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Comment by KittenInABox | Hacker News Reader

I have complicated feelings about universal healthcare... namely that the issue seems to be more-or-less not whether the system is socialized or private but if the healthcare system is provided adequate funding (via government or a private entity) to give acceptable outcomes on a population level. A lot of the detractors to private healthcare is simply that healthcare isn't being administered appropriately (pressure to only see patients for 15 minutes for example or to charge by procedure encouraging specialists where systemic issues go ignored) but so is the case for socialized medicine (waiting too long for specialists, understaffed hospitals).

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Providing a socialized system with adequate funding requires elected officials and voters to have appropriate and matched priorities. Voters, regardless of party in Canada for example, generally all agree that the socialized healthcare system needs more funding and to be a higher priority. I understand that when you remove party affiliation from the prompt a majority of Americans are also generally in favor of socialized healthcare and would like to see it expanded.

Critics of socialized healthcare often point at things like waiting too long for specialists, or understaffed hospitals, presenting them as inherent to socialized medicine itself when it's more often the product of elected officials who simply don't think socialized healthcare deserves adequate funding, or are against the idea of socialized healthcare entirely. Politicians will often piss in your cup and insist to you it's champagne.

There is, of course, the economic arguments around public vs. private health-care systems; but there are also the philosophical, moral, and ethical, arguments regardless of economics. Some things are expensive and yet we still understand they are a good and humane thing to do.

> Some things are expensive and yet we still understand they are a good and humane thing to do.

I think this is often a sticking point for agreement. It is hard to get buy in without some level of guardrails on cost and impact. I dont want to bet my house, retirement, and children's future on the promise socialized healthcare will be a net savings for both the public and for me.

For this reason, I think opt-in Medicare is a reasonable middle path, where governments can demonstrate the cost reductions and care, allowing people to voluntarily convert at their own pace.

This would go a long way do dealing with the risk aversion, but I think many people ostensibly for socialized healthcare are too scared test if it could actually compete on price and value.

The thing about Medicare is you can only go to places that accept the Medicare plan, so people who opt-in will be de-facto taking a lower standard of care for a very long time until everyone opts-in. If you go to one of these places in my area the doctors treat you very differently even if you have really good insurance because they presume that you're poor and on Medicare.

Isn't that a good preview of what universal socialized healthcare would be like?

One of the major selling points is that universal healthcare would provide everyone the efficient administration and low costs of Medicare.

I'm not saying that socialized systems are inferior to private ones, nor am I attributing things like specialist waitlines to socialized healthcare specifically. I'm pointing out that I think both criticisms to private or socialized healthcare fundamentally are more about how well-administered they are. I don't know if there's been a real analysis about the systems outside of their administrations, in which case both parties for either side can argue "well it's an issue of funding, not the system itself"...

yeah, I think socialized healthcare is seen as a solution without articulating the specific problem, usually affordability.

Surely a $550 copay for referral would still be frustrating if it was charged by the government.

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