-based solution. But it's clear at this point that some governmental action is needed to grease the wheels here.
http://visual.ons.gov.uk/how-does-uk-healthcare-spending-com...
Government spending (not including insurance)
> Despite less than half of the USA’s total healthcare expenditure coming from government expenditure or compulsory insurance schemes, it still spends more per person on these financing schemes than the UK- £3,111 in the USA in 2014, compared with £2,210 in the UK. In the USA spending on privately-funded healthcare is over five times more per person than in the UK.
No one is going after the industrial profiteers and exploiters here. People either want to leave those profiteers completely alone or force them to continue to be paid exorbitant rates by the government (that only look non-exorbitant by comparison to other nations where they're even higher). Those are both bad answers! The marketplace must be kickstarted so it can stay in the hands of the people, surrendered to neither government bureaucrats (as proposed by pro-universal healthcare advocates) nor heartless capitalists (as is mostly the current state).
We need to start from first principles here and say "What does a sick person need to get better, and how can we provide that in a cost-efficient way that allows medicine to be like all the rest of our industries: open to competition, appropriately regulated, and run by fair and competitive private enterprises?"
That kind of system promotes poor and expensive health.
Yes, services and goods procured, even necessary services and goods like food, clothing and housing, cost money.
If you're arguing that no life necessities should cost money, I'm afraid you're not going to get anywhere with the non-socialist crowd. Since most Americans are non-socialist, this is not a politically tenable position. Do you have an objection that isn't "it should cost literally no money"?
The US has a (admittedly obfuscated) fee based health care system. However, if one necessarily needs medical treatment, you can go to an ER it will be provided to you. You might end up with a debt that you can never pay but you won't be turned away. These emergency visits actually account for a large amount of the US government health care costs.
So if your society accepts that all people will be treated regardless of their ability pay then you might as well start looking at better and cheaper ways of doing that. Waiting till someone is so sick that they need the ER is a huge waste and bogs down the entire system; even for paying users! By comparison, simple doctors visits are considerably less expensive and produce better outcomes than waiting until people have no other option.
As for socialism, your society doesn't want to let people starve either and provides plenty of mechanisms to prevent that too. Socialism is automatically baked into any society that won't let the poorest or the sickest simply die.