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by enraged_camel 2629 days ago
>>Socialized insurance rates in Germany are 15% of income. Unless your family doesn't earn any money, they have been paying far more than 50 Euros.

Comments like this always miss the larger point, which is that healthcare overall is cheaper in socialized systems because the government as a large entity negotiates on behalf of citizens and puts strong downward pressure on prices.

3 comments

Meanwhile, US governments pay more per capita for healthcare than other "socialized medicine countries", but with terrible clinical outcomes.

https://en.wikipedia.org/wiki/List_of_countries_by_total_hea...

I wouldn’t say that the govts of socialized systems negotiate rates down, it’s more of “this is what you will get paid”.

Salaries for doctors are the highest in the US. If we want to move to a single payer system they will have to take significant pay cuts.

Guess what, private insurance companies will also negotiate prices.

What happens in socialized systems is that the government does price fixing, which makes healthcare worse and it limits supply. Try getting a specialist appointment with socialized healthcare in Germany, it can take several months. Get private insurance (or pay out of pocket) and suddenly appointments become available. Doctors are leaving the country in droves.

Some of the hospitals in Germany are in an abysmal state, MRSA rates are extremely high:

https://correctiv.org/en/latest-stories/super-bugs/2017/01/1...

>>Guess what, private insurance companies will also negotiate prices.

They negotiate prices based on the size of the pool. This is why if you are a small business the rates you will get will be worse than if you were a large enterprise.

With socialized healthcare, the pool is the entire citizenry, which is what gives the government substantial leverage when negotiating.

The German government doesn't negotiate anything. They set prices, period. Set them too low and you create shortages. Guess what the German healthcare system has, it's a shortage of doctors, especially specialists. German doctors are leaving for greener pastures, like Switzerland. They are replaced by doctors from Eastern Europe. Quality suffers. Waiting times are high. Most Germans are too uninformed or arrogant to admit it (especially to Americans) but the system sucks.

That's not to say the American system is good, but I can't stand all this talk about how socialized healthcare is so great. It isn't. A lot of what people are calling "socialized" systems are actually private systems with a compulsion to purchase insurance, for example Switzerland, Netherlands, Australia. Even Germany technically has a dual system (public and private) but only the top earners are allowed to go private.

> The German government doesn't negotiate anything. They set prices, period

Incorrect. In the public system, the fees are negotiated between the GKV Spitzenverband (federal association of public health insurers) and the KBV (federal association of public doctors).

Germany still is in the top group regarding quality of care indicators.

Australia doesn't have any compulsion to purchase insurance. It's perfectly normal to skip it and receive treatment on Medicare. However, if you don't have private insurance, and have a relatively high income, you pay a tax surcharge.
You have a point. There are a lot of people comparing the worst parts of the US system with the best parts of the single payer systems.

As a Canadian, I will say there are a lot of people dissatisfied with the Canadian system. Likely to a lesser degree than in the US, but the system is far from perfect.

Health care can never be perfect unless you (personally or government) are willing to pay an indefinite amount of money towards it. The positive with an imperfect socialized system is that it's under democratic control. In other words society decides what to prioritize.