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Old 09-05-2018, 11:31 AM
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Originally Posted by Scylla View Post
People talk about Sweden and other countries with single payer, but these are not without their issues and drawbacks as well. I read a report yesterday (sorry, not on the internet, but can’t cite) that the average wait in Sweden for someone to see an oncologist after they’ve been diagnosed with prostate cancer is now 270 days. Sweden is dealing with a crisis of scarcity. This is more or less happening everywhere.
Too bad you don't have a cite, because I have a lifetime of experience with single-payer in Canada and no such phenomena have occurred in my direct or indirect experience, because the critical determinant in successful health care is triage so that treatment is provided commensurate with the degree of urgency, and in my experience it always has been, and always with an abundance of caution when the level of urgency is unknown. Also in my experience, when one hears about these kinds of wait times from critics -- and wait times do exist -- the critics always seem to forget to mention that the procedure in question was elective and non-critical.

I have no idea about the specific situation you're referring to in Sweden, but my guess is that since some types of prostate cancer are frequently very slow growing -- indeed so slow that in some cases the best recommendation is not to treat it at all -- that this anecdote is a mischaracterization of that type of situation. In any case, there are wait times of some kind everywhere, and it's only a function of funding level and not something intrinsic in single-payer. What single-payer UHC does do is make health care accessible to everyone. That's a feature, not a bug. I don't know about you, but I don't want to live in a country where I get slightly faster access to non-critical care because other people with more critical needs don't get access at all, and die because of it.
Originally Posted by Scylla View Post
Another issue with single pay is that those countries that implement it are being subsidized in a very real way by our health care system. Almost all of the innovation, the new drugs, the new techniques come out of our system. There is little incentive to innovate and advance medicine under single pay.
That's total bullshit, and it's bullshit on several levels. First of all, there's absolutely nothing about the fact that the government is paying for or subsidizing public health care that has anything whatsoever to do with the market for medical goods and services. As a matter of fact, it tends to increase the size of that market. It's true that many medical innovations come from the US, but that's just because the US is a large country with a strong technology base -- it sure as hell has nothing to do with the private health insurers, who are basically useless parasites.

The other level on which this is bullshit is that pharmaceutical and medical technology innovations come from all over the world, and some of the most prominent innovators in many of these areas are not American. For example, here are the largest providers in the field of advanced diagnostic imaging in the world -- things like MRI machines and related technologies -- and their nationalities:

1. Fujifilm Holdings - Japan
2. GE Healthcare - headquartered in the UK
3. Siemens Healthcare (Germany)
4. Philips Healthcare (Netherlands)
5. Shimadzu Corporation (Japan)
6. Toshiba Medical Systems (Japan)
7. Carestream Health (US)
8. Hitachi Medical (Japan)
9. Hologic (US)
10. Esaote (Italy)

Among the top 10 diagnostic imaging innovators, only two are American (or three if you count GE's UK subsidiary), and except for GE they're mostly small players in this market.
Originally Posted by Scylla View Post
Our system sucks, and there is not a quick fix and single pay is not the answer.
So you say. Much of the world says otherwise.
Originally Posted by Scylla View Post
A first question then, is healthcare a right or a commodity? If it’s a right, than we should all have free access to multimillion dollar procedures that might extend our lives slightly when we face grave, likely fatal illness. Thanks to the advancement of medecine this is becoming an increasingly common issue. People want that for their loved ones.

It’s not realistic that this can be provided by society.
Why is it not realistic? I've often described the single-payer health care system where I live as providing unconditional payment for all medically necessary services on the fee schedule, regardless of cost. Which is a critically important aspect of health care, because a system that denies payment when you need it the most is not a working system at all. So why, then, is our system not bankrupt from multimillion dollar procedures? It's not hard to guess the answer. Because the system is supported universally by the entire population, and most people are reasonably healthy, and those with conditions that are very expensive to treat are proportionately very rare. Ironically, it's the private insurer, whose entire business is geared to minimizing medical payouts by scrutinizing individual claims, who is likely to balk at a costly medical payout. Single-payer structurally doesn't do this at all.
Originally Posted by Scylla View Post
Food and electricity are not treated like rights. They are treated like commodities that everyone has reasonable access to at reasonable prices. We need to treat healthcare like that.
Well, how about that, that isn't true either! Which is to say, for most of us they usually are commodities, but if the lack of either causes undue suffering, or has any risk of becoming life-threatening, then civilized societies can and do come to the aid of the afflicted. Civilized societies don't let their citizens starve to death in the midst of plenty, and they don't cut off electricity in the dead of winter, or at any time when it may cause hardship due to poverty without offering assistance and alternatives. Health care, moreover, is unique because costs aren't predictable, and some of us who are less fortunate may have very costly needs due to disease or accident, and so it makes sense for reasons of both civilized compassion and cost-efficiency to treat all medically necessary health care as a public service, funded from some combination of tax revenues and common community-rated premiums.

Each and every one of your points sounds like it was dredged up from AHIP propaganda rather than a balanced assessment of how health care systems really work.

Last edited by wolfpup; 09-05-2018 at 11:35 AM.