Tweet is from around February 2022; I’m not visiting that cesspool to find the exact date.
Americans pay more for healthcare than any other country, for worse results than any country with universal single-payer healthcare. Moving to the same model as Canada or the UK would mean paying less for healthcare, and getting better healthcare.
Which is obvious once you understand how private health insurance works.
My friend, you’ve been sold a story about Canadian healthcare that is a complete lie. It’s a province-based system that is in complete shambles. Just look at what Doug Ford, the premier (equiv. to governor) of Ontario has done: https://www.ona.org/news-posts/20221124-healthcare-union-sos/
What would likely work the best in the US is a system akin to Australia’s. It’s federal-based, and is a combination of public and private. Private health insurance still exists to cover “gap” fees and similar, but, similar to medicaid, low/no-income earners don’t pay. America is already doing most of this, but nationalising most hospitals would be required, as well as forcing private health insurers to divest ownership of other medical clinics. This would be to eliminate the inane “in-network” crap, which we don’t have in Australia (for the most part).
Doctors here aren’t employed by the government like with the NHS in the UK either. They’re able to run private clinics, and can charge above the government “bulk-billing” rebate. That government rebate is set nation-wide for all services in a master price-list, and is always paid out for those services whether the patient has private health or not. Then the provider and insurance negotiate for what is paid above and beyond that only. This gap fee can be paid directly by the patient, or by private health insurance. Clinics generally waive these fees for both disability and aged pensioners.
It’s far from perfect, but I think the US would need to follow a system like this. Otherwise doctors, used to a certain wage and lifestyle, would likely revolt in some fashion.
Its not the doctors who are reaping the benefits its the insurance companies and hospital administration that make most of the money
This take really completely misses the point of my comment. US doctors still make much more money than UK ones who work under the NHS. Obviously insurance companies and hospital administration make the vast majority of it. They can safely be ignored if you were transitioning the system, as they provide literally no value. If you try and pay all the doctors less though, and they revolt, you won’t have anyone to do the actual work.
Alberta adopted this model and saw an increase in public health wait times and a sharp increase in the required government spending required to run the public system.
Creating a two tiered system means that it bleeds doctors, nurses and admin into the private sector which is fundamentally at odds with the philosophy that everyone deserves the right to life sustaining care. If the rich want to dodge the cue then they can quite frankly afford the plane ticket. If the system is being undermined by politicians - oust the politicians. Let them know that that system is of the highest priority and should be first to see reinvestment.
But we should all be aware that Canada is one of the most challenging landscapes for delivery of any kind of health care. We are diffuse over a large landmass and the commitment to the system means that if you live in a remote place 2 hours away from the nearest surgery then the government is on the hook to spend an outsized amount of budget to uphold the commitment of care for you. The temptation to cut corners is always there and each Provincial trust is its own battleground. That we have the level of service we do is a credit to the efficacy of public health systems… Which means upping the costs to create competitive private sector development hurts us all.
It may be a step up for Americans to have any system at all as a right to health safety net but it’s a sharp step down for anywhere running a full public system.
The point of my comment is that doing it that way would be far more likely to actually be supported in the US politics, given the current state of their system. It feels like so many people there want to skip straight to single-payer. Having that goal is counter-productive, it’s never going to happen.
All that would do is set a baseline pricing model, hospitals would price everything above it and people would be on the hook for the difference. It doesn’t solve anything and let’s politicians say “look we have national healthcare!” All while maintaining the same overly expensive, inefficient, less effective system we currently have.
Except, that doesn’t happen in Australia. Places will “bulk bill” to be competitive, aiming for volume to make their profits.
Otherwise, good luck convincing those politicians to transition to a fully nationalised system I guess. I just strongly believe that’s never going to happen in the US, and that something is better than nothing. If we can’t even manage that in Australia, what hope do you all have?
Like yes taxes go up, but also you’re already paying for health insurance
This is the thing that drives me crazy. Especially with those “I don’t want my money going to pay for the wrong kind of person’s healthcare” idiots. It already does. You already pay for that. Private healthcare is socialized healthcare except with some rich dumbass acting as a middleman so he can scrape a ton of money out while denying grandma that new hip she needs in the name of profits.
Just because you call it an “insurance fee” and pay more than if it was called a “tax” doesn’t somehow make it better.
Your taxes would go down, actually. The federal government pays more now than they would with a Single Payer healthcare system, because it turns out allocation and claim management for hundreds of millions of people, and allowing insurers and pharma to be price-makers, is more expensive than just giving the hospitals what they need on a regular basis.
Here’s Life Expectancy vs. Healthcare Expenditure, and there you can see Americans on average living about as long as people in Turkey or Poland while spending dramatically more than people in Germany or Switzerland.
With my portion and my companies portion, it would almost be the equivalent of what Germans pay in taxes for all the programs they have over there. I think most are in the same boat we just don’t realize that we are getting fucked or we do but we don’t realize by how much.
It was an eye opener to actually look at it since your health insurance is taken from your paycheck before you actually see it so most people don’t even think about it.
Funny how Reagan ran on fiscal responsibility, gutted social programs and then spent all that money on military crap and subsidies for industrialist pals. It’s never been different. Even the tea-party was miserly about social programs but happy to give the military everything it wanted (but not to improve the DVA and things to improve the lives of soldiers were right out.)
And yet somehow who’s going to pay for it is regarded as a valid argument even though these social programs would be a tiny fraction of what we spend on our toys for killing people.
Libertarians be like “But with free healthcare, I would pay for liver treatment for alcoholics, and lung treatment for cig smokers! No one will incentivized to live healthy lives!”
They already do, though, that’s what insurance is. They’re just paying for the premium luxury version of liver treatment.
I think I found a way to convince them. we can say that with free healthcare kids under 18 will be able to go to a hospital and ask for treatment b without their parents because they won’t need money anyway and doctors would want to keep their medical history confidential.
if kids can make healthcare decisions without their parents getting involved, that would be a first step towards lowering the age of consent!
I made it up but if we make it sound convincing they’ll be advocating for free healthcare in no time.
Unfortunately i think “Medical privacy” is going to scream “abortion” to your target audience.
You can also take a fairly selfish view and come to the same conclusion. Like, I don’t want to see homeless encampments, or really sick and untreated people, or panhandlers, or (…) while I’m walking around in my city. I can solve this problem by 1) moving to a nice suburb, or 2) having my tax dollars go to fix a problem that affects me. 1) is off the table because I want to live in the city, and 2) — while it helps the greater good — also helps me directly. (2 can also be addressed in a draconian fashion, which is not what I’m advocating at all.)
I think one problem is looking at things as zero sum. It’s not. If you are healthy and housed and fed then you’re not — to be very crass — an eyesore, you’re adding to the fabric of the city. I want street musicians who are playing for fun, not because they’re trying to make enough to afford dinner.
This is something I just don’t get how so many folks don’t seem to get it. Social safety nets make just a better overall environment to live in. Most people work jobs interacting with other people and have all sorts of things outside of work interacting with people. Ideally they are clean, healthy, educated, and are happy in the sense they are not worried about their prospects for basic necessities like food and shelter.
There is some percentage of people that simple can not think in any other way than zero sum games. Every transaction, interaction, etc needs to have winners and losers. They can’t see that some spending is good because it helps people which in turn helps them. It is a completely alien world view that I also don’t understand. They are the foot soldiers for fascism.
