In 2022, the British government spent £3.5k ($4.4k) per person per year on healthcare. The US spent $13k per person per year in 2022, of which $6.2k was government (national+state+local)[2]. The UK government spends less per person than the US government on healthcare, even before the amount paid privately.
Even if you think the UK's healthcare is worse than the US (which I fundamentally disagree with), you have an extra $2k to play with and do better than the UK before it costs more than the current system to the government, and then another $6k of extra tax before people would be more out of pocket than with private healthcare.
Healthcare is complicated, all systems have flaws and all are vulnerable to being manipulated. None of that changes that the US has the worst system, run in the worst way, with the least efficiency. And that's without even getting to the obvious point that a country where people are healthier is worth paying for: my friends and family, colleagues, people I interact with being well, living longer, and not having diseases is very worth paying for and I want to be taxed to achieve that.
[1]: https://www.ons.gov.uk/peoplepopulationandcommunity/healthan... [2]: https://www.cms.gov/data-research/statistics-trends-and-repo...
The difference in medical spending is largely due to wage costs being much higher in the USA than the UK; healthcare insurance companies are not as profitable as it may seem (they're about as profitable as other insurance businesses). Pharmaceutical prices don't explain much of the difference either, because they’re only a single-digit percentage of healthcare spending (in the USA).
Aren't healthcare insurance companies intrinsically an inefficiency that could be outright eliminated?
https://en.m.wikipedia.org/wiki/File:Life_expectancy_vs_heal...
(Can't reply that deep)
Every other developed nation?
Historically private healthcare here was just about fancier rooms, better food, etc... Now it's often "the NHS said I need to wait 6 months to get this procedure, if I pay I can get it next week". A lot of the time with the same doctors and same facilities as if you went NHS.
In general, if you weren't waiting a long time for NHS healthcare, people were happy with it: five or so years back I worked for an American company that offered private healthcare as standard, even in the UK, and the healthcare company offered you £50 a day while you got NHS treatment rather than actually using their services while you had coverage, as it was obviously much cheaper for them, and everyone I knew took that deal every time.
Increasingly this is less true though, a decade and a half of being slowly throttled, then Covid, and you can feel that everyone is rushed and stretched to breaking point.
[1]: https://www.statista.com/statistics/283221/per-capita-health...
I get your point but for reality's sake the last time I saw a doctor, on the NHS in the UK it took one day. The service is a bit ropey but in strange ways.
https://www.healthsystemtracker.org/chart-collection/health-...
It would also require public non profit manufacturing of drugs to reduce the cost.
Generic drug manufacturers have very low profit margins. Switching manufacturing of generics to non-profit organizations would have very little impact on total healthcare system costs.
If you're suggesting handing over ownership of patent protected drugs to non-profit organizations, well that would lower costs in the short term. It would also ensure the pipeline of new drug development is slowed to a trickle.
It's made more expensive by allowing the private healthcare industry to operate in such a parasitic way.
Americans and their employers pay an obscene amount of money to insurance companies every year for "health insurance". In turn, those companies use that money to employ people full time to find ways to deny people the coverage that they pay for based on technicalities. They do this so that they can pay people like Brian Thompson more money.
It's a disgusting and immoral system that should not be allowed to exist.
It is so confusing to me that "socialized healthcare" is such a dirty word, when the whole purpose of insurance is, a it's core, introducing socialism into healthcare. If you are anti-socialism, cancel your healthcare and just private pay for your healthcare. :-)
Sadly, we in the US seem to be sliding in that direction with the noises being made about "healthcare pools".
As I see it, health insurance is uniquely bad for a few additional reasons:
1. People don't treat it as insurance against catastrophic events so much as a subscription for ongoing care, which greatly expands the scope of what costs are socialized.
2. It's often paid for through employers, which reduces consumer choice in deciding what plans to purchase.
3. Demand for healthcare services is relatively inelastic and with modern medicine there's often almost no limit to how much it can cost. If you wreck your car, at most your car insurance company is on the hook for the cost of the vehicle (and perhaps some additional costs up to a fixed limit). But if you're suffering from some disease with no known cure, you could easily spend tens of millions trying hundreds of different procedures trying to find something that will work to mitigate the effects of the disease, and that's an ongoing cost that goes on forever until you're either cured or dead. Somebody has to decide which procedures are worth it or not, and if you're not paying for it yourself that "somebody" isn't going to be you, which creates lots of inefficiencies and is heartbreaking for everyone involved. This is also why we end up with systems such as "in network" and "out of network" providers, and government regulations intended to make things more fair at the cost of even more layers of inefficient bureaucracy.
A few other thoughts:
> If you are anti-socialism, cancel your healthcare and just private pay for your healthcare.
Even for those who might be inclined to do so, this often isn't viable because of #2; they'd be leaving a bunch of free money on the table. I've also heard stories of some healthcare providers charging private individuals many times what they'd charge an insurance company for the same thing, though I'm not sure how common that still is today.
> inserting a group of middlemen into an already expensive system is going to make it more expensive
This is true, though note that government healthcare just replaces one set of middlemen with another.
No, its not. Socialism is when the working class exercises control of the (non-financial) means of production. Insurance is neither about workers qua workers or control of the non-financial means of production.
Using disproportionate control of financial resources to sell risk-leveling as a service and therebu increase your disproportionate control of financial resources isn’t socialism.
So, can we focus on problems and solutions and not argue about definitions? I don't think it brings anything to the table.
This is mainly an Americanism which is grounded in a similar mistake about socialism, though in a society which is actually democratic and predominantly working class, a State directed use of resources for a particular public service is at least not-entirely-unrelated to socialism (though if it is a single payer atrangement where the payees are private owners of the means of production actually employing providers of service, it is still not socialism; actually socialized medicine is, for example, where the worker-controlled state controls the hospitals, equipment, and other capital used in providing healthcare, and employs the doctors, nurses, etc. directly), whereas a commercial offering by a private capitalist profit-making entity is... nothing like socialism.
> So, can we focus on problems and solutions and not argue about definitions?
You are literally attributing a problem specific to capitalism to “socialism” and badly twisting the definition of socialism to do it. That’s not really a sign of being interested in “problems and solutions”, but of being interested in promoting ideological fantasies about capitalism.
If you were interested in what works, you'd look at why the problem is unique to the US and what distinguishes the US healthcare system from those of other developed economies.
_People_ don't treat it this way, it IS this way.
Health insurance resembles insurance in almost none of the important ways.
Picture health insurance models laid on top of your car:
Imagine your car gets totaled. Your insurer says, "Hey, we're going to pay out $25K for your vehicle. So you have a $1,000 deductible, so that's $24,000, and then your copay for a total loss is $2,000, so that brings us down to $22,000. For total losses, your coinsurance as your contribution for your vehicle coverage is 20%, which is $5,000, so here's a check for $17,000. But that's only if you're buying a Hyundai, otherwise the vehicle is out of network and you'll get a check for $8,500 instead."
(And to be clear, I'm not saying auto insurance is without its own issues and sketchiness, just that it at least conforms to actual "insurance").
But you're right, that's part of the reason we end up with things like copays. My 3rd point above is also responsible for a lot of this.
How much is this oil change going to cost?
-- Can't tell ya. you have insurance though, right?
I have Geico. The oil change was $25 last year. Let's just do it, you're telling me it's necessary.
-- Great! It'll be done in about 25 minutes.
...
-- That'll be $1895.00, I'll send you the bill. But if you take care of it right here, I'll lower the price to $425.00.
WHAT!? 425 for an oil change? What a RIP! $125 is all you're getting from me.
-- Pleased doing business with you. See you again next year!
Regardless of how we might wish it to be, it's an observable fact that the latter sense is how the word socialized is understood in the USA. And yeah, people rightly object to totalitarian control over their health care, whether it's by a government or a for profit cartel that has managed to achieve a stranglehold on medical payments.
I've visited emergency multiple times over the 20+ years I've been living in Australia. The first time I left with crutches, a casted ankle, and a whole slew of scans indicating it was just a serious sprain, not a bone break or tissue tear. I was almost out of emergency before I turned around and uncomfortably announced that I was leaving and yet hadn't paid for anything. A doctor came directly over, pressed the button for the automatic doors, and said "It's ok, this isn't America. You're free to leave, and you don't owe us any payment. Your taxes cover this."
I have severe spinal stenosis. On Tuesday I had an EOS scan. $0. Last year I had both an MRI and CT scan. Both cost me nothing and were covered by the public health system. If I had these 3 scans done in the US without private health care I'd be out of pocket $10k or more.
I've also had that "so I've just come out of the doc's, how much do I owe?" at reception, only to be told "nope, you're good, see you in 3 months for your next checkup" shock.