Comment by BugBrother | Hacker News Reader

Comment by BugBrother | Hacker News Reader

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First, the US health care system is uniquely dysfunctional. But there are lots of mosquitos in Scandinavia.

For instance, the health care is a centralised system. Those never work. Doctors don't have time/incentive to diagnose problems unless they are obvious (or you're related to a politician -- yes, like in Soviet). Many Swedes (how many? No one knows) drag easily cured problems around for years and decades.

From my own and friends' experiences -- simple knee problems that stopped favorite exercise, lack of iron/vitamines that gave depressions, hard to recognize allergies that resulted in tiredness, thyroid problems etc.

I am here to tell you Scandinavians that it doesn't have to be like that!

If you go into a health care place in Romania, you are a valued customer they want to make happy. They will screw you over by giving you extra tests, not telling you something (anything) to get you out the door (because they only have minutes with any given client)!

You can't get that for money in Sweden. If you have health care problems, go to East Europe or something for the next vacation. (A recent article on BBC discussed that Polish doctors were working in Britain, because Polish immigrants were spoiled with the health care and the British system seemed similar to Sweden).

Please remember this when you're too chronically tired to make enough fuss so the doctors will try to find your problem to get rid of you.

(I have experience with the Swedish and partly with the Finnish health care systems, e.g. the Norwegian is a bit different but I don't really know enough to have an opinion.)

The difference is one of philosophy. The Scandinavian systems largely are based on the idea that it is unfair to allow anyone to pay to cut in the healthcare queue given that it is an essential public good.

It aligns everyones incentives when it comes to healthcare funding (as individuals at least). Conversely, while the UK NHS is excellent, the wealthy often "opt out" of depending on the NHS (as well as the state schools), and so have little incentive to support NHS funding (and in fact, the Conservatives were strongly against the NHS until they realised just how popular it had become in just a couple of years after it was introduced).

The Scandinavian model is inferior from the point of view of those who can afford to pay their way to superior care. It is also strongly dependent on a rough consensus on how much health care is worth, as those who believe health care is worth more does not have an easy option for getting more if they're in a minority, and this is certainly a problem.

I'm Norwegian, but I must admit I prefer the UK model - as much as people in the UK complain about the NHS, it's still one of the public services with the highest approval ratings, and so popular it is pretty much untouchable, yet there are "outs" for those who believe they are particularly badly served and it doesn't seem to majorly affect other service allocation in the UK. On the other hand, there are aspects with the UK model that demonstrate exactly what the Scandinavian models tries to prevent: The UK NHS is often accused of a brain drain from Africa and other regions, by hiring large numbers of doctors and nurses away from poor countries.

I wrote that the Scandinavian health care systems destroy many lives because it fails to diagnose health problems (again, I don't really know about Norway. It do seem less bureaucratic. Or Britain.).

I also wrote about how people can get real health checkups. (This might drastically improve the life of 0.5% - ?% of the population, no one has examined this afaik.)

A philosophical/political discussion as answer to that -- arguing why it is morally right to have a system that doesn't work (here, even destroy people's lives) -- is very Scandinavian. And very "Animal farm".

Edit: About Britain's NHS and Eastern Europe. tl;dr: NHS sucks, Eastern Europe health care cures people. I.e. same as in Sweden. http://www.economist.com/news/britain/21579018-health-clinic...

'the wealthy often "opt out" of depending on the NHS'

I don't know how practical it is to really opt out completely of the NHS - I'm not aware of much private emergency care and if you have an accident you'll almost certainly get taken to an NHS hospital. Also we had an experience where although we have private health insurance (I get it from my job) - when my son had a nasty eye infection we were actually better off going to the specialized NHS eye hospital rather than waiting to see the same consultant at a private hospital a few days later.

> For instance, the health care is a centralised system. Those never work.

Seems to work great for all my relatives in Norway. However, if your statement is more that a centralized system is not perfect I agree.

The single payer system in Norway works generally so well that health-care is something a norwegian does not have to worry about. This is very different from the USA where it has to be on the top of your mind, and a significant portion of the population has no insurance.

> Doctors don't have time/incentive to diagnose problems unless they are obvious (or you're related to a politician -- yes, like in Soviet)

You are still buying in to the cold world propaganda where socialism equals communism, and because soviet was communist then all socialism is bad?

Even america has socialism in all it's confusing array of emergency and social support infrastructure. However, the system here is not well organized and therefore confusing and inefficient.

I think the discussion would be more productive if we focus on if there should be more more socialism in the US, and if that is a good thing. Pretending that socialism does not exists in the US government is not productive.

> From my own and friends' experiences -- simple knee problems that stopped favorite exercise, lack of iron/vitamines that gave depressions, hard to recognize allergies that resulted in tiredness, thyroid problems etc.

I know people that have been diagnosed and treated for all of these and more complex issues in Norway. And no, the people that got treated was normal working-class families with few connections. However, anecdotes are not very useful since I am sure you can find those in any health-care system.

I see a lot of these anecdotes from opponents of single-payer health care, and I am sure you can find plenty of anecdotes in any health care system. However, do you have any study comparing health care systems that supports your claim that a single-payer system can never work?

Evidence seems to suggest otherwise and Dr Danielle Martin answered some of the more common "evidence" given by opponents like e.g Sen. Bernie Sanders:

  http://www.huffingtonpost.com/2014/03/13/danielle-martin-richard-burr_n_4958164.html

Also, the wikipedia page on the topic cites plenty of studies that seems to cotradict your conclusion http://en.wikipedia.org/wiki/Comparison_of_the_health_care_s...

You are arguing against something I didn't write.

First, I explicitly mentioned that I'm not familiar with Norway, but it is similar to Sweden/Finland, where I have lived.

Second, I argue that lots of cases, but hardly a majority, fall between chairs in Sweden/Finland. Diagnosis (access to doctors etc) is bad in Sweden, according to international benchmarking.

No one knows how large these problems are since this is not researched, which is typical for Sweden with the big Ol' Boys networks where media, politicians and big corporations have understandings.

>>However, do you have any study comparing health care systems that supports your claim that a single-payer system can never work?

You are reacting by reflexes on internal US discussions here. See my other comments.

I am arguing something else: Centrally planned systems, like the Swedish/Finnish health care, are inefficient with lots of problems. This is not controversial. And have nothing to do with all possible "single payer systems".

See my other comments for a link to the Economist, re British health care.

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