The USA healthcare price gouges via run away prices. Healthcare corporations corrupting congress is the fuel that forces this on people (and breaks a free market).
That being said, Canada has a huge health care problem right now. Frequently they need to close emergency services in major (& minor) cities at night due to staff shortages. The wait times for basic diagnostics is on the order of months (not days or weeks). For example, a relative of mine has lost 90 pounds since the start of the year, complained of chest pains and couldn’t (still can’t) swallow. They just got a basic scan after 6 months of waiting to confirm a baseball sized tumour in their lungs.
For many years we ran with just the bare minimum of staffing and equipment to keep costs low, and now, due to a number of factors our system can’t keep up.
Waste is not good, but a little bit of extra capacity (and cost) isn’t a bad thing when it comes to emergency services.
(Ridiculousness not being the pandemic itself, but inadequate resources, planning, and political cover from all levels of government.)
We are now reaping what they have sown.
This is a classic "underfund to prove the system doesn't work thus we must privatize it!" move.
You don't have to assume. It costs twice as much as the most expensive health systems on earth, but delivers Afghanistan-level life expectancies. The problem isn't that we're spending too little.
Life expectancy is a particularly bad metric to use to compare health care systems, because it's heavily influenced by (1) how much people drive, (2) how much violent crime there is, and (3) how much drug addiction the country has. None of those are health care metrics.
I don't believe there's any credible critic of American health care that premises their complaint on America delivering bad health care. We deliver pretty excellent health care, and we deliver it faster than a lot of countries with better health care outcomes. We are in many places in the US overprovisioned for care (by measurements like empty hospital beds, or overprescription of elective procedures). The chief complaint about American health care is how expensive it is, not how good it is.
That distinction is especially important because getting costs down may involve confronting the ways American care is better than it needs to be or should be. For instance: we do a lot more elective surgeries than countries with better outcomes, in part because we do them outpatient here, and they're inpatient (a much bigger deal) elsewhere. For example, my understanding is you're much more likely to get a hernia repaired (probably needlessly) here than in the UK.
Afghanistan is a whole decade off that cohort.
Ref: https://www.fao-on.org/en/Blog/Publications/interprovincial-...
It's being underfunded by at least 10-15%, which is a lot for a system expected to run as cost effectively as possible. I'm getting that number from the average of $5336 vs ON at $4800. 4800/5336 = ~89%
I don't think we should aspire to US levels of GDP share. That seems quite excessive.
I think the solutions to our issues are structural changes and adequate funding.
Governments of the last 20 years have held the status quo, which leaves them equally culpable.
Second sentence: explain people’s motivations
The NHS is still wildly popular so it's politically impossible to privatize from the outside in but it's becoming less popular as its effectiveness declines due to expanding mismanagement, underfunding and corruption when awarding contracts.
The frog has to be boiled slowly though.
Part of this is COVID burnout. It wasn't this bad in 2019. Wife works in healthcare and sees the difference every day. Nurses crying etc.
It's also impossible to get a 2nd opinion. The specialists all tend to belong to the same groups so you'll call a different doctor and eventually get shunted back to the exact same doctor you started out with. Where the the competition?
This seems like a completely reasonable approach and I’m always surprised that it’s not the default.
The crazy thing to me about this is, most Americans simply skip medical procedures, or tests due to cost.
So American wait times aren't lower because their hospitals are better, they just server a much smaller pool of people due to so many being priced out of being healthy.
And honestly, the longer you go without doctor visits, more expensive, complicated and involved the process is.
That is an atrocious number and something that needs fixing but we don’t need to exaggerate it to make that true.
We don’t know how many people skip healthcare because a doctor is inconvenient (in the states or in other regimes) either. So it seemed the most appropriate comparison to make.
The 1/3rd is people avoiding treatment recommended by a doctor. 43% of people reported to have avoided healthcare due to costs.
To me "Not most people, only 43%" isn't what I would consider too much of an exaggeration.
For many years Canada (and similar countries) have relied on cutting costs by importing health care professionals from other countries. That pipeline has now shrunk considerably, resulting in the exposure of the underlying problem.
This says 10.2% as of 2020 : https://www.aihw.gov.au/reports/health-welfare-expenditure/h...
Any improvement in efficiency would mean those people lose out on jobs. A new use for them must be found, or there will be massive unemployment (at least, short-medium term).
Thankfully the economist bastiat solved this absurdity in 1850.
https://en.m.wikipedia.org/wiki/Parable_of_the_broken_window
you laugh, but this is exactly what the US gov't does, esp. with military budget allocation. Why do you think all sorts of military products are split into different pieces for manufacturing, separated into different states? It certainly doesn't help efficiency.
I'm not saying that healthcare shouldn't be improved via efficiency increases - it needs improving! But let's not kumbaya and ignore the plight of those whose livelihood would be disrupted (and not of their own fault).
Another example of political economy is two different efforts to address climate crisis, with very different outcomes.
During the Obama Admin, the push was for carbon taxes. Wonks loved it. Logical, concise, moral. Complete nonstarter. Because carbon taxes has no built-in constituency that's willing to advocate and defend it.
Whereas in 2020, progressives pushed "green new deal" themed industrial policy and investment strategy. Made most everyone a benefactor. Millions of jobs. 100s of billions of dollars. Much better political economy.
I mean I don't want anyone suffering either (one would hope you'd have adequate social safety net to take care of these people until they find another job) but it's such a bizarre exemption to carve out
For a theoretical based on what actually happened where I live, Hospital X is contractually obligated to use a specific kind of infusion pump from supplier Y and order blood tests from specific supplier Z in order to get Blue Cross Blue Shield coverage. Meanwhile the state university pushed out the other hospital in the city and heavily expanded the surviving hospital campus they sponsored to take on the increased capacity and introduce the services they were previously lacking compared to their now dead competitor. So Hospital X is just following the policy of University Network A. All of which is a common practice.
In many states the state university sponsored medical care networks are the or are close to being the biggest employers. The University Of Iowa medical network, the West Virginia University network, and University Of Pittsburgh Medical Center network all have taken over a majority of medical care functions in their states, leaving mostly specialists and those in mental health to independent practices. That exacerbates the issue of insurance and supplier contracts, because these small places that are competing with the university networks often don't bother with insurance unless it's government provided and just prefer patients pay up front instead. They lose too much time and money sorting through the myriad private insurance providers, plans, and coverage obligations without full time staff to handle that for them. Medical billing is a massive industry for a reason.
Now, if everyone wasn't chained to private insurance and juggling all of these providers, coverage limits, and contractual obligations the number of inefficiencies and thus the overall cost would decrease. We have historical examples of this even in the U.S., by comparing what happened between 1960 to 1975 and it's modern equivalent of 2005 to 2020. Healthcare costs were increasing rapidly, doctors were dwindling in number, and there weren't enough medical students for generalist fields in the 1960s just like the 2010s. The major difference is that while quality of care continued to increase through the 1960s and early 1970s, both the efficacy and quality of care has gone down since the 2000s. The several minor differences were that nationwide coverage was rarely available in the 1960s compared to the 2010s, that Medicare was spending more than it was receiving in the early 1970s thanks to how Medicare was funded in the 1960s, and that privatization of entire hospitals was uncommon and frowned upon in the 1960s because of the income impact it had on the doctors. The U.S. barely survived the 1960s medical crunch with enough government intervention, but it is dying under the weight of the 2010s medical crunch because the government can't easily intervene and is lobbied to maintain distance.
So the reason the lead figures in the American right are worried about single payer is because they won't make as much money. And they're very good at convincing people to vote against their own interests because they know those people don't care to look into complex systems too deeply. As a result many of the regular voters and workers are worried because someone told them a lie about where the money is actually being wasted and what the actual history is.
Just picking this point out - how can lobbying stop something? As in it's worth too much lobby money to politicians to change it?
For instance, Germany is producing the Leopard 2. They may export most of them during peacetime, but should they need to, they could start pumping out those tanks for the Bundeswehr instead. Furthermore, with the skills available domestically, it would take much less time to repurpose VW/BMW/Audi factories to also produce weapons.
The first economist says to the other “I’ll pay you $100 to eat that pile of shit.” The second economist takes the $100 and eats the pile of shit.
They continue walking until they come across a second pile of shit. The second economist turns to the first and says “I’ll pay you $100 to eat that pile of shit.” The first economist takes the $100 and eats a pile of shit.
Walking a little more, the first economist looks at the second and says, "You know, I gave you $100 to eat shit, then you gave me back the same $100 to eat shit. I can't help but feel like we both just ate shit for nothing."
"That's not true," responded the second economist. "We increased the GDP by $200!"
You used a wrong allegory to try to demonstrate a point that noone was making.