if the government directly subsidized healthcare instead of relying on the insurance middlemen to perform its duties, this wouldn't be an issue.
Look at the table here: https://en.wikipedia.org/wiki/List_of_countries_by_total_hea...
The US is spending 50% more per-capita than Norway already and we are worse off. This doesn't include private insurance money which is insane amounts already.
The only issue raised by OP that would go away if it were managed by a US government bureaucracy instead of a private company would be people running out of coverage, and that only if healthcare were subsidized universally.
And to preempt the comments saying it doesn't have to be this way: it doesn't matter what if US government bureaucracies are incompetent by the design of politicians or by necessity, the point is that they are, and the idea that this case would be the exception is just wishful thinking.
And for that, I'd like you to point me to a state with government-operated medicine that doesn't have a therapist shortage. Because I'm hearing from several people in this thread that their countries have the same problems.
You should also understand that I am not suggesting that insurance companies should be banned. If you don't like the USGOV subsidy, you or your employer can still subsidize private insurance for you. But now, insurance companies have to compete with the government!
I didn't say the IRS was worse, I just said it wasn't any better.
The amount of extreme cases of stonewalling, long holds, call transfers, inconsistent interpretations of policy, requests for faxes that get lost, requests for new paperwork, and general lack of urgency, across numerous companies in numerous states, is mind boggling, and easily an order of magnitude more extreme the IRS experiences I've seen shared here.
raises hand
I have! I've actually worked a shocking amount with the IRS, not because I'm a criminal but because I'm working class and wasn't educated on how to file taxes more complicated than a 1040-EZ, presumably because it was never expected I would make that much money or own my own business.
Strictly my experience, I would much, much rather deal with the IRS than my insurance company. Yes, they're intimidating at first, but ultimately every person I've worked with both at the IRS and my state agency has been calm, professional, and frankly to a degree I found surprising, extremely understanding about how badly I fucked up my taxes on a number of occasions. I was never treated like a criminal; they explained what I did wrong, how they found out, what I owed, and how to prevent those issues in the future. And I was given interest-free payment plans with a one-time administrative cost to setup, that I now pay monthly. I'll be fully 0'd out in about 2 years.
This contrasts sharply with my experience with my insurance company! My insurance company tries to get out of paying for every last thing they can manage. My dental insurance has a maximum pay out of a measly $5,000 per year, which seems completely backwards to every other insurance I have ever had, but what do I know. You know how fast you can crush 5 grand in dental work? And paradoxically it still has co-pays, so apparently I'm paying so they will cover most of some bills, up to a predetermined maximum. Additionally, since I own my own business, I do have the luxury of choosing my own insurance, which most people can't, and for that luxury I pay simply princely sums each month to insure both myself and my spouse. I've picked the best for my area (at time of comment) and have to spend many many days of unpaid labor every year re-evaluating that choice, both because circumstances and networks change coverages, and because every single year my insurance goes up despite both of us, by and large, being quite healthy, and I get fucking annoyed about it and want to see if I'm getting my money's worth. I wouldn't say I am by a long shot, but the alternatives cover less, and cost more, so I'm still paying.
Frankly, and I don't mean this as a personal attack against you, but I have to assume people who talk like you have never interacted directly with the IRS, and are instead absorbing that opinion through the same cultural osmosis I did, because I too was initially terrified to the bone when I got my first letter from them several years after starting my company, and honestly, they are incredibly over-hyped. The only way to truly get the IRS to take you to to task is to, for years on end, purposely try and weasel out of paying taxes.
I would LOVE, absolutely LOVE, the ability to get my healthcare funded via an organization templated off the IRS.
> - Have to deal with filing claims, which ultimately becomes an additional expense, since chances are you have to pay someone to do this for you.
> - Get your money later instead of now.
> - Have to keep meticulous notes in case you ever get audited by the insurance companies, who can refuse to issue payments if your notes don't meet their standards.
This description could be lifted up and dropped in to be describing my tax situation each year. Meanwhile, I've never interacted with the kind of nightmarish insurance companies that some people have, so I'm strictly comparing two relatively painful bureaucracies, not nightmare stories about either one.
Maybe I'm missing something, but I don't see anyone who brought up the IRS as a model example except for you. It seems like people are just talking more generally about steamlined than the current status quo experience, and there are so many ways to steelman that which have nothing to do with analogies to the IRS.
To your credit you did note that you wanted people to take you up on your suggestion of using only bad examples, but I don't think your insistence on that front holds water because this is the type of thing where the difference that makes the difference is going to be the very details you are asking everyone to gloss over.
> I would LOVE, absolutely LOVE, the ability to get my healthcare funded via an organization templated off the IRS.
I'm not at all sure what you're getting at with the rest of your comment, because it doesn't seem to relate to anything I actually said. I'm insistent that we be realistic about what a US bureaucracy will inevitably look like and not expect it to produce less red tape than is already present. I said nothing about glossing over anything.
Also, I attempted to preempt these comments. They're not clever or new or even particularly accurate:
> And to preempt the comments saying it doesn't have to be this way: it doesn't matter if US government bureaucracies are incompetent by the design of politicians or by necessity, the point is that they are
It was, by far, the best insurance I have ever had in the US. It was effectively a gold insurance plan with no deductible, a $2 copay, drug and dental coverage.
It was very easy to sign up for, and the paperwork was literally the exact same as buying marketplace insurance.
I found it to be a better experience, and better administered than any other American health insurance I ever had.
If I could have paid money to stay on it when I got a job I would have.
Every other insurance company I've dealt with has actively cost me money, time and unnecessary pain through ineptitude or beurocracy. My FAANG healthcare was good, but had relatively fewer health issues
I'm guessing they don't. As a US person we hear a lot of, presumably insurance company sponsored, anti-Canadian-healthcare propaganda and then dumb people repeat it online.
This is my experience in BC as an American immigrant. It doesn’t apply to Toronto or Ontario.
Counselors are very easy to find. I had my pick and the wait was about a week. The province didn’t cover it in my case but my extended benefits did. Most of the ones I talked to offer pay scales based on extended insurance coverage, and many will provide pro bono care. Some counselors are covered by the province if you get a referral from a doctor.
The longest I’ve personally waited to see a general doctor is 6 hours at an ER on a weekend night, typically the wait is about an hour if you go to a clinic in the morning without an appointment.
For specialists, appointments are done on a triage system with a referral. If your case is urgent, or worsening you typically get seen asap. I’ve seen MRIs get done same day, or take as long as six months for non-urgent needs.
What I’ve never seen is someone wait a day with a broken arm to make sure they actually need to see a doctor because they can’t afford it. That’s something I saw twice in college in the states.
I’ve also seen people get referred to a specialist and never get seen because their insurance wouldn’t cover it.
Also seen people declare bankruptcy over medical debts in the states despite having insurance.
Canada’s healthcare system could be improved, but if you have ever dealt with low end insurance or uninsured healthcare in the states, you would understand how much better the system is here.
Most psychiatrists I know refuse to take Medicare because it has the same paperwork and pricing issues.
So we already have evidence of how it goes when the government manages it directly and it’s worse than private industry.