@treboR the countries I've spent most my time in seem work okay. Taxpayer funded medical systems with private/insurance options. The worst one is HK, where you can get multi year wait times for some illnesses (definitely sucks) but conversely my son was hit by a car last week (just scratches)- ambulance on scene within 10 mins, A&E checkup with x-rays within 2 hours. Cost was $12.50.
I think the key is to keep pharma lobbyists out of influencing government policy.
I've lived in HK, Oz, Canada, UK. The systems there are far from perfect, but seem workable. The medical system in the US is one big thing that stops me from moving there.
This is just my own view - being an economist and having written a couple public finance papers on long term fiscal outcomes. The only sustainable healthcare system in the very long term in the US is a national, single-payer, opt-out system. It's not impossible to build something that results in better outcomes and which costs less to operate than the ACA plus medicaid and whatnot.
At the end of the day the US pays much more per person in healthcare costs compared to all of Europe with much worse health outcomes. A well implemented single payer system will be able to take out those inefficiencies. And governments are capable of doing that, look at something like the NHS or the German SHI system, neither is perfect but both have far better outcomes per dollar.
@YMO The analogy might not work the way you want it work. USPS exists for a very good reason, because people need basic courier services regardless of where they live. If you want better/faster services, you're free to use UPS or Fedex. The current system benefits nobody but the insurance companies. People overpay for subpar service, hospitals face uncertainty over income, and costly emergency rooms are overburdened.
@Zhanming057 last post before I'll drop the subject. USPS exist because it was authorized by the US Constitution to create the Post Office system. Also if you weren't aware, US Law grants the Post Office a monopoly on all First Class mail.
Fedex and UPS by law can't do anything First Class Mail, and Fedex and UPS do reserve the right as private businesses to say no to mailing certain things based on subject (while USPS can't refuse due to Gov censorship). Also, the US Gov is $23 Trillion Dollars in Debt. Do we want to give the Gov another program to run it to the ground?
As a Libertarian, I do believe any type of single payer system is beyond the role of the Federal Government, including at least in my opinion being unconstitutional. This also brings up another point: Americans have a thing about a big gov telling us what to do, 1776 is calling.
@YMO Clicked post by accident. The bottom line is that medicare and ACA is simply not designed for what society has become where some people will struggle to pay for medicare and have to find costly last-resort services. We are already spending far, far more than any other other developed country per capita on healthcare, in an ideal world single payer should be cheaper than the mess we've got, not more expensive.
@YMO Ideologies are cheap talk. I am part of a group of economists who train career advisors to help people return to employment and the number one kicker is medicare costs. Lots of programs (nursing) require you to have insurance and those careers are entirely shut off to people and they have to resort to medicaid which should strictly be a last resort option.
In 1776 free land was up for grabs, lots of states had access to cheap, plentiful labor, and wealth inequality is a fraction of what it is today. We may have to agree to disagree on this but when I see something that is just not working and can be fixed I don't consider the opinion of people who have been dead for 200 years to weigh in on that particular decision.
I mean, if you hear a pair of cans and they're really bad you think that either the can/amp is broken or you need a better setup. You don't think "all headphones must sound like shit", you go about and try to fix whatever is causing the problem.
I say we we privatize and deregulate everything, put our faith in the good will of corporate CEOs and let the free market police our healthcare system. Worked out well enough with banking.
The healthcare system in NL is pretty good. Not excellent but if you know how to manage medicin and treatments you can afford a lot. It is becoming more expensive though.
Haha. Obviously no one here has ever tried getting a doctor's appt with Medicare. The few providers we found who accepted Medicare initially said they didn't take it, until we got Medicare admins to "clarify" that they did for us. This is normal - providers hate accepting Medicare patients. Let's not even talk about the service during the actual appointment.
As far as banks, US banks are extremely strong. The mortgage crisis 10 years ago would not have happened if politicians didn't step in and try to artificially inflate home ownership rates and loosen borrower requirements at quasi-Federal loan buyers Fannie Mae and Freddie Mac.
I suggest people to try actually use these shitty government services before thinking about expanding them. The US isn't technocrat oriented like Europe or Canada. Perhaps we should fix Medicare as a first step. If I had Medicare last year when I contracted Valley Fever, I would have died of chosen to die. I can see people avoiding the doctor because the service is so shitty with Medicare.
And I'd like to see politicians who advocate for certain solutions forcing people to take a certain action be forced to do so themselves. If it's good for the people, then it should be good for them too. None of this ivory tower "I know better than thou, do as I say, not as I do" Mao or Pol Pot BS
Yep, the banks are bigger now than when they were to big to fail. That doesn't speak to whether unregulated banks will take on enormous risk knowing that they'll be bailed out by the U.S. taxpayer (again). And the loosening of borrower requirements (a deregulation in itself) may have been part of the fiasco, but so was the repeal of regulatory Glass Steagall without a sufficient replacement.
Having lived in Canada for 7 years, recently, I don't ever remember a Canadian lamenting their health care system. Not once. It's amazing some times how many Americans though are willing to do that on their behalf.
UHC, democratically established, results in cheaper, more rational, more affordable health care, rather than the current expensive system that rations health care by the luck of income.
I lived in Canada too. Had Canadian citizenship. Thought the healthcare was decent there. However, what works in Canada may not work in the USA. Different cultures, history, challenges, demographics, etc.
And as far as banks being too big to fail: This is even a worse problem now because of more gov't regulation, i.e. Dodd-Frank that killed small and medium sized banks. Good intent, bad outcome. And you still want to trust gov't? Why do "gov't great people's programs" in the US mostly result in the big players winning instead of the little guy?
After 2008, every big bank that hadn't gone out of business was paying multi-billion dollar penalties for fraud. Every single one. These people were pulling stunts like knowingly selling toxic assets to their own customers and using their own customers personal info to create massive amounts of fraudulent accounts. That's before you get in to the risk they were taking on by leveraging 30:1 and etc.
The idea of leaving our healthcare in these people's hands, unchecked, and the consumer/patient not getting absolutely effed from every direction seems pretty unlikely.
So you want the USA gov't, the one who encouraged bad lending standards, engineered the housing bubble, and wasted billions on the F35 fighter and now the Ford carrier programs with tech that doesn't work to manage healthcare for everyone? No thanks, I think I'd be better off with the imperfect Evil Corporate health I have now.
One thing people don't consider about Medicare is that it is the primary reason why prices are so inflated in the first place over the course of the last 4 decades. Just as government money was pumped into subsidized student loans, thus making College more expensive, the institution of Medicare and pumping government money into Healthcare grossly exaggerated prices.
The HMO / Medicare system was designed by Washington DC, so I think it's a little disingenuous of certain politicians who whine about the healthcare system when they helped create it in its current form
Make college accessible for everyone via loans = put boys and girls who majored in Indian basket weaving or cisgendered studies into lifelong debt. If you are middle class schlep like me, you treat college as an investment, not a luxury dalliance in a subject that sounds interesting to study.
If you're saying that the U.S. Gov 'engineered the housing bubble' then they did so by deregulating and opening the door for the private banks to gut our economy, which is on the private banks. There's no reason to expect privatized and deregulated healthcare to turn out any better than what we went through in 2008.
You are confusing provisions of Glass-Steagall being neutered with the housing bubble. Yes banks got bigger because of that, but what caused the housing bubble was gov't policy to make it easy for more people to "own" homes, unintended consequences of low Fed rates after dot.bomb 1.0, bad underwriting, and Fannie Mae going nuts b/c of gov't guarantees. You can even argue that government regulator OTS failed.
Don't assume government is a benevolent force that can't be corrupted or execute best of intentions competently. BTW, the housing bubble probably would have never happened had the US government not backed Fannie Mae. Lots of people raised flags, but Fannie Mae had backers in Congress, who wanted to see moar people own homes.
I'll rephrase. When Clinton neutered Glass-Steagall by way of Gramm-Leach-Bliley there was a conscious decision to not regulate derivatives which includes mortgage backed securities.
The US government ain't running hospitals nor having doctors under their yoke, which is what you seem to be worried about if Medicare was expanded to all. Single payer has nothing to do with those concerns, it's simply covering the costs of healthcare to all thru taxes. Bottom line is the entire system is broken and needs to be scraped for single payer.
Repeal of the Glass-Steagall Act was a mistake, but it wasn't responsible for the financial crisis. The proximate cause of the crisis was the infection of the banking system with CDSs, which could have been regulated, but Phil Gramm snuck a provision into the 2000 budget exempting CDSs from regulation.
Funny, I preferred my less regulated HSA health insurance plan before Obamacare messed with it. It cost 60% less and even allowed me to save for a rainy day with tax-deductible deposits. Obamacare forced me out of working for a small business. Thank goodness I can now work for a corporation where I can have a less regulated private plan like I had before Obamacare. The key is choice. Obamacare gave me less.
Maybe you guys would understand if you had mouths to feed and suddenly got a letter in the mail that your health insurance (which a certain President promised I could keep) was being canceled, and that the most similar plan cost was going to go from $450 to $1100 per month, and that HSAs were going kaput. And then your small business customers started vanishing because of Dodd-Frank. In gov't I don't trust.
Dude I hear ya. Obamacare sucks. You won't see my defending it. But imagine if you weren't forced out of working for that small business if you were covered under Medicare. You'd have more freedom to choose what employer to work for instead of making more of a decision based on who offers the best/cheapest plan. Moreover, why should we be burdened to make these kind of choices regarding our health?
It's super stressful deciding on the plan, and then what it covers, then the cost of premiums/deductibles/etc. So remove that stressor with UHC. This illusion of choice on what crummier mickey mouse health insurance you can get is a false freedom. You would be freer if you didn't have to worry about such stuff. And hey corporations/small biz would be happier to get out of employer-based insurance too.
Quite frankly, I just wanted my old plan back. The private plans were never a stressor, I didn't want gov't helping me. We had long terms savings, being cheap on a lot of stuff. The stressor only cames when gov't with good intentions tried to help, imposed help, but instead maked everything more expensive with less choice. The good thing is some of this has been fixed, years after the fact.
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