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Comment by lumberjack | Hacker News Reader

Universal healthcare is already much more cost effective than fully or semi-privitised health care.

Sorry, I forgot to pretend that all the other developed countries haven't figured out healthcare already.

Geez.

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Oh and btw, when you have a universal healthcare system payed by taxes (none of that bullshit insurance crap that only ends up being costly regulation/financial bloat) you can have entire and fully private hospitals and health clinics where you can get service for cash, and surprise, surprise, it's ridiculously cheap because it has to compete with the effectively free public healthcare system.

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>Universal healthcare is already much more cost effective than fully or semi-privitised health care.

That's not true. Most developed countries have some form of privatized system, falling into your 'semi-privatized' definition. It's more cost-effective.

In Australia we have a universal healthcare system for everybody and a private system that runs alongside that essentially gets you a more comfortable bed and the ability to jump the queue for non-critical surgery.

An importing part of the Australian system, is that for people and families earning over a certain threshold ($80k for singles, $160k I believe for families) you have the option to either

* pay for private health insurance, or

* pay an additional 2% surcharge/tax on your income

This is to encourage people who can afford it to purchase private health insurance, to lessen the load on the publicly funded system where possible.

Even an economic nightmare like Argentina manages to run on the same idea (I grew up there.) The level of complexity and inane amount of paperwork you have to do in the US to get the simplest care is still baffling to me. I get it that it's the inefficiencies that make this system profitable to some, and that's why you might get the "best doctors in the world", but it could definitely use some modernization.

All the money involved means that the companies and their lobbyists have too much at stake and have to mobilise against change. Huge shame when it impacts hundreds of millions.

Exactly what I'm talking about

In many countries there is some element of private healthcare, but it only provides luxurious services that are in no way needed to treat health conditions (1-bed rooms in hospitals, choosing any doctor you like, shorter wait times for non-urgent treatments). Good examples here are UK and Germany. In both countries you'll get full coverage of any medical condition with public insurance.

The reason that private elements exist at all are NOT because they are more cost efficient. They exist just because some people like to have more comfort and are willing to pay for it. Not sharing a room in a hospital doesn't make you healthier (and is certainly not more efficient), it's just nicer.

I'd agree with your parent-comment that most states have actually figured out that public health care is the most efficient option. Private health-care providing necessary treatments is the more expensive option for society.

The UK is not a good example - it has a fairly unique nationalized system.

Germany, on the other hand, has a regional and national market system with compulsive health insurance, much like the ACA attempted. It's not a public only system by any means.

It's not about sharing a room, actually. It's about reducing the burden on the state, providing more efficient service for cost for everyone.

Further, the main issue with public-only systems is wait times. In Canada now the wait times are extremely long - in the area of 20+ weeks. http://www.ctvnews.ca/health/healthcare-wait-times-hit-20-we...

That's not about comfort, it's about getting treatment.

In Germany, it is about comfort. The public insurance is achieved via competing entities, but those are not-for-profit organizations. It's safe to say that there's no health benefit whatsoever of having private insurance in Germany. It's just nice and you can feel good getting quick appointments with any doctor you like. Necessary treatments are free for anyone else as well.

Hospitals in the US are also non-profits. Many insurers used to be as well.

The difference really is in who negotiates. In the US, it is usually individuals organizations or companies - in Germany it is mostly the state, though people still have choice. It's not administrated by the state, though - it's administrated through public/private partnership. Personally, I think it's a great system, and I wish the US would have implemented a version of it more successfully.

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