Affordable (not only in terms of, low deductibles, but also in terms of the premiums themselves not being too high,)
and
High-quality healthcare (“free” does you little good if it’s absymal low quality);
and
There are not long wait times?
With other nations with UHC, it seems like it is often a choice of 2 out of 3 and that if you pick two of the three, then the third will be the price you suffer. Canada has long wait times for specialist procedures, for instance, and so do some other UHC nations. Throwing lots of money at the problem might enable you to get high quality and short wait times, but then everyone’s premiums skyrockets.
And the US, currently, does NOT have long wait times for specialists? Only if you have enough money. When people moan about “long wait times” in UHC countries I just have to snicker to myself and wonder if they’ve ever had to deal with the VA or Medicaid or when they have one of those garbage policies with a network the size of a lunch lady’s hair net. Frankly, if UHC were to result in the well to do having to split the difference in wait times with what the poor already experience I’d consider that a great life lesson for them.
Nonsense. Your OP is loaded with the assumption that American healthcare is expensive, but that we get what we pay for. We don’t.
On the contrary, as has been documented countless times on other threads, U.S. healthcare cost are at least double those of pretty much any other developed country (all of which have some form of UHC), yet the overall quality of U.S. healthcare is significantly worse by any metric that you care to choose.
It’s not a given that current high costs are directly correlated with high quality or short waits. So, the first thing to do is to figure out the ways in which the system uses resources in ways that don’t increase quality of care and make changes.
Also, sure, hiring more docs will (probably) reduce wait times, and that will cost money. This is true under any system, no? If there’s a demand for doctors or hospital beds that isn’t being met in Canada, is that a problem inherent in a UHC system, or a result of some other issue?
My PCP has twice referred me to a dermatologist. Each time, in order to stay “in network” I’ve had one specific dermatologist to pick from and she was booked solid for close to a year. Each time I said “fuck it” and looked at WebMD or similar.
The point isn’t a debate on America’s ***current ***healthcare system, it’s asking about America’s potential ***future ***healthcare system. Talk about the merits or demerits of the current system is irrelevant.
This is like as if I started a thread saying, “We’re going to buy a new car next year. It has to be cheap, fuel-efficient and safe” and then people saying, “What, are you claiming that our *current *car is cheap or safe?”
Doesn’t have to be “perfect.” But IMHO, for anything to be good, it has to meet 3 criteria: Price, quality and speediness. Right now there are a number of healthcare systems around the world that meet two of the criteria but not all three.
I’m asking how UHC can be done in a way that meets all three criteria. I am ***not ***saying that non-UHC (like America’s current system) meets the criteria; I’m just asking how UHC can be done so that it does.
No, it’s more like saying a government program to increase car safety must ensure seat belts are not uncomfortable and then getting pissy when people ask if you mean less uncomfortable than seatbelts are now or whether you’re asserting seatbelts are currently comfortable but would somehow become uncomfortable under the new program.
Are you asking how UHC could shorten the current long wait times? Falsely assuming wait times are short now but would become long under UHC unless addressed? Or acknowledging that wait times are long now but assuming they’d become longer under UHC unless otherwise addressed?
Given that we start from a much worse place than most countries, “better, cheaper health care than now” seems manageable. And UHC won’t make existing wait times magically go away.
Let’s be clear, under the NHS you may have to wait longer. May. Because there are a limited number of doctors, surgeons, and nurses and more urgent cases will be treated ahead of you. If you are scheduled for a minor operation and somebody at death’s door gets wheeled in, they’re going to take priority. If you think that’s wrong, consider that one day the somebody might be you.
The benefit to UHC isn’t speed - it’s that everyone is covered. This is like the electric car discussions, where everyone wants them to do more than ICE cars do (like be self-driving) for less money, before they’ll consider one, ignoring all the other advantages.
But setting aside the actual goal of UHC for your desired goal: in the short term, it’s impossible. The wait times are based on supply of medical staff and the demand for their services and UHC will increase demand on the same supply.
Long term, a sensible (i.e. unworkable for the US) strategy would be to increase supply by identifying the fields where we need more staff and offering incentives to people entering those fields, like full-ride scholarships, and a second set of incentives once they graduate to get those people into needed areas.
People too often mistake “convenient for me” for “speedy”.
As someone else already mentioned, under UHC the most urgent cases are seen first. If you are having a genuine emergency you go to the head of the line. If you are not having an emergency then you wait until everyone who is having an emergency is taken care of.
I had a Canadian friend who needed hernia surgery. Because it was not an emergency he had to wait six months. His roommate at the hospital where he had his surgery had had his operation within 24 hours of being diagnosed - because in THAT case there was a genuine emergency. My friend could wait the six months. Honestly, he probably could have waited longer if he had had to do so. On the upside - he never had a bill, never had to worry about cost, and now no longer has a hernia.
Do you routinely complain about wait times at emerg? Insist your child’s broken arm get seen ahead of aliphatic shock, because you came in first?
This isn’t hard to understand.
When a cohort the size of baby boomers comes into needing new hips and knees there will be wait times. Those with greater need gain access ahead of those who can wait. Of course, old people are often cranky and don’t wait well, especially since all their lives every medical thing was straight up on demand, as needed. Who waits is determined by Drs not insurance hacks, and hospital paper shufflers looking to increase profits.
If the trade off for waiting a few months for a new hip is my neighbour doesn’t lose his house when his wife gets sick, then the waiting seems a sacrifice worth making. A trade off where you need never worry how you’ll pay, (you don’t get a bill!) or what it costs, no copay, no network, any Dr, feel free to change jobs, never fill out a form. Dr gets paid, effortlessly, EVERY time. No one loses their house, their retirement savings or their kid’s college fund. And when your child has been in an accident, or your spouse is strickened you can focus on getting better, being with them etc.
You really couldn’t see hobbling around taking Tylenol for few extra months in exchange for all that?
Seems like a defeatist constraint. The health care of the future can never be perfect, nor could the car of the future be a pefect mix of cheap, efficient and safe. It’s perfectly justified to compare what it could be to what you have now to see if it is enough of an improvement to justify the transition. Otherwise you could end up waiting forever for some perfect solution you’ll never get.
If the goal was to delay transitioning to UHC indefinitely, then I can understand declaring that comparisons to the current system are off-limits and that a perfect (or at least improbably optimal) solution must be found first.
So while we’re spitballing about general starting criteria, I say that if a new system is available to everyone and does not bankrupt those who use it, that’s a good start. Wait times are pretty far down the list of important starting points.