I'd add that "healthcare" as a benefit is a very American concern. In most real countries, that's taken care of separate to our jobs.
[1] http://www.econtalk.org/archives/2017/01/mark_warshawsky.htm...
The big problem with employer provided insurance is that they suck a lot of healthy people out of the individual market. We already know richer people are healthier, and they are likely to be enrolled in group plans. So what is left in the individual market are necessarily less healthy on average, so the premiums suck.
For us, it's that our insurance is tied to our jobs, so we can't think of leaving or even "taking a break" if we can afford it!
At the very least, there should be a federal program that covers all children. We can easily afford it.
Why I have to choose health insurance and my employer together is beyond me.
Of course, the trick with healthcare funded through taxation is to avoid having it cut down until everyone is worse off, not just low income earners.
I can't choose not to die. I can't choose not to get sick.
I can choose not to continue my family's income. I can choose not to receive medical treatment.
There is nothing uniquely special about health insurance.
Since EMTALA means the hospital has to treat you, and as a society people will ensure you get taken there, you are in fact incapable of doing the opting out at the times it's likely most expensive.
And frankly, as a society, we shouldn't trust you: because the outcomes speak for themselves - people don't voluntarily choose not to get medical care. They lie about it when they don't need it, to suit their politics and greed.
My sarcasm detector is weak today, but I'm assuming that's what that is.
For example I tore my right ACL last summer. I chose to wait 6 months to have an MRI and surgery (in fact, I had no idea what the injury was for that entire time), because we have a high deductable and my wife will give birth this year.
You might say that's just an artifact of a broken system, and you might be right. But say, if I was 50+, I'd likely choose to avoid the surgery and expense altogether. People forgo medical treatment all the time.
Of course, before Obamacare it was because pre-existing conditions made the private health insurance market ridiculous.
It means the employee can get their treatment weeks, even months before they would have otherwise - that's important if you have a painful or debilitating condition. That is, the employee struggles to be an employee due to government budget constraints.
A suspect a few people are going to read "weeks, even months before they would have otherwise - that's important if you have a painful or debilitating condition. " and assume that is a given for a public system. You often have to wait for non urgent issues in the US as well if you want a specific doctor or clinic.
Belgium is split right down the middle by language and culture, with many people supporting a split into two independent countries. Spain has Catalonia and the Basque country, two culturally and linguistically distinct regions that have long fought for independence. Ireland has spent most of the last century in a slow-burning civil war. Half of Germany was part of the Soviet Union until 1989.
When people say that universal healthcare can't work in the US because of "diversity", what exactly do they mean by that word?
Just set up multiple systems. The US even has very convenient boundaries to split up the systems along: States, just like the EU.
Even most countries with universal healthcare further subdivides their systems. E.g. Norway (5 million people) operates regional health trusts that are largely independent. The UK (60 million) does the same on a larger scale (more trusts) and leverages the number of trusts to improve management of individual trusts by occasionally having successful trust take over the running of trusts where management is failing.
The "size" argument is almost always a total red herring.
But I agree that "size" in this case definitely does not mean geographic size. Geographic size might be a factor for why America doesn't have better telecommunications or rail system, not health care.
I think most insurance providers are multi-state entities so higher costs in one state can be balanced by lower costs in others. But there may be some limits; if the ACA requirement that insurers use 80% of revenue on health care costs is applied per-state, they may not be able balance out a really unhealthy state. But this isn't an issue due to America's geographic or population size or even the quantity of states, it's that America has much more political power at the state level.