Universal healthcare - Yay or nay?

[ES 148]

Emergency healthcare should definitely be free imo - if someone gets hit by a drunk driver or attacked in the street, they shouldn't end up thousands of dollars in debt as well as losing out on work (and in extreme circumstances, stuff like loss of movement/function) because their health insurance doesn't cover it or whatever.

 

[Just Some Other Guy]

XRay is a 30 minute wait at a walk-in clinic.

The issue with judging Canadian healthcare is that the system is heavily decentralized. Your province decides the quality of your healthcare.

Canada has longer wait times for certain operations but in America people just die. Dead men tell no tales.

Not Canada, Italy.

*Edit* Also saying in the US people just die is a very disingenuous statement. Let's look at the big bad cancer and we see the US has one of the highest survival rates for cancer. According to the UN as of 2015, more people 15-60 die in Europe than in the US (that reverses in the older bracket). There's also the age old saying "People die on the steps of hospitals each day". So no, universal healthcare is not a magic bullet fix to mortality.

 

[hambeerlyingnreed]

Universal Healthcare is Breaking Bad being a 1 season series. Guy goes to doctor, shows healthcard at receptionist desk, gets tested and then undergoes treatment for cancer. Maybe there's some sappy side story, like a female cousin shaving her head in solidarity and then gets made fun of, but when people find out the reason why she has a new haircut a bunch of the cool kids shave their heads too. Or some sultry side story, like the wife cheating on him with one of the nurses in the chemo clinic. Bonus points if it's a female nurse.

 

[Hellbound Hellhound]

what other goods and services? cause there's a ton of them that are a lot less elastic than healthcare. housing, food, water, electricity, heating, fuel - and most of them (or all, it varies by country) are matters of private business, not state owned.

I've already explained why food is not an inelastic good, and all of the others you've mentioned are heavily supervised and regulated by the government even when they're not state owned.

As for housing, that's a bit more complicated, because while supply is relatively inelastic, demand is not. What we observe with housing is that when real estate prices go up, the number of households contracts (in real terms: more young people continue to live with their parents; siblings are more likely to share rooms, etc). The subject of housing is made even more complicated by the way that prices have been inflated in recent decades due to the government's laxness in the face of permissive bank lending. This is one of the reasons we're in such a mess following the housing crash.

The point to take from this is that the market is not always effective at regulating itself, and this fact is particularly evident when you're talking about goods and services that are heavily resistant to changes in supply and demand, like healthcare.

the part where a massive amount of time and resources is wasted on unproductive endeavours.
when the person making the decision about purchasing something is not the person who has to pay the bill, then there is no incentive for efficiency anymore, which in the case of healthcare results in massive overprescription of drugs and treatments.

I think you'll find that overmedication is especially pronounced in the United States, where the healthcare industry is managed by private enterprise. I also think you'll find that most people (especially parents) will happily "pay the bill" when a healthcare professional can convince them that the treatment being offered is beneficial.

The question this begs is: who is better suited to decide which treatments are necessary and which are not? Is it the private companies who have a vested economic interest in selling you their treatments, or is it government agencies who are charged with helping consumers make an informed decision? Personally, I'm more inclined to go with the latter.

more specifically, the decision to purchase treatment is made by patients and doctors and is loosely regulated by insurance policy. cost is not a concern for either of them because neither of them pays the bills.
doctors are incentivised to maximize the amount of medicatio nand treatment the patient receives, because they are the ones getting paid to prescribe, administer and supervise it. this incentive to maximize prescriptions naturally aligns with the interests of the pharmaceutical industry, which is also keen on maximizing drug prescriptions for obvious reasons.

The incentive to overmedicate on the part of doctors and pharmaceutical companies is not the fault of insurance companies, they merely exacerbate the problem. What you're actually describing is the ineffectiveness of the market to look out for the best interests of patients in the face of the healthcare industry's bottom line, and it doesn't seem clear to me that the market is ever likely to fix this.

It might help if patients were more informed regarding which treatments are beneficial and which are not, but asking for such a thing is deeply naive. Most people are not in a position to make an informed choice, which is why we depend upon people with medical PhDs to make those decisions for us.

the bill for the whole process gets passed to the insurance provider (which, in the case of socialized care, is the state) where it is processed and reorganized. eventually the insurance provider passes on the costs to its customers - this is where the major problem arises: if the insurance provider is working in a market setting, it has a natural incentive to minimize this cost in order to keep its customer base - if insurance prices are too high, customers might think about switching to a cheaper competitor, or drop their insurance altogether.

Insurance in the US does operate in a market setting, and it is still much more expensive than healthcare costs in Europe. One problem here is that the insurance market suffers from a lack of competition due to the excessive barriers to entry involved, but this isn't something that market forces alone can fix.

A workable solution did come close with the Affordable Care Act, but the act was butchered with the removal of the public option. Had the public option remained, I think the cost of healthcare would have been measurably reduced.

but when you have socialized healthcare, this incentive goes out the window - because now the insurance provider is a state-owned monopoly, there is no competition that the customers could go to, and because the government forces everyone to be part of the insurance, they do not have the option of dropping out either. in such a system, customer agency is eliminated, and with it all incentives to act efficiently.

Why does universal healthcare necessarily have to be "socialized"? There are many forms it can take, and just about the only commonality between these systems is that the government is playing a role in reducing the excesses of market incentives which don't work in the best interests of the public. Just about every developed country apart from the US does this, and they have better access to healthcare than the US as a result.

I don't buy the argument that universal healthcare is automatically less efficient or less competitive. Would the public option in the original draft of the Affordable Care Act have reduced competition? Because it seems to me that the opposite would have been true, which might be why no insurance company wanted to compete with it.

 

[Slap47]

Not Canada, Italy.

*Edit* Also saying in the US people just die is a very disingenuous statement. Let's look at the big bad cancer and we see the US has one of the highest survival rates for cancer.

I did some reading and apparently the USA lets you sue doctors for failing to diagnose cancer an that these lawsuits are common.

The thing about Americans is that they're insanely good at pursuing incentives. This is good but can also lead to insane shit when you have perverse incentives (private prisons are the best example).

The American healthcare system is also full of perverse incentives. People are milked dry for medicine that is cheaper everywhere else and organizations like insurance companies have developed a parasitical relationship with the govt and American people.

Why does universal healthcare necessarily have to be "socialized"? There are many forms it can take, and just about the only commonality between these systems is that the government is playing a role in reducing the excesses of market incentives which don't work in the best interests of the public. Just about every developed country apart from the US does this, and they have better access to healthcare than the US as a result.

I don't buy the argument that universal healthcare is automatically less efficient or less competitive. Would the public option in the original draft of the Affordable Care Act have reduced competition? Because it seems to me that the opposite would have been true, which might be why no insurance company wanted to compete with it.

People keep looking to social democrats in Europe but even uber-capitalists like Singapore and HongKong have these systems in place. It really is just cheaper and better for the people to have a govt run system.

 

[Just Some Other Guy]

I did some reading and apparently the USA lets you sue doctors for failing to diagnose cancer an that these lawsuits are common.

The thing about Americans is that they're insanely good at pursuing incentives. This is good but can also lead to insane shit when you have perverse incentives (private prisons are the best example).

The American healthcare system is also full of perverse incentives. People are milked dry for medicine that is cheaper everywhere else and organizations like insurance companies have developed a parasitical relationship with the govt and American people.



People keep looking to social democrats in Europe but even uber-capitalists like Singapore and HongKong have these systems in place. It really is just cheaper and better for the people to have a govt run system.

Are you saying it's better for people in those countries, or it's better for all people? Once again, our mortality rates would beg to differ. The huge problem of heart disease in the US is actually killing less people per capita than in Europe.

 

[Slap47]

The huge problem of heart disease in the US is actually killing less people per capita than in Europe.

It seems like Americans are far more likely to get heart disease than any Europeans because of their diet and work-life balance. The French, Mediterraneans and Slovaks have an especially low rate of heart disease while the British have a much higher rate.

Those EU regulations and all that biking probably play a role. Anyway, I don't know where you got that statistic. Perhaps far less Europeans getting heart disease plays into that per capita mortality.

 

[Harbinger of Kali Yuga]

Everything could have been done better. Obamacare seemed to only make the system more complicated to me. Either go fully single payer (which I admit, I favor) or let the free market have full reign, but don't create a half-assed abortion that doesn't actually make it easier to get coverage.

I came in under the poverty line one year and was told I didn't make enough money to qualify for assistance. WHAT THE FUCK SENSE DOES THAT MAKE?

I'll make a bold claim I can't really substantiate:

Obamacare was a stop-gap the Democrats intended to be a short-term solution until they felt univeral healthcare was politically viable, and it was never intended to succeed long term.

 

[Slap47]

I'll make a bold claim I can't really substantiate:

Obamacare was a stop-gap the Democrats intended to be a short-term solution until they felt univeral healthcare was politically viable, and it was never intended to succeed long term.

Obama took massive donations from insurance companies and basically raided the treasury to pay them off.

https://www.forbes.com/sites/theapo...he-treasury-to-pay-off-insurers/#7d864296164d
https://www.huffingtonpost.ca/entry/obama-2012-health-care-campaign-donations_n_1048673

The Democratic party is one of the most corrupt organizations on the planet. The only reason they oppose pipelines is because their top donors like Warren Buffet want the oil to be transferred on the railways they own.

Healthcare, oil, war... its always for a small clique of donors.

 

[The Shadow]

I'll make a bold claim I can't really substantiate:

Obamacare was a stop-gap the Democrats intended to be a short-term solution until they felt univeral healthcare was politically viable, and it was never intended to succeed long term.

I think that's what they want us to think but I think in reality the insurance companies have a tight grip on the balls of congress.

 

[Just Some Other Guy]

I just realized the best arguement against universal healthcare in the US from another thread. Look at how much we spend on public education, then look at the results. That's the government you want to run your healthcare?

 

[Harbinger of Kali Yuga]

I just realized the best arguement against universal healthcare in the US from another thread. Look at how much we spend on public education, then look at the results. That's the government you want to run your healthcare?

I'm not sympathetic to either public education or public healthcare (lol) but it's not quite a valid comparison in that public education is handled on a more local level which is where funding comes from; universal healthcare would be something (probably) managed by the federal government.

I'll leave you to decide if that actually makes it better or worse.

 

[Just Some Other Guy]

I'm not sympathetic to either public education or public healthcare (lol) but it's not quite a valid comparison in that public education is handled on a more local level which is where funding comes from; universal healthcare would be something (probably) managed by the federal government.

I'll leave you to decide if that actually makes it better or worse.

Fair enough point, I raise you the whole mess that is Social Security. Wonderful federal management of a social program at it's best.

 

[The Great Chandler]

I think universal healthcare should operate differently depending on the state since every health issue in each region is different.

 

[lameandgay2]

Never trust the government to give you healthcare worth having.
I've paid a scary amount of money for private treatment (out of pocket, insurance isn't really a thing here) to avoid NHS 'treatment' like the plague.
All you have to do is Google 'NHS failings' and you'll see why. Including them hiring fake Doctors from overseas because they're too busy saving money to avoid unnecessary deaths and suffering.

 

[pwincess fwuffypants]

Nothing's free. If you don't pay for it with money, you'll pay for it with time. Or political favors. The more socialist the system, the more the access to goods and services matter and who you know.

I find it interesting that hardly anyone demands "universal car maintenance" where you can get your car repaired and diagnosed on demand for cheap or free. Or that anyone demands "universal pet maintenance" where you can take your dog or cat to the vet and have most of the costs covered by some state-run plan.

In general, although not perfect, you find that the prices for vet and mechanic services tend to be fairly transparent and that between that, internet ratings and access to decent consumer credit, the services tend to be priced close to their value. Bad actors get weeded out pretty quick and avoided when they get too many bad ratings and most people pay out of pocket when the services are needed.

Whereas hospitals in the U.S. tend to be these slimy opaque things that operate more like car dealers where they open with some bullshit bill and then more or less force you to dicker and haggle over and over and over again, even so, leaving you with no idea whether you got ripped off or paid a fair price. You're supposed to depend on some insurance entity that will shield you from some of the assraping, but what tends to happen is the insurance entity tries to find any little reason to run away and leave you bent over with your pants down for the hospital to have its way with you.

If I had the power to fix things, first thing I would demand is some sort of book price and book time where all hospitals have to tell you how much it's going to cost and how long it's going to take for every single thing they do. You should be able to login to some site, tell it what kind of service you want and get multiple bids on your request. If you're not in a position to be able to do that, you can delegate to someone you trust who can.

I'm not holding my breath. If I can help it, I avoid the medical system here like the plague it is and do my best to avoid the preventable things that send most people into it (like weight and smoking). If I need to visit a hospital, I'll buy a plane ticket and do some medical tourism.

More fixit type things I would do. If access to medical care in some rural region gets too thin or scarce, the region is declared an entrepreneurial medical zone and the barriers to entry for providing medical services gets lowered way down until people are once again getting medical services. Want to be a doctor but don't have the license? If nobody else in say, W Virginia wants to be a doctor, well, go ahead and try being one yourself. Something is better than nothing, I say.

The other fixit thing I would do is ask what kind of medical plan could be realistically put together for something that costs $30/mo. Sure it wouldn't cover much, probably only accidents, but again something is better than nothing. Government could serve a role to set standards and make things uniform.

 

[Sweetpeaa]

I live in Canada in a province (Ontario) that has a healthcare system that has taken a hit from years of under funding and cuts. The doctors are excellent however it's the amount of funding that creates the issues within the system causing the waits, delayed diagnosis and immediate and inappropriate discharges of people recovering from surgery.

Let me tell you a story, I had surgery on a tumor in my parotid gland when I was 23. Five hour surgery and quite complex. Though the surgical technique was excellent but there was still huge the problems post-operatively. I was given less than 30 minute of recovery time. I spent ten minutes in the post op room (just coming out of the surgery) and then 20 minutes in some other part of the hospital quickly rushed. I briefly talked with the surgeon for less than seemingly five minutes who gave me a post op appointment within one month. The nurse then discharged me. Most people in other countries who have had this surgery in the U.S and even the U.K spend time in the hospital recovering - I never got the chance.

I had to call a cab and spend the night in a motel before I had to back home (3 hour drive). I parked my car in the hospital parking lot over night so I had to pay that overinflated parking bill in the morning after taking another cab from the motel back to the hospital. I was numb around the incision for the first 18 hours but on the drive back this is when I started having trouble with my wound both in pain and bleeding. I was also never given a drain tube either (most people who have had this surgery have a tube inserted). I ended up getting a hematoma and an infection in my wound. within the week. I was given zero instructions for post wound care and had to go to my local hospital for help, draining and treatment of infection. This was all the result of hospital cuts and poor provincial funding of healthcare. This type of thing in the largest drawback we face in the Canadian system.

 

[Kornula]

"universal" health care is all around a bad idea. We already have seen how poorly the US government has been running health care for the Millitary.. why would we want that? Plus, the biggest problem would be: Insurance companies, Medical supply companies and Pharma. - Even if we started out with a Health care plan that made sure those assholes could not bleed everyone dry, they would within 10 years make sure to reverse that to the point we would be paying 80% of our income just to support them. That alone is reason enough to keep Health Care out of the hands of the goverment.

 

[Had]

I'll say this about universal health care, if your young and don't mind waiting a week it's nice. But if your older and the level of care matters then private health care is gonna be much better off for you.

Private health care is like dealing with a shady businessmen who's always trying to get more out of you.
where as universal health care will kick you out if they need the bed.

Plus, the biggest problem would be: Insurance companies, Medical supply companies and Pharma.

I wouldn't have nearly as much of a problem with the Us's health care systems if they made Insurance pay out, but as it is they don't. You can get shit that's meant to be covered and they will only pay 10% of a bill in a thousands, at that point your literally better having put the money in savings and paying for it yourself. The idea Insurance companies act in good faith rather than taking money is just untrue.