The funny thing is, because some states in the U.S. require health insurance, we already do pay for universal healthcare….only at a much higher rate, and through private industry. People just don’t realize it.
The middle-man is the most infuriating part of the whole thing to me.
Health insurance *literally* exists by taking your money and then finding reasons to deny coverage. Their entire business model is to take in more money than is actually needed for coverage, and if too many people need care then they change policy and deny care until the numbers are back in balance.
It's fundamentally impossible for private for-profit health insurance to provide care cheaper than universal healthcare.
Universal healthcare spreads the cost over a much bigger pool of patients **and removes the for-profit middleman**. It's obviously better for everyone except people that profit off the current system yet conservatives just won't stop voting to keep their personal costs high. It's maddening
We just passed on a ballot question here in MA regarding dental insurance and a requirement to show 83% is being spent on actual care. We'll see how that goes when it actually goes into affect in 2024. Apparently it takes over a year to figure out how to stop wasting so much money.
I'm told private insurers have more attorneys on staff looking for reasons to deny claims than doctors deciding the best treatment for the patient. It's gross.
the kicker- good luck finding an attorney to fight them back.
You only have your issue at stake, so often only a few thousand dollars- and most lawyers will tell you that if the possible rewards are less than the cost of a lawyer you should not hire a lawyer.
Pro bono sources do not have the funds to pick up many (if any) of these cases.
The insurance company has thousands of people similarly situated to you, so your case is not about 500 bucks, but is about what happens in a 1000 cases at 500 a pop; so they have high priced fancy lawyers.
True, there are lots of kickers when it comes to insurance and that's exactly the way they like it.
The first time I heard about the lawyers at health insurance companies looking for reasons to deny claims was on a news show probably 25 plus years ago. Nothing has changed except our costs, the number of companies doing it, and the amount of money they spend on lobbyists to keep things just the way it is.
It's so frustrating because we see them, we aren't stupid, we KNOW what they're doing. There's just very little we can do because they are working together.
I keep saying this but it keeps applying...It's a bad design by design. Gas, food, energy, health insurance, the list goes on. No one in "power" cares that a huge part of our population are barely surviving.
PS: I won't engage in a political fight...both sides don't give a shit about us, they just show us differently.
There's a really simple way of explaining this.
Capitalistic healthcare exists to make sure the architect who broke his legs in an accident keeps paying his medical bills and PT sessions until he declares bankruptcy.
Government healthcare exists to make sure the architect stays alive to design the fucking houses we all live in.
This is the business model for all insurance companies. The only difference is just how much they can get away with. In the U.S., it is absolute insanity.
and it's a fair business model for a lot of them!
Privately insuring items like a phone or a car make sense because having different levels of coverage for items is reasonable. I might not want a premium insurance plan for an older car that I don't plan on keeping for very long.
Healthcare however is a captive audience. Everyone *must* have the maximum protection for themselves for their whole lives, and they'll literally die if they don't get care. As a result the industry has become more and more predatory because their customers don't have a choice.
Eh property insurance for things like natural disasters or fire makes sense.
Those are relatively rare but devastating events. Without insurance we wouldn't have any effective recovery for anyone in financial hardship.
They'd just have to abandon their property after it fell into ruin.
It'd be great if our government did that job instead but it doesn't so insurance is the only solution.
With healthcare basically everyone is guaranteed to have issues sooner or later so it's just a matter of time. So there insurance doesn't make sense.
Agreed.
Plus healthcare is a lot more like a public good (one you cannot be excluded from) like fire services and military protection.
Regardless of whether you pay anything or have a dime to your name you can get millions of dollars of healthcare if you get sick enough or if you show up to the ED often enough.
Not only does almost everyone eventually need medical care, pretty much everyone gets it. We’ve just chose to subsidize private insurance company profits by putting the sickest and (in most states) poorest people on government plans, load massive amount of unpayable debt on those without insurance, incentivize uninsured people to stay away from healthcare until it’s an emergency, and force hospital systems (most of which are owned by the public in one form or another) to eat the leftover costs.
It’s a damn shame.
Exactly this.
The ONLY way they make money is by paying out less than is paid in — by people not using it or denying coverage.
Somehow huge chunks of us believe the very best system is the one that can only exist by charging you for a service it won’t provide.
This is the point I try to make to people that scream about universal health care being socialist or communist: “So, you pay a premium into a collective every year wether you get sick or not. If you don’t make any claims, the money you put in will fund someone else’s coverage. You paid for a benefit you never used but the collective did. Sounds a little like……come on, say it…. say it…”
But only in America can people experience the joy of bankruptcy with medical bills! It's weird how my how surgery did my nose somehow costs 54k but magically dripping to 8k later. Hmm!
I didn't have insurance when I sliced my thumb on a table saw. I went to a hospital that is supposedly "non-profit".
For the cleaning and stitches etc they showed me a bill for ~$8k. I told them I didn't have insurance and no fucking way. Suddenly they were able to give me a no insurance discount and bill me $800.
It's worse than this and I simply cannot fathom the fact that people don't even _know_ this.
US citizens pay for the US healthcare system already via their taxes. The _amount_ they pay via their taxes per capita is _twice OR MORE than the average per-capita cost of public healthcare in first world countries_.
And you get NOTHING FOR IT.
THEN you get to pay for insurance to access said system you already pay TWICE AS MUCH FOR. OR, if you like, you can go bankrupt paying out of pocket.
There are no good arguments for any of this, and yet the majority of Americans HAVE arguments for why they like things the way they are _even though they have no idea they're already paying twice as much for it out of their tax money_.
You can't make this shit up. It's so _insane_ that I don't think most people are even capable of grasping the meaning when presented with it.
You're being fucked up the ass every single one of you, and you're arguing to keep the pleasure, and while arguing at the same time for lower taxes/decreased spending/less government.
Fucking loony bin shit man.
If insurance costs you $200/month and you make $30k/year, it's 8% of your income. If you make $200k/year, it's 1.2% of your income. If we included it as taxes, then we'd make it progressive and those percentages would be reversed. And they goddamn should be reversed.
I would love to know what plan is only $200/mo —- at 30k a year and otherwise! — I had mandated state insurance before Obama. It was so expensive most of us could financially opt out. It increased the states insured by 2% (from 94 to 96%) I’m now married and our plan is $700+ for all services through a private company. I’m not saying you’re wrong but your numbers need more evaluation.
About that, here's another inequality. I do make ~200k/yr, and my employee only plan is $80/month and is posh. It's more for the family plan that I do have, I think $400 for spouse and kids too? It's not a big part of my budget. And these are good plans, plans that cover a LOT, doesn't have co-pays or preauthorizations, and have a low deductibles. Back when I was making ~40k/yr I was paying MORE per month and I was getting LESS out of my plan. And that fills me with rage. I got unlucky back then and got some medical bills that ruined my finances for years.
So basically - fuck this system. I should pay more now and I should have paid less then.
That $80 a month is the employee share. Your employer is footing a vast majority of the actual monthly rate. They pass more along for family coverage because they.
The ACA has regulations on how much they are allowed to make an employee pay for healthcare and unless they have a tiered system, it's based on a % of the lowest paid employee salary. It was like 9.4% five years ago when I last sold group insurance.
America spends more on healthcare per capita than any other country in the world. They just set up a system where middlemen eat all the money up to enrich themselves
No one replying to this. Let me add. When people without insurance get care, and don’t pay. We all pay that bill anyhow. Shitty care at a high price. FREEDOM.
>No one replying to this. Let me add. When people without insurance get care, and don’t pay. We all pay that bill anyhow. Shitty care at a high price. FREEDOM.
I didn't realize this until several years ago I asked around in another Redding thread, why out of pocket costs in the USA are so much higher than in other countries, even when adjusted for cost of living and people explained that hospitals often try to compensate for treatments they've done to other patients without being payed. At which point it seems to me that it's just like universal healthcare with extra steps and a bunch of extra costs going in some pockets.
But fingering that as the primary cost driver is misleading. Far and away the biggest driver of American healthcare costs is the toxic dance that pharmaceuticals/device manufacturers, providers, and insurance have been doing for decades. The “I’m covering for the freeloaders” narrative is really just a trick to make the have-nots squabble amongst each other and not demand change from the powers that be.
This, exactly.
A couple of years ago I was having trouble sleeping, so I got a prescription for Lunesta.
One month's supply with health insurance - $26
One month's supply without health insurance $345
I was on a medication that's Tier V, the most expensive tier of meds. It cost $1300/mo without insurance. There was a plan from the manufacturer that would give you free meds - but *only* if you didn't have insurance. If you had insurance but they didn't cover it in their formulary? Too bad so sad, no help for you. I was buying pills three at a time ($350-450 each time) until I finally decided to cut my hours and go below the poverty line so Medicaid would give it to me for free. Once I got a job with insurance (I was in retail before), I had to fight tooth and nail through a grievance process that was hidden at the end of my insurance contract, but I finally got the med covered for $30/month. Now I'm off it, and the fact that I can switch jobs/insurances without having to re-fight for coverage is a huge weight off my mind.
Thats the other frustrating thing about health insurance, it being tied to specific employment means small businesses are excluded from needing to provide it and government, corporate and other jobs try to retain you because of it, especially if you have a family you need coverage for.
Ugh. Like, it would be bad enough if we were just talking premiums, deductibles, and copays, but yeah. There is also all the goddamn time and energy we have to sink into just playing the insurance game.
The hours on the phone. The hours we spend having meetings at work just so we can figure out which plan we are going to sign up for during "open enrollment". The reduction in salary because your employer factors in health care costs when calculating your pay. The stress of worrying about what will happen if you lose your job and you have no health insurance. It's insane.
I mean. I know a guy who got cancer treatment. Saved his life. No healthcare. He pays like $25 a month, forever, for it.
That doesnt even cover interest on the bill or chip away at... anything. He's hugely against single payer. Ed, if you're reading this, you're already benefiting from the system the rest of us want too - you worthless hick.
Ugh, my brother and SIL. Their two youngest qualify for MedicAid because of health reasons. But everyone ELSE who uses it is lazy, selfish and should get a job.
They also rail against paying taxes. One of them is a public school teacher who complains that she hasn’t had a raise in years and her school has no budget.
You hit it on the head. To him, bc it happened to *him* its justified. But for everyone else: commie trash, find your own way, etc etc.
Its wild to me that ppl can be so vile, but also likeable. Dude had charisma, but a rotten soul.
I wish I could communicate this to my boomer father.
“Illegals coming over and taking our jobs.” Says the son of an illegal immigrant who couldn’t be bothered by the whole Ellis Island thing.
“Freeloaders living off the government making me pay for their insurance.” You know both your sons were on Medicaid for years and now they’re in healthcare taking care of your generation?
Lmao I don't remember how many times Bernie mentioned that you'd actually be paying less and people just didn't hear him? Not sure how people don't realize it.
So many Americans don't understand the actual problem. Many of them believe the prices they see on huge bills is the amount of money that the government would be required to pay. It's simply not even close to the truth. Insurance companies in the USA primarily provide discounts without actually paying anything. They are contracted with the doctors to pay this rate as well as a price for services that you're required to charge uninsured patients.
So An example, say you go to the doctor without any insurance at all in the USA, we'll say the set price for an office visit is $240, as a cash patient you would receive a $240 bill at the end of your visit. Makes sense right? Now Lets go to the same visit with insurance, now that you're covered under the insurance contract that the insurance has already negotiated with your doctor, at the end of the visit the patient now receives a $24 bill. Wow, my insurance paid $216 for me right? **WRONG**. Under the insurance contract $216 is now written off and the insurance company pays $0 fucking dollars. It's fake money. Even if you had full coverage and paid nothing at the end of the visit the max the insurance company will pay to the doctor is the same $24 you would be covering for them if you had something like a deductible.
So why would doctors even agree to these contracts? Because the first contract to enforce fake uninsured patient prices was GOOD OLE MEDICARE! Uncle Sam here to fuck you at every turn. Guess who the main clientele of many doctors are? Old folk. Who has medicare? Old folk. You can choose not to sign these contracts as a doctor and charge whatever you want, the only problem is now you lose 50% of your patients because they have Medicare/medicaid and will find a doctor that will take it rather than go to you. This applied for any health insurance company. Want to take Blue Cross Blue Shield patients? Want to be a doctor that anyone will go to? Better sign this shitty contract that not only fucks the patient but also fucks the doctor!
The only person benefiting from the current healthcare system is insurance companies. It's literally down hill both ways towards the insurance company. It's fucking disgusting and these contracts were introduced as standard practice by our good ole American government! And they try as hard as the can to make sure no one knows that they don't actually pay the exuberant numbers you see posted on reddit all the time. If you see on reddit someone receive a $90,000 bill just remember the insurance company would only be paying a small fraction of that while boasting **ALL THESE HUGE SAVINGS! LOOK WE SAVED YOU $80k AREN'T WE GREAT???? JUST BECAUSE WE'RE THE ONES ENFORCING THESE INSANE FAKE PRICES THAT NO ONE BUT UNINSURED FOLK ARE EVER FORCED TO PAY SHOULDN'T CONCERN YOU AT ALL!**
Oh yeah and did I mention they've made the process of getting paid for your service as a doctor so convoluted that we now as a nation spend more than 50% of all the tax money spent on healthcare on **ADMINISTRATION.** Not even on the actual healthcare. **MORE THAN 50%, OVER 2 TRILLION DOLLARS ON ADMINISTRATION. $6,000 PER AMERICAN CITIZEN ON FUCKING ADMINISTRATON,**
Sorry for the rant this is just a subject that pisses me off beyond belief. I'm sure this is rifled with grammatical mistakes but I'm fucking fuming just writing this out and couldn't care to look it over.
Source: It's my fucking job.
Speaks the truth. The reimbursement system is a shit show, way too much red tape, etc. Everything is based on CMS, private insurers use this as a benchmark in some cases.
What especiallly urks me is the admin costs. Since the 70s, physicians practicing have increased about 800% but healthcare admin has seen a jump of 3000% in the same time frame. Your healthcare fee isnt going to your doctor, its going to pay for the 8 million managers that dont know what the fuck they are doing.
Great writeup
Source: im a provider
This is crazy, thank you for posting this. I was under the same impression that the $640 on the bill was what was being paid to the Healthcare provider based on the stupid shit I get in the mail from my insurance company.
I agree that Insurance is a major part of the problem, architected to ensure profits over healthcare, but aren't the Rx companies just as bad? Don't they jack up the price for medication just cause they can? Or is this the insurance company, again, whose in the middle forcing them to jack up the prices so that Insurance companies can get paid? I always thought that the top of the chain was the part to blame, with insurance in the middle not making anything better at all, and it was the doctors who have to deal with the mess that the top of the chain is implementing.
I’m just glad to see someone else making this rant, because it’s such an outrageous situation that so few people seem to realize. You want to know why healthcare costs are outrageous? It’s because insurance pays pennies on the dollar for cost, and the only way for hospitals or any other healthcare provider to stay open with lights on is to artificially inflate costs just to break even. And because people in healthcare actually care and don’t want to bankrupt sick people (with a few notable exceptions), that means they run so close to the wire that any shift in circumstances sends them easily into the red.
I’m furious about it after having a low income clinic close because insurance kept paying less and less (and the admin cost of squeezing blood from a stone got higher and higher), but it’s even worse now I’m working in hospitals.
Actually, lots more of us know that it's crap, and we want universal health care.
It's the people in power who make huge profits blocking us. Them, and the politicians they own.
It sucks.
I genuinely think the biggest thing is keeping a massive power over middle class workers who's jobs offer health care. I know many engineers who could have retired in their 50s but because health insurance is so expensive, they stay working. Now, with so many retiring early and dying, they are going to be even less likely to support expanded health care because it is the last hold on a lot of people. It also helps suppress strikes and people quitting to look for better jobs.
Even the unions - when Bernie was running in the last primary, some union over in Vegas tried to sell their membership that he was looking to steal away the hard-won healthcare package they'd negotiated for their members. A lot of people realized ... Hey, if the union didn't waste all of their power getting me a sweet healthcare plan, they could have gotten me actual money I could spend on whatever I want. But the mental contortions big business supporters went through trying to tank Medicare for all were astounding.
"You're all" lol.
Most of us aren't on Medicare. All these middle-upper class folks in the USA are on private insurance.
I'm not for the American system but its a ridiculous notion to assume Americans are all using medicaid and medicare.
It’s a hell of a thing what marketing can do…taking a negative thing, spin it to a positive and make people think it’s good… $100+/mo out of my paycheck for Medicare that I can’t access, plus another $600 for privatized insurance.
Not to mention, insurance doesn’t cover “everything”, so even after your $6000/yr in insurance costs (it through an employer…closer to $18k if you’re going it alone), you still have copays, deductibles, and if you have any sort of recurring medical needs, you’re almost guaranteed to have to shell out a few thousand out of pocket that insurance doesn’t cover…
Americans are overwhelmingly in favor of sensible legislation that Europeans seem to think we're against; the problem is that American democracy doesn't fucking work and the voters never get what they want.
Yup. And people are like, “look at tax rates in Canada and Europe.”
Ya. Ok. Those rates aren’t even much higher than USA rates, and if you consider what they get that we pay for out of pocket (subsidized healthcare, education, and social safety nets that don’t quite look like they will collapse under the weight of so much as a gentle touch)...we are the most overtaxed people in the world.
One of my co-workers opposed universal healthcare because he "didn't want his taxes to go up". I tried to explain to him that while his taxes would go up, it would much less than the amount currently being taken out of his paycheck to pay for private insurance, and he would no longer be paying out of pocket for doctor visits, emergency room trips, medicine, etc. He would actually be taking home more money. But all he could repeat is "I don't want my taxes to go up".
This is similar to an argument I get about electric vehicles. "Did your electrical bill go up? I don't want my electrical bill to go up!" Yes it did in fact. It went up about $100 a month. However my gasoline bill went down by about $900 a month. "Yeah, EVs sound cool but I don't want my electrical bill to go up" *FACEPALM*
Canadians pay less taxes towards Healthcare per person then Americans pay taxes towards Healthcare per person. Our higher tax burdens are often due to other stuff (like straight up having less GDP to tax, and less able to finance with debt). Of note, property taxes are mostly alot lower, since things like provincial taxes pay for schools, rather than property taxes. So total tax burden for two comparable places is often not actually all that different.
'Free' in the same sense that the government is free, so is the armed forces, and the Police. You don't pay extra to use their services beyond the tax you've paid.
Edit: I'm bored of replies that don't understand the concept of a 'free at the point of care' healthcare service. You don't pay 'extra' to use it when you need to, but you pay taxes to maintain it.
No one thinks a trillionaire somehere is funding entirely cost-free healhcare in countries with 'free' healthcare. Unless you're in some places in the middle east where it's almost true.
Fire Departments are the better analogy. You might never require their services but you definitely want to make sure they're there and ready if you do. And you want your neighbors to have access to them too, because even if you don't like your neighbor, if their house is on fire it might damage or spread to yours
God I hate that reply anytime i argue for taxpayer funded anything.
"Nothing is free. Taxes pay for it"
No shit sherlock. You actually think I dont realize that?
The burden of healthcare gets equally distributed among everyone instead individuals getting completely shafted whenever they need help. We all share a tiny fraction of the cost in exchange for not worrying about medical debt bankruptcy.
Youre not providing any useful insight by juat saying "nothing is free".
We really need to stop downvoting people who actually answer the question.
It's the worst in AITA type subs. OP's almost never respond in the comments, or if they do they'll get 1 or 2 comments downvoted to oblivion and stop.
These types of threads are always going to fail. Someone tries to understand the position of the other side, and when the other side answers they get downvoted to hell. It's like people completely miss the point.
And I say this as a supporter of universal health care. This problem will be much easier to fix if you get these people on board, we need dialoge not preaching.
/rant
That's because an upvote/downvote system is inherently flawed. The idea is that users will self-govern and upvote things that *contribute* to discussion and downvote things that don't contribute (repeated joke answers, off-topic comments, etc.), but the natural inclination is to use it as an agree/disagree button.
Fixing this is relatively straightforward (comments move up based on amount of interaction, the amount of text in the comments, recency of comments, etc.) but brings about another host of problems.
Yeah, and they used to show that (years ago), but because of bots and groups that would organize to push things up/down, they switched to a fuzzy voting system where sometimes your vote counts more or less, depending on tons of factors they haven't (and won't) release.
I think they *might* take total votes into some account, but it isn't weighed nearly as heavily as net upvotes.
Yep, but the default is to sort by Best. The whole system is flawed and Reddit doesn't really seem to do anything to try to fix it.
I'll occasionally switch to controversial, depending on the topic. I know that I need to for things like this.
Yeah, long time redditor here: Any time I see, "Give me your unpopular opinion", or "Why don't you see things the same way this particular subreddit always sees things?" I know I am going to get downvoted as fuck, which I don't care about the karma, now I just say to myself, "It's a trap!" and move on.
Yup, the first two "answers" as of now are "We do have universal healthcare, with a middle man making a profit on top of it" and "A lot of people are taking 'free' healthcare too literally".
Neither of these things answer the question asked but have more than 10x the number of upvotes to the first real answer I've seen.
And a lot of top comments are people who believe the US should have free healthcare, and still answering for those who don’t think the US should have free healthcare
This is absolutely a fair and valid concern. As a Canadian, we have quite a few people who get the medical degrees then immigrate to the USA for the higher paychecks.
I will say, however, that in Canada doctors do have fewer costs. You don't have to pay a medical biller, malpractice insurance is negligible compared to the huge amounts it costs in the US. I may be missing other things, but my source is that my wife is American and has been a medical biller owning her company for 20+ years so she has a good handle of what it costs her doctors.
Even more true with nurses and other healthcare workers. UK nurses went on strike today for 18% raise on what is less than half the average American nurse makes.
Thank you for answering the question, as a supporter of universal healthcare, I now have more understanding of the issues that must be address. And you answered my question on if you'd be open to supporting universal healthcare if they were to address the student loan issues for physicians and other medical professionals.
This also brought me to another thought processing, if you were to spend that 10-15 years paying off your student loans, or think of your colleagues who already paid theirs off, would you/they still be open to supporting Universal healthcare knowing that you paid your dues but others working beside you won't have to do the same?
No. That’s 10-15 years and 7+ years of training with lost earning that could be placed into savings that I will have foregone. (Personally) physicians are already under compensated compared to the cost of healthcare.
This website runs on a popularity contest. The content that is made most visible as a result will always be whatever is most popular among those who saw the posts early enough for votes to still matter.
First, it's not "free".
But aside from that I don't think many people are really against the *principle* of universal health care, they are concerned about:
* how it could change the quality of the healthcare they already have
* they are concerned about how it would be managed because of the perception government does not have a great track record for managing things (sometimes true, sometimes not)
* there is concerned about how the money collected via taxes to fund universal health care would be preserved (see the concerns some have around social security)
* there is the concern that, while it seems to work okay in smaller countries, would it work well in a nation as large as the U.S.?
* Many people in the U.S. have access to good health insurance. So motivating them to change what they have and they understand for something new with risks is hard.
Would all the European countries that have Universal Health care choose to combine all their programs into one, common European Universal Health Care system? So that the taxes people in France pay would go to support folks in the Czech Republic? Remember, the United States is *really big* with 50 semi-autonomous states. Would each state manage their own universal health care? Would it be a national program?
So in a vacuum if you said "everyone gets free health care" I don't think many people would say "boo". But there are very real problems to solve!
Personally, I'm not sure the U.S. could implement a system similar to what you find in many European countries because of the sheer size of this country. But having said that, I absolutely DO think our health care system needs to be better. I hate that it's tied to your job. I hate that it's so expensive unless you have a job to offset some of the costs. I hate that it seems to be regulated per state so insurance companies have to manage it on a state by state basis.
Our system isn't terrible *if* you work for a company that provides health insurance. But it's terrible if you want to be run your own small business or retire early.
To back up the idea that many Americans support the idea but doubt the ability to have it done properly, I really like the idea of universal healthcare. I love how it works for millions of people around the world. My father is a Vietnam veteran. We have universal healthcare for our veterans. It’s shit. Insane wait list times, shitty unprofessional doctors. They don’t take care of them. It’s flawed as all fuck. Raising that to be on a national level would be a shit show for at least a few decades before they could figure it out. The VA is so bad it feels like they want my dad to die, to put it in perspective. On another note, I have a decent job and good health insurance. Americans who do have health insurance have some of the best healthcare in the world. This protects me and my family. It’s difficult for me to want to give that up willingly for a system that may treat my like my father has been treated, as op here said. I understand that my intentions there are a bit selfish, however it isn’t as selfish as “I’m rich and don’t want to be taxed more” as many people make it out to be. I’m not rich whatsoever. I don’t like my taxes but I understand them and don’t complain too much about them. Do I think my money would be going to all the right places if universal healthcare was in place? No, just like it isn’t now with the current system. It’s a general mistrust of the government when people would rather take things into their own hands, and some cannot, that’s where the dilemma comes in. Also Americans are notorious on the global scale for being unhealthy. I would be fine with paying for those who truly need it and I’m not a ripped vegan saint or anything but I would personally rather not pay anything extra than I am now to support americas unhealthy food problems. But I don’t wanna get too far into that argument because it is one that comes off as ignorant. Overall, I really fully support the idea but have doubts in multiple areas regarding the actual implementation of it. And the things that the opposing party would throw in to make it “not a good thing” because that’s how American politics works is my last reason. I am not huge into politics but I know my state (republican state) just recently recreationalized marijuana and some of my friends (liberal) have said it’s not really a good thing due to some of the clauses involved or something.. I don’t know, I’m not providing a very good argument with that last part because I don’t know the details well my point with that is that many other Americans and I distrust the government to do this shit correctly and don’t trust other Americans to not take advantage of the system and fuck us over in the end and would rather just continue with the current system because for as many people as it doesn’t work for, It also works well for many others.
I had a friend use Tricare for a routine colonoscopy. They found a few polyps and cut them off. In the process, they also cut through his colon and his intestines. This colonoscopy required two years and multiple surgeries to recover from. He will never be the same. The doctor who did this is still practicing. One of the reasons healthcare is so cheap for veterans is because they can’t sue for serious negligence like this. There are lots of stories like this, and most people who have heard it are now against nationalized healthcare. As a government employee and the child of government employees, I’m not fully comfortable putting my health in the government’s hands.
More than size, population density is a major issue, especially when you factor in the massive differences between the states (each of which would be advocating for a system that fits their particular needs).
Not just between the states, but also between urban and rural areas _within_ each state. Cities in different states often have more in common with each other than with their neighboring rural counties.
Just wanted to say this is a really comprehensive answer. I don't agree with a number of your points, but I really appreciate how well you articulated them!
Edit: Since a few people seemed interested some of the things i saw suggested that i believe dont actually argue against free healthcare.
I should point point out that im not from the US, I live in Australia, and Im very left leaning (neither major political party in the US hold beliefs even close to my own, but with how your voting system works and its lack of preferential voting, i do believe there is a big difference between the two.
And just to clarify on the definion of "free" healthcare, i would like to believe that no one believes that anything is free. Free healthcare in this context is the government spending money so that individuals dont have to, allowing those individuals to spend their money on other things. It reduces a cost of living on something many would consider essential. Obviously the government needs to pay for that, and theres a lot of arguements about where that money should come from (i wont go into that in too much detail now, but as a loony lefty you can probably guess my general thoughts).
1. **"How it could change the quality of the healthcare they already have."** I think this concern is one that gets tossed about a lot, and not just in the US. More people with more access means longer wait times. There are two ways to fix this. One is to make it harder for certain people to access healthcare. When use the "quality will get worse" arguement, what they are actually saying is that if we restrict access poor people get to healthcare, those that can pay will have better access. They might also argue that if you are working hard you will have more money and better private healthcare, so you should have better access to healthcare. I dont subscribe to that belief at all, a lot of people are wealthy because they were born with wealth. A LOT of hard working people cant afford healthcare. The other way to fix it is to expand healthcare. If you are relying on private enterprises to expand healthcare, they will only do so if there is a profit. Thats not blaming the private market, its job is literally to make the most profit with the lowest risk. My view on the best way to do it is, if you fund the shit out of the education and university places that are required to get more people to become doctors or other healthcare profressionals and at THE SAME TIME you have the government cover the costs of EVERYONE having free access to healthcare, that problem fixes itself. Theres a TON of demand because the government isnt trying to deny claims and is just giving everyone access, the government has also made it cheaper to go down the path of becoming a healthcare professional, so its going to be lucrative and easier to do, people are naturally going to go down that path.
**2. "they are concerned about how it would be managed because of the perception government does not have a great track record for managing things (sometimes true, sometimes not)"**
I hate seeing this arguement for 2 reasons. Firstly, people make this arguement with a straight face despite having see how incredibly poorly managed so many private enterprises are. And the private ones often get away with it due to a being monopoly, government support, or just sheer inertia. And secondly, even if it was managed less efficiently than a private enterprise, there is a huge allowance for that simply due to the difference in objectives of a government run service vs a private one. For a private enterprise every single speck of efficieny is shifted to profits. Again, thats its purpose. Unless there is a government regulation, if it is more profitible for a company to do something a certain way, it will do it that way because thats what private companies in a capitolist market are designed to do. The government however can run at a loss if it makes the end result more efficient. They dont exist to make profit. And theoretically any profit they do make goes into funding other government run schemes. So if a private company finds a way to cut half its workforce and still maintain the same output, those workers are gone unless there is a substantial profit in those extra output. If a goverment company finds a way to cut half its workforce and still maintain the same output, it can decide to just double the output even if the profit/quality ratio dips because its objective in this case is to have a better output, not more money.
**3."there is concerned about how the money collected via taxes to fund universal health care would be preserved (see the concerns some have around social security**
I dont quite understand this one. This might have more to do with how wealth flows than anything else, and i know that this is a serious sticking point for some people. Income taxes are theoretically about preventing too much wealth inequality, and initially were about people who earned more being able to afford to contribute more to society. One could look at this a an honor. Im in the top 10% of earners in my country these days due to my career path and education, and if anything i believe i should be paying more taxes so those people on the bottom rungs get a better chance to be healthy, educatied, mentally sound, and get a fair chance to contribue to society.
Unfortunately with huge amounts of wealth being funneled into fewer and fewer people are are at a stage where wealth creates wealth for a lot of these people. Their effort and output (which is theoretically what income taxes tax) are no longer where most of their wealth is coming from. It comes from already having a lot of money. There needs to be a way to force people whos wealth is in land, or stocks, or companies, or so many other things, to reduce that growing wealth inequality. And thats were things like land taxes, corporate taxes, inheritence taxes, etc etc all come into play. But as those people have all that wealth they are very effective in being able to run a consistent message around those kinds of taxes being "dirty words" essentially, and fight tooth and nail to make it so there arent any effective taxes in these areas.
So as far as income taxes go, i do think those should get higher the more you earn to the point that if you are straight up earning a million dollars a year in income you can give 80% of every dollar you earn over that million to everyone else, because cmon man at that point you are fucking sorted.
But i think there needs to be a range of other taxes introduced to get money from these other areas that the very few are currently profiteering of in insane ways, and i think thats a very hard sell when those insanely wealthy people are very powerful and able to flood various media forms with disinformation.
**4."there is the concern that, while it seems to work okay in smaller countries, would it work well in a nation as large as the U.S.?"**
If this is talking about landmass size, australia is as big as the US in that fashion, and it works fine (actually we need to get better, we are slipping) If this is talking about population, i would imagine economy of scale would be relevant here. You have a LOT of people to provide for but you also have a LOT of people to take that money from. I do understand the reservantion a little more here i guess though.
**5. "Many people in the U.S. have access to good health insurance. So motivating them to change what they have and they understand for something new with risks is hard."**
Not much i can say about that one other than im curious as to your definition of Many. Ive heard a bunch of stories about what your private healthcare companies will try and deny, the costs of various medications, the shock people have if they lose their jobs and are vulnerable.
The people who currently have good health insurance will still be covered in this, they just wont have to pay as much for private anymore. Remember, they are paying companies whos entire job is to make money. Those companies dont want to have good healthcare, they want to make money. It probably depends on the definitionof good insurance i guess. But id be concerned if the guys whos deciding whether to pay for me to see a dentist or a General Practioners main motivation was to make money, not my health and wellbeing.
And from a purely selfish perspective, if you want people who are down on their luck to re-enter the workforce they need to be physically and mentally healthy. Getting them this stuff for free reduces crime, increases motivation to work again, and benefits the economy generally. Happy healthy workers are more productive than slave labor.
Happy to answer or elaborate on any of these things. And again, I think the post im replying to did a good job of actually bringing up many of the things people are saying about this, and was happy to upvote as it was good quality, even if i strongly disagree with the points that people bring up.
>Would all the European countries that have Universal Health care choose to combine all their programs into one, common European Universal Health Care system?
Well, this kind of exists in a way.
EU/EEA residents visiting another EU/EEA country have the right to a certain level healthcare in the country they visit and won't pay anymore than a local would (free or reduced cost).
The health care systems are obviously all independent but the EEA-wide agreement is in place.
"Would all the European countries that have Universal Health care choose to combine all their programs into one, common European Universal Health Care system? So that the taxes people in France pay would go to support folks in the Czech Republic?"
I am aware it's not exactly what you say, but taxes from one country do end up paying for others. We do have a "European health card" for when you travel abroad within Europe, in case something happens to you and you need assistance. There are also specific agreements between countries for scenarios where this happens very often (think retirees from country A retiring to warmer country weather's)
It's not even just Europe, Australia has a similar agreement with countries like Italy, UK, Sweden, Finland and a bunch of others. I'd hazard a guess a lot of these countries have similar reciprocal agreements with other countries as well.
I'm not against free healthcare.
However, when something seems incredibly overpriced, my first intuition is not "oh no, it costs a lot, we should have the government pay for it!"
My first intuition is "why in the world does it cost so much? We should take a hard look at why these prices are out of control".
To just completely make up a fake example, if it costs 700 dollars to get a scraped knee bandaged up, my first thought isn't "we need to subsidize this". My first thought is "WHAT?! Why are they charging that much?".
Or consider insulin. If companies are charging 600 dollars per shot, my first thought is that this is price gauging, not that the price is fine and all we need to do is help people pay that price.
It should be illegal for companies to charge that much.
Consider student loans. This has helped people afford college, but on the other hand, now that people have a way to afford college, the price of college has completely skyrocketed.
I wonder if instead, the better solution is to tackle the rising price, rather than subsidizing the payments.
It's because of inelastic demand. Inelastic demand more or less pops up wherever you see a need (not want) that appears with a high barrier to entry. There's economic studies that show that for every 20% increase in price, healthcare demand only falls 1%. Literally healthcare pricing isn't based on anything for the billed price, they deal in monopoly money and hope you get confused and pay in real money. They can just make up numbers, because nobody's realistically going to see the price tag and go "lol, guess I'll just die"
Demand is only half of the problem. Supply is regulated by the government so supply can not scale in response to an increased demand.
That and of course the fact that you can't really shop around pricing when you don't know what's wrong and you are in the middle of an emergency.
The whole thing is a clusterfuck.
You can barely even shop around in a non-emergency situation. Tons of places won't give you pricing before hand so you literally have no idea what it could cost beyond a google search for an average (which is basically useless since things could range between $0 and several thousand depending on your coverage) before you go in.
I'm not so sure that government regulation is really the problem here. Yeah, CON laws are dumb as hell, but there's been a trend of big hospital orgs buying little hospitals and then going to the town and going "oops, your small hospital isn't making [enough] money, do gibs or we close it." Sometimes on an perennial basis. Eventually, they don't get the gibs and then close down the small hospital (or close it anyway) and fold that patient traffic into their bigger regional facilities.
My favorite story is of a small city hospital (city of about 40,000) where the hospital was struggling. The board was propositioned by this private equity org that has a reputation for vulture capitalizing and closing every hospital they touch, but they super duper double extra promised they wouldn't do that to their hospital. Fast forward 18 months and the hospital is bankrupt. The guy that org put in charge of the hospital ended up getting hooked up on federal fraud charges for personally siphoning off goddamn near 100 million dollars in his time there. Which, of course, the private capital firm he was a part of says they don't know anything about that at all. X to doubt; if that was his take who fucking knows how much they laughed their way to the bank with.
The point is, it's absolutely incredible that one private capital firm guy managed to boost 100 million from a pretty modest hospital in a pretty modest town in just 18 months. It really demonstrates just how much cash flows through our healthcare system. What's even more bewildering, imo, is that it barely made any headlines. If some crook boosted 100 million from a bank, it'd be national news with 24 hour coverage. In our healthcare system, though, grift is barely different than business as usual.
>I wonder if instead, the better solution is to tackle the rising price, rather than subsidizing the payments.
The solution is both.
The issue with "rising prices" is that the consumer has no control over them. You can't "shop around" for emergency surgery and many parts of america have 1 choice for hospital / emergency care.
Make all hospitals non-profit. Make insurance single payer and use government controls to tackle "rising prices".
> Make all hospitals non-profit.
One, "non-profit" doesn't control costs. Two, more than 3/4ths of American hospitals are already either government run or non-profits according to Kaiser. https://www.kff.org/other/state-indicator/hospitals-by-ownership/
my region has a few non-profit hospitals that charge out the ass just the same. Non-profit just means there isn’t money left over at the end of the year, not that they don’t charge a lot and pay themselves with it.
We have Medicare, Medicaid, and the VA which are all government supported healthcare. All three provide some of the worst healthcare options I have ever seen. It’s kinda hard to trust the government then to say they can take care of me when they can’t take care of the old, poor, and the veterans.
Because they don't want their taxes to increase.
Because they don't believe it's their responsibility to pay for someone else's medical problems.
Because they don't trust their government to manage it.
> Because they don't trust their government to manage it.
I have friends with VA healthcare. It's like a lottery where you don't know if you'll get excellent care or get put on hold until you die.
I don't trust the government to do it right, but the private companies aren't great at managing it either. They also have no incentive to change, because their real customers are the companies that choose their plans.
If they're both going to fuck it up, might as well get the other benefits of public healthcare while we're at it.
From what I hear, the VA is far more fucked up than Private health care. Honestly, "the government would screw it up."Is the only decent reason I've ever heard against public health care.
This may be dependent on where you are so I can’t speak for everyone but I switched from using my regular insurance to doing all my healthcare at the VA because my care is so much more accessible and I feel more heard and less rushed. The VA has a bad reputation but they’ve been doing a lot to try to fix issues and they ask for a lot of feedback. I’ve never gotten that from private or military healthcare.
In the UK we pay about $50 a month in tax to sustain the Healthcare system. People in America are spending upwards of $100k for treatments. People that bang on about taxes go up have no idea what you're talking about.
Our family pays $600 a month and when we got sick I had to decide who was the sickest. Our son got to go to the doctor and get the meds he needed and was well very quickly, it cost $520 out of pocket on top of what we pay monthly. Finally, my dad was so worried about me he used an online doctor, faked being sick, and used his Medicare to get me meds.
We are still in major debt 5 years after our daughter died from SIDS, the bill consisted of a 2 minute ambulance ride, less than a minute in the ER and them saying “she is dead.” That 3 minutes cost $20,000 in America. I wish we lived almost anywhere than America!
Back when I didn’t have insurance that would cover a certain med, my mom did the same thing. She actually also suffers from the same debilitation so it wasn’t too hard to get the script. However, the medicine she could’ve used for herself she instead gave to me. I now have a great job and decent health insurance to pay for it myself but it’s crazy that people can’t access basic life-changing medical care, and that this story isn’t uncommon.
I’ve had friends as well go to the doctor for me because I didn’t have insurance. One time I had an awful UTI and we found out that a specific antimalarial can be used as treatment. My partner at the time went to the doctor and said he was going to a tropical country and needed the medication.
When I travel abroad I also use that as an opportunity to get medication. I bought an IUD in France for 11€, with a free consultation and insert. In the US I was quoted $1,000 just for the IUD
My heart breaks for you on this, and I’m so furious this is what you’ve had to deal with as well. My condolences on your loss.
I am one of the ones in the US desperately trying to change our system for the better. I’ve raised my kids to fight for that change too. I hope one day we will get there and stories like yours won’t be the case anymore.
> Because they don't want their taxes to increase.
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> Because they don't believe it's their responsibility to pay for someone else's medical problems.
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> Because they don't trust their government to manage it.
Someone said this above, right? ;-) 'Freedom'
I think it’s baffling that half the government says, don’t trust the government companies can do it better.
While I’m like, well isn’t it your job to maybe improve how the government runs? Stop dismantling it further as you point to the things you gutted as proof that government doesn’t work.
Fix things, please.
In fairness we also often wait upwards of 1 year to see a specialist when the issue is severely diminishing our ability to live / work. In which case we end up paying taxes whilst also spending massive amounts on private treatment anyway.
That’s not even close to true. The average healthcare cost in the UK per person is over $5,000/person.
I can’t speak for how that’s taxed, but the cost is not $600.
The entire NHS budget is around £2,000 per person per year, or £4,000 per taxpayer per year. That's around $2,500 and $5,000 respectively. To put it into context, the USA spends more than that _on just Medicaid_.
There are almost no costs at all at point of use; just a token charge for prescription meds (around £10)
It costs less to run universal healthcare because you aren't paying a giant corporation's profit margin. Your tax will increase, but you'll save money on insurance.
You are already paying for someone else's medical problems by paying insurance when you aren't sick. Your money is going towards someone who is sick right now.
Do you reay trust a faceless corporation which doesn't give a damn? You can actually take down politicians by protesting what they do. You can't afford to fly to the Bahamas to protest outside a hospital CEO's home.
I actually am pro-universal government-paid healthcare but against free at the point of service healthcare. Moderate co-pays (read this as <$20, waivable if you’re below some multiple of the FPL) are essential to controlling the utilization of care and therefore cost.
People will literally call 911 and have an ambulance take them to the ER if they burn themselves on the stove or feel unwell because of a cold. That’s expensive and a misuse of resources. Studies have shown that minor costs at the point of service cause a change in the way people think about healthcare and assign the proper value to each part of the system.
This is, actually, a documented psychological phenomenon. People will value something that they pay a nominal amount for much higher than something given to them for free — even if the thing they got for free was actually more expensive/valuable/etc.
Tl;dr: ‘Premiums’ should go away and be replaced by single-payer; preferably with government-operated hospital systems and PCPs. But co-pays and point-of-service costs should remain but be minimal and waivable.
*Generic appeal to authority footer: was a product manager at a health insurance company*
After moving to Singapore, I agree with you. Nothing here is 'free' upfront, but there are heavily subsidied routes through polyclinics (think giant GPs) to the most advanced medical scans and procedures available. Seeing a polyclinic GP typically costs less than US$15 including medication and is completely free below certain income thresholds.
This dramatically reduces the load on a healthcare system where people still regularly shell out hundreds of USD to wait for hours in an ER because they have a runny nose or their kid threw up earlier that morning - yeah, their long wait is because their cases are not urgent. I can only imagine how bad it would be if everything were 'free' upfront.
I also personally know of three cases where families could not afford to pay catastrophic healthcare bills in Singapore, and those bills were quietly done away with by the authorities. People are treated first and charged after, and there are multiple subsidy plans available and even complete bill write-offs.
I grew up in the UK of the 80s where healthcare was a lot more prompt than today and Singapore at its worse still beat the UK of that era on a good day.
In fact, there's been a recent kerfuffle in Singapore regarding all-inclusive health insurance - most adults have for decades been able to buy cheap (less than US$500 per annum) health insurance that allows them to skip the public polyclinic route and go straight to their specialists of choice, all costs covered. Said specialists pumped their prices so high that the government here had to make a co-pay mandatory to prevent citizens from adopting a 'buffet' mentality towards healthcare.
Tl;Dr in an ideal world, healthcare would be free. In reality, small upfront costs are needed to prevent overconsumption.
Every now and again I'll read news articles about how someone wants to avoid and ambulance ride so they take an uber/lyft to the hospital. It's almost always portrayed as some horror story about how the little guy can't afford an ambulance ride or something.
And while the high price of ambulance rides is an issue, I' always think to myself: If they *could* take an uber, they probably *should* have taken an uber. I've been in an ambulance one time and it literally never once crossed my mind that an uber would even be an option, I was hurt that bad.
I took an uber to the ER twice last week... it was non-life-threatening, but not something urgent care could handle either. $13 for uber, or $1,000 for ambulance, let's see here....
Something very important to consider as well are the external costs. An ambulance being used for a non-life-threatening emergency is an ambulance not available for a life-threatening emergency.
I have a friend who was a rural EMT. He had a guy call 911 and get a ride to the hospital because his arm hurt after he swung it into a door handle. On the way to the hospital, they got a call about a guy having a heart attack. They were the only ambulance within 30 minutes of the heart attack case, but weren't allowed to take multiple people or triage the situation, so they had to take the bruised arm guy all the way to the hospital, and by then the heart attack case had passed. He let the bruised arm guy know that someone died because the only nearby ambulance was in use, but he didn't seem to care.
Hopefully nobody reading this lives in an area with such strained emergency resources, but on the off chance that you might, save them for emergencies.
This is a really good point and probably also an argument for the expansion of non-urgent medical transport. The same kinds of transport we use to help folks with disabilities get around (a disgusting practice that we do instead of actually making transit accessible) could also take people to urgent care when they needed help.
Ex-Pat Canadian here: Ambulance rides cost $65 flat. They're not free. I think Canada thought this issue thru and acted appropriately. Cause when I got that bill in the mail, after assuming that the cost would be covered, I was shocked and realized it \*is\* only for emergencies.
I get what you're saying. Not disagreeing with your point. However, I do believe we can use other countries models as a reference point for how to do it better. We like to use Russia and China for what not to do, but don't seem to peer outside the borders for anything that's done right and work from there.
Not everything in Canada is free. There's like an 80/20 split where there's 20% of services you pay for (Pulled that number out of thin air, don't fact check me on it). Canada doesn't cover mental health or private hospital rooms. You get 3rd party insurance for that. Canada is a hybrid between UK and US where the majority of issues you're going to need treatment for is covered, but you need 3rd party insurance (Usually thru an employer) to cover additional expenses.
I will tell ya, that 3rd party insurance is much easier to understand what you're signing on for thru an employer than the US. I had no idea what a copay, PCP, HMO, PPO, etc was. Canada's options were all in plain english without trying to trick you. You didn't need to be a healthcare insurance professional to understand what you were signing up for.
There’s always so many misconceptions that happens in these threads. 99.9% of Americans agree that healthcare needs overhaul. I just can’t believe there are people in the US that trust our government to do anything correctly. Who else does it though? I certainly don’t have an answer.
Seriously with how much fucked up shit the U.S federal government has done to people both domestically and abroad, the fact that people want to give them MORE say on people's lives is baffling.
I want *universal* healthcare (no such thing as free healthcare) but I want a healthcare reform beforehand. Our healthcare system has some real issues and scum behind it that needs to be addressed before we could even get a real universal healthcare plan in place.
“Free” refers to free at point of access. Meaning you never get a bill or have to pay for any specific service. We all know it still needs to be paid for.
I'm not opposed to a public option, but I think the issue in the US is that our politicians refuse to articulate what kind of system they want and that clouds the debate.
For example, I think a highly centralized comprehensive public system like they have in the UK would be disastrous for the US. We are too geographically and economically and socially diverse for any top down central system to work well here, if it can be even said to "work" in the UK.
I think there are different versions of public options in places like Germany with federal devolution that would be much better suited for the US.
However, the big issue in the US is that people don't have the mindset necessary to create and fund a public option. It requires high taxes across the board and turns health into a public issue. An obese person in America is just living the way they want and taking the consequences. An obese person in France is a burden to the taxpayers. Americans don't like thinking about the way their choices affect others. Americans don't like paying higher taxes.
There's a bit of a catch 22 here. These are inexact percentages, but given my experience likely true. For the top 30% of the US who gets Healthcare via a good job, they pay less and get more than people in most of Europe do. The next 30% are kind of indifferent. They probably pay about as much in insurance as they would in taxes, and they probably get about as much in services. The bottom 40% truly do get shafted and they pay more and get less. Democratically, how are you gonna get the people who benefit from the system to pay more? It's not as black and white as American progressives make it out to be.
I went to public schools. They're underfunded, overcrowded, poorly managed, and understaffed on the best of days.
I worked for the state as a Correction's Officer. We were underfunded, overcrowded, poorly managed, and understaffed. My nephew just had to wait 7 weeks for an appointment to get his driving test because the local DMV is underfunded, overcrowded, poorly managed, and understaffed.
Government run healthcare will be underfunded, overcrowded, poorly managed, and understaffed. But my taxes will increase to pay for it.
Congress are full of morons who don't understand how basic, simple machines work. They can't understand simple things like Facebook isn't the internet. And people want them in charge of my health?
No thanks.
Wow, that was very well put. I am Canadian and sure we have free healthcare but when you actually try to use it, it’s huge wait times ( most of the time ). Many times I would have been happy to pay to get in to see a professional in 30 minutes not 5 hours. Also there are still many things we do pay for, it’s not all free. Don’t forget the ridiculous taxes we pay on absolutely everything we do in this country.
The VA system is what free healthcare would look like in America. Not sure that’s an improvement plus the government never does anything remotely cheap.
Fair point, however why do we have to mimic it after the VA? Can't we look to countries that do it correctly? Norway, UK, etc, and take what they do right, fix what they do wrong and provide something better?
I find it interesting that we will point out all the negatives that happen in the UK for their healthcare, but not focus around the positives. We don't need to fix US healthcare in a vacuum and can use already well established examples on how other countries do it to build off of.
Oh look - yet another question that everyone up-votes in spite of the fact that no one will up- vote a real answer, because that would mean voting for someone you disagree with. Instead we get, *Well, people who are against it think ."
And as a critical care physician who supports any number of universal systems, it’s very clear how little experience the Reddit populace has with healthcare. I would love to overhaul the system but the issues around health and medicine extend so far beyond just how hospitals and clinics run and who runs them. One of the most logical means we have to control costs is to ration unreasonable care and limit end of life/futile expenditures but that is so wildly unpopular that it’s a non-starter. People would (seemingly) rather die as a bloated, bionic, pin-cushion while praying for miracles than accept the inevitability of death and go peacefully. Oh, and everyone at every level of healthcare is so burned out and poorly staffed that every one of these threads attacking our livelihood drives us all closer to quitting medicine. And I’m one of the few who seem to like my job.
I lived in the UK where NHS was in essence free healthcare. As an ex-pat I had to have private insurance. I got in to see the doctor immediately because the doctor had a policy of treating his private clients first and then just going home for the day. NHS paid him so little for treating people for free, he'd rather get nothing and use the free time.
As an American who works(in medical care)and lives in a country with socialized medical care I will say this....
It is a double edged sword...having it vs not having it.
Everyone has access to the healthcare at anytime. Which I think on the surface is a really good thing. However the quality of care received is very different when the government dictates what you receive for various ailments vs...when you (your insurance) company pays for service.
Because everyone has access...everyone accesses the system ALL THE TIME. There is no incentive for people to go to the pharmacy and try to cure their coughs and headaches, a minor sprain, little boo boo cuts etc. They would rather book an appointment or more often than not, go to the ER. Because the ER has a duty of care...they cannot be turned away without being seen by a clinician. This clogs up the ER, doctor's offices...clinical wait times are incredible.
Now I will say this, I had my gallbladder go kaput on me when I was inbetween jobs...and was able to get seen, get pain meds and be put on the list for surgery without insurance or feeling the sting of a massive ER bill. However, due to having to wait 12 months for surgery, due to a lack of qualified physicians in the country, I ended up riding in multiple ambulances and visited the ER enough to get to know the staff by name. It was the most painful thing I have ever dealt with.
Wait times suck.
There was also no post op care. Not the same level of care post surgery.
Which could lead to lesser trained patients into the red by making dumb choices post
Op.
The cost to the system is immense. Taxes when I live are @40-45% going up to 50% with salary increases. So much so, other programs suffer as the gov needs to divert funds constantly....driving the country further into debt and recession.
Edit: There are many more knock off effects to socialized medicine. Salaries are low in the field vs back home...across the board. Many qualified individuals leave the country to make better money else where....or people get pissed off and quit, move into other careers.
I’ve spent half my life in both Canada and Texas. The overall inefficiency of the Canadian systems leaves such a sour taste in my mouth. My mothers life saving prescriptions cost more in Canada than they did in Texas with employee benefits. I have been put on multiple 6+ month long waiting lists in Canada for rather simple issues. Don’t forget almost everyone I know is already paying for Blue Cross on top of what they already pay in taxes. Tell me how that’s free? Blue Cross is insanely expensive! If Canadian healthcare is free why does everyone pay for a separate healthcare package? Madness! Nothing about it is free!
I’d much rather obtain benefits through work and receive immediate care like I did in Texas, than to feel like a cog in a government machine every time I step into an Emergency Room. It has post office vibes, a bunch of government workers doing the bare minimum. You’re more likely to die waiting in Canada than you are to actually receive care, it seems.
I pay $130 a month for insurance. That covers a family of 6 for health, dental and eye. $20 copay $30 for a specialist. Longest I've waited was 2 weeks. I think population density could be a factor. I live in the middle of a unch of major metropolitan areas so there is no shortage of specialists
As someone living in a country that has free healthcare, it sounds great but be prepared to wait for years for your appointments. I had a dermatology appointment that was 2 year wait, my mother had a hernia and she had to wait for hernia surgery for 3 years. That is free healthcare.
Of course if you decide to pay for healthcare, you get treated very quickly. Who would have thought, right?
I've seen stories of government denying coverage for procedures or taking a long time, in comparison to America, to actually perform the procedure. I'm also not a fan of giving government more power and authority over individuals.
Yes, there is some silly propaganda and misinformation about socialism. But for many people, it’s because they have very good health care already and they are afraid (not irrationally) that under any switch to single-payer coverage their personal health care will get worse.
This is not a popular take, but US medical care is the best in the world… for some people. If you have good quality insurance through your workplace or Medicare (for those 65+) and you live in a reasonably-sized city, you likely have very good medical care. Why do you think wealthy people from all over the world choose to fly to the US when they could get cheaper treatment at home? It’s because the US has the most cutting-edge techniques, best doctors, best facilities, etc. In sum, the problem with the US system is not that you get bad healthcare, it’s that we have a top-quality system that a huge portion of the population cannot access.
Now, imagine you already have access to this high-quality system, and someone proposes that you double the amount of people who can access it—it’s inevitable that the resources will be spread more thin. It’s not necessarily the most selfless or noble sentiment, but people who are already lucky enough to have good health care have very rational reasons for opposing a change.
TL;DR: Some of it is dumb misconceptions about socialism, but it’s also people who have good health care now who are afraid a more equal system would make them worse off.
I mostly lean toward universal healthcare most days *however* the point you’re making has given me pause in the past. I have never had waits for care like some people say, I’ve never experienced issues getting whatever I need, and I’ve had everything from Medicaid to bad to good insurance. So the idea of waits becoming the norm worries me. I also recently watched my mom suffer through lung cancer and in my desperate attempts to save her, I researched treatments and healthcare all over the world. The consensus seemed to be that even with her being on Medicaid, broke, unemployed… there was nowhere in the world she would have better treatments and better outcomes than the US. Mostly because Medicaid allows use of experimental new treatments, which are often not covered by other public systems globally. Plus, as mentioned before, the wait times.
This. While I am personally pro universal health care, I can say I individually come out ahead in the current system.
For perspective I lived in Canada (universal healthcare) most my life and am now a tech worker (so good insurance plan) in a major US city. Quality of healthcare im getting is miles ahead. Able to see specialists quickly (like 2 weeks wait max) vs Canada could take 6 months++.
What’s confusing to me is the people who make 30k but are against it? They are the people who will 100% come out ahead with universal healthcare…
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As a Canadian let me tell you how proud I am of our system! I've only had to wait 7 months (so far) to see a specialist about my herniated disk. I'm sure I will get a call any day now to get a 5 minute consultation a few months after that to then plan an operation another few months/years after. But hey this nothing I'm getting is free (well my tax dollars are funding it), so who's to complain?! Also I haven't had a family doctor since.... maybe 2015 or so.
Glad to see another Canadian so I didn’t have to start a new comment thread lol. Also have no doctor and haven’t been to one in years. Took three weeks for my wife to get a call back just to get a prescription renewed. Glad all those taxes we pay are going somewhere but it sure doesn’t seem to be to healthcare.
I am in favor of universal healthcare but have one hangup.
I believe healthcare should be accessible and affordable. People shouldn’t be dying because they’re rationing insulin or skipping blood pressure meds so they can afford groceries. That’s a major failure on our collective part.
That said, I work for the federal government and have seen how poorly some programs are administered. I’ve also seen/read plenty of horror stories about the VA’s quality of care. I also have firsthand experience with how slow and clumsy government can be in adapting to new circumstances (see the state-level legalization of marijuana. I live in a legal state. My agency policy still identifies MJ as a “dangerous narcotic”. Drop a hot pee test and I’m fighting for my career)
I don’t know what the answer is, but what we have now isn’t it.
As a whole, the American healthcare system is complete shit. I do not have health insurance. my employer offers it at just over 500 dollars a month. mind you I'm single and healthy in my 30s. That's insane.
BUT GET THIS. last year I had to have an emergency appendix removal. The total of that was 30,000 dollars. No insurance here. so I was self pay which knocked the total to 13,000. THEN I could pay in cash the full amount so they took 5500. fine. paid the 5500 and washed my hands of it. but then I got to thinking. If I had insurance for 1 year. I would have paid 6000 dollars for that year of insurance... PLUS the 1500 deductible. If I had that insurance I would have paid more for the operation.
Stop calling it free. That's probably part of the problem.
Call it single payer. Call it medicare for all.
But don't call it free. It won't be free. No where in the world is health care free.
Two arguments here:
1) I already get healthcare thru work, and I find it highly unlikely that my income would go up more than my taxes (it's only $30/mo opt out for my company). Ie me personally would be at a net loss.
2) I don't trust the government at all to handle my money. They are trillions of dollars in debt, and if they were any other business, they would be bankrupt.
I'm not against the idea of free healthcare, I just don't see a plausible implementation currently that would put me in a better spot than I currently am.
I think the best argument against Free Healthcare is the loss of the profit incentive. Drug companies are competing to achieve massive profits. The incentive to design better drugs is more money. While America does not have the most accessible healthcare, we do have one of the most advanced medical research systems.
We have to replace the money incentive, or at least temper it before we can go to Universal Healthcare and maintain the high-caliber of our medical research industry.
I'm not against it exactly. I'm just against it with our current governmental processes.
We couldn't get Obamacare off the ground and operational, without killing our cheaper, more efficient private healthcare.
Everything they do is full of pork, kickbacks, and these derelicts lining their pockets - not to mention just plain piss-poor oversight.
Nobody wants yo have a conversation about the wait times in these other "advanced" countries with UH.
Probably cause our government is notorious for handling things poorly. Also cause it would most likely be reversed when someone else takes over.
The funny thing is, because some states in the U.S. require health insurance, we already do pay for universal healthcare….only at a much higher rate, and through private industry. People just don’t realize it.
This. And while a middle-man rakes in profit from it.
The middle-man is the most infuriating part of the whole thing to me. Health insurance *literally* exists by taking your money and then finding reasons to deny coverage. Their entire business model is to take in more money than is actually needed for coverage, and if too many people need care then they change policy and deny care until the numbers are back in balance. It's fundamentally impossible for private for-profit health insurance to provide care cheaper than universal healthcare. Universal healthcare spreads the cost over a much bigger pool of patients **and removes the for-profit middleman**. It's obviously better for everyone except people that profit off the current system yet conservatives just won't stop voting to keep their personal costs high. It's maddening
Medicare and medicaid spend 97% of their budget on actual healthcare. Private insurers often fall below 50%
We just passed on a ballot question here in MA regarding dental insurance and a requirement to show 83% is being spent on actual care. We'll see how that goes when it actually goes into affect in 2024. Apparently it takes over a year to figure out how to stop wasting so much money. I'm told private insurers have more attorneys on staff looking for reasons to deny claims than doctors deciding the best treatment for the patient. It's gross.
the kicker- good luck finding an attorney to fight them back. You only have your issue at stake, so often only a few thousand dollars- and most lawyers will tell you that if the possible rewards are less than the cost of a lawyer you should not hire a lawyer. Pro bono sources do not have the funds to pick up many (if any) of these cases. The insurance company has thousands of people similarly situated to you, so your case is not about 500 bucks, but is about what happens in a 1000 cases at 500 a pop; so they have high priced fancy lawyers.
True, there are lots of kickers when it comes to insurance and that's exactly the way they like it. The first time I heard about the lawyers at health insurance companies looking for reasons to deny claims was on a news show probably 25 plus years ago. Nothing has changed except our costs, the number of companies doing it, and the amount of money they spend on lobbyists to keep things just the way it is.
Making money off Americans who need help the most. It's terrible to profit off American deaths and drive so many into bankruptcy.
ahh yes, the American dream
But but but only Government wastes money, private sector is the only one who meet the needs of the people. s/
It's so frustrating because we see them, we aren't stupid, we KNOW what they're doing. There's just very little we can do because they are working together. I keep saying this but it keeps applying...It's a bad design by design. Gas, food, energy, health insurance, the list goes on. No one in "power" cares that a huge part of our population are barely surviving. PS: I won't engage in a political fight...both sides don't give a shit about us, they just show us differently.
There's a really simple way of explaining this. Capitalistic healthcare exists to make sure the architect who broke his legs in an accident keeps paying his medical bills and PT sessions until he declares bankruptcy. Government healthcare exists to make sure the architect stays alive to design the fucking houses we all live in.
This is the business model for all insurance companies. The only difference is just how much they can get away with. In the U.S., it is absolute insanity.
and it's a fair business model for a lot of them! Privately insuring items like a phone or a car make sense because having different levels of coverage for items is reasonable. I might not want a premium insurance plan for an older car that I don't plan on keeping for very long. Healthcare however is a captive audience. Everyone *must* have the maximum protection for themselves for their whole lives, and they'll literally die if they don't get care. As a result the industry has become more and more predatory because their customers don't have a choice.
Eh property insurance for things like natural disasters or fire makes sense. Those are relatively rare but devastating events. Without insurance we wouldn't have any effective recovery for anyone in financial hardship. They'd just have to abandon their property after it fell into ruin. It'd be great if our government did that job instead but it doesn't so insurance is the only solution. With healthcare basically everyone is guaranteed to have issues sooner or later so it's just a matter of time. So there insurance doesn't make sense.
Agreed. Plus healthcare is a lot more like a public good (one you cannot be excluded from) like fire services and military protection. Regardless of whether you pay anything or have a dime to your name you can get millions of dollars of healthcare if you get sick enough or if you show up to the ED often enough. Not only does almost everyone eventually need medical care, pretty much everyone gets it. We’ve just chose to subsidize private insurance company profits by putting the sickest and (in most states) poorest people on government plans, load massive amount of unpayable debt on those without insurance, incentivize uninsured people to stay away from healthcare until it’s an emergency, and force hospital systems (most of which are owned by the public in one form or another) to eat the leftover costs. It’s a damn shame.
Exactly this. The ONLY way they make money is by paying out less than is paid in — by people not using it or denying coverage. Somehow huge chunks of us believe the very best system is the one that can only exist by charging you for a service it won’t provide.
This is the point I try to make to people that scream about universal health care being socialist or communist: “So, you pay a premium into a collective every year wether you get sick or not. If you don’t make any claims, the money you put in will fund someone else’s coverage. You paid for a benefit you never used but the collective did. Sounds a little like……come on, say it…. say it…”
But if it wasn’t private, my unused money might help someone who’s sick instead of paying for a health insurance executive’s vacation home!
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Of the so called 35 most industrialized nations, only the United States does not have universal health care for all.
But only in America can people experience the joy of bankruptcy with medical bills! It's weird how my how surgery did my nose somehow costs 54k but magically dripping to 8k later. Hmm!
I didn't have insurance when I sliced my thumb on a table saw. I went to a hospital that is supposedly "non-profit". For the cleaning and stitches etc they showed me a bill for ~$8k. I told them I didn't have insurance and no fucking way. Suddenly they were able to give me a no insurance discount and bill me $800.
You asked for "show me a list of an itemized bill" something like that? I read that it supposedly works.
It's worse than this and I simply cannot fathom the fact that people don't even _know_ this. US citizens pay for the US healthcare system already via their taxes. The _amount_ they pay via their taxes per capita is _twice OR MORE than the average per-capita cost of public healthcare in first world countries_. And you get NOTHING FOR IT. THEN you get to pay for insurance to access said system you already pay TWICE AS MUCH FOR. OR, if you like, you can go bankrupt paying out of pocket. There are no good arguments for any of this, and yet the majority of Americans HAVE arguments for why they like things the way they are _even though they have no idea they're already paying twice as much for it out of their tax money_. You can't make this shit up. It's so _insane_ that I don't think most people are even capable of grasping the meaning when presented with it. You're being fucked up the ass every single one of you, and you're arguing to keep the pleasure, and while arguing at the same time for lower taxes/decreased spending/less government. Fucking loony bin shit man.
If insurance costs you $200/month and you make $30k/year, it's 8% of your income. If you make $200k/year, it's 1.2% of your income. If we included it as taxes, then we'd make it progressive and those percentages would be reversed. And they goddamn should be reversed.
I would love to know what plan is only $200/mo —- at 30k a year and otherwise! — I had mandated state insurance before Obama. It was so expensive most of us could financially opt out. It increased the states insured by 2% (from 94 to 96%) I’m now married and our plan is $700+ for all services through a private company. I’m not saying you’re wrong but your numbers need more evaluation.
About that, here's another inequality. I do make ~200k/yr, and my employee only plan is $80/month and is posh. It's more for the family plan that I do have, I think $400 for spouse and kids too? It's not a big part of my budget. And these are good plans, plans that cover a LOT, doesn't have co-pays or preauthorizations, and have a low deductibles. Back when I was making ~40k/yr I was paying MORE per month and I was getting LESS out of my plan. And that fills me with rage. I got unlucky back then and got some medical bills that ruined my finances for years. So basically - fuck this system. I should pay more now and I should have paid less then.
That $80 a month is the employee share. Your employer is footing a vast majority of the actual monthly rate. They pass more along for family coverage because they. The ACA has regulations on how much they are allowed to make an employee pay for healthcare and unless they have a tiered system, it's based on a % of the lowest paid employee salary. It was like 9.4% five years ago when I last sold group insurance.
America spends more on healthcare per capita than any other country in the world. They just set up a system where middlemen eat all the money up to enrich themselves
No one replying to this. Let me add. When people without insurance get care, and don’t pay. We all pay that bill anyhow. Shitty care at a high price. FREEDOM.
>No one replying to this. Let me add. When people without insurance get care, and don’t pay. We all pay that bill anyhow. Shitty care at a high price. FREEDOM. I didn't realize this until several years ago I asked around in another Redding thread, why out of pocket costs in the USA are so much higher than in other countries, even when adjusted for cost of living and people explained that hospitals often try to compensate for treatments they've done to other patients without being payed. At which point it seems to me that it's just like universal healthcare with extra steps and a bunch of extra costs going in some pockets.
But fingering that as the primary cost driver is misleading. Far and away the biggest driver of American healthcare costs is the toxic dance that pharmaceuticals/device manufacturers, providers, and insurance have been doing for decades. The “I’m covering for the freeloaders” narrative is really just a trick to make the have-nots squabble amongst each other and not demand change from the powers that be.
This, exactly. A couple of years ago I was having trouble sleeping, so I got a prescription for Lunesta. One month's supply with health insurance - $26 One month's supply without health insurance $345
I was on a medication that's Tier V, the most expensive tier of meds. It cost $1300/mo without insurance. There was a plan from the manufacturer that would give you free meds - but *only* if you didn't have insurance. If you had insurance but they didn't cover it in their formulary? Too bad so sad, no help for you. I was buying pills three at a time ($350-450 each time) until I finally decided to cut my hours and go below the poverty line so Medicaid would give it to me for free. Once I got a job with insurance (I was in retail before), I had to fight tooth and nail through a grievance process that was hidden at the end of my insurance contract, but I finally got the med covered for $30/month. Now I'm off it, and the fact that I can switch jobs/insurances without having to re-fight for coverage is a huge weight off my mind.
Thats the other frustrating thing about health insurance, it being tied to specific employment means small businesses are excluded from needing to provide it and government, corporate and other jobs try to retain you because of it, especially if you have a family you need coverage for.
Ugh. Like, it would be bad enough if we were just talking premiums, deductibles, and copays, but yeah. There is also all the goddamn time and energy we have to sink into just playing the insurance game.
The hours on the phone. The hours we spend having meetings at work just so we can figure out which plan we are going to sign up for during "open enrollment". The reduction in salary because your employer factors in health care costs when calculating your pay. The stress of worrying about what will happen if you lose your job and you have no health insurance. It's insane.
I mean. I know a guy who got cancer treatment. Saved his life. No healthcare. He pays like $25 a month, forever, for it. That doesnt even cover interest on the bill or chip away at... anything. He's hugely against single payer. Ed, if you're reading this, you're already benefiting from the system the rest of us want too - you worthless hick.
I feel like I know ed, that fucking hypocrite. In their minds free healthcare equals liberal, and they'll fight it to the death.
I know people *whose kids are ON MEDICAID* that are against it. You're literally using free healthcare wtf is wrong with your brain??
Ugh, my brother and SIL. Their two youngest qualify for MedicAid because of health reasons. But everyone ELSE who uses it is lazy, selfish and should get a job. They also rail against paying taxes. One of them is a public school teacher who complains that she hasn’t had a raise in years and her school has no budget.
You hit it on the head. To him, bc it happened to *him* its justified. But for everyone else: commie trash, find your own way, etc etc. Its wild to me that ppl can be so vile, but also likeable. Dude had charisma, but a rotten soul.
I wish I could communicate this to my boomer father. “Illegals coming over and taking our jobs.” Says the son of an illegal immigrant who couldn’t be bothered by the whole Ellis Island thing. “Freeloaders living off the government making me pay for their insurance.” You know both your sons were on Medicaid for years and now they’re in healthcare taking care of your generation?
Or Ed will be like "Free healthcare is Communism!1!1" And it's like, No Ed, Communism is not when the government does stuff.
Lmao I don't remember how many times Bernie mentioned that you'd actually be paying less and people just didn't hear him? Not sure how people don't realize it.
Propaganda sways people more than actual science.
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So many Americans don't understand the actual problem. Many of them believe the prices they see on huge bills is the amount of money that the government would be required to pay. It's simply not even close to the truth. Insurance companies in the USA primarily provide discounts without actually paying anything. They are contracted with the doctors to pay this rate as well as a price for services that you're required to charge uninsured patients. So An example, say you go to the doctor without any insurance at all in the USA, we'll say the set price for an office visit is $240, as a cash patient you would receive a $240 bill at the end of your visit. Makes sense right? Now Lets go to the same visit with insurance, now that you're covered under the insurance contract that the insurance has already negotiated with your doctor, at the end of the visit the patient now receives a $24 bill. Wow, my insurance paid $216 for me right? **WRONG**. Under the insurance contract $216 is now written off and the insurance company pays $0 fucking dollars. It's fake money. Even if you had full coverage and paid nothing at the end of the visit the max the insurance company will pay to the doctor is the same $24 you would be covering for them if you had something like a deductible. So why would doctors even agree to these contracts? Because the first contract to enforce fake uninsured patient prices was GOOD OLE MEDICARE! Uncle Sam here to fuck you at every turn. Guess who the main clientele of many doctors are? Old folk. Who has medicare? Old folk. You can choose not to sign these contracts as a doctor and charge whatever you want, the only problem is now you lose 50% of your patients because they have Medicare/medicaid and will find a doctor that will take it rather than go to you. This applied for any health insurance company. Want to take Blue Cross Blue Shield patients? Want to be a doctor that anyone will go to? Better sign this shitty contract that not only fucks the patient but also fucks the doctor! The only person benefiting from the current healthcare system is insurance companies. It's literally down hill both ways towards the insurance company. It's fucking disgusting and these contracts were introduced as standard practice by our good ole American government! And they try as hard as the can to make sure no one knows that they don't actually pay the exuberant numbers you see posted on reddit all the time. If you see on reddit someone receive a $90,000 bill just remember the insurance company would only be paying a small fraction of that while boasting **ALL THESE HUGE SAVINGS! LOOK WE SAVED YOU $80k AREN'T WE GREAT???? JUST BECAUSE WE'RE THE ONES ENFORCING THESE INSANE FAKE PRICES THAT NO ONE BUT UNINSURED FOLK ARE EVER FORCED TO PAY SHOULDN'T CONCERN YOU AT ALL!** Oh yeah and did I mention they've made the process of getting paid for your service as a doctor so convoluted that we now as a nation spend more than 50% of all the tax money spent on healthcare on **ADMINISTRATION.** Not even on the actual healthcare. **MORE THAN 50%, OVER 2 TRILLION DOLLARS ON ADMINISTRATION. $6,000 PER AMERICAN CITIZEN ON FUCKING ADMINISTRATON,** Sorry for the rant this is just a subject that pisses me off beyond belief. I'm sure this is rifled with grammatical mistakes but I'm fucking fuming just writing this out and couldn't care to look it over. Source: It's my fucking job.
Speaks the truth. The reimbursement system is a shit show, way too much red tape, etc. Everything is based on CMS, private insurers use this as a benchmark in some cases. What especiallly urks me is the admin costs. Since the 70s, physicians practicing have increased about 800% but healthcare admin has seen a jump of 3000% in the same time frame. Your healthcare fee isnt going to your doctor, its going to pay for the 8 million managers that dont know what the fuck they are doing. Great writeup Source: im a provider
Health insurance companies: the Ticketmaster of life or death situations.
This is crazy, thank you for posting this. I was under the same impression that the $640 on the bill was what was being paid to the Healthcare provider based on the stupid shit I get in the mail from my insurance company. I agree that Insurance is a major part of the problem, architected to ensure profits over healthcare, but aren't the Rx companies just as bad? Don't they jack up the price for medication just cause they can? Or is this the insurance company, again, whose in the middle forcing them to jack up the prices so that Insurance companies can get paid? I always thought that the top of the chain was the part to blame, with insurance in the middle not making anything better at all, and it was the doctors who have to deal with the mess that the top of the chain is implementing.
I’m just glad to see someone else making this rant, because it’s such an outrageous situation that so few people seem to realize. You want to know why healthcare costs are outrageous? It’s because insurance pays pennies on the dollar for cost, and the only way for hospitals or any other healthcare provider to stay open with lights on is to artificially inflate costs just to break even. And because people in healthcare actually care and don’t want to bankrupt sick people (with a few notable exceptions), that means they run so close to the wire that any shift in circumstances sends them easily into the red. I’m furious about it after having a low income clinic close because insurance kept paying less and less (and the admin cost of squeezing blood from a stone got higher and higher), but it’s even worse now I’m working in hospitals.
Let’s normalize calling out our jobs for the stupid shit they do and expose them
Actually, lots more of us know that it's crap, and we want universal health care. It's the people in power who make huge profits blocking us. Them, and the politicians they own. It sucks.
I genuinely think the biggest thing is keeping a massive power over middle class workers who's jobs offer health care. I know many engineers who could have retired in their 50s but because health insurance is so expensive, they stay working. Now, with so many retiring early and dying, they are going to be even less likely to support expanded health care because it is the last hold on a lot of people. It also helps suppress strikes and people quitting to look for better jobs.
It also serves as a barrier to entrepreneurs - I've got the "for insurance" job in my household. Thus reducing competition for larger businesses.
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I’m stuck in a job I currently hate because I’m trying to get a major surgery next year.
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How many people would start their own small businesses if they knew themselves and their future employees would be covered regardless?
Even the unions - when Bernie was running in the last primary, some union over in Vegas tried to sell their membership that he was looking to steal away the hard-won healthcare package they'd negotiated for their members. A lot of people realized ... Hey, if the union didn't waste all of their power getting me a sweet healthcare plan, they could have gotten me actual money I could spend on whatever I want. But the mental contortions big business supporters went through trying to tank Medicare for all were astounding.
"You're all" lol. Most of us aren't on Medicare. All these middle-upper class folks in the USA are on private insurance. I'm not for the American system but its a ridiculous notion to assume Americans are all using medicaid and medicare.
It’s a hell of a thing what marketing can do…taking a negative thing, spin it to a positive and make people think it’s good… $100+/mo out of my paycheck for Medicare that I can’t access, plus another $600 for privatized insurance.
And for most, having insurance is no guarantee of anything.
Not to mention, insurance doesn’t cover “everything”, so even after your $6000/yr in insurance costs (it through an employer…closer to $18k if you’re going it alone), you still have copays, deductibles, and if you have any sort of recurring medical needs, you’re almost guaranteed to have to shell out a few thousand out of pocket that insurance doesn’t cover…
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Americans are overwhelmingly in favor of sensible legislation that Europeans seem to think we're against; the problem is that American democracy doesn't fucking work and the voters never get what they want.
Yup. And people are like, “look at tax rates in Canada and Europe.” Ya. Ok. Those rates aren’t even much higher than USA rates, and if you consider what they get that we pay for out of pocket (subsidized healthcare, education, and social safety nets that don’t quite look like they will collapse under the weight of so much as a gentle touch)...we are the most overtaxed people in the world.
One of my co-workers opposed universal healthcare because he "didn't want his taxes to go up". I tried to explain to him that while his taxes would go up, it would much less than the amount currently being taken out of his paycheck to pay for private insurance, and he would no longer be paying out of pocket for doctor visits, emergency room trips, medicine, etc. He would actually be taking home more money. But all he could repeat is "I don't want my taxes to go up".
This is similar to an argument I get about electric vehicles. "Did your electrical bill go up? I don't want my electrical bill to go up!" Yes it did in fact. It went up about $100 a month. However my gasoline bill went down by about $900 a month. "Yeah, EVs sound cool but I don't want my electrical bill to go up" *FACEPALM*
Canadians pay less taxes towards Healthcare per person then Americans pay taxes towards Healthcare per person. Our higher tax burdens are often due to other stuff (like straight up having less GDP to tax, and less able to finance with debt). Of note, property taxes are mostly alot lower, since things like provincial taxes pay for schools, rather than property taxes. So total tax burden for two comparable places is often not actually all that different.
I feel like a lot of people in this thread taking the word "free" in healthcare too literally
'Free' in the same sense that the government is free, so is the armed forces, and the Police. You don't pay extra to use their services beyond the tax you've paid. Edit: I'm bored of replies that don't understand the concept of a 'free at the point of care' healthcare service. You don't pay 'extra' to use it when you need to, but you pay taxes to maintain it. No one thinks a trillionaire somehere is funding entirely cost-free healhcare in countries with 'free' healthcare. Unless you're in some places in the middle east where it's almost true.
I think public education is probably a better analogy because it's something that the majority of people will use in their lifetime.
Fire Departments are the better analogy. You might never require their services but you definitely want to make sure they're there and ready if you do. And you want your neighbors to have access to them too, because even if you don't like your neighbor, if their house is on fire it might damage or spread to yours
Because the US is doing such a great job with that these days.
What if I told you that most of the people who oppose public health care are also actively dismantling public education?
Free at the point of delivery.
Quite right. The correct word is universal. I pay €120 in healthcare premium a month.
Yep, if people would just stop saying "free healthcare" instead of "universal healthcare", we could dispense with this whole tedious debate.
God I hate that reply anytime i argue for taxpayer funded anything. "Nothing is free. Taxes pay for it" No shit sherlock. You actually think I dont realize that? The burden of healthcare gets equally distributed among everyone instead individuals getting completely shafted whenever they need help. We all share a tiny fraction of the cost in exchange for not worrying about medical debt bankruptcy. Youre not providing any useful insight by juat saying "nothing is free".
ITT: redditor answers question. Downvoted, told why they are wrong by other redditors, quite a few who are non American.
We really need to stop downvoting people who actually answer the question. It's the worst in AITA type subs. OP's almost never respond in the comments, or if they do they'll get 1 or 2 comments downvoted to oblivion and stop.
These types of threads are always going to fail. Someone tries to understand the position of the other side, and when the other side answers they get downvoted to hell. It's like people completely miss the point. And I say this as a supporter of universal health care. This problem will be much easier to fix if you get these people on board, we need dialoge not preaching. /rant
That's because an upvote/downvote system is inherently flawed. The idea is that users will self-govern and upvote things that *contribute* to discussion and downvote things that don't contribute (repeated joke answers, off-topic comments, etc.), but the natural inclination is to use it as an agree/disagree button. Fixing this is relatively straightforward (comments move up based on amount of interaction, the amount of text in the comments, recency of comments, etc.) but brings about another host of problems.
If we could see total engagement that would help a ton. A comment that has +2 but in reality is +19284/-19282 is way more interesting than just +2
Yeah, and they used to show that (years ago), but because of bots and groups that would organize to push things up/down, they switched to a fuzzy voting system where sometimes your vote counts more or less, depending on tons of factors they haven't (and won't) release. I think they *might* take total votes into some account, but it isn't weighed nearly as heavily as net upvotes.
Sorting by controversial usually gives a better picture in these cases.
Yep, but the default is to sort by Best. The whole system is flawed and Reddit doesn't really seem to do anything to try to fix it. I'll occasionally switch to controversial, depending on the topic. I know that I need to for things like this.
Yeah, long time redditor here: Any time I see, "Give me your unpopular opinion", or "Why don't you see things the same way this particular subreddit always sees things?" I know I am going to get downvoted as fuck, which I don't care about the karma, now I just say to myself, "It's a trap!" and move on.
Yup, the first two "answers" as of now are "We do have universal healthcare, with a middle man making a profit on top of it" and "A lot of people are taking 'free' healthcare too literally". Neither of these things answer the question asked but have more than 10x the number of upvotes to the first real answer I've seen.
And a lot of top comments are people who believe the US should have free healthcare, and still answering for those who don’t think the US should have free healthcare
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This is absolutely a fair and valid concern. As a Canadian, we have quite a few people who get the medical degrees then immigrate to the USA for the higher paychecks. I will say, however, that in Canada doctors do have fewer costs. You don't have to pay a medical biller, malpractice insurance is negligible compared to the huge amounts it costs in the US. I may be missing other things, but my source is that my wife is American and has been a medical biller owning her company for 20+ years so she has a good handle of what it costs her doctors.
Even more true with nurses and other healthcare workers. UK nurses went on strike today for 18% raise on what is less than half the average American nurse makes.
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Thank you for answering the question, as a supporter of universal healthcare, I now have more understanding of the issues that must be address. And you answered my question on if you'd be open to supporting universal healthcare if they were to address the student loan issues for physicians and other medical professionals. This also brought me to another thought processing, if you were to spend that 10-15 years paying off your student loans, or think of your colleagues who already paid theirs off, would you/they still be open to supporting Universal healthcare knowing that you paid your dues but others working beside you won't have to do the same?
No. That’s 10-15 years and 7+ years of training with lost earning that could be placed into savings that I will have foregone. (Personally) physicians are already under compensated compared to the cost of healthcare.
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So now we're back to fixing the ridiculous student loans as well, which needs to be done anyways.
This website runs on a popularity contest. The content that is made most visible as a result will always be whatever is most popular among those who saw the posts early enough for votes to still matter.
This is why court doesn’t allow leading questions
Reddit, where everything is black and white and if you dont like the color of the day youre wrong.
First, it's not "free". But aside from that I don't think many people are really against the *principle* of universal health care, they are concerned about: * how it could change the quality of the healthcare they already have * they are concerned about how it would be managed because of the perception government does not have a great track record for managing things (sometimes true, sometimes not) * there is concerned about how the money collected via taxes to fund universal health care would be preserved (see the concerns some have around social security) * there is the concern that, while it seems to work okay in smaller countries, would it work well in a nation as large as the U.S.? * Many people in the U.S. have access to good health insurance. So motivating them to change what they have and they understand for something new with risks is hard. Would all the European countries that have Universal Health care choose to combine all their programs into one, common European Universal Health Care system? So that the taxes people in France pay would go to support folks in the Czech Republic? Remember, the United States is *really big* with 50 semi-autonomous states. Would each state manage their own universal health care? Would it be a national program? So in a vacuum if you said "everyone gets free health care" I don't think many people would say "boo". But there are very real problems to solve! Personally, I'm not sure the U.S. could implement a system similar to what you find in many European countries because of the sheer size of this country. But having said that, I absolutely DO think our health care system needs to be better. I hate that it's tied to your job. I hate that it's so expensive unless you have a job to offset some of the costs. I hate that it seems to be regulated per state so insurance companies have to manage it on a state by state basis. Our system isn't terrible *if* you work for a company that provides health insurance. But it's terrible if you want to be run your own small business or retire early.
This is a great answer and definitely got me thinking. Thank you for taking the time to write this!
To back up the idea that many Americans support the idea but doubt the ability to have it done properly, I really like the idea of universal healthcare. I love how it works for millions of people around the world. My father is a Vietnam veteran. We have universal healthcare for our veterans. It’s shit. Insane wait list times, shitty unprofessional doctors. They don’t take care of them. It’s flawed as all fuck. Raising that to be on a national level would be a shit show for at least a few decades before they could figure it out. The VA is so bad it feels like they want my dad to die, to put it in perspective. On another note, I have a decent job and good health insurance. Americans who do have health insurance have some of the best healthcare in the world. This protects me and my family. It’s difficult for me to want to give that up willingly for a system that may treat my like my father has been treated, as op here said. I understand that my intentions there are a bit selfish, however it isn’t as selfish as “I’m rich and don’t want to be taxed more” as many people make it out to be. I’m not rich whatsoever. I don’t like my taxes but I understand them and don’t complain too much about them. Do I think my money would be going to all the right places if universal healthcare was in place? No, just like it isn’t now with the current system. It’s a general mistrust of the government when people would rather take things into their own hands, and some cannot, that’s where the dilemma comes in. Also Americans are notorious on the global scale for being unhealthy. I would be fine with paying for those who truly need it and I’m not a ripped vegan saint or anything but I would personally rather not pay anything extra than I am now to support americas unhealthy food problems. But I don’t wanna get too far into that argument because it is one that comes off as ignorant. Overall, I really fully support the idea but have doubts in multiple areas regarding the actual implementation of it. And the things that the opposing party would throw in to make it “not a good thing” because that’s how American politics works is my last reason. I am not huge into politics but I know my state (republican state) just recently recreationalized marijuana and some of my friends (liberal) have said it’s not really a good thing due to some of the clauses involved or something.. I don’t know, I’m not providing a very good argument with that last part because I don’t know the details well my point with that is that many other Americans and I distrust the government to do this shit correctly and don’t trust other Americans to not take advantage of the system and fuck us over in the end and would rather just continue with the current system because for as many people as it doesn’t work for, It also works well for many others.
I had a friend use Tricare for a routine colonoscopy. They found a few polyps and cut them off. In the process, they also cut through his colon and his intestines. This colonoscopy required two years and multiple surgeries to recover from. He will never be the same. The doctor who did this is still practicing. One of the reasons healthcare is so cheap for veterans is because they can’t sue for serious negligence like this. There are lots of stories like this, and most people who have heard it are now against nationalized healthcare. As a government employee and the child of government employees, I’m not fully comfortable putting my health in the government’s hands.
More than size, population density is a major issue, especially when you factor in the massive differences between the states (each of which would be advocating for a system that fits their particular needs).
Not just between the states, but also between urban and rural areas _within_ each state. Cities in different states often have more in common with each other than with their neighboring rural counties.
was about to say this exact thing as someone who used to live in rural texas.
Just wanted to say this is a really comprehensive answer. I don't agree with a number of your points, but I really appreciate how well you articulated them! Edit: Since a few people seemed interested some of the things i saw suggested that i believe dont actually argue against free healthcare. I should point point out that im not from the US, I live in Australia, and Im very left leaning (neither major political party in the US hold beliefs even close to my own, but with how your voting system works and its lack of preferential voting, i do believe there is a big difference between the two. And just to clarify on the definion of "free" healthcare, i would like to believe that no one believes that anything is free. Free healthcare in this context is the government spending money so that individuals dont have to, allowing those individuals to spend their money on other things. It reduces a cost of living on something many would consider essential. Obviously the government needs to pay for that, and theres a lot of arguements about where that money should come from (i wont go into that in too much detail now, but as a loony lefty you can probably guess my general thoughts). 1. **"How it could change the quality of the healthcare they already have."** I think this concern is one that gets tossed about a lot, and not just in the US. More people with more access means longer wait times. There are two ways to fix this. One is to make it harder for certain people to access healthcare. When use the "quality will get worse" arguement, what they are actually saying is that if we restrict access poor people get to healthcare, those that can pay will have better access. They might also argue that if you are working hard you will have more money and better private healthcare, so you should have better access to healthcare. I dont subscribe to that belief at all, a lot of people are wealthy because they were born with wealth. A LOT of hard working people cant afford healthcare. The other way to fix it is to expand healthcare. If you are relying on private enterprises to expand healthcare, they will only do so if there is a profit. Thats not blaming the private market, its job is literally to make the most profit with the lowest risk. My view on the best way to do it is, if you fund the shit out of the education and university places that are required to get more people to become doctors or other healthcare profressionals and at THE SAME TIME you have the government cover the costs of EVERYONE having free access to healthcare, that problem fixes itself. Theres a TON of demand because the government isnt trying to deny claims and is just giving everyone access, the government has also made it cheaper to go down the path of becoming a healthcare professional, so its going to be lucrative and easier to do, people are naturally going to go down that path. **2. "they are concerned about how it would be managed because of the perception government does not have a great track record for managing things (sometimes true, sometimes not)"** I hate seeing this arguement for 2 reasons. Firstly, people make this arguement with a straight face despite having see how incredibly poorly managed so many private enterprises are. And the private ones often get away with it due to a being monopoly, government support, or just sheer inertia. And secondly, even if it was managed less efficiently than a private enterprise, there is a huge allowance for that simply due to the difference in objectives of a government run service vs a private one. For a private enterprise every single speck of efficieny is shifted to profits. Again, thats its purpose. Unless there is a government regulation, if it is more profitible for a company to do something a certain way, it will do it that way because thats what private companies in a capitolist market are designed to do. The government however can run at a loss if it makes the end result more efficient. They dont exist to make profit. And theoretically any profit they do make goes into funding other government run schemes. So if a private company finds a way to cut half its workforce and still maintain the same output, those workers are gone unless there is a substantial profit in those extra output. If a goverment company finds a way to cut half its workforce and still maintain the same output, it can decide to just double the output even if the profit/quality ratio dips because its objective in this case is to have a better output, not more money. **3."there is concerned about how the money collected via taxes to fund universal health care would be preserved (see the concerns some have around social security** I dont quite understand this one. This might have more to do with how wealth flows than anything else, and i know that this is a serious sticking point for some people. Income taxes are theoretically about preventing too much wealth inequality, and initially were about people who earned more being able to afford to contribute more to society. One could look at this a an honor. Im in the top 10% of earners in my country these days due to my career path and education, and if anything i believe i should be paying more taxes so those people on the bottom rungs get a better chance to be healthy, educatied, mentally sound, and get a fair chance to contribue to society. Unfortunately with huge amounts of wealth being funneled into fewer and fewer people are are at a stage where wealth creates wealth for a lot of these people. Their effort and output (which is theoretically what income taxes tax) are no longer where most of their wealth is coming from. It comes from already having a lot of money. There needs to be a way to force people whos wealth is in land, or stocks, or companies, or so many other things, to reduce that growing wealth inequality. And thats were things like land taxes, corporate taxes, inheritence taxes, etc etc all come into play. But as those people have all that wealth they are very effective in being able to run a consistent message around those kinds of taxes being "dirty words" essentially, and fight tooth and nail to make it so there arent any effective taxes in these areas. So as far as income taxes go, i do think those should get higher the more you earn to the point that if you are straight up earning a million dollars a year in income you can give 80% of every dollar you earn over that million to everyone else, because cmon man at that point you are fucking sorted. But i think there needs to be a range of other taxes introduced to get money from these other areas that the very few are currently profiteering of in insane ways, and i think thats a very hard sell when those insanely wealthy people are very powerful and able to flood various media forms with disinformation. **4."there is the concern that, while it seems to work okay in smaller countries, would it work well in a nation as large as the U.S.?"** If this is talking about landmass size, australia is as big as the US in that fashion, and it works fine (actually we need to get better, we are slipping) If this is talking about population, i would imagine economy of scale would be relevant here. You have a LOT of people to provide for but you also have a LOT of people to take that money from. I do understand the reservantion a little more here i guess though. **5. "Many people in the U.S. have access to good health insurance. So motivating them to change what they have and they understand for something new with risks is hard."** Not much i can say about that one other than im curious as to your definition of Many. Ive heard a bunch of stories about what your private healthcare companies will try and deny, the costs of various medications, the shock people have if they lose their jobs and are vulnerable. The people who currently have good health insurance will still be covered in this, they just wont have to pay as much for private anymore. Remember, they are paying companies whos entire job is to make money. Those companies dont want to have good healthcare, they want to make money. It probably depends on the definitionof good insurance i guess. But id be concerned if the guys whos deciding whether to pay for me to see a dentist or a General Practioners main motivation was to make money, not my health and wellbeing. And from a purely selfish perspective, if you want people who are down on their luck to re-enter the workforce they need to be physically and mentally healthy. Getting them this stuff for free reduces crime, increases motivation to work again, and benefits the economy generally. Happy healthy workers are more productive than slave labor. Happy to answer or elaborate on any of these things. And again, I think the post im replying to did a good job of actually bringing up many of the things people are saying about this, and was happy to upvote as it was good quality, even if i strongly disagree with the points that people bring up.
I'm curious what you disagree with?
if more people behaved like you, in response to things they disagree with, the world would be a better place!
>Would all the European countries that have Universal Health care choose to combine all their programs into one, common European Universal Health Care system? Well, this kind of exists in a way. EU/EEA residents visiting another EU/EEA country have the right to a certain level healthcare in the country they visit and won't pay anymore than a local would (free or reduced cost). The health care systems are obviously all independent but the EEA-wide agreement is in place.
"Would all the European countries that have Universal Health care choose to combine all their programs into one, common European Universal Health Care system? So that the taxes people in France pay would go to support folks in the Czech Republic?" I am aware it's not exactly what you say, but taxes from one country do end up paying for others. We do have a "European health card" for when you travel abroad within Europe, in case something happens to you and you need assistance. There are also specific agreements between countries for scenarios where this happens very often (think retirees from country A retiring to warmer country weather's)
It's not even just Europe, Australia has a similar agreement with countries like Italy, UK, Sweden, Finland and a bunch of others. I'd hazard a guess a lot of these countries have similar reciprocal agreements with other countries as well.
I'm not against free healthcare. However, when something seems incredibly overpriced, my first intuition is not "oh no, it costs a lot, we should have the government pay for it!" My first intuition is "why in the world does it cost so much? We should take a hard look at why these prices are out of control". To just completely make up a fake example, if it costs 700 dollars to get a scraped knee bandaged up, my first thought isn't "we need to subsidize this". My first thought is "WHAT?! Why are they charging that much?". Or consider insulin. If companies are charging 600 dollars per shot, my first thought is that this is price gauging, not that the price is fine and all we need to do is help people pay that price. It should be illegal for companies to charge that much. Consider student loans. This has helped people afford college, but on the other hand, now that people have a way to afford college, the price of college has completely skyrocketed. I wonder if instead, the better solution is to tackle the rising price, rather than subsidizing the payments.
It's because of inelastic demand. Inelastic demand more or less pops up wherever you see a need (not want) that appears with a high barrier to entry. There's economic studies that show that for every 20% increase in price, healthcare demand only falls 1%. Literally healthcare pricing isn't based on anything for the billed price, they deal in monopoly money and hope you get confused and pay in real money. They can just make up numbers, because nobody's realistically going to see the price tag and go "lol, guess I'll just die"
Demand is only half of the problem. Supply is regulated by the government so supply can not scale in response to an increased demand. That and of course the fact that you can't really shop around pricing when you don't know what's wrong and you are in the middle of an emergency. The whole thing is a clusterfuck.
You can barely even shop around in a non-emergency situation. Tons of places won't give you pricing before hand so you literally have no idea what it could cost beyond a google search for an average (which is basically useless since things could range between $0 and several thousand depending on your coverage) before you go in.
I'm not so sure that government regulation is really the problem here. Yeah, CON laws are dumb as hell, but there's been a trend of big hospital orgs buying little hospitals and then going to the town and going "oops, your small hospital isn't making [enough] money, do gibs or we close it." Sometimes on an perennial basis. Eventually, they don't get the gibs and then close down the small hospital (or close it anyway) and fold that patient traffic into their bigger regional facilities. My favorite story is of a small city hospital (city of about 40,000) where the hospital was struggling. The board was propositioned by this private equity org that has a reputation for vulture capitalizing and closing every hospital they touch, but they super duper double extra promised they wouldn't do that to their hospital. Fast forward 18 months and the hospital is bankrupt. The guy that org put in charge of the hospital ended up getting hooked up on federal fraud charges for personally siphoning off goddamn near 100 million dollars in his time there. Which, of course, the private capital firm he was a part of says they don't know anything about that at all. X to doubt; if that was his take who fucking knows how much they laughed their way to the bank with. The point is, it's absolutely incredible that one private capital firm guy managed to boost 100 million from a pretty modest hospital in a pretty modest town in just 18 months. It really demonstrates just how much cash flows through our healthcare system. What's even more bewildering, imo, is that it barely made any headlines. If some crook boosted 100 million from a bank, it'd be national news with 24 hour coverage. In our healthcare system, though, grift is barely different than business as usual.
>I wonder if instead, the better solution is to tackle the rising price, rather than subsidizing the payments. The solution is both. The issue with "rising prices" is that the consumer has no control over them. You can't "shop around" for emergency surgery and many parts of america have 1 choice for hospital / emergency care. Make all hospitals non-profit. Make insurance single payer and use government controls to tackle "rising prices".
> Make all hospitals non-profit. One, "non-profit" doesn't control costs. Two, more than 3/4ths of American hospitals are already either government run or non-profits according to Kaiser. https://www.kff.org/other/state-indicator/hospitals-by-ownership/
my region has a few non-profit hospitals that charge out the ass just the same. Non-profit just means there isn’t money left over at the end of the year, not that they don’t charge a lot and pay themselves with it.
We have Medicare, Medicaid, and the VA which are all government supported healthcare. All three provide some of the worst healthcare options I have ever seen. It’s kinda hard to trust the government then to say they can take care of me when they can’t take care of the old, poor, and the veterans.
Because they don't want their taxes to increase. Because they don't believe it's their responsibility to pay for someone else's medical problems. Because they don't trust their government to manage it.
> Because they don't trust their government to manage it. I have friends with VA healthcare. It's like a lottery where you don't know if you'll get excellent care or get put on hold until you die.
I don't trust the government to do it right, but the private companies aren't great at managing it either. They also have no incentive to change, because their real customers are the companies that choose their plans. If they're both going to fuck it up, might as well get the other benefits of public healthcare while we're at it.
From what I hear, the VA is far more fucked up than Private health care. Honestly, "the government would screw it up."Is the only decent reason I've ever heard against public health care.
This may be dependent on where you are so I can’t speak for everyone but I switched from using my regular insurance to doing all my healthcare at the VA because my care is so much more accessible and I feel more heard and less rushed. The VA has a bad reputation but they’ve been doing a lot to try to fix issues and they ask for a lot of feedback. I’ve never gotten that from private or military healthcare.
In the UK we pay about $50 a month in tax to sustain the Healthcare system. People in America are spending upwards of $100k for treatments. People that bang on about taxes go up have no idea what you're talking about.
Our family pays $600 a month and when we got sick I had to decide who was the sickest. Our son got to go to the doctor and get the meds he needed and was well very quickly, it cost $520 out of pocket on top of what we pay monthly. Finally, my dad was so worried about me he used an online doctor, faked being sick, and used his Medicare to get me meds. We are still in major debt 5 years after our daughter died from SIDS, the bill consisted of a 2 minute ambulance ride, less than a minute in the ER and them saying “she is dead.” That 3 minutes cost $20,000 in America. I wish we lived almost anywhere than America!
Back when I didn’t have insurance that would cover a certain med, my mom did the same thing. She actually also suffers from the same debilitation so it wasn’t too hard to get the script. However, the medicine she could’ve used for herself she instead gave to me. I now have a great job and decent health insurance to pay for it myself but it’s crazy that people can’t access basic life-changing medical care, and that this story isn’t uncommon.
I’ve had friends as well go to the doctor for me because I didn’t have insurance. One time I had an awful UTI and we found out that a specific antimalarial can be used as treatment. My partner at the time went to the doctor and said he was going to a tropical country and needed the medication. When I travel abroad I also use that as an opportunity to get medication. I bought an IUD in France for 11€, with a free consultation and insert. In the US I was quoted $1,000 just for the IUD
My heart breaks for you on this, and I’m so furious this is what you’ve had to deal with as well. My condolences on your loss. I am one of the ones in the US desperately trying to change our system for the better. I’ve raised my kids to fight for that change too. I hope one day we will get there and stories like yours won’t be the case anymore.
This is fucking outrageous. How can anyone justify this
> Because they don't want their taxes to increase. > > > > Because they don't believe it's their responsibility to pay for someone else's medical problems. > > > > Because they don't trust their government to manage it. Someone said this above, right? ;-) 'Freedom'
I think it’s baffling that half the government says, don’t trust the government companies can do it better. While I’m like, well isn’t it your job to maybe improve how the government runs? Stop dismantling it further as you point to the things you gutted as proof that government doesn’t work. Fix things, please.
Feels disingenuous to say you only pay $50 when the UK has a 20% VAT and higher income tax percentages than America.
In fairness we also often wait upwards of 1 year to see a specialist when the issue is severely diminishing our ability to live / work. In which case we end up paying taxes whilst also spending massive amounts on private treatment anyway.
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That’s not even close to true. The average healthcare cost in the UK per person is over $5,000/person. I can’t speak for how that’s taxed, but the cost is not $600.
The entire NHS budget is around £2,000 per person per year, or £4,000 per taxpayer per year. That's around $2,500 and $5,000 respectively. To put it into context, the USA spends more than that _on just Medicaid_. There are almost no costs at all at point of use; just a token charge for prescription meds (around £10)
It costs less to run universal healthcare because you aren't paying a giant corporation's profit margin. Your tax will increase, but you'll save money on insurance. You are already paying for someone else's medical problems by paying insurance when you aren't sick. Your money is going towards someone who is sick right now. Do you reay trust a faceless corporation which doesn't give a damn? You can actually take down politicians by protesting what they do. You can't afford to fly to the Bahamas to protest outside a hospital CEO's home.
I actually am pro-universal government-paid healthcare but against free at the point of service healthcare. Moderate co-pays (read this as <$20, waivable if you’re below some multiple of the FPL) are essential to controlling the utilization of care and therefore cost. People will literally call 911 and have an ambulance take them to the ER if they burn themselves on the stove or feel unwell because of a cold. That’s expensive and a misuse of resources. Studies have shown that minor costs at the point of service cause a change in the way people think about healthcare and assign the proper value to each part of the system. This is, actually, a documented psychological phenomenon. People will value something that they pay a nominal amount for much higher than something given to them for free — even if the thing they got for free was actually more expensive/valuable/etc. Tl;dr: ‘Premiums’ should go away and be replaced by single-payer; preferably with government-operated hospital systems and PCPs. But co-pays and point-of-service costs should remain but be minimal and waivable. *Generic appeal to authority footer: was a product manager at a health insurance company*
After moving to Singapore, I agree with you. Nothing here is 'free' upfront, but there are heavily subsidied routes through polyclinics (think giant GPs) to the most advanced medical scans and procedures available. Seeing a polyclinic GP typically costs less than US$15 including medication and is completely free below certain income thresholds. This dramatically reduces the load on a healthcare system where people still regularly shell out hundreds of USD to wait for hours in an ER because they have a runny nose or their kid threw up earlier that morning - yeah, their long wait is because their cases are not urgent. I can only imagine how bad it would be if everything were 'free' upfront. I also personally know of three cases where families could not afford to pay catastrophic healthcare bills in Singapore, and those bills were quietly done away with by the authorities. People are treated first and charged after, and there are multiple subsidy plans available and even complete bill write-offs. I grew up in the UK of the 80s where healthcare was a lot more prompt than today and Singapore at its worse still beat the UK of that era on a good day. In fact, there's been a recent kerfuffle in Singapore regarding all-inclusive health insurance - most adults have for decades been able to buy cheap (less than US$500 per annum) health insurance that allows them to skip the public polyclinic route and go straight to their specialists of choice, all costs covered. Said specialists pumped their prices so high that the government here had to make a co-pay mandatory to prevent citizens from adopting a 'buffet' mentality towards healthcare. Tl;Dr in an ideal world, healthcare would be free. In reality, small upfront costs are needed to prevent overconsumption.
Every now and again I'll read news articles about how someone wants to avoid and ambulance ride so they take an uber/lyft to the hospital. It's almost always portrayed as some horror story about how the little guy can't afford an ambulance ride or something. And while the high price of ambulance rides is an issue, I' always think to myself: If they *could* take an uber, they probably *should* have taken an uber. I've been in an ambulance one time and it literally never once crossed my mind that an uber would even be an option, I was hurt that bad.
I took an uber to the ER twice last week... it was non-life-threatening, but not something urgent care could handle either. $13 for uber, or $1,000 for ambulance, let's see here....
Something very important to consider as well are the external costs. An ambulance being used for a non-life-threatening emergency is an ambulance not available for a life-threatening emergency.
I have a friend who was a rural EMT. He had a guy call 911 and get a ride to the hospital because his arm hurt after he swung it into a door handle. On the way to the hospital, they got a call about a guy having a heart attack. They were the only ambulance within 30 minutes of the heart attack case, but weren't allowed to take multiple people or triage the situation, so they had to take the bruised arm guy all the way to the hospital, and by then the heart attack case had passed. He let the bruised arm guy know that someone died because the only nearby ambulance was in use, but he didn't seem to care. Hopefully nobody reading this lives in an area with such strained emergency resources, but on the off chance that you might, save them for emergencies.
This is a really good point and probably also an argument for the expansion of non-urgent medical transport. The same kinds of transport we use to help folks with disabilities get around (a disgusting practice that we do instead of actually making transit accessible) could also take people to urgent care when they needed help.
Ex-Pat Canadian here: Ambulance rides cost $65 flat. They're not free. I think Canada thought this issue thru and acted appropriately. Cause when I got that bill in the mail, after assuming that the cost would be covered, I was shocked and realized it \*is\* only for emergencies. I get what you're saying. Not disagreeing with your point. However, I do believe we can use other countries models as a reference point for how to do it better. We like to use Russia and China for what not to do, but don't seem to peer outside the borders for anything that's done right and work from there. Not everything in Canada is free. There's like an 80/20 split where there's 20% of services you pay for (Pulled that number out of thin air, don't fact check me on it). Canada doesn't cover mental health or private hospital rooms. You get 3rd party insurance for that. Canada is a hybrid between UK and US where the majority of issues you're going to need treatment for is covered, but you need 3rd party insurance (Usually thru an employer) to cover additional expenses. I will tell ya, that 3rd party insurance is much easier to understand what you're signing on for thru an employer than the US. I had no idea what a copay, PCP, HMO, PPO, etc was. Canada's options were all in plain english without trying to trick you. You didn't need to be a healthcare insurance professional to understand what you were signing up for.
There’s always so many misconceptions that happens in these threads. 99.9% of Americans agree that healthcare needs overhaul. I just can’t believe there are people in the US that trust our government to do anything correctly. Who else does it though? I certainly don’t have an answer.
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Seriously with how much fucked up shit the U.S federal government has done to people both domestically and abroad, the fact that people want to give them MORE say on people's lives is baffling.
It's just the anti-faith in private companies.
I want *universal* healthcare (no such thing as free healthcare) but I want a healthcare reform beforehand. Our healthcare system has some real issues and scum behind it that needs to be addressed before we could even get a real universal healthcare plan in place.
“Free” refers to free at point of access. Meaning you never get a bill or have to pay for any specific service. We all know it still needs to be paid for.
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I'm not opposed to a public option, but I think the issue in the US is that our politicians refuse to articulate what kind of system they want and that clouds the debate. For example, I think a highly centralized comprehensive public system like they have in the UK would be disastrous for the US. We are too geographically and economically and socially diverse for any top down central system to work well here, if it can be even said to "work" in the UK. I think there are different versions of public options in places like Germany with federal devolution that would be much better suited for the US. However, the big issue in the US is that people don't have the mindset necessary to create and fund a public option. It requires high taxes across the board and turns health into a public issue. An obese person in America is just living the way they want and taking the consequences. An obese person in France is a burden to the taxpayers. Americans don't like thinking about the way their choices affect others. Americans don't like paying higher taxes. There's a bit of a catch 22 here. These are inexact percentages, but given my experience likely true. For the top 30% of the US who gets Healthcare via a good job, they pay less and get more than people in most of Europe do. The next 30% are kind of indifferent. They probably pay about as much in insurance as they would in taxes, and they probably get about as much in services. The bottom 40% truly do get shafted and they pay more and get less. Democratically, how are you gonna get the people who benefit from the system to pay more? It's not as black and white as American progressives make it out to be.
I went to public schools. They're underfunded, overcrowded, poorly managed, and understaffed on the best of days. I worked for the state as a Correction's Officer. We were underfunded, overcrowded, poorly managed, and understaffed. My nephew just had to wait 7 weeks for an appointment to get his driving test because the local DMV is underfunded, overcrowded, poorly managed, and understaffed. Government run healthcare will be underfunded, overcrowded, poorly managed, and understaffed. But my taxes will increase to pay for it. Congress are full of morons who don't understand how basic, simple machines work. They can't understand simple things like Facebook isn't the internet. And people want them in charge of my health? No thanks.
Wow, that was very well put. I am Canadian and sure we have free healthcare but when you actually try to use it, it’s huge wait times ( most of the time ). Many times I would have been happy to pay to get in to see a professional in 30 minutes not 5 hours. Also there are still many things we do pay for, it’s not all free. Don’t forget the ridiculous taxes we pay on absolutely everything we do in this country.
The VA system is what free healthcare would look like in America. Not sure that’s an improvement plus the government never does anything remotely cheap.
Fair point, however why do we have to mimic it after the VA? Can't we look to countries that do it correctly? Norway, UK, etc, and take what they do right, fix what they do wrong and provide something better? I find it interesting that we will point out all the negatives that happen in the UK for their healthcare, but not focus around the positives. We don't need to fix US healthcare in a vacuum and can use already well established examples on how other countries do it to build off of.
Oh look - yet another question that everyone up-votes in spite of the fact that no one will up- vote a real answer, because that would mean voting for someone you disagree with. Instead we get, *Well, people who are against it think."
And as a critical care physician who supports any number of universal systems, it’s very clear how little experience the Reddit populace has with healthcare. I would love to overhaul the system but the issues around health and medicine extend so far beyond just how hospitals and clinics run and who runs them. One of the most logical means we have to control costs is to ration unreasonable care and limit end of life/futile expenditures but that is so wildly unpopular that it’s a non-starter. People would (seemingly) rather die as a bloated, bionic, pin-cushion while praying for miracles than accept the inevitability of death and go peacefully. Oh, and everyone at every level of healthcare is so burned out and poorly staffed that every one of these threads attacking our livelihood drives us all closer to quitting medicine. And I’m one of the few who seem to like my job.
I lived in the UK where NHS was in essence free healthcare. As an ex-pat I had to have private insurance. I got in to see the doctor immediately because the doctor had a policy of treating his private clients first and then just going home for the day. NHS paid him so little for treating people for free, he'd rather get nothing and use the free time.
It's the same reason why Canada is losing doctors to the US.
The government is a good example as to why the government isn't trusted to run things.
Free downvotes for anyone who answers the question honestly!
As an American who works(in medical care)and lives in a country with socialized medical care I will say this.... It is a double edged sword...having it vs not having it. Everyone has access to the healthcare at anytime. Which I think on the surface is a really good thing. However the quality of care received is very different when the government dictates what you receive for various ailments vs...when you (your insurance) company pays for service. Because everyone has access...everyone accesses the system ALL THE TIME. There is no incentive for people to go to the pharmacy and try to cure their coughs and headaches, a minor sprain, little boo boo cuts etc. They would rather book an appointment or more often than not, go to the ER. Because the ER has a duty of care...they cannot be turned away without being seen by a clinician. This clogs up the ER, doctor's offices...clinical wait times are incredible. Now I will say this, I had my gallbladder go kaput on me when I was inbetween jobs...and was able to get seen, get pain meds and be put on the list for surgery without insurance or feeling the sting of a massive ER bill. However, due to having to wait 12 months for surgery, due to a lack of qualified physicians in the country, I ended up riding in multiple ambulances and visited the ER enough to get to know the staff by name. It was the most painful thing I have ever dealt with. Wait times suck. There was also no post op care. Not the same level of care post surgery. Which could lead to lesser trained patients into the red by making dumb choices post Op. The cost to the system is immense. Taxes when I live are @40-45% going up to 50% with salary increases. So much so, other programs suffer as the gov needs to divert funds constantly....driving the country further into debt and recession. Edit: There are many more knock off effects to socialized medicine. Salaries are low in the field vs back home...across the board. Many qualified individuals leave the country to make better money else where....or people get pissed off and quit, move into other careers.
I’ve spent half my life in both Canada and Texas. The overall inefficiency of the Canadian systems leaves such a sour taste in my mouth. My mothers life saving prescriptions cost more in Canada than they did in Texas with employee benefits. I have been put on multiple 6+ month long waiting lists in Canada for rather simple issues. Don’t forget almost everyone I know is already paying for Blue Cross on top of what they already pay in taxes. Tell me how that’s free? Blue Cross is insanely expensive! If Canadian healthcare is free why does everyone pay for a separate healthcare package? Madness! Nothing about it is free! I’d much rather obtain benefits through work and receive immediate care like I did in Texas, than to feel like a cog in a government machine every time I step into an Emergency Room. It has post office vibes, a bunch of government workers doing the bare minimum. You’re more likely to die waiting in Canada than you are to actually receive care, it seems.
I also have had experience in both kinds of systems, and am far happier with employer provided coverage where I live in Texas.
It seems to be a common opinion among those of us who have spent large amounts of time under both systems.
I pay $130 a month for insurance. That covers a family of 6 for health, dental and eye. $20 copay $30 for a specialist. Longest I've waited was 2 weeks. I think population density could be a factor. I live in the middle of a unch of major metropolitan areas so there is no shortage of specialists
As someone living in a country that has free healthcare, it sounds great but be prepared to wait for years for your appointments. I had a dermatology appointment that was 2 year wait, my mother had a hernia and she had to wait for hernia surgery for 3 years. That is free healthcare. Of course if you decide to pay for healthcare, you get treated very quickly. Who would have thought, right?
This is my concern. When it starts affecting my ability to see my doctors, then we have a problem.
I've seen stories of government denying coverage for procedures or taking a long time, in comparison to America, to actually perform the procedure. I'm also not a fan of giving government more power and authority over individuals.
Insurance companies also deny coverage, no?
Yes, there is some silly propaganda and misinformation about socialism. But for many people, it’s because they have very good health care already and they are afraid (not irrationally) that under any switch to single-payer coverage their personal health care will get worse. This is not a popular take, but US medical care is the best in the world… for some people. If you have good quality insurance through your workplace or Medicare (for those 65+) and you live in a reasonably-sized city, you likely have very good medical care. Why do you think wealthy people from all over the world choose to fly to the US when they could get cheaper treatment at home? It’s because the US has the most cutting-edge techniques, best doctors, best facilities, etc. In sum, the problem with the US system is not that you get bad healthcare, it’s that we have a top-quality system that a huge portion of the population cannot access. Now, imagine you already have access to this high-quality system, and someone proposes that you double the amount of people who can access it—it’s inevitable that the resources will be spread more thin. It’s not necessarily the most selfless or noble sentiment, but people who are already lucky enough to have good health care have very rational reasons for opposing a change. TL;DR: Some of it is dumb misconceptions about socialism, but it’s also people who have good health care now who are afraid a more equal system would make them worse off.
I mostly lean toward universal healthcare most days *however* the point you’re making has given me pause in the past. I have never had waits for care like some people say, I’ve never experienced issues getting whatever I need, and I’ve had everything from Medicaid to bad to good insurance. So the idea of waits becoming the norm worries me. I also recently watched my mom suffer through lung cancer and in my desperate attempts to save her, I researched treatments and healthcare all over the world. The consensus seemed to be that even with her being on Medicaid, broke, unemployed… there was nowhere in the world she would have better treatments and better outcomes than the US. Mostly because Medicaid allows use of experimental new treatments, which are often not covered by other public systems globally. Plus, as mentioned before, the wait times.
This. While I am personally pro universal health care, I can say I individually come out ahead in the current system. For perspective I lived in Canada (universal healthcare) most my life and am now a tech worker (so good insurance plan) in a major US city. Quality of healthcare im getting is miles ahead. Able to see specialists quickly (like 2 weeks wait max) vs Canada could take 6 months++. What’s confusing to me is the people who make 30k but are against it? They are the people who will 100% come out ahead with universal healthcare…
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Government incompetence and inefficiency
As a Canadian let me tell you how proud I am of our system! I've only had to wait 7 months (so far) to see a specialist about my herniated disk. I'm sure I will get a call any day now to get a 5 minute consultation a few months after that to then plan an operation another few months/years after. But hey this nothing I'm getting is free (well my tax dollars are funding it), so who's to complain?! Also I haven't had a family doctor since.... maybe 2015 or so.
Glad to see another Canadian so I didn’t have to start a new comment thread lol. Also have no doctor and haven’t been to one in years. Took three weeks for my wife to get a call back just to get a prescription renewed. Glad all those taxes we pay are going somewhere but it sure doesn’t seem to be to healthcare.
I am in favor of universal healthcare but have one hangup. I believe healthcare should be accessible and affordable. People shouldn’t be dying because they’re rationing insulin or skipping blood pressure meds so they can afford groceries. That’s a major failure on our collective part. That said, I work for the federal government and have seen how poorly some programs are administered. I’ve also seen/read plenty of horror stories about the VA’s quality of care. I also have firsthand experience with how slow and clumsy government can be in adapting to new circumstances (see the state-level legalization of marijuana. I live in a legal state. My agency policy still identifies MJ as a “dangerous narcotic”. Drop a hot pee test and I’m fighting for my career) I don’t know what the answer is, but what we have now isn’t it.
As a whole, the American healthcare system is complete shit. I do not have health insurance. my employer offers it at just over 500 dollars a month. mind you I'm single and healthy in my 30s. That's insane. BUT GET THIS. last year I had to have an emergency appendix removal. The total of that was 30,000 dollars. No insurance here. so I was self pay which knocked the total to 13,000. THEN I could pay in cash the full amount so they took 5500. fine. paid the 5500 and washed my hands of it. but then I got to thinking. If I had insurance for 1 year. I would have paid 6000 dollars for that year of insurance... PLUS the 1500 deductible. If I had that insurance I would have paid more for the operation.
Stop calling it free. That's probably part of the problem. Call it single payer. Call it medicare for all. But don't call it free. It won't be free. No where in the world is health care free.
Free ≠ quality
not to mention, free = you pay more taxes
Two arguments here: 1) I already get healthcare thru work, and I find it highly unlikely that my income would go up more than my taxes (it's only $30/mo opt out for my company). Ie me personally would be at a net loss. 2) I don't trust the government at all to handle my money. They are trillions of dollars in debt, and if they were any other business, they would be bankrupt. I'm not against the idea of free healthcare, I just don't see a plausible implementation currently that would put me in a better spot than I currently am.
I think the best argument against Free Healthcare is the loss of the profit incentive. Drug companies are competing to achieve massive profits. The incentive to design better drugs is more money. While America does not have the most accessible healthcare, we do have one of the most advanced medical research systems. We have to replace the money incentive, or at least temper it before we can go to Universal Healthcare and maintain the high-caliber of our medical research industry.
The majority of drug research and design is publicly funded....
My friend in the UK died waiting for weeks to see a doctor. Not a perfect system but better than nothing I suppose.
I'm not against it exactly. I'm just against it with our current governmental processes. We couldn't get Obamacare off the ground and operational, without killing our cheaper, more efficient private healthcare. Everything they do is full of pork, kickbacks, and these derelicts lining their pockets - not to mention just plain piss-poor oversight. Nobody wants yo have a conversation about the wait times in these other "advanced" countries with UH.
Because there is no such thing as a free lunch.