We have a similar problem in a way with our trains. They’ve all been ‘privatised’ but if only one train company runs your route there can’t be any competition, so our trains suck big time and are really expensive.
End result is it costs upwards of £4k for an annual pass for a half hour train journey.
Add to that the fact that nobody would ever allow the trains to cease operating, and you have a really big question mark over what the point of privatizing was?
We know this doesn't work because we tried it and it didn't work.
But it doesn’t hold water. France, Germany, Spain all have cheap, really good government-owned trains - in fact they also operate some of our trains in the UK and use the profit to fund their own trains.
Prices have gone up by the maximum operators are allowed to increase them every year (there’s a 1 year exception where I think they were frozen for political reasons) https://www.bbc.co.uk/news/business-49331238
Just because we tried something before and did it badly doesn’t mean it won’t work in future if done well. Execution is everything, right?
Define really good? They are less safe, the prices charged to consumers may be lower but what is the overall subsidy (I understand that you want other people to subsidise your commute...other people tend not to be happy about this), and it is fair to say that UK trains are less punctual but the difference is not massive (and we do come ahead of the nations you mention some years too).
The discussion on this in the UK is pathetically weak, and largely a function of trade union lobbying (if you didn't know, the TUC pours money into this cause like nothing else...presumably they just really really care about commuters).
For a business to be good for customers it needs to be accountable to those customers. These businesses are only accountable to governments and even then only ever X years when the contract comes up for review. Their motivation is therefore to service the government not the customer and the customer suffers.
These problems include a tremendous shortage of doctors [0]. Even Canada and the UK have more doctors per capita, and they are known for extremely high wait times (the jokes of the socialized medicine countries, so to speak). There are a number of possible reasons for this, most notably the hassle of occupational licensing (12-14 years of expensive college + 'indentured servitude' residency in the US).
Nonetheless, American healthcare science is still ahead of the curve and subsidizes socialized countries -- ~60% of all new drugs between 2001-2010 were invented in the US, and foreign dignitaries of socialized medicine countries often still get important procedures done in the US [1]. It would be interesting to see how the R&D dynamic plays out if America loses its market incentive to innovate in the space, and no other developed countries have the financial incentive left.
[0] https://data.worldbank.org/indicator/SH.MED.PHYS.ZS?end=2018...
[1] https://xconomy.com/seattle/2014/09/02/which-countries-excel...
The Swiss seem to have something right. They have actual competition between insurers, though you are restricted to changing supplier at the annual window. Everyone is obliged to buy basic coverage from somewhere, but you can choose. And the obligatory level is fairly cheap, maybe a few hundred CHF per adult per month (kids cost fractions of an adult, basically nothing). You can then add on perks like guaranteed single rooms and such, costing as much as they can get you to pay.
In return you get a service that seems magical. My colleague crashed his bike and needed stiches. He was at work in the morning only slightly later than the normal time. The time I needed the emergency room I wondered how on earth that could be room, it was empty. When my wife gave birth it was like a hotel stay, they even fed me (the father) three meals a day for the best part of a week.
The NHS these days is super stressed. Everyone seems busy, the halls seem very old and crowded. If you're not bringing in a kid, be prepared to wait. And there's plenty of articles about waiting times and busy staff, which seem believable given I know some of those staff.
UK private seems to work nicely if you can pay for it. I had a couple of knee operations, and everything was very comfortable. Barely even saw another patient, and there were lots of people attending to me.
Also, I live in Scotland where the NHS has been getting more money for a while...still awful. The NHS drop massive wedges of cash on vanity projects (always over budget, usually issues because of poor project management) but never hit waiting time targets. Definitely, there is an issue with care and old people having to stay in hospital...but there is also something far deeper (my area is rural, total population of 30-40k...the NHS just dropped £75m on a ten-ward hospital...I go there four or five times a week, 75-80% of the people you see walking around are staff).
I don't know what the solution is, I just know that other countries do it better and they have larger private sectors.
There is no such thing. A free market for healthcare will end up with people being trapped or simply lacking access. The entire concept of insurance is just a middle-man on a necessary service, one which should be considered a right for a society as rich as ours.
You either massively regulate private companies to force them to cover sick poor people at a big loss and compensate by making healthy people pay more, or you just get rid of the middleman and cover everyone directly (single payer).
Seriously, what value do insurance companies provide? How is it not just rent-seeking on people's health?
(No-one seems to have actually read the article, it says that her insurer would have paid ~$650 if the lab wasn't one owned by the doctor she saw...and, if I understood correctly, the doctor also did a whole bunch of totally unnecessary testing...this looks a bit like plain ol corruption).