The best time to start training more doctors and nurses is ten years ago. The second best time is today.
Combine this with providers incentivised to provide as much healthcare as possible at the highest possible markup, and insurers incentivised to deny as much care as they can ... and you have what always looks (from the other side of the Atlantic) like a gigantic life-and-death financial nightmare.
https://fee.org/articles/the-idea-that-the-us-has-a-free-mar...
I'll take an adequately funded NHS, thanks.
>> leaves millions without any access to healthcare
Absolutely, 100% completely false.
>>can result in bankruptcy as a result of an illness or accident
This is true, however contrary to the social stigma bankruptcy can be a good thing for many. In the US Medial Bankruptcy is often made inevitable by various government regulations that prohibit creative solutions by providers.
Perhaps virtually everyone has access to health care, but certainly millions opt out at the cost of their own well-being because they can’t afford it. There have been times in my life when I have.
My reasons for opting out have nothing to do with finances, it would get exactly the same amount of care if it was free.
The common refrain is that they can go to a hospital, except an emergency room is not going to help chronic conditions.
Any idea that a majority of these people are choosing to have no coverage, goes against all research on this topic.
Ok I'll be more specific: "leaves millions without insurance and since they're usually low-income and therefore cash-poor, unable to get any adequate access to healthcare". Is that really, meaningfully any different from what I said?
I have to say, the words "bankruptcy can be a good thing" is going to be bouncing around my head for a while. I don't know how less regulation could help these people, and I'm a little bit horrified thinking what kind of creative solutions these providers would come up with ...
This is still false, infact the most impacted group by medical costs is the Middle Class not the poor. People too "rich" to be on public assistance programs like Medicade but too poor to afford a medical emergency and work for employers that either do not offer insurance, or have poor coverage.
>>the words "bankruptcy can be a good thing" is going to be bouncing around my head for a while.
I have known more than a few people that have gone through bankruptcy and it was the best thing they could have ever done. One mistake people often make is waiting tooo long to declare bankruptcy. Bankrupcy is a legal tool designed to provide aid to people who find themselves in too much debt, there are all kinds of things built into that system to assit people. It really is not a punishment. For example most people do not realize that they can Keep their primary residence and primary transportation even after declared Bankrupcy. People have this vision that is you file for Bankrupcy *protection* the police are going to come take all your things and put you on the street.
>>I'm a little bit horrified thinking what kind of creative solutions these providers would come up with ...
One thing that is prevented by Regulation is Medical Coop's several have been tried but they can not navigate the regulations to make them workable. Non-profit Member owned Coops would be a great thing for medicine, just has it did for Utilities in many regions of the US.
When even companies like Walmart can not make low cost medical services work directly as a result of regulation you know there is an issue.
I kind of feel like you're trolling me a bit, if I'm honest.
Would you agree that subsidies and regulations increase prices?
Why?
Or I guess I should ask what other requirements of life should be completely under the governments control? Should Government run farms and give you food for free? Should government build homes and issue them to people?
I have never been clear why healthcare is uniquely something that must be provided by government but other things are not.
If you think the government should provide everything you need to live like they were a parent or nanny well then we have completely and incompatible views as to what a government should be
The government do provide assistance for food for those in need, and they are right to.
> Should government build homes and issue them to people?
Local governments in most developed countries build homes and issue them to the needy. And I believe this is correct.
You've obviously deployed exaggeration to try to make these things sound ridiculous ("...completely under the governments control..." and "...live like they were a parent or nanny...") but really none of this is controversial, they're pretty common, mainstream beliefs.
I believe that a government should work to better the lives of the citizens it governs. This includes things like providing education, healthcare, road and rail infrastructure among other things you probably wouldn't like. I am quite sure we have incompatible views as to what government should be and that we both believe the other's vision of an "ideal" country would actually be a dystopia. However some of the happiest, healthiest and best-educated countries operate pretty close to my ideal.
This is always the comeback to that question. The US provides food assitance and Medical Care Assitance to low income people via many many many government programs, very expensive government programs
That is NOT the same thing as NHS, which completely takes over and provides the care. Food Assistance gives people with out income money to go buy the resources on the open market. Medicade gives people with out income money to go by resorces on the very regulated US health system
This is not an analog to NHS or other government run single payer health systems
So again I ask, not about providing social safety net, but should the government completely take over farming and housing like the NHS and other government provided programs do for health services
>>This includes things like providing education, healthcare, road and rail infrastructure among other things you probably wouldn't like
Correct, Government is incompetence personified. The incentives for government programs do not include providing quality services at the most value. Driving on my roads, going to the government schools I went to, and seeing first hand what "government housing" is has cemented the fact that government provides poor quality services at extremely high costs
>>However some of the happiest, healthiest and best-educated countries operate pretty close to my ideal.
That is very debatable, and not really supported by hard data
> Should Government run farms and give you food for free?
Probably not, the existing system works ok enough. They can maybe help the poor a bit more so they're not dependent on food banks (free school lunches was a recent controversy that shouldn't have been)
> Should government build homes and issue them to people?
I answered and you didn't like this but - yes and they should build more. I'll give you a little bonus and answer what you wanted to ask - "Should the government be the sole central authority providing housing?". Probably not, the housing market works ok enough in general. However they can maybe help the poor a bit more by building more council housing, not doing so is has directly contributed to making housing unaffordable for many.
And to bring us back to the original topic:
> Should the government have setup a national healthcare system back in 1948?
Yes - in the wake of WW2 there was no existing, competitive alternative that served the needs of providing quality, affordable healthcare to the populace. The NHS went on to deliver and then some. Plus with ~70 years of hindsight we see that in spite of a decade+ of brutal austerity, the NHS still costs less and delivers better outcomes than privatised systems like the USA has. It was the right thing to do, it is the right thing to do.
Also you seem to think they’ve shut out private providers altogether. This isn’t true, private healthcare exists if you want quicker access to some elective or non-urgent procedures or treatments.
Re your final point - this is very interesting. I'd like to know what countries you think I'm talking about, and if your libertarian (I think I'm right in saying this?), small government setup is anywhere close to implemented somewher right now or if it's purely theoretical/fantasy.
There's loads of reasons to dislike NHS care and it's genuinely weird that people who are so against the NHS never manage to hit on something real, and instead resort to stuff that's simply fiction.
NHS England spends billions commissioning care from private providers. That's why we have Priory Group, Cygnet, Operose, etc etc all providing care. (And in the case of cygnet and priory, often poor quality care).
And patients have a right to chose where to get their care - that's what chose and book is.
People who don't understand the NHS think it's a single organisation -which is what you've done here- and that's not correct. Patients have a choice of where they get elective care. NHS England commissions specialist services, and 42 ICSs commission the bulk of regular services. They're not allowed by law to have a preference for NHS providers, so if a private provider can do it for the money they should put a bid in. That commissioned care is provided by about 200 - 220 NHS trusts. NHS Trusts include ambo services, acute hospitals, community hospitals, mental health care, and community care. These NHS trusts are independent organisations that have their own boards of directors and their own accounts and they can compete against each other to provide services to particular regions. This does not include primary care which is provided by GP surgeries.
Which are and have always been private businesses operating as NHS contractors - this was actually the concession the post-war government had to make in order to get the British Medical Association onboard with the NHS. And recent surveys indicate GPs are against any change to their private status.
And how exactly would that have improved this discussion with "phpisthebest" who seems to be against the very idea of insurance altogether, given that they have the means to take care of all their healthcare needs in cash (for now), and who thinks that everyone else should really see bankruptcy as a sort of spiritually cleansing and enriching experience?
If you're going to argue against fundamental human rights like "right to life" then you're going to have to do better than the arguments you're using here.
>Medicaid is the largest source of funding for medical and health-related services for people with low income in the United States, providing free health insurance to 74 million low-income and disabled people (23% of Americans) as of 2017,[3][4][5] as well as paying for half of all U.S. births in 2019.[6] It is a means-tested program that is jointly funded by the state and federal governments and managed by the states,[7] with each state currently having broad leeway to determine who is eligible for its implementation of the program. As of 2017, the total annual cost of Medicaid was just over $600 billion, of which the federal government contributed $375 billion and states an additional $230 billion.[6] States are not required to participate in the program, although all have since 1982. In general, Medicaid recipients must be U.S. citizens or qualified non-citizens, and may include low-income adults, their children, and people with certain disabilities.[8] Along with Medicare, Tricare, and ChampVA, Medicaid is one of the four government-sponsored medical insurance programs in the United States.
No, I'm not sure why this set of false alternatives keeps popping up. There's no need to read those implications into the comment. It was succinct and to the point.
The comment seemed to be observing a failure in resource (medical professionals) allocation on the part of the central planners.
We don't need to get into the weeds of what is communism or neoliberal third-positionism.
I think the problem with the "third way" and with "communism" vs "neo-liberalism" is that they are all not focused on anything it's just a way to create a new "tribe". Conservation of Nature and worries about environmental decline used to be an elitist right wing conservative topic. Now its a leftist topic. Its not really about the topics, its about drawing lines in the sand and saying: "We from the left/right/third way, stand firmly behind this line! Who is with us?" It is just a way to define a group that can be used to gain power.
Its a simple fact of how markets work. A free market is just an ideal, just like democracy, open borders and justice. It is not some law of the universe. In fact: countries that profit most of their markets are countries that highly regulate them. These countries include the US, China, South Korea, Zwitserland, Norway and Dubai. But not: Mozambique, Venezuela, Sudan, Russia, Haïti. <-- these countries dont have functioning markets because there is too much unregulated behavior, too much corruption.
The once shining example of Socialism that has now collapsed as socialism always does is "capitalist" now that it has failed? that is rich right there.
Russia is more or less the same... A Collapsed socialist state that never really adopted free markets, sure they adopted some aspects of capitalism but only because after the inevitable collapse of socialist policies the people in power divided up all everything of value between themselves and their friends. That is not capitalism either.
Free market is from the liberal ideology, and is like "well separated market with rationnal actors will take the most appropriate decision according to available information automatically". Basically.
Capitalism however: "an economic and political system in which a country's trade and industry are controlled by private owners for profit." And this is the Oxfor dictionnary definition because i don't want to misconstrue or be accused of bias.
I don't see how one replace another, in any situation. Sorry. You can very well have free market in a socialist country. More than that: in an anarchist country (which doesn't and would never exist, this is more than highly hypotetical), free market is the default and would need fewer regulation, as power in a market couldn't be leveraged to gain advantages in others.
you literally can not.
Free markets are one form Capitalism, All Free markets are Capitalistic, but not all Capitalist Systems are Free Markets. Other Capitalist non-free Market systems include things like Corporatism, Welfare State, Oligarchic, etc
That seems pretty uncontroversial.
There is, however, a large contingent of private companies profiteering from this situation; as the NHS was forced to buy things from private hands.
More money will not fix this mandated profiteering.