How much are you paying for health insurance, and would you be willing to give that over for UHC instead?
Even with that qualifier that request is still about ‘the perfect’ being the enemy of ‘the good’.
One annoying aspect of concentrating on the speediness item is that there are no common ways to measure waiting times. And yet, surveys and other reports can give some clues about the places Europeans see as having few issues with waiting.
One survey asked people if they were willing to travel to other member nations to get health care (and some health systems there are beginning or starting to allow that) when waiting was an issue, among the ones that did not see much waiting to make it an important issue (Figure 3.1) were nations like: Denmark, Ireland and Great Britain. (Showing how uncertain other measurements can be; Belgium, that appeared among the worst with waiting times in this survey, was seen as excellent in other reports)
So then one has to mention that theUK does appear in better measurements to be much cheaper than what we see in the USA,
As for quality, a recent Commonwealth Fund study pointed at the UK as the one that had the best quality too, so the system in the UK then deserves to be given a look IMHO.
(Of course the caveat here is that I do know already that some issues in the UK makes the system to be not perfect, but for this thread it is important to see who is doing it better or good out there.)
Of course I would. Currently my wife is covered through her Job (she works for the State) and my portion is $700 give or take. Hers which covers the kids is roughly double that
So “yes” to taxes, as long as they do not surpass what insurance currently takes from you?
It’s not about who came in first, it’s about who can afford to be first. If I have more money than you, then my needs are more important than yours, even if a doctor would assess differently the relative merits of the cases.
Triage is about your credit score, not the nature of your injury or illness.
Sure, I’d be on board with that. Assuming the obvious things like my coverage doesn’t change all that much etc etc
Affordability and much lower costs can be assumed to be pretty much automatic, as it happens in every country in the world that has UHC. “Low deductibles”? I have no deductibles at all, and no co-pays. It happens because (1) it’s truly astounding how much money, time, and effort is wasted having every single payment decision vetted by insurance bureaucrats, and (2) every UHC system has a systematic method for regulation and oversight of provider fees.
High quality health care doesn’t come from indiscriminately throwing money at it, especially not if large amounts of that money disappear in completely useless administrative overhead. It is at least in part a cultural thing, where top quality health care is seen as an imperative basic right for everyone, and where, in particular, the idea that more money buys you superior health care is seen as immoral and abhorrent.
This is largely a pervasive myth. The key here is triage, to ensure that those with time-critical issues get treated in an appropriately timely manner, which UHC systems in all developed countries are able to achieve, and that’s what really matters. Access time to non-critical elective services is largely a matter of convenience, and for some services it can be expected to be longer under UHC, and that’s a feature, not a bug – just an outcome of queueing theory in the efficient utilization of expensive resources, for which idle time is excessively costly. For the rich and well-off, it doesn’t really matter, and for the disadvantaged, a modest wait time is a good deal better than an infinite wait time because you can’t afford the service at all, followed by an early death. This is not a matter that should be subject to any kind of debate at all.
In view of the efficiencies noted above, arbitrarily short wait times for non-critical elective procedures – if for some reason that’s so incredibly important to you – could still be achieved for far less than today’s costs. It’s just a matter of providing the funding levels to meet the desired criteria. But when cost-benefit tradeoffs are being rationally managed, sometimes longer wait times for obviously non-critical matters in return for lower system costs are the right choice.
I can never tell if this is just a horrible parody or just horrible.
Canada is rationed in how many doctors we can graduate, but as well its a complete package in that you also need nurses and specialist positions for radiology. That has to be done at a price the tax payer will support, revenue canada will not plunder and incentives for living and practicing in locations other than the big majors.
If it were up to me as long as they can pass the required certs, I would pay for them to become doctors and nurses and what not. Full ride, but stand up the medical service like the Army. Ten year commitment and then your on your merry way if they want to practice in the states. Deploy them as needed and where ever, actual military deployments would be an incentivised option in time of peace.
Grand father in existing docs and offer to pay off their med debts for a pro rated commitment. No hospitals, no problem, aquire portable combat surgical facilities and rotate mash units where they are needed on a continous basis.
I just noticed this thread so hope it’s not bad form to re-post here what I, a Canadian, said in a related thread in GQ. I had wanted to note a few things about health care up here in igloo country:
Basically, ALL your medical costs are covered by the government. That includes virtually ALL blood/tissue tests, ALL investigative procedures, and ALL surgery.
If you have a catastrophic illness or any accident requiring medical attention, you will receive care immediately upon seeking it. You will pay exactly nothing.
If you need elective surgery, you will wait for it. Sometimes for weeks, more often for months, but not too many (usually). The operation is gratis.
If you have a chronic illness and are being followed by a specialist in the relevant area, you’ll experience regular, appropriate care (and possibly too much care, IMO). The first time you need to a specialist, though, your family physician must refer you to him/her and people will often wait months for that first appointment.
A major problem is that many people (at least in Ontario) don’t have family physicians. Not only is it tough for them to see a specialist (since they have no one to refer them), they are pretty much dependent on the Emergency Departments for much of their medical care. This isn’t too horrible for the patient but it sure screws up the workings of many hospital EDs (and also the hospital to which the patient gets admitted if that was required).
Is it a good system? It’s a lot, lot better for a lot, lot more people than the system in the US.
(NB - drugs are not covered except for while you are being treated in a hospital)
BTW, not too many years ago, about 35 percent of the provincial budget was going to health care. That used to very roughly equate to about 17 percent of all income tax I’d pay. In other words, roughly one-sixth of my income tax was going to health care. Please keep in mind that I also paid federal income tax.
As we used to say (behind our clients’ backs,) “Fast, good, or cheap? Pick two.”
Aye, that’s a truism that’s used in a number of industries (including my old industry of market research).
BTW, too late to edit what I said above regarding waits for surgery. I should have stated explicitly that cancer surgery (and biopsy) wait times are generally very short (with the time spent waiting deemed irrelevant to patient outcome based on ‘expert opinion’). ; Further, wait time can be reduced to zero by the surgeon simply by declaring it to be an emergency, and he/she will face no risk of being challenged on that conclusion).
How many doctors are educated each year has absolutely nothing – zero – to do with the health care insurance system, provided of course that doctors earn reasonable livelihoods, which they do (check out the vehicles in a typical Canadian hospital “doctors only” parking lot – Mercedes, Lexus, etc. – these guys are not exactly worrying about where their next meal is coming from. Doctors in my view deserve to be well paid, and they are).
Your second sentence is just incoherent. I literally don’t even understand it, but in any case the Canada Revenue Agency (there hasn’t been such a thing as “Revenue Canada” for many years) has absolutely nothing to do with where doctors choose to establish their practices.
Right, but two additional notes to that. Certain very expensive drugs are covered under special programs, and retired old farts like me get seniors’ drug coverage, which pays for everything except a few bucks of dispensing fees and – in one of the rare instances of a deductible applying in Canadian health care – a $100 annual deductible for prescription drugs. And even that deductible is waived if one is below a certain threshold of income.
Generally true, indeed, but the trouble with simplistic truisms is that they may gloss over very significant factors that occur in the real world. In this case, “cheap” versus “expensive” is heavily mitigated by the fact that expensive US health care is mainly due to extreme waste, occurring at a level unheard of in the rest of the developed world. The primary cause of it being, in a nutshell, the administrative necessities and lack of cost oversight that arise from the utterly bizarre and immoral practice of treating access to health care (that is, the funding of it) as a business commodity with opportunity for vast profits.
It is not an exaggeration to say that under the Canada Health Act, and provincial laws in conformance to it, anyone running a business under the model of some of America’s most vaunted health insurance corporations like Aetna, Cigna, or UnitedHealth would be subject to cease and desist orders and, ignoring those, would wind up in jail. These are not corporations in even the remotest sense of contributing value; they are parasites, pure and simple.
Neither, it is an unfortunate observation into the healthcare system of the US.
I know people who, if they stub their toe, will see an orthopedic surgeon within an hour.
And I also know people who struggle with a chronic injury, and only go to the hospital when it literally becomes too painful or debilitating to live with.
I never agreed with that “truism” as it is really just an excuse for delays, shoddy workmanship, or budget overruns (pick 2)
I don’t need “fast”, but I need it on time. I don’t need it “good”, but I need it functional. And I don’t need “cheap”, but I need it to be affordable. If you cannot find a way to work with those criteria, then I will find someone who can.
The nature of competition is that given comparable quality, everyone is going to take about the same amount of time and charge about the same.
So if you say you need it in two weeks and need it to cost $X, and I say it will take a month and cost $Y, you’ll go someplace else. What if they say it will take a month and cost $Y? And the next place says the same thing?
I’ll make it easier for you. We’ll agree on good. Fast or cheap? Pick one.
Don’t know what your coverage is.
Here’s what mine is:
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full coverage of anything my doctor thinks is medically required/necessary/recommended;
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no bureaucrat second-guessing my doctor’s assessment;
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Canada-wide network: I can walk into any ER, any medical clinic anywhere in Canada, show my provincial health card, and get whatever medical treatment is necessary;
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no personal premiums;
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no employer premiums;
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no deductibles;
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no ci-pays.
To get that coverage, I pay my income taxes every year.
How much would it cost you to get that coverage in the US under your current system?
I’ve got a solution to the OP’s problem. All you have to do is to make all the doctors and nurses slaves, and select some segment of each graduating college class to be slaves and go to medical school. Cheap, fast (you just have to enslave enough of them) and if the quality is no goo, they get whipped.
Don’t like it? Then don’t ask for the laws of economics to be broken - plenty of quality resources at minimal cost does not happen.
Given that much of the US dolesn’t get even one of these., two would satisfy me just fine.
As long as we’re making things easy for one another, let me make it easy for you, too. You can have all three.
How is this possible, you ask, in apparent defiance of basic laws of economics? The answer begins with another question: why would you think the laws of economics apply under the present system? In the present system, essentially the entire funding model for health care in America is based on the machinations of a sordid private enterprise that is, at its core, little more than a criminal organization whose ability to extort vast sums of money while adding zero value is closely analogous to the racketeering of organized crime. It is, indeed, the only enterprise I know of outside of the Mafia where the bosses routinely make decisions that cause people to die.
In the rest of the civilized world, the medical profession itself aspires to “good” and the principle of clinical triage provides for “as fast as necessary”; it’s up to the public funding model to ensure that there are adequate resources to allow the medical profession to meet these ethical criteria. Since the public model is enormously more efficient than the criminal racketeering model, you also get “cheaper”, if not necessarily “cheap”, as an added benefit. As an added bonus you also get “reliable”, because in single-payer, refusing to pay – and deaths from medical neglect – are not a thing, whereas stiffing their clients and medical providers by refusing to pay is a very popular practice with private insurers.
In short, get private insurers out of the health care business, and amazing things can happen.