Waits are pretty even with the US actually. Not counting the people in the US who can’t get healthcare, and in effect have infinite waits. And the costs are increasing from a level that is half the US costs. US costs have also averaged a faster rise since 1980, which is how thy got so much higher.
No system is perfect. There are problems with all of them, but not all problems are equal. In many cases, they US system would give its eyeteeth for the problems of other systems.
Laptops don’t just disappear into thin air. Someone now has those laptops without paying for them, and that someone profited.
To the root of the question, though, why do we have American Exceptionalism? I think fundamentally it’s because we designed our highest level of government to be weak, because when our nation was founded, we were afraid of government. Unfortunately, this means that the highest level of government ends up being too weak to do many things that realistically can only be done by governments, leaving a hole in the system that can only be filled by less efficient entities like state governments and private industry.
to be honest, it’s just easily bought. The US system of government is not resistant to capitalism.
I wasn’t aware that these six countries were compelled to finance the health care systems in The Ukraine or Bessarabia.
What does the health care systems look like in the 6 most prosperous American States if none of their citizens had to pay Federale taxes? Or perhaps a better question is whether you’d want to be a citizen of Tennessee getting into a motorcycle accident in Mississippi, or a citizen of Croatia getting into a motorcycle accident in Serbia?
I understand that the best health care system in the rest of the world is better than that in the best American State, but we also need to look at the worst health care system in the rest of the world compared to the worst among the American States … the OP goes too far to say health care in Arkansas is a cluster-fuck. It’s much better than what half the world’s population receive. If for no other reason, hospitals in Arkansas have electric power.
Apart from not making sense (“there are no good healthcare systems”), are you arguing people are unwell for longer?
Before you get anywhere near age, the huge and rising cost issue is obesity. And that’s in the UK.
On age, as the population lives longer cancer becomes more common - in the older age groups. Cancer costs the UK about $150 a year per head of population, or 5% of the NHS budget.
There are always huge forces brought to bear on increasing efficiencies because it is absolutely everyone’s interest to do so. Cost of cancer treatment in elderly people is not a huge concern, not least because sometimes it’s better left untreated.
If it’s any help people in Arkansas live five years less than elsewhere in the USA. That’s about 7 years less than the UK average where healthcare costs around 60% of the US level. It’s almost 10 years if you’re black:
Medicare for all will not solve our problems, even PNHP (a physician group calling for a single payer system) admit that.
We spend 18% of GDP on health care vs 8-11% for the rest of the industrialized world. If we had medicare for all we would spend 16% instead of 18%, still far higher than any other wealthy nation.
Plus other nations like Israel, Germany, Netherlands, etc. have multi-payer systems and their systems work perfectly well and cover everyone. Countries with single payer systems, multi payer systems, socialized systems, privatized systems, etc. all still end up paying far less than we do.
Either way, wealthy and powerful people like our system. That and large swaths of the electorate hate the government and really hate the idea of people they consider themselves morally superior to (re: non-whites and the poor) getting health care that they build a coalition that will block any meaningful reform.
We are a wealthy country, so naturally we have electricity. I don’t get the comparison.
I believe every latin american nation has a UHC system. Several asian nations have them or are building them. In fact, when a nations per capita income hits about 5-15k one of the things they tend to do is build a UHC system. Mexico now has a UHC system.
So what is your argument? The US has a better health system than Croatia? Croatia has a UHC system and their per capita income is 1/4 of the US. Life expectancy is 0-3 years shorter in Croatia depending on which chart you look at. I’m sure many Americans would take a 1 year hit to life expectancy in exchange for never having to worry about being able to see a doctor or visit a hospital due to financial reasons, or worrying about losing their life savings if they get sick.
Middle income nations are building more humane and better run health systems than the US, so now people are having to say stuff like ‘at least we aren’t Africa’. How does that help? Of course we aren’t africa, that doesn’t change the fact that Mexico and Thailand are building more humane systems than the US with a fraction of the wealth.
Also, I don’t think you can strictly blame the republicans for any of this. There is nothing stopping the states from enacting meaningful health reform as far as I know. California or NY can enact meaningful health reforms to drive down prices. They have one party rule and supermajorities in their state congresses but they choose not to.
There are a lot of things that could drive down prices:
Transparent prices that are easily searchable
Government negotiations of prices
Comparative effectiveness research
Streamlined administration
A public option tied to medicare (the guy who designed Vermont’s system that Vermont bailed on found that just having a public option would provide 2/3 of the savings of converting the whole state to a single payer system).
I don’t think there is any reason a state couldn’t enact them but they choose not to. Both parties are in the pocket of the wealthy on this issue. If California wanted to rebuild the states system to look like the Netherlands or Israel they could, they just don’t want to. If anything I think single payer is a problem more than a solution. You can drive down costs w/o single payer, and single payer becomes one of those things that can’t be obtained anytime soon (not even Vermont could do it) which distracts from more meaningful reforms that could be accomplished like the ones above (a strong public option, government negotiations, comparative effectiveness, transparent prices, etc).
I’m not sure anything in nature provided the USA with electric power, I’m pretty sure we had to build that infrastructure.
The point I’m trying to make is that it’s not a fair comparison between what France can provide her 60 million people to what the USA provides her 325 million people. How much of France’s tax dollars go to fund health care in Greece? How much of California’s tax dollars fund health care in Kentucky? There’s very few places in Louisiana where with a single phone call one would have an ambulance sent and and transported to an emergency room, no questions asked. Part of this is funded by Texas. How much of Thailand’s UHC system is being used to provide this service in Cambodia?
Unless you happen to be on the slopes of Mt Everest, you’ll be waiting a long time before the UHC in Nepal sends an EMT.
Is there a citation that life expectancy depends exclusively on health care availability? It’s certainly one factor, but I’d think the lack of processed foods in Cuba would have an impact to their statistics as well.
But why would that matter? New Zealand has 4 million people, Israel 8, France 66 and Japan 120. They all provide UHC, why would that break down at the 320 million mark?
Medicare covers 50 million people all over the US and it works fine.
Other developed nations seem able to provide electricity as well. To seek comfort through comparisons to the performace of third world nations seems like a big drop in the standards America normally holds itself to.
This is basically a “special snowflake” argument. Iceland has 300 000 people, Finland 5 million, Germany 80 million and Japan 126 million. Not only does population not seem to affect the delivery of healthcare, but no-one else seems to use size-difference as an argument. Iceland and Norway has no problems comparing performance with the UK and Spain, whereas the US protests that there is too much of a size difference to measure performace against Germany and the UK.
In Public Health its considered fairly fundamenetal that lifespan is a useful measure of the efficiency of a countrys healthcare system. There can be confounding factors, like particularily bad wars, and it is not exclisivly the only factor. It is however a very large one.
Good god, California - 5.7 years diff between white and black …
Great call, Japan makes an excellent example of how these systems scale up. There absolutely no doubt that a UHC system would work in the USA if it was illegal for hospitals to earn a profit, clinic could only be owned by doctors. It might immediately cut costs in half just eliminating profit margins.
We could even stop letting our best and brightest from becoming engineers or investment bankers … make them study medicine.
Just say “Serbia” and we’re done.
watchwolf49, I just want to chime in with others here who are having a really hard time making sense of your arguments. It seems you have two points:
I don’t understand what in the world this is supposed to demonstrate. What, we should be thankful we aren’t an impoverished third-world country? That should be the scope or our collective national ambition? Is that it?
Is there something missing from your posts that’s impeding our understanding of your arguments?
I too am having trouble following the argument. On the one hand, he seems to be arguing about cross-subsidies between states, which I just don’t get.
And then, he seems to be arguing the opposite of economies of scale: that only small countries can afford UHC, not a large, rich country like the US.
Colour me puzzled. 
Single-payer systems take care of anybody who gets sick there. Some of them have exchange systems set up so if place A takes care of someone from place B, they can charge each other, but someone from Saskatchewan getting sick in Quebec won’t get hit with a monstrous hospital bill, someone from Sweden getting in a car acciden in Italy won’t get hit with a monstrous hospital bill, and someone from the US getting hurt in any of those four places won’t get hit with a “may as well burn down the house and declare bankruptcy” hospital bill.
And what’s with the Italian, anyway?
Maybe his view is changing. While not the whole story, it’s quite difficult to deny the life expectancy argument once you become aware of it and start to take it on board.
I wonder if, for people used to thinking in terms of self - as insurance does, the ‘life expectancy’ aspect implicitly encourages you to think also in terms of loved ones.
It’s true that, at some level, how/where money is transferred is at the heart of the problems in the US system.
It’s not true that the Democrats could fix it if only. Healthcare inefficiencies result in a broadly-distributed largess across political boundaries, and as such are promoted by both sides of the political aisle.
When so much money has been poured into a system for so long, and represents such a large part of the economy, any fix has to be incremental, but within a long-term framework. If tomorrow we “fix” the insane amount of money we give to healthcare (in comparison with what we receive in health), the economy would collapse the following day.
Unfortunately, the transient nature of our political system means there is no such thing as a long term framework.
Eventually, economics will catch up with our political system, and the political system we call the United States will dissolve. That’s just the nature of political systems dealing with self-interested humans.
The Canadian system isn’t perfect and there’s always something to improve, but it’s BETTER. We pay less and get service that, generally speaking, works very well and enjoys more public confidence than almost any other institution, public or private, in the entire country.
Why it works better than the mixed US system is a long-winded speech on externalities and adverse selection blah blah blah.
The question, which hasn’t been answered, really, and I do not have a good answer myself, is why didn’t the USA do what almost every other Western country did? It’s not as if the United States is some sort of apocalyptic wasteland when it comes to social programs; it has a comprehensive government-run retirement system, Medicare and Medicaid, so on and so forth, but for whatever reason it skipped over the universal health care/insurance thing. Nor can you simply say “it’s money.” There was moneyed resistance to UHI in other countries, too.
The argument that the USA is too big to do it really doesn’t wash, either. Ever one of watchwolf49’s arguments can be applied to Canada, a larger and even more geographically disparate country; rich provinces subsidize poor ones, big cities subsidize little towns, and so on. If you think it’s easy to get top notch medical care in some asshat mining town in northern Ontario, you’ve never been up there. It is indisputably MUCH harder to implement infrastructure in Canada (or, to use another example, Australia) than it is in France - not that France doesn’t have some hard to service areas, it’s a bigger place than you might think - and yet those big countries can pull it off.
Being really big doesn’t prevent the USA from having Social Security, and for that matter there’s no requirement UHI be one system - Canada doesn’t have a national health insurance system at all, it has ten, which abide by rudimentary rules of universality to get federal money. If 50 states can abide by a few rudimentary rules to get Interstate money they could do the same for medical money.