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Comment by Insanity | Hacker News Reader

I think that might be worse than just having the high price. Such a kafka-esque systems just to get medicine.

The best thing about universal healthcare isn't how much money I may or may not have to pay, it's that I literally don't once have to think about a bill or filling out a form to avoid paying too much.

I wouldn't care if I ended up paying more in tax than I would in an insurance model. The benefit is being able to 100% focus on my health instead of navigating a system to try to reduce what I'm paying.

When you're diagnosed with an illness, that's a huge peace of mind.

Most countries have both public and private. In Spain I have public and then private on top of that which 220 eur a month for a family of four all services included and no co-pay. The public option works to set a roof on what private insurance can charge.

> The public option works to set a roof on what private insurance can charge.

Exactly! This is what no one in the US seems to understand. My encounters with private clinics and hospitals in the UK (all 10+ years ago, at this point) were unbelievably luxurious, at prices that (totally, completely free-market driven, mind you) were affordable on middle-class incomes. Or, yeah: there's private medical insurance, also free-marketed to "shockingly reasonable", by US measures. Americans on good salaries have been bamboozled into believing that a single-payer system will trap them into some kind of hell-hole hospital° with no recourse, when in fact the exact opposite is true.

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°And, of course, the "hell-hole hospital" examples are cherry-picked. Bad on their own, of course, but not representative of a system as a whole, nor recognize that equally awful anecdotes are abundant in the USA.

Unfortunately a lot of us do understand this, but our representatives (who definitely know this) don't care or are actively opposed to making improvements other than reducing taxes (which hurts more than helps, IMO).

Looks at Nancy Pelosi

Of course: "No one" is an obvious exaggeration. It wouldn't surprise me, however, if a great many members of Congress didn't understand much about other countries' healthcare / welfare / transportation / energy / etc systems. I think they ought to, but many of them show little knowledge or curiosity about these subjects in their own country, and with an electorate in which fewer than half of all voters have a passport they face not much penalty for incuriousity about the wider world.

Right, and in my country you can even mix and match it.

I went to see my GP, paid for by public health, they referred me to a specialist.

I chose to pay €100 to see a private doctor who was available sooner (the next day) and had better ratings.

They referred me for an MRI which was done at another private provider, paid for by public health.

I went back to the private doctor and paid for a non-surgical treatment, which wasn't available on public health.

If that doesn't work, later I can opt for surgery, paid for by public health.

And even more importantly: There is one system that tracks all diagnoses, treatment, medication etc used by both public and private healthcare providers, so medical history is available instantly to everyone.

Honestly one of my main healthcare related complaints about living in Canada is not having centralized health records. Sometimes Europe feels like living 2 decades in the future lol.

Depends in the country. The Spanish system is completely siloed as the competence of health is by region and they all run their own systems

Trust me it doesn’t work perfectly in other countries. Yes, americas system is messed up but in countries like Sweden you will still have to navigate the system to actually get the healthcare you need. There are people who are denied healthcare in Sweden because the govt has deemed that it’s too expensive to save them (while people with similar conditions and a good insurance in the US are covered).

Also inflexibility, large backlogs, quality of staff, etc.

In Canada all of our best doctors go to the US and there's often nurse shortages. It's not just a private incentive either, the US gov pays out far more in public healthcare coverage as a percentage of GDP and per capita than Canada and almost all of Europe.

Despite their reputation the US doesn't have a lack of public healthcare spending (ranking #1-3 in the world). It's just their system's insurance regulation is extremely convoluted, creating risky edge-cases and perverse incentives. If they fixed that they would by far have the best healthcare system in the world.

USA spends the most to get worst results. Spending just dont go to people who meed healthcare.

And usa have shortage of nurses. And waitlists. And people actually bankrupt by medical bills. It was number 1 reason for bankrupcy.

> There are people who are denied healthcare in Sweden because the govt has deemed that it’s too expensive to save them

but how many people are deemed too poor to save in the US, when sweden gov't would've easily have had the same medical procedure provided at low cost?

All of that happens in the US, the big difference is that if you get care you stand a good choice of going bankrupt. The largest single reason for bankruptcy in the US is medical care and of that group the largest chunk is folks who previously had insurance but no longer do.

That may be, but I'm speaking from experience in my country.

Almost 10 years of treatment for a health condition, and the only forms I've ever filled in were:

    1. Legal risk document to say I understood the risks of treatment
    2. Change of address form
    3. Form to say I wouldn't impregnate people while on a certain medication

And honestly, that's it. I've genuinely been able to focus on my health without being bothered by forms.

My mum was diagnosed with stage four lung cancer. Almost three years of radiation, chemotherapy, trail drugs, appointments etc. free transport and accommodation at the major city four hours away when required. Insane prescription drugs that seriously raised the eyebrows of the pharmacist every month.

Never paid a cent, never had a single call or piece of paper for logistics or payment or any of that bs.

She was a teacher her whole life, middle class, no private insurance ever.

It can be, and is, phenomenal in countries that do it right.

Aim higher.

In many countries where "universal healthcare" actually exists, you end up with waiting lists and rationed care. Choose your poison.

The US also has "waiting lists and rationed care".

Not limited to healthcare btw. This is also how I feel about my public transport card, unlimited data on my cellphone plan, and so on.

I'll take a queue over bankruptcy any day. And these queues people complain about are triaged - if you're dying you skip to the front. The complaints about waiting hours are from people with broken arms, and at least they get seen and their arms get fixed, for free or a nominal price.

Absolutely. I'd prefer to go to the pharmacy and just pay my $20 and go.

Do you prefer sunny (Greece) or snowy (Norway)? You can just pay your $20 and go. It is an option.

I prefer to pay thousands in tariffs and/or private companies, thank you very much. I'm not a communist.

Sir, your visa application is denied anyways.

Yes Sir Mr President Sir.

I'm happy in both (Australia). But thanks!

That's usually how it works for me in the US. I go in to the pharmacy, and at least half the time they say 'no cost' and hand me my medication. Sometimes I pay a $25 copay. And if I get an expensive drug from Eli Lilly (e.g. Zepbound) then Eli Lilly pays Walgreens up to $1950/year on my behalf and I never even know about it. The only way I figured it out myself was trying to figure out why my insurance said they paid X, and I paid Y, but I had actually only paid $25. Took a trip onto a Zepbound subreddit to learn about the backdoor payment thing. "Savings card" but not actually a card.

Probably not just medicine. I heard that prices in US shops are different than final price at the counter.

It's the efficiency of capitalism at work.

It's more efficient to allocate capital to systems and processes that delay or stop you claiming on your insurance than it is to actually pay out a genuine claim.

This has nothing to do with capitalism, and everything to do with regulatory capture and archaic rules established in a bygone era for a purpose that has since been outlived.

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