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Comment by ethbr1 | Hacker News Reader

> there's no reason for our medical care to be inaccessible for most people in the US.

A limited number of physicians, especially general practices? High cost therapies and treatments? Capital-intensive diagnostic devices? Lack of access outside of cities?

There are certainly a lot of things that could be done better, but this isn't 1950 -- some available medical technology is incredibly expensive.

Simply unshackling Medicare/aid and allowing it more freedom to negotiate costs would go a long way towards reducing US health care expenditures.

I.e. doing for more payments what the Inflation Reduction Act allowed Medicare to do for (a limited number of) drugs: https://www.cms.gov/files/document/fact-sheet-medicare-selec...

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umm... what? do you think there was free healthcare in the 50s in the US?

every single other country has free healthcare, lower costs, and better outcomes than USA.

There's a big difference between training, staffing, and funding free health care when we're talking about a doctor's bag and penicillin vs MRIs and monoclonal antibodies.

> every single other country has free healthcare, lower costs, and better outcomes than USA.

Aside from those first two being mutually exclusive, no, they don't all.

There are a large variety of funding methods, ultimate out of pocket costs, and outcomes throughout the world.

You'd probably find this an interesting read: https://ourworldindata.org/financing-healthcare

The US is certainly an outlier based on {total spent of healthcare}:{health outcomes}, but it's generally in the middle of the pack in terms of GDP-adjusted out-of-pocket costs. (Mostly as a consequence of private insurance + Medicare/aid)

Also https://blog.petrieflom.law.harvard.edu/2022/03/15/ama-scope.... This mistake made some 20 years ago is a festering problem today.

which first world countries don't have single payer health care?

usa has by far highest cost and worst outcomes. practically speaking, most americans don't have access to medical care.

All the countries listed here? https://en.m.wikipedia.org/wiki/Health_care_systems_by_count...

It's easiest if you sort by decreasing coverage, then look at all the 100% coverage countries, which tend to be developed.

To summarize though, aside from single payer, mandatory public-private hybrid and private are also used.

And you should look into the numbers before making absolute statements.

The facts, in contrast to how you stated it:

- The US spends more per capita on healthcare than many (all?) other countries

- Of that, an average amount is out of pocket (relative to developed country peers)

- The US has some poor metrics, particularly in maternal mortality and lifestyle diseases, but is average on others (relative to developed country peers)

- Because of EMTALA [0], all Americans within range of a hospital (that accepts Medicaid) have access to emergency care, whether or not they're insured. The primary problem with access is the scarcity of rural doctors, especially generalists (an AMA/federal-government problem because of limits put in place in the 80s)

[0] https://en.m.wikipedia.org/wiki/Emergency_Medical_Treatment_...

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