What will happen when we don’t, and those millions don’t get even a 15 minute visit with a doctor?
Yes. The U.S. is ‘exceptional’. We are the exception, in that we are incompetent to do what every other Western country has managed.
Why? Because Americans would rather pay more for poorer benefits and results, just so ‘Those People’ don’t get anything ‘for free’. 
The thing about covering more people with less money is that it isn’t actually theoretical. It’s already being done. All over the world. In every single country that has UHC.
The real question is, can the US run a health care system more competently than the typical 1st world nation that isn’t the US.
They’re in the one trillion dollar DOD/military-industrial complex budget, for global adventuring and hegemonic dick-waving.
This is the “somehow” I mentioned.
Which of the 1st world countries with UHC experienced an overall reduction in health care spending of 25-40% after they implemented their system vs. before they implemented their system? I am wording that as clearly as I can, because that is what is purported to be what the US has to do by switching to UHC.
A reduction in spending - not a slowdown in growth, an actual reduction of 25-40% of what that country was spending compared to before UHC. Because that is what the US is supposed to achieve.
That is the real question.
Regards,
Shodan
Let’s say we can’t reduce our spending 25-40% while expanding coverage to everyone. What if we just get a slowdown in growth? What if we get nothing BUT expanding coverage to everyone and don’t save a dime?
It’s still worth doing.
The only way it isn’t is if we are so hilariously inept that it actually costs more, despite the fact that every country that has done it has successfully managed their costs at the same time.
THAT is the real question, are we the most inept country in the world?
Screw that - I’d settle for universal coverage for everyone in the US on par with what other developed countries have for the exact same price we currently pay for our jacked-up non-system.
It’s inhumane not to do this.
In Cuba, the doctors come to you. When people are sick, the last thing they want to do is leave the house.
Both of which kind of leave the question of the OP unanswered. If we want to spend the same amount overall, but cover more people, then pretty much by definition we have to spend less on people who are now covered in order to spend more on people who aren’t. Where does that money come from?
Regards,
Shodan
Well, on the question of “free” versus not “free”, from a certain perspective it is actually free. That is the perspective of the US taxpayer.
The US already spend as much tax money on public, government healthcare, adjusted for population, as other first world nations and often a bit more. The difference is that the people who are actually taxpayers in the US often do not get healthcare for the money. If they went from getting nothing for their tax dollars to getting health care, to them its effectively free.
I suspect you are going to have a hard time finding a country that let its healthcare spending get as remarkably out-of-control as the US before instituting a system. You are not going to save money because other countries have had a drop after instituting controls, but because you have a uniquely wasteful situation.
There is this tendency to assume that what you grew up with is normal and that the spending is what it ought to be, but that leads you astray when it comes to the US healthcare system. It is not normal, it is very far from it. That it is the system you grew up with only normalizes it in your perspective.
Its like watching a guy who has bought a used car from the same dealer every year, and had the prices raised on him every year until the used car costs twice what a new model does. And when you tell him about buying a new car he keeps insisting “There ain’t no such thing as a free lunch” refusing to believe that he could have something better for less.
Where does what money come from? The money that we won’t be spending?
When I was justifying my budget by specifying how much my group saved my company, I ran into the cost reduction versus cost avoidance problem. Cost reduction is when you cut down too high costs, cost avoidance is when you prevent the too high expenses from happening. The other countries got decent healthcare systems before the costs exploded, and so didn’t have it as bad as we who never got a decent system did. Thus, no examples.
There is also the concept of benchmarking, which is looking at companies who do things better than you do and try to learn from them. The first thing the fuddy-duddies who don’t want to change say is that the benchmarked companies are different, and so you can’t learn anything.
Sound familiar?
From removing unnecessary health care middlemen who take significant money and don’t actually deliver any medical services. Also by reducing some of the outrageous pricing models that can be charged to people who have no other choice.
Again, by following the established model in other countries that deliver similar or better healthcare at a lower price.
This is what’s usually called operational efficiencies.
Let’s imagine for a moment that we’re talking about a business. This business performs tasks, and 50 similar businesses in other countries perform largely similar tasks using a lot less money. Do you think it would make sense to take maybe a bit of a peek under the covers and see how they do it? Maybe try it in your business?
Because, if I ran a business, and one of my managers refused to look at this other operation and simply declared that we can’t do it here, he’d be out on his fucking ass. It’s not his job to tell me we can’t do it, it’s his job to do it.
This isn’t a magic trick, I absolutely guarantee every one of our allies who has UHC would be happy to tell us exactly how it all works, in excruciating detail. We don’t have to divine the secret to how UHC works.
Now, in the interest in not being a handwaving moron, implementing UHC and driving efficiencies would be a HUGE job impacting millions of Americans. You’re not doing to drive health care spending from 18% of GDP to 12% without a big impact to the workforce. It’s not something to be done overnight, it’s a change that requires years, maybe a decade or more, of transition.
Haven’t you read any of these threads? Where does the money come from? How about from all the people in the insurance companies denying payments. How about all the people in doctors’ offices spending their time dealing with insurance companies.
How about all that underutilized equipment bought so that each hospital/clinic is competitive. I’ve done two MRIs in the past few months, and in neither case was there a lot of people waiting to use the machine. In one place there were several machines besides the one I went into not being used.
And we know that some hospitals charge a lot more than others for the same procedures.
I saw the Bell System eliminate a lot of overhead and waste when we had to become competitive. I think there is a lot of room for the health industry to improve. You, as a telephone user, never noticed the cutbacks, and probably saw improvements. Patients don’t have to get affected either.
ETA: Similar to what **Cheesesteak ** said while I was typing.
India, which is far less wealthy and developed as the US, has a health care system that is run far more efficiently. Even if the medical professionals made western wages, due to other efficiencies in their health care system their prices would still be drastically lower.
We spend 18% of our economy on health care, most other western nations spend 8-12%. We have a very wasteful, poorly run system. However that ‘waste’ translates into trillions of dollars into extra business and income for hospitals, insurance companies, physician groups, pharma, medical suppliers, etc who will fight tooth and nail against any effort to make the health care system more efficient or cost effective.
It comes from all the money currently sent to private middle-men called “health insurance companies”. Sure, a bunch of people, including executive types, will have to find new jobs but the health and welfare of human beings trumps any individual’s right to a particularity job in a particular industry. They can all get jobs in, say, auto insurance or stocking toilet paper at Walmart. Doesn’t matter.
The only thing health insurance companies are there for are to discourage/prevent you from going to the doctor or getting healthcare so they can keep more of your premium dollars.
I sometimes mention that von Bismarck established the first welfare state in the Western world, not because he loved filthy proletarians and peasants, but to 1) steal a political issue from socialists, 2) provide a healthier, more prosperous citizenry to pay the Kaiser more taxes, and 3) discourage the underclass from rising and slaughtering the aristos.
Parallel in USA: Those opposing universal healthcare 1) are enabling socialists, 2) want a sicker, poorer America, and 3) think they’ll escape payback. IOW they’re not friends of America but are serving other interests. I think it’s fair to question their patriotism.
No, the money that we will be spending on people who are not currently covered.
Doesn’t sound familiar at all. Because your first paragraph makes it clear that other countries are doing cost avoidance, and the US is supposed to do cost reduction. So none of the other countries can be used as examples, because they are, in fact, different.
If you need to cut expenses by 25-40%, and the benchmarked companies were able to cut expenses by 25-40%, you could certainly learn from them. If they never spent as much, then not so much.
Regards,
Shodan
So there’s nothing we can learn from the rest of the modern world?