...convince me to not support Universal Healthcare

[Banquet_Bear]

…I’m self employed and I live in New Zealand.

I pay up to a maximum of $50.00 if I need to see the local GP but if my income were below a certain bracket I’d get a substantial discount. Each individual prescription cost me $5.00 each to a maximum of 20 prescriptions per year, then after that its no charge.

In 2016 I had a pulmonary embolism. The doctor told me “the good news is: you are not dead.” But it was a close thing. They kept me in hospital for five days, treating me with blood thinners and for a bout of pneumonia. When I left the hospital the only bill that i had to pay was for the taxi home.

I got issued a CPAP machine to help me deal with issue with some of the effects of the PE. Cost out of pocket? 0. I have yearly catch ups with Respiratory doctors and nurses, cost out of pocket? 0. I met with a cardiologist every three months, then as I got better it became every six months, and now I see them once a year. Cost out of pocket for each of those visits? 0.

Last year I started to feel unwell again. On doctors advice I went to get a blood test: cost out of pocket: 0 . It was late Friday afternoon. When the results got faxed to the doctors surgery they were read by the duty doctor (not my personal doctor) who called me immediately and said the test showed an elevated level of somethingIdon’tunderstand and he recommended I got straight to the hospital to get further testing. He asked if he could call an ambulance for me, but I said I’d be fine to drive in. (The cost of the ambulance in Wellington would have been 0 )

I got to the hospital and I got a voucher to park my car overnight. (Cost of carparking out of pocket? 0 ) They admitted me immediately and started to run me through a barrage of tests including an MRI. Cost out of pocket, including an overnight stay in hospital, dinner and breakfast? 0. After they finished the testing the concluded that the elevated levels of somethingIdon’tunderstand was probably just a false positive, that this sometimes happened, but it was better to be safe than sorry. Cost out of pocket for me to spend a night in hospital just in case? 0.

It doesn’t matter what flavour of Universal Healthcare we are talking about, the basic principle is the same. The goal is healthcare for all. Nobody misses out. I won’t pretend that every country gets it right every time, that there aren’t flaws or problems and that we all couldn’t do better than we are. But we pay less per head than you do in America for (arguably) better outcomes overall.

So the Great Debate here is a simple one: convince me that we’ve got this one wrong. Convince me that we should switch to the American system, and explain to me how being self-employed in such a system would make me better off. I am at a loss on how to fund the American system here. The costs are sure to be staggering because adding an entirely new infrastructure of insurance companies whom add absolutely nothing of medical value and only exist to make a profit will surely just exponentially increase our costs. Major minus.

But I’m willing to be convinced. So tell me why countries with Universal Healthcare are doing it wrong, and what we should be doing instead. And while you are at it, convince me that the American Healthcare system isn’t an absolute clusterfuck, a literal dystopian nightmare and one that the coronavirus is going to expose all of the failings in one horrible swoop.

[asahi]

I can’t convince you, nor would I try. It seems like NZ’s health system works quite well.

The debate we’re having in the US is how to go from the shoddy, patchwork system we have now that works for people who don’t get too sick too often or for too long…to one that reliably gives more people access to the health system without fear of bankruptcy. It’s more politically challenging than it looks.

[snfaulkner]

Let’s see…the usual cases are dumb shit like wait times are shorter, I’ll get to choose my plan/doctor that’s right for me, the feds are too incompetent and fuck everything up. But what it all really is is the smug moral superiority of being able to say “I got mine, Jack.”

[needscoffee]

@snfaulkner

Let’s see…the usual cases are dumb shit like wait times are shorter, I’ll get to choose my plan/doctor that’s right for me, the feds are too incompetent and fuck everything up. But what it all really is is the smug moral superiority of being able to say “I got mine, Jack.”

I thinks it’s more that they’re afraid they’ll lose choice (of doctor, of treatment, etc.). They have visions of being treated the way we would hear about veterans being badly treated at poorly run VA hospitals. Seems like nothing will change their minds.

[Skypist]

@needscoffee

I thinks it’s more that they’re afraid they’ll lose choice (of doctor, of treatment, etc.). They have visions of being treated the way we would hear about veterans being badly treated at poorly run VA hospitals. Seems like nothing will change their minds.

They’re delusional if they think they have “choice” now.

[XT]

So the Great Debate here is a simple one: convince me that we’ve got this one wrong. Convince me that we should switch to the American system, and explain to me how being self-employed in such a system would make me better off. I am at a loss on how to fund the American system here. The costs are sure to be staggering because adding an entirely new infrastructure of insurance companies whom add absolutely nothing of medical value and only exist to make a profit will surely just exponentially increase our costs. Major minus.

Seems kind of silly and pointless. You obviously like your system. It does what you want it to do. You aren’t bothered by the costs and think it’s a good cost to benefit balance for you and, presumably, for your fellow New Zealanders. You certainly wouldn’t want to enact a cluster fuck system such as ours in the US…no one would, since our system evolved over the last 100 years of changing needs and political shifts at all levels. Is there even any sort of push in your country for change? :dubious:

@asahi

The debate we’re having in the US is how to go from the shoddy, patchwork system we have now that works for people who don’t get too sick too often or for too long…to one that reliably gives more people access to the health system without fear of bankruptcy. It’s more politically challenging than it looks.

Pretty much this. I assume this OP is yet another ‘but we do it, so you can too!’. The problem is, we have a huge amount baggage and history in our system, and it’s going to be a monumental task for us to shift direction, involving large billion or even trillion dollar corporations, political footballery, preconceptions, fears, and the fact that the new system will have to suddenly bring on 10’s of millions of people who don’t currently have full time healthcare. We have decades, nearly half a century of medical price fixing, basically, and a system and process that is completely entrenched. There isn’t any easy fix, no magical silver bullet so that we can suddenly have UHC just like ‘everyone else’…hell, looking at the various ways other countries do health care, there isn’t even one model for us to go too, meaning that here in the US we have different people, sometimes in the same political party, who are looking at different potential solutions and fighting each other on which way we should go.

I get that folks from other countries don’t understand why the US can’t just be like them, and get frustrated when people tell them that it’s not that easy. I also get that people want to pretend the US isn’t unique and could be just like them, if only the Republican’s or the Democrat’s or whatever would just stop getting in the way. But we ARE different, our voters are different, our healthcare issues are different, our history is different, and if we were going to do this the easy way we needed to start down that path 70 or so years ago. Doing it today is going to be a major undertaking, and getting the voters on board is just one of the issues. You have to also get the various siloed and quasi-monopolistic regional healthcare providers on board, the hospitals and suppliers on board to change the various fixed pricing, the political parties on board, etc etc. It’s going to be rough.

For the OP, I’m happy you like your system and wish there was a magic wand that would give us something like that, or something like what Canada has, or other systems, but there isn’t. Be thankful you have a system that works for you.

[Fugazi]

@needscoffee

I thinks it’s more that they’re afraid they’ll lose choice (of doctor, of treatment, etc.). They have visions of being treated the way we would hear about veterans being badly treated at poorly run VA hospitals. Seems like nothing will change their minds.

I like my VA healthcare. It is infinitely better than the private insurance horror stories I read about all the time.

[Banquet_Bear]

@XT

Is there even any sort of push in your country for change? :dubious:

…no need for the dubious smilie. Of course there has been. Just look at how the NHS is under assault in the UK. In the 80’s we saw a solid push by the then Labour government to privatise health services and bring in insurance companies. We managed to stop it at the time but profit motive is a powerful thing. It would be a dangerous thing to simply think “it cannot happen here.”

Pretty much this. I assume this OP is yet another ‘but we do it, so you can too!’.

We can do it here. What is so unique and special about America that you **can’t **do it there? Elizabeth Warren even had a plan to get you there. A plan developed by Americans that was adapted to your unique situation that was costed and fundable and doable. So why can’t you do it?

The problem is, we have a huge amount baggage and history in our system, and it’s going to be a monumental task for us to shift direction, involving large billion or even trillion dollar corporations, political footballery, preconceptions, fears, and the fact that the new system will have to suddenly bring on 10’s of millions of people who don’t currently have full time healthcare.

So you have tens of millions of people who don’t have “full time healthcare.” Whats the plan to fix that? Do you not think it needs fixing? I just don’t understand how you can admit that 10’s of millions of people don’t have access to healthcare yet you don’t seem to want to do anything about it. Why not?

We have decades, nearly half a century of medical price fixing, basically, and a system and process that is completely entrenched. There isn’t any easy fix, no magical silver bullet so that we can suddenly have UHC just like ‘everyone else’…hell, looking at the various ways other countries do health care, there isn’t even one model for us to go too, meaning that here in the US we have different people, sometimes in the same political party, who are looking at different potential solutions and fighting each other on which way we should go.

I’m not sure why you are giving me this lecture. I fully comprehend that its going to be an uphill battle. But at some point if you think the system needs to change then you are going to have to start somewhere. But do you want the system to change? Or are you happy that 10’s of millions of fellow Americans don’t have access to healthcare?

And you don’t have to look to overseas to find a model of healthcare. The experts have already done that for you. There exists a model to transition the US healthcare system to a universal one. Warren had a comprehensive plan and she has said that anyone who wants to use it is welcome to do so. Sanders doesn’t have as strong of a plan but still, its a plan that is better than what you have now.

I get that folks from other countries don’t understand why the US can’t just be like them, and get frustrated when people tell them that it’s not that easy.

Strawman. Nobody expects it to be easy. But you are already waving the white flag. You aren’t even trying. Paragraph after paragraph telling me “we are so special!!! We can’t do it!”

I also get that people want to pretend the US isn’t unique and could be just like them, if only the Republican’s or the Democrat’s or whatever would just stop getting in the way. But we ARE different, our voters are different, our healthcare issues are different, our history is different, and** if we were going to do this the easy way **we needed to start down that path 70 or so years ago.

You don’t get to do it the easy way. We all know that already.

Doing it today is going to be a major undertaking, and getting the voters on board is just one of the issues. You have to also get the various siloed and quasi-monopolistic regional healthcare providers on board, the hospitals and suppliers on board to change the various fixed pricing, the political parties on board, etc etc. It’s going to be rough.

Of course its going to be rough. Its going to be hard. Its going to be painful. Its going to be nasty.

None of this is a good reason to abandon 10’s of millions of people with no access to healthcare.

For the OP, I’m happy you like your system and wish there was a magic wand that would give us something like that, or something like what Canada has, or other systems, but there isn’t. Be thankful you have a system that works for you.

This isn’t about me. This is really about people like you. You can see the obvious benefits of healthcare centred around universality. But you don’t want to support it because “its too hard.” I’m sure the 10’s of millions of people with no access to healthcare appreciate your concern.

[Velocity]

I grew up in a nation (Taiwan) with single-payer. The only few legit gripes I can see in the system are:

1. Doctors and nurses are often paid relatively little. Indeed, many hospitals have to make ancillary income off of restaurants, convenience stores, etc. American doctors and nurses wouldn’t like to be low-paid - especially considering that many U.S. doctors graduate med school with over $250,000 in student debt.

2. Many patients exploit the cheap healthcare for really unnecessary things like the common cold, trying to get their money’s worth out of the system. Abuse of the system is common, not only straining the system but also overworking the (low-paid) medical staff.

3. There can be very long wait times for some procedures.

Is it better than America’s current system? For sure. But single-payer has legit problems.

[Banquet_Bear]

@Velocity

But single-payer has legit problems.

…the thread isn’t about single-payer, but about the principle of universality. And the OP concedes there are problems and that no system is perfect. The question was can you convince me that countries that have adopted universal healthcare are doing it wrong? Doctors aren’t **that **underpaid (in comparison to other work in society.) Waiting times are often comparable to wait times in America with the added bonus that eventually (unlike in America) everyone will get treated.

As for exploiting the system: accessing the system to get treatment for the common cold isn’t “abuse.” Its what the system is set up and designed for.

[Sage_Rat]

The US has something like twice the number of CAT scanners per capita as any other country.

The end result of that is that, because of American obesity, our average life expectancy is lower than everywhere else that would be worth comparing the US to. But that’s a different quirk of America that has no real relevance to the discussion other than that it corrupts the numbers.

If Americans weren’t fat - and yes, I’ve done the math - we would have comparable life span to other countries. Not above, just comparable. But we would still have twice the number of CAT scan machines.

The American system allows bonus money to flow into the system and that allows for cutting edge technology to break in earlier and come into wider use. On the other hand, cutting edge technology, in the world of health, is currently more of a gimmick for most cases than it is a savior. CAT scans don’t save enough lives to change the results very much. Basic sanitation, healthy lifestyles, and vaccines are so immensely successful for longevity that once you add in the free cures that we have discovered for a few big diseases (like diabetes and malaria), it’s really hard to find something that moves the needle at a population scale. Until we can break cancer (properly) and “heart disease”, we’re probably not going to see any big wins through advancing technology. If you have a disease, a particular breakthrough might mean all the world to you, but you’re not the population at large.

The thing is, though, future tech exists when people pay for it. It doesn’t come into being through magic and wishes.

There’s nothing, theoretically, to stop governments from financing future tech but, from a practical standpoint, governments tend to be cheap because people refuse to vote for increased taxes. Other countries don’t have CAT scans because they don’t feel like putting forward the extra money to support progress.

Progress hasn’t accomplished a ton (at a population level) for several decades, but it will eventually. And if the US ever goes single payer, it will throw the global medical industry into a crisis.

Ideally, all the countries would be splurging a little. The nice thing with open market usage is that the wealthy voluntarily spend for big medicine, where they won’t pay for taxes.

[Darren_Garrison]

Okay, here’s one factor to consider: one aspect of New Zealand’s universal health care policy is a “no fattys” immigration rule–if you are overweight, you aren’t allowed to immigrate to New Zealand and if you are already there, you get kicked out. Does that ping your human rights radar?

[needscoffee]

@Fugazi

I like my VA healthcare. It is infinitely better than the private insurance horror stories I read about all the time.

Yes, I was referring to the stories we used to hear about how bad it was in the recent past. We hear now about how much it’s improved, and that’s also what I hear from the people I personally know who are on it. To me, that’s a pretty good indicator of how the system can make corrections when it’s understaffed or mismanaged, which is what some people are so afraid of.

[Sitnam]

When is a New Zealander going to asks us why his nation’s gun banning is a mistake? Similarly, why doesn’t Eritrea stop being poor?

It’s complicated.

[Banquet_Bear]

@Darren_Garrison

Okay, here’s one factor to consider: one aspect of New Zealand’s universal health care policy is a “no fattys” immigration rule–if you are overweight, you aren’t allowed to immigrate to New Zealand and if you are already there, you get kicked out. Does that ping your human rights radar?

…several factors to consider: the New Zealand immigration policy is not “one aspect” of our universal healthcare system and policies, it is a separate and distinct system. You do not have a fundamental right to immigrate to another country, and it isn’t a violation of human rights to refuse an application. There is plenty that myself and others disagree with about our immigration policy and we are working to make fundamental changes. If you want to start a thread to discuss this then you are welcome too and I would probably agree with a lot of what you said. But it has nothing to do with this discussion.

And for clarity: the person who (in 2013) was allegedly declined an extension to their work visa wasn’t declined only because of their weight, but “the main reason Buitenhuis’ application had been declined was due to the osteoarthritis in his knee.” He still managed to get granted an extension to his work visa for an additional 23 months until what is described as a “new scuffle” occurred with immigration that prompted them to leave before they were deported. What that “new scuffle” was is entirely relevant to this particular case: but we don’t know what that was.

As for fatties: I’m happy to say that I am a fattie, I’ve been a fattie most of my life, and being classified as a fattie has not restricted my access to the New Zealand healthcare system one bit, as can be demonstrated by what I wrote in the OP.

[Banquet_Bear]

@Sitnam

When is a New Zealander going to asks us why his nation’s gun banning is a mistake? Similarly, why doesn’t Eritrea stop being poor?

…most New Zealanders don’t consider the gun banning to be a mistake.And the ones that do are pretty vocal about it. And this thread is about universal healthcare. I’m sure you have strong feelings about Eritrea: but I don’t know what it has to do with this thread.

It’s complicated.

Whats complicated?

[D_Anconia]

@Banquet_Bear

And while you are at it, convince me that the American Healthcare system isn’t an absolute clusterfuck, a literal dystopian nightmare and one that the coronavirus is going to expose all of the failings in one horrible swoop.

Since you live in New Zealand, why are you so concerned about the healthcare system in America?

[Banquet_Bear]

@D_Anconia

Since you live in New Zealand, why are you so concerned about the healthcare system in America?

…why wouldn’t I be concerned at the plight and the suffering of 10’s of millions of fellow human beings? I don’t understand the question.

[Euphonious_Polemic]

One interesting argument I got here from a poster (long since banned) could be summed up as:

“America is an exceptional place, in that there are many lazy, shiftless brown and black people who do not look after their health, and are not interested in pulling their own weight. Therefore, due to our exceptional situation with these lazy sick people who would probably go to a doctor every week for shits and giggles if it had no cost, we cannot possibly have Universal Healthcare.”

As a bonus, he assured me that Canada would soon go completely bankrupt, as it was plainly evident that we could never afford Universal Healthcare, and also we were Godless Socialists.

I guess it’s not too surprising that he got the ban-hammer.

[XT]

@Banquet Bear

…no need for the dubious smilie. Of course there has been. Just look at how the NHS is under assault in the UK. In the 80’s we saw a solid push by the then Labour government to privatise health services and bring in insurance companies. We managed to stop it at the time but profit motive is a powerful thing. It would be a dangerous thing to simply think “it cannot happen here.”

There is approximately zero chance that the UK is going to dump the NHS…and your bio says you live in New Zealand. Has there been any serious attempt to change your system to something like the US? :dubious:

We can do it here. What is so unique and special about America that you can’t do it there? Elizabeth Warren even had a plan to get you there. A plan developed by Americans that was adapted to your unique situation that was costed and fundable and doable. So why can’t you do it?

People have tried and continue to try. I suspect that even if Bernie gets elected (note that Warren dropped out), he will try and maybe some progress will be made. But they will be baby steps. Kind of like what Obama had to settle for. The reasons boil down to what makes the US unique and one of the few western nations without some sort of single payer or universal healthcare.

So you have tens of millions of people who don’t have “full time healthcare.” Whats the plan to fix that? Do you not think it needs fixing? I just don’t understand how you can admit that 10’s of millions of people don’t have access to healthcare yet you don’t seem to want to do anything about it. Why not?

There isn’t one. There hasn’t been one. What we do is we kick the can down the road, and we have a bunch of ad hoc methods to deal with it, which mainly boil down to emergency care being basically free, and any sort of supportive care being out of reach to anyone without a full time job with benefits. It’s stupid, but it’s what we’ve been doing for decades now. If it could be fixed easily by simply pointing out the failings we’d have collectively fixed it by now. Again, it’s one of the things that makes us unique, since, pretty obviously, no one else does stupid shit like this.

I’m not sure why you are giving me this lecture. I fully comprehend that its going to be an uphill battle. But at some point if you think the system needs to change then you are going to have to start somewhere. But do you want the system to change? Or are you happy that 10’s of millions of fellow Americans don’t have access to healthcare?

Do you though? Because your follow on questions seem to indicate you don’t…not really. Again, if it was something we could just hear lectured to us for the millionth time by someone from another country and have a eureka moment, we’d have done that half a century ago. Or maybe 75 years ago.

Do I want the system to change? Absolutely. Do I want 10’s of millions to not have healthcare? Nope, I definitely don’t want that and think that the richest country on the planet SHOULD be able to figure this out. But we haven’t so far, and I’m doubtful it’s going to happen when/if a Democrat becomes president, any more than it will happen under the Republicans. I also think that the compromise system that will inevitably happen will be basically more like the ACA than UHS, and it will put in yet more baggage.

No political party has the power in the US to just junk the old system and bring in something like what you have…what the Brits have…even what the Germans or Japanese have. Instead, we have basically a dystopian system more like what China has.

Strawman. Nobody expects it to be easy. But you are already waving the white flag. You aren’t even trying. Paragraph after paragraph telling me “we are so special!!! We can’t do it!”

Again, this gets back to your assertion you understand, when clearly you don’t. It’s not that it’s not easy…of course it isn’t easy. It wasn’t all that easy for Canada to bring in it’s current system, and they had far less baggage than we do. But their political system is nothing like ours. Another one of those things that make us unique that you clearly don’t get or don’t agree is unlike any other.

That said, people HAVE and CONTINUE to try. Several Democrats ran on healthcare reform. Our former president ran on it. He actually had a majority in the house as well. And what we got was STILL a compromise system that didn’t really please anyone, didn’t really fix anything major. If Bernie can do it, fine by me. I plan to hold my nose and vote for ANYONE but Trump. But I don’t see it happening, and it’s not ME that is the problem.

This isn’t about me. This is really about people like you. You can see the obvious benefits of healthcare centred around universality. But you don’t want to support it because “its too hard.” I’m sure the 10’s of millions of people with no access to healthcare appreciate your concern.

Well, I get that…you didn’t really expect or want to be convinced. Nor do the majority of your countrymen. For good reason…you aren’t idiots. But, again, you really don’t grasp the core issues of WHY the US hasn’t gone to UHS or a single payer, or even something like Medicare for all…or anything else remotely like that. You don’t really understand the dynamics or why it’s more than simply ‘too hard’.