[conanbatt]

I am from a partially socialist country that has free healthcare. I have had private healthcare, along with most of my socio-economic class, my entire life.

Making it socialized does not mean it will be better. Coldly, see it as a different system with different consequences. Bringing it to the US: look at how much medicare costs today: 3.6% of gdp, servicing 56 million americans. If you extended medicare to the entire population at the same per capita, it would be 26% of GDP.

[trowawee]

Actually, the first world nations that have socialized healthcare systems experience better outcomes than the United States with less per capita spending.[1] Medicare as it is currently formulated is specifically targeted towards at-risk populations that have higher incidences of medical usage than the general population; you can't just apply the exact same per capita spending across the American population. 80 year-olds use more health care than 25 year-olds.

[1]: http://www.commonwealthfund.org/publications/issue-briefs/20...

[conanbatt]

> Actually, the first world nations that have socialized healthcare systems experience better outcomes than the United States with less per capita spending

It is beyond question that the healthcare market in the US is terrible, because its expensive and ineffective. That is out of discussion for any reasonable debate.

What is also out of debate are many reasons why is it so expensive today: restrictive immigration of doctors, importation restrictions on drugs, self imposed gov restrictions on bargaining, hospital building regulations, malpractice legal costs.

Government taking full control of the system fixes NONE of the problems listed above, which are by and large some of the biggest price drivers. It might make them worse, because all of the ones above are exclusively decisions of the government.

> you can't just apply the exact same per capita spending...

I agree, tho at the same time you cant expect the government to be more efficient as it increases its scope of scare. Economies of scale dont work for the government. 10x service might cost 50x. It should be clear however that its a reasonable order of magnitude: more than barely double digits. A 20% gdp cost on healthcare will come with cuts in service, I guarantee that.

[trowawee]

The link I posted does suggest that economies of scale do, in fact, work for other governments, and that despite covering 100% of their population, they see significantly better efficiencies than our system does. If you're going to claim that economies of scale don't apply here, you're going to have to provide some evidence that contradicts the lower per capita spending/better outcomes we see in other systems.

[conanbatt]

Medicare has more patients than the population of england, or spain, or many of the european first world countries.

It is already visible that medicare is not efficient.

[trowawee]

You still haven't actually laid out a metric showing that Medicare is inefficient; you just keep asserting it is not efficient in the face of evidence that single-payer systems are in fact pretty efficient. To add more evidence to the "you are incorrect and single-payer systems are in fact pretty efficient" pile, here's another potential efficiency metric we could compare: Medicare spends significantly less (approximate 1.4%) on overhead costs, compared to private insurers that average around 12.4%.[1]

So, again: the US as a whole, using a primarily market-based healthcare system, spends more money per capita for worse results than most other developed nations, most of which are using single-payer systems. Within the American healthcare system, there is a limited single-payer system that only covers a particularly high-risk patient population, and yet despite that patient population, runs more efficiently as an organization than the market alternatives. What evidence are you offering to make the argument that that limited single-payer system is actually more inefficient than the private alternatives?

[1]: http://www.politifact.com/truth-o-meter/statements/2017/sep/...

[conanbatt]

> You still haven't actually laid out a metric showing that Medicare is inefficient; you just keep asserting it is not efficient in the face of evidence that single-payer systems are in fact pretty efficient

Medicare is an example of a government run healthcare service in the US. Its way more relevant to compare to Medicare than to compare with foreign countries health results. Its also revelant because single payer proposals in the US are basically expanding Medicare. So even if every single single-payer system in the world were efficient, if Medicare isnt, it wouldn't matter.

> Medicare spends significantly less (approximate 1.4%) on overhead costs, compared to private insurers that average around 12.4%.[1]

Sure, thats because it doesn't do price-fighting like private providers have to with insurance companies. It has the basic incentive to cede at every corner as an institution. But lets look at other reasons why healthcare is spending and how medicare solves them. How about pharma costs, doctor salary costs and legal costs. Is medicare cheaper on these other predominant reasons why healthcare is expensive?

You will find that Bernie sanders understands well that pharma is expensive because government restricts its importation. So if as an organization the government is strained to even bring drugs from abroad, a problem it has unique power and responsibility to solve today and no-one else can do except for 'retail smuggling', and we are supposed to put our entire faith into the same hands that cant solve that?

If you just eliminated restriction of drug importation, you would drop healthcare costs enormously in 24 hours. The only thing you have to do as a government, is to stop doing a thing. How simpler can it be.

The core idea here is that the debate of public vs private is a red herring. Healthcare is not expensive in the us because of private vs public. Its expensive for its own particular policies, which economists have consensus on and are hard to take on due to lobbying, or lack of public interest, or mere gubernamental complexity. The topic is presented as two black bentos, where you can only see the results in the faces of people eating them. But they really aren't. You can see what each has and why.

[ferongr]

I live in a "first world nation" and 10 years ago (before the global financial crisis even) public vs private healthcare meant the difference between leg amputation and implantation. The public system is only good for routine diagnosis and minor surgery. For everything else, care quality goes down the toilet. Not to mention on the effectively complete lack of dental care.

[trowawee]

I'm not sure where you live and you're not providing any links or statistics to back this claim up, so it's difficult for me to respond to what you're trying to claim here. If you read the link I provided, you would see that they use cancer, heart disease, and diabetes mortality as a shorthand for patient outcomes in significant health events, and that while the US healthcare system ranks reasonably well in cancer treatment, it is significantly behind other developed nations in treating heart disease and diabetes. They also provide statistics regarding mortality rates in various populations, and the US lags other developed nations in basically all of those populations.

Your point about dentistry is interesting, although also mostly unsupported, and I'm having a difficult time finding good statistics about dental care, spending, and outcomes. Anecdotally, dental care in the United States is sharply linked to money; people with money have good/great teeth and excellent dental care, people without it frequently have major issues with their teeth. I don't know how that compares to other countries.

[maxxxxx]

What country is this?