The people being involuntarily detained have to pay the hospital bill, and in the US that is expensive.
People absolutely should not be subjected to bankruptcy in order to get adequate health care, but there's an aspect of personal responsibility that needs to be considered.
In NZ we have ACC, ACC is a universal insurance plan that covers injuries only (we don't have universal healthcare) so some dickhead can shatter his knees jumping of the roof of a three story building and be fully covered, but my little cousin with a disintegrating hipbone got no help from the state.
I think we should expand to universal healthcare (no chance), and failing that ACC should not be abolished (no need to throw ambulance chasers and insurance fraud into the mix) but I do think that the state should have the power to recoup the costs in the case of grossly negligent behaviour that leads to predictable outcomes.
Beyond momentary acts of idiocy, there are also lifestyle choices that have a significant impact on the health - for example, my morbidly obese aunty has had damned near every one of her non essential organs removed - I firmly believe that tax payers should not be on the hook for her (or anyone else's) wilful self-neglect.
https://www.madinamerica.com/2019/06/involuntary-hospitaliza...
And before you ask, doing nothing does work, or at least it beats this option. Yes there are yet better options, actual interested attention from an actual human being, but literally leaving the person on the street works better than any mandatory treatment, and is a lot better than involuntary detention.
https://pubmed.ncbi.nlm.nih.gov/1023455/
And frankly, find a local Psychiatrist and ask them this question "Who is best of: a person committing suicide, or a person in involuntary detention NOT committing suicide for 6 months". They will illuminate what causes this problem.
So why are we doing this? Well, this gets done to those people to give Police an option to deal with people who've done nothing wrong but are judged to be "at risk" and generally being a nuisance, or the police judges they're "at risk" of doing serious damage by killing themselves, slowly getting worse but not actually having done anything wrong.
Lastly, some people are doing this because they see it as a form of euthanasia. They are ill, or have destroyed their lives (for example with medical bills) beyond repair and they just want out. It takes a long time for them to actually do something about this. Needless to say, any form of "treatment" for this will only (sometimes rapidly) make things worse. In fact most old people die not from old age but from starving or dehydrating themselves to death (this gets a lot easier once you're past 70 or so. Energy/calorie shortage causes cascading organ failure, which ironically feels good, and you fall asleep as your blood poisons itself. Obviously doctors do not make a habit out of telling next-of-kin this is what happened, nor do they try to prevent this by for example force-feeding them). But, there is sadly no age limit on this. For example, in one famous case a 15 year old kid relapsed into Cancer after a very intense and destructive cancer. She'd had chemo from 5 to 9 years old, which handicapped her phsysically and mentally, permanently. She caused a lot of damage killing herself by putting a certain person in a position where the police could indict her for murder, a hospital was involved, psychiatrists, she got people to cover up her earlier attempts at suicide, psychiatrists lied to her parents, her parents got divorced and partially remarried, youth services got involved because the parents did not agree on what to do ...
Note that this is independent of the actual health care system. The same problems manifest in Europe with public systems. The problem is that psychiatric help ... well, somewhere between doesn't help and actually destroys people.
Who pays for this is beside the point because mostly, of course, these people are homeless, very ill and/or (ex-)criminals. You can charge them all you want, but as the expression goes "you can't get blood from a stone".
The sad part is that parents and children can be held liable if a suicide (attempt) does damage, which then causes more problems. This is done to "protect" society against psychiatric patients and to redirect as much of the cost of totally rejecting people to those people and their families as possible.
Comment threads often branch down different rabbit holes - the issue of how health care is paid for is generally orthogonal to the question of the nature of the care (although industrial lobbying makes this far less true than it should be).
You don't really have to convince me of anything regarding the utterly useless nature of western models of mental health - I've been depressed for over 20 years.
The first thing they did "for" me was put my on SSRIs - which turned me into an asexual robot (fuck you pfizer) the effects only reversed in the last couple of years due to this bad boy - https://en.wikipedia.org/wiki/Bupropion (thanks GSK).
I've gotten more help from fists full of illegal mushrooms than I ever have from the system (but at least they stopped drilling holes in people's heads).
Because hospitalization takes a lot of expensive resources. The bill has to go somewhere.
> Keeping your people healthy should just be a given.
For the entirety of human history, up to and including this point, it hasn't been.
> How many hundreds of years will it take before universal healthcare is finally accepted as the basic standard of a humane civilization?
Realistically? When they have AI doctors that can treat the plebs for very little cost.
Until then, we're talking about at least 10-15% of GDP of a rich country, which is a massive amount of money. Even places with "universal healthcare" make tradeoffs (e.g. IIRC, healthcare waiting lists for many things are absurdly long in Canada compared to the US).
The UK has a famously stingy system which costs 7.5% of GDP, however the UK has better infant mortality than the state with the best infant mortality, Massachusetts. The worst states have infant mortality 2-3 times that of the UK. (Note that the poorest states in the US, LA and AL, still have GDP higher than the UK. So the 7.5% is of a much lower per capita GDP.)
The average EU country spends a little more than the UK, as a % of GDP. But has health outcomes well ahead of the UK, and considerably far ahead of the best-performing US states.
It seems kind of distorted not to point out that around half of the US spend goes either on luxury healthcare for the rich, or emergency healthcare to those who can't afford proper healthcare, or simple rent-seeking by entrenched players (pharma, doctors, insurance companies) and that none of these improves health outcomes by very much.
The US uses a different definition for infant mortality than the UK or any other European country. (One major difference is whether a borderline-nonviable birth gets counted in the infant mortality or stillbirth column.) The raw numbers are not directly comparable. Correcting for the expected effect of difference in definitions, the UK still has lower infant mortality than the US overall, but by a far smaller factor.
It was part of living in that village.
So no, under modern less-personal systems this hasn’t been the case.
>> For the entirety of human history, up to and including this point, it hasn't been.
> For the majority of human history, health care was done by village shamans etc (that did actually treat most ailments they could) for free.
Would you be OK with universal shamanistic healthcare? Because I don't think that would count as succeeding at "keeping your people healthy" by any reasonable definition. My strong hunch is that village shamans could successfully treat far, far fewer aliments than you could with OTC medications and first aid supplies.
Things start getting expensive once you try to be more effective than that.
And the shamans almost certainly weren't doing it "for free," but a village like that almost certainly is primarily a non-market economy, so their compensation could be obscure to modern eyes (e.g. for a more modern example and easy-to-understand example, Jewish priests were compensated by being entitled to a portion of religious sacrifices).
If we have resource constraints (not enough doctors, hospitals, medications) then one of our top priorities should be to solve the shortages.
If you factor in insurance, Americans pay more as their percentage of income. In the US there is more private and public bureaucracy in the healthcare system, higher wages for doctors (because they often have to repay their student debt and prices are on average higher in the US) and overall higher prices for equipment and drugs (often due to (often lobbied) laws that favor some US businesses). In Europe health care is treated more as a public service (although there is also for profit health care there). The high profits for US companies in the medical sector have to come from somewhere and they often come from the pacients and the taxpayer, because the US also subsidizes their health care system by taxes. In fact the US government spends more per capita than other governments in the world on health care. https://en.m.wikipedia.org/wiki/List_of_countries_by_total_h...
Besides that the taxes in the US are more inefficiently spend than in many western European countries. I could write a long essay about that, but this is just a comment to a hn comment and I already spent to much time on writing it.
Life, liberty, and the pursuit of happiness—so long as you have a premium healthcare plan brought to you by Blue Aetna Cigna Humana Kaiser(tm)!
https://www.propublica.org/article/cigna-pxdx-medical-health...
> Who are “your people”?
This seemed (to me at least, but it wasn't entirely clear) to be reading a comment to be race based when it obviously wasn't.
> Should every person consider people with the same citizenship as “their people” and treat them better than others? Is it really uncivilized and inhumane to not follow that norm?
Really? This just completely misinterprets the comment it replied to.
> There are no logistics issues with residents and tourists.
This assumes that a system aiming to provide universal healthcare to the citizens of a nation will refuse to help non-citizens within the nation.
It seemed so to you because you tried to read something imaginary between the lines. It is ironic that it is exactly what you accuse me of.
> Really? This just completely misinterprets the comment it replied to.
I don't think it misinterprets anything. If you think it does, provide a better interpretation.
> This assumes that a system aiming to provide universal healthcare to the citizens of a nation will refuse to help non-citizens within the nation.
No, I didn't assume anything. OP said "Keeping your people healthy should just be a given". Following basic language pragmatics, it means that keeping not your people healthy is not a given. I asked who are "your people" and was given an answer that it means citizens.
Then perhaps that's the problem - as per the guidelines "assume good faith".
> "Keeping your people healthy should just be a given".
> Following basic language pragmatics
Quite frankly, that's rubbish; here you are taking the least charitable interpretation of the parent comment.
Most people would have interpreted that as excluding those outside of a country's borders - its region of direct control.
You misinterpreted my comment, where I said "citizens" in much the same way.
> In every comment you made in the thread, you seem to have taken minor issues of phrasing and used them to wildly misinterpret comments in the least charitable way imaginable.
My previous comment hits the nail on the head, and you've done the same damned thing with your latest response.