I don’t disagree that providing care only to those who can afford it should count as rationing - but I know that to an awful lot of people it doesn’t count unless the government is somehow involved. So somehow, when the doctor/hospital won’t treat you because you can’t afford to pay, it’s not rationing. When the insurance company won’t pay for the $20K MRI because a couple of hundred of hundred dollar lumbar puncture will give the same results, that’s not rationing. It’s only when the government is involved , however remotely, that it becomes rationing.
I know the first photo shows the great room where the teat-suckling bureaucrats sip champagne and nibble caviar on the taxpayer’s dime, but what are the boxes in the 2nd photo? Are those where they keep the “patients” who haven’t been killed off yet? How many patients can they cram into one box?
I join the rest of America in pitying the horrors of Europe. But at least your “healthcare” is free. I have to pay $10 for my monthly meds in Thailand and another $1 just to talk to the doctor.
[quote=“Shodan, post:8, topic:782904”]
They want
[ol][li]The best health care in the world[/li][li]Available to everyone, and[/li][li]At a reasonable price.[/ol]They can have, at most, any two of these.[/li][/QUOTE]
Are you under the impression that you’ve articulated some kind of universal law? Because it’s completely false. It’s possible to have all three, and the proof is in the health care systems of all other advanced first-world nations.
“The best health care in the world” is kind of a nebulous criterion, but one can say in practical terms that what people are looking for is the best possible medical outcomes, outcomes that are not jeopardized by the nature of the health care system. This requires access to skilled physicians and the best possible facilities and equipment. This is what people in the above countries get, and indeed their medical outcomes are broadly either the same as that of the well-insured in the US or, in some specific cases, better. It’s the US that fails so terribly in this objective, because those who are inadequately insured or not insured at all – and sometimes even those who are – are the ones who lack preventative services and proper treatments, and many are literally left to die.
What the US does have, uniquely, is a handful of medical centers of excellence that can provide new leading-edge procedures that may not yet be widely available anywhere else. This, however, is not due to a broken and overly costly health care system, but rather to the fact that the US is a large and wealthy country that is a global nexus for medical research and technology development. It’s certainly not due to the presence of the totally unproductive health insurance industry which contributes exactly zero value and is the epitome of uselessness, and would be exactly the same if the country transitioned to single payer. In fact it could be even better if some of the money now being wasted on the insurance industry and its administration was actually spent on health care research.
“Available to everyone” is self-evidently true for any UHC system.
“At a reasonable cost” must also be acknowledged when you realize that the OECD average per-capita cost of health care is less than half of what it is in the US.
They’re not only starting from a much lower baseline, they are also rising more slowly. And that should be no surprise, since the costs of the US system reflect a fundamental structure that is laughably inefficient.
The part about paying for more than you consume on average is a pointless truism, but you’re conveniently overlooking the two important ways that taxpayer funded healthcare is, in fact, quite different from insurance.
First, it supports a universal system, which is fundamentally different from an insurance system because it’s a uniform community-rated model that provides unconditional coverage for everyone, and as such is far more efficient and less costly than the insurance model. Private insurance premiums must not only pay the real costs of health care, they must also pay the enormous administrative costs for a restrictive rate-based and adjudicated insurance system, and for what is essentially uncontrollable profiteering by health service providers.
Second, as a tax-supported system the costs are distributed progressively according to income, so no one has an undue burden as they do under an insurance scheme.
I don’t know why, but this post reminded me of the time North Korea showed off their new airport terminal: http://www.huffingtonpost.com/2015/06/25/north-korea-new-airport_n_7659582.html
I don’t know why, either. None of us are in North Korea. Maybe we should just acknowledge that the architecture and furnishings of hospitals tends to reflect the standards and expectations of the communities in which they’re located. Some are dingy, some are downright luxurious.
Cite.
Regards,
Shodan
I hate groats.
I’m not sure that’s true. The US already spends more taxpayer dollars per citizen than countries with full single payer health care. To be clear, I am not saying it spends more than those countries per citizen on government-run healthcare like medicaid and medicare, I’m saying it spends more government money per capita, including every non-covered citizen or citizen with private health insurance.
So we already spend more government money on health care than single payer countries - and that doesn’t even account for private insurance spending, just on government spending alone.
I’m not sure it’s impossible that we couldn’t reform the system in a way where the same level of government spending couldn’t be used to simply cover everyone in single payer. The money is already taxed and paid out. Just not very efficently.
And obviously that lowers the average cost per person because their taxes could potentially stay the same while the need to pay for private insurance just disappears. Those how incredibly inefficient and expensive it is for us to ensure we don’t cover everyone - we could cover everyone and for cheaper than we’ve already got it.
And it’s not some far off pipe dream - every other first world country does it already.
It all depends what sort of time-frame you choose: certainly in the UK, there’s a pattern of slow growth in public expenditure under some governments followed by a faster period of catch-up under others. I don’t agree with most of what you say, but it’s not clear what conclusions one could draw about the principles of a system from the pattern of expenditure growth for any given period - :except that in a tax-financed system, the expenditure is open to pretty transparent inspection and review, and priorities for expenditure are a matter of public debate and decision.
What do Americans want of a healthcare system?
Look at what came out of the first attempt at a national system - the ACA (still reviled by GOP).
First choice - whatever your employer gives you
Second Choice - Medicare for all eligible for Medicare
Third - Send more money to huge health insurance companies, with some subsidy from Federal government for low-income households.
As a first pass, I was surprised that any program would subsidize a large group.
What was not surprising: “Keep doing what you are doing” - we are not going to replace employer-provided, and we sure as Hell ain’t going put the private insurance companies out of business.
Another two generations, and Americans will be familiar enough with what health care CAN be to get a real UHC system here.
Yep, there are 20-30 mature first world national healthcare options around the world. Just fucking pick one and give the people a proper deal.
This is just so much bullshit.
Change it to 5x the cell phone bill and I think this would be reasonable.
And what’s worse is the public voted for this since 1948. And then they had an Olympic Opening Ceremony in 2012 that celebrated this 64-year old insanity in front of the world.
If only we could tug our forelock and thank our corporate employer for their gracious contribution to the well being of our loved ones. With conditionals.
Seconded. Health care, not a health industry.
IMHO many people see healthcare as a burden of society, not the individual. Basic Karma, as some disability can hit any person at any time, and it is not in society’s best interest, as a humane society, to let those fall by the wayside. Now it is true that many still view lifestyle ‘choices’ (such as risky sex and sky diving) as individual choices and they should pay more, but healthcare is fickle and can charge a law abiding bible thumping christian the same as a hang gliding homosexual promiscuous person when they come down with a similar condition such as cancer.
That would be great! Because we don’t have any of them right now.
Maybe. But my family bitched for years (actually, they never stopped) about the dingy hospital my grandfather had to go to in Italy. Never mind that he was treated just fine and billed like $100 (which would have been $10k in the US). But no private rooms! Horror!
Perhaps so, but if the similar rates of increase are your only answer to ALL my arguments which I notice you haven’t even tried to address, then you really don’t have an argument. One has to keep in mind the tremendous disparity in the costs in the first place – the US is truly an outlier.
My general impression of lower rates of increase probably comes from the frequent comparisons between the US and Canada – which are the most similar socioeconomic environments except for the structure of health care – and where costs in Canada are both much lower and, in general, rising more slowly:
While the dollar figure [for health care expenditures in Canada] continues to climb, the rate of increase is actually falling when adjusted for inflation and population growth …
… The report groups health-care spending into four periods: 1975-91, when annual increases averaged 2.7 per cent; the mid-1990s, when they fell to 0.5 per cent; the late 1990s to 2010, when major investments were made; and 2011-15 when increases fell back to mid-1990s levels.
Plus people greatly underestimate the dinge levels in US hospitals. Sure there are expensive private clinics with big, well-lit, foyers and modern architecture in the rich parts of the country, but there are also many, many drab, utilitarian brutalist buildings, millions of fluorescent lights, and acres of off-white linoleum.
Yes, this