They just suck in different manners, different countries have different degrees of "suckness" and so on.
And then there's the big problem beyond the question of who is paying: How much is being paid.
Healthcare costs in the US are absurdly high both on relative terms (things are way more expensive) and on absolute terms (more of the same things is needed because the American population is relatively too unhealthy for what you'd expect in a developed country with similar demographics). You need to ask why relatively inexpensive stuff like insulin is so much expensive in America than say, Germany or the UK.
If you don't solve this issue, a single payer system would probably become more similar to the terrible situation in most Latin American countries, where you have terrible supposedly universal public healthcare systems, but where in practice if you can pay for private insurance, you will do it.
Must be that law of economics that says the more you make of something the more expensive it gets.
https://www.investopedia.com/terms/l/lawofdiminishingmargina...
Yes, and let's also imagine all of the existing single-payer systems (de facto or otherwise) work as advertised and didn't have elites-with-means flee to other nations for quality care.
Let's also imagine these systems provide stellar quality care and more importantly, timely care.
We can daydream all we want - but the reality isn't so obvious or absolute.
For those who are really in the know... the US already is a socialized medicine nation. Look at how much of the US annual budget is blown on medical care. Hint... it's larger than the military budget.
You mean the US...?
It's a quaint idea... but nobody likes the reality once it's implemented. Evidenced by the fact that the US is already the largest public health system in the world, and people do not even realize it.
I'm not sure why you're ignoring a lot of Europe, Canada, Australia and New Zealand.
These are exactly the ones I had in mind.
> universal public health care with costs covered by the government.
To be pedantic, this doesn't exist anywhere in the world. The taxpayers foot the bill universally. You may not personally care, but it matters when we're discussing spending other people's money.
In the US, we already have universal public health care. If you cannot afford to pay a portion of your premium, you can be eligible for healthcare at zero expense to you.
The US government spends more on healthcare than any other nation. The US is already socialized healthcare. It's just not the utopia people thought it would be so they continue to complain...
It gets way more complicated than we can discuss here - things like private premiums are so expensive because the socialized system does not pay it's entire bill, etc. The entire thing is a massive C.F. but speeding further down that same tunnel is not going to suddenly magically make it better. It's very much-so the "but we can do it better" mentality, despite however many previous attempts there has been.
Those countries citizens rate their happiness with the healthcare system in their country ~2x higher than US citizens do. So that line of thinking doesn’t hold.
>> it matters when we're discussing spending other people's money
That’s not how money works and until that fundamental misunderstanding is eliminated, learned helplessness will prevail. A country that issues its own currency cannot save money in its own currency.
The hard limitation a government faces is resources, not capital.
Ah, the so-called "Modern Monetary Theory"... the same one that told us governments can spend infinitely without consequences... and then runaway inflation and looming recession happened. Of course, not MMT's fault...
In case my sarcasm wasn't thick enough - it is indeed how money works. The attempts to "1984" economics thankfully are failing spectacularly enough to put it to rest.
> Those countries citizens rate their happiness with the healthcare system in their country ~2x higher than US citizens do. So that line of thinking doesn’t hold.
This is a false statistic designed to mislead people into thinking some other system is objectively better.
you’re making a strawman argument. You’ve mischaracterised then proceeded to knock it down.
Here’s Randall Wray, a leading MMT scholar on this topic in early 2020: https://www.levyinstitute.org/publications/covid-relief-and-...
“The inflation worriers’ objection seems to be largely over the “stimulus checks.” While we prefer targeted spending in normal times (and prefer pay for work over transfer payments), these are not normal times. The extra $1,400 (above the $600 already approved) will and should go to most families to help cover those bills. The propensity to consume out of these checks will not be high, as most people will use them to pay down debts or replen- ish savings (only 29 percent of the first round of checks was spent on consumption, while 34 percent was used to pay down debt and the rest was saved). What little boost to consumption they will provide can be handled without inflation, as production around the world has rebounded sufficiently.”
Before we dive into the relief part, note the “While we prefer targeted spending in normal times (and prefer pay for work over transfer payments)”. This refutes your argument as being a strawman. MMT doesn’t say what you said it does.
That doesn’t refute that stimulus is mostly inflationary though, so let’s look under that rock.
All spending, private or public inescapably contains inflation risk, however we saw something else for the most part.
Building on Randall’s reference to what the first relief was spent on (mostly non inflationary - but with some inflation where checks were issued to those without need for relief), we then went on to see supply side shocks (it’s still a pain to source some cars). There were demand shocks very early on - toilet paper predated stim checks so something else caused that demand side shock…
To this day We still see the predictable bullwhip in some markets.
We also see evidence of suppliers opportunistically increasing prices - some of our largest corporations are currently enjoying record profits.
So let’s be more direct in knocking this argument down - what are the cases of inflation that can’t be completely explained with one of:
1. increased profits in the supplier
2. global supply shock (oil, gas, manufactured goods etc)
So what exactly is the argument around inflation if it is limited to a few asset classes that are ripe for obvious taxation solutions to eliminate said inflation?
>> it is indeed how money works
but going back to this bit, ignoring bs macro fairy tales and looking specifically at the system itself (which most macro theories rarely do, the stated assumptions in most macro bs are laughably absurd).
So how do things work in practice?
Ignoring that the fed has bought treasuries and thus literally means the government created money from nothing on a whim - ignoring this case because while it does sink the argument that taxes come before spending, it is a complex case with lots of gotchas that mean it’s not fair to characterise it as govt create money regardless of circumstance in all cases.
So instead let’s look at the policy that gives exactly this operation:
Step 1: The fed finances the primary dealer banks that participate in treasuries auctions - it accepts treasuries as collateral for repos.
https://www.newyorkfed.org/markets/domestic-market-operation...
Step 2: The primary dealer banks are obligated to stand ready to purchase treasuries
https://www.newyorkfed.org/markets/counterparties/policy-on-...
Step 3: and the Federal Reserve ensures there are sufficient reserves to do so by supplying them through temporary repos (a matched purchase of Treasury debt with a requirement that the seller must repurchase later). While the Federal Reserve is not in that case directly buying the new issue directly from the Treasury, it uses the open market purchase to buy an existing bond in order to provide reserves needed for a private bank to buy the new security. The end result is exactly the same as if the central bank had bought directly from the Treasury.
https://www.newyorkfed.org/markets/domestic-market-operation...
>> In case my sarcasm wasn't thick enough - it is indeed how money works.
I won’t be sarcastic, but you have been overconfident and mistaken.
NB: Great rebuttals include links to authoritative sources.
>> This is a false statistic
People’s opinions are invalidated only if they feel a different way than you? Come on… behave!
Sorry... these are borderline crackpot theories. The devastation left in the wake of only a taste of MMT implemented is enough to drive MMT to bed, thankfully.
It's also rather interesting how one can tell a MMT'er is in their midst without much even being said.
I flee the U.S. to have all my medical related tests and work, out of pocket, in the E.U. And it is cheaper and much much better experience. (And I don't get different treatment compared to any members of my family that are insured in Europe for paying out of pocket.)
First of all: I speak with a doctor. Not a nurse, an administrator to size me up, to see if I am in actual need of an appointment, but a doctor. (Yes, this has happened to me in the U.S. I find it unacceptable, especially given that I was apparently in much more dire situation than I even thought, and was lucky to be seen by a doctor, otherwise I would have joined the disabled group of individuals.)
I am not sure why people in the U.S. keep bringing up the UK [Edit: -- not sure if that is what you are implying but most people are in other comments]. Pick any EU country. Sure, you might not have a 5 star doctor's office, but you are going to be treated by a doctor efficiently. And that is what matters. Don't waste money on administrative tasks and fees.
Wow. Imagine a world where one entity received all the peoples medical bills instead. Too bad the EU can't achieve that.
Also looking at a primary care wait time is fine, but what is broken in most single player systems is specialists and "non-emergency surgery"... which is often stuff that significantly affects your quality of life.
https://worldpopulationreview.com/country-rankings/health-ca...
(the colors represent a primary care, but actually hover over each country...)
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I ruptured a ligament in my knee and since it wasn't a traumatic injury, the surgery to repair it was considered a non-emergency and I was sent home from the ER.
My uncle is an orthopedic surgeon in Norway and was shocked to hear I was already scheduled for surgery to repair within a week. He said in Norway that would easily have been a month or two wait, which is alarming to me.
At the end of the day the US system is broken, but I think this illusion that single player is some strictly better concept that the US is just rejecting is also wrong. Care is noticeably worse in many EU countries when you look past the singular measure of "Time to see your primary care"
Do you have a suggestion where in the US that is? The US has many doctors but essentially all of them are gated behind insurances and especially hospitals.
You can see your doctor pretty much freely within the US for nearly any reason. This idea you cannot see your doctor in the US, or that you receive treatment from nurses or administrators is simply not true.
> insurances and especially hospitals
You may be confused, because some doctors operate private practices, while others choose to work for large hospital organizations. Private practices may be more akin to what some people's idea of a doctor should be. Most insurance plans offer a selection of hospitals and doctor networks, allowing you to chose the style and type that works best for you.
In all cases, you can see your doctor if needed, with very little lead time if any.
I think this is pretty uneven across the country but it is definitely far from guaranteed that you can see a doctor on demand with a short lead time. I have heard of similar problems pretty much throughout the central region of the country. In an attempt to alleviate the situation a number of states have programs where they pay subsidies to providers in areas with longer wait times, but this turns into a complex billing system and states often can't afford enough to really make a big difference.
In some ways the private insurers are doing some good here, as several offer "patient concierges" that will do things like try to find a provider for you that's accepting new patients. But in a recent experience that involves calling every two weeks and being told they still can't find any availability, for a couple of months.
Sorry, as someone who knows multiple people in various parts of the US healthcare system, this is pretty laughable. At the very least, we have different definitions of 'freely'.
Most of the urgent care clinics near me, for example, no longer accept patients without appointments. ER wait time is several hours, and you will owe hundreds if not thousands of dollars after unless you have _very_ good insurance.
> This idea you cannot see your doctor in the US, or that you receive treatment from nurses or administrators is simply not true.
Not from administrators, but nurses yes. Many clinics will only have a RN on duty large parts of the time. There are also systems where you can set up telehealth appointments, but a lot of the time they will be with a nurse and not a doctor.
> In all cases, you can see your doctor if needed, with very little lead time if any.
My parents have been trying to address some conditions they've developed, in one case, pretty serious. There's a several month lead time on their appointments to deal with this.
Although actually re-reading your post, it sounds like you're really just trying to take a dig at Nurse Practitioners, most of which hold doctorates.
I guess if you're too good for a DNP, the primary care must in fact seem like an impossible thing, in which case I do wish you good luck on the 8 hour flight for "all my medical tests".
So, not an entity which by its very nature spends other people's money and can never run out? I agree, sounds like a great idea, but someone will have to invent such an entity first. The ones we have would not meet the requirement.
... what's that? The entire OECD has more centralized government control of healthcare than the US, ranging from extensive price controls, to de-facto or de-jure monopsony, to outright direct control of the healthcare system, and nowhere is there a strong populist movement to ditch that for a heavily free-market-based solution? And literally all of them are way cheaper per-capita than our system? And outcomes remain between pretty-good and great? And instead of the bureaucratic billing mess we have, that's all nice & simple and takes up almost none of the time of sick people and their families? This makes no sense, I read several columns on mises.org proving from first principles that this is impossible!