[dlo]

> How do you convince someone like this that universal healthcare is better for all of us?

Here is one approach.

1) Enumerate the different options.

2) For each option, enumerate the upsides versus the downsides, which includes cost of implementation and operations, along with their likelihoods. Every option has potential downsides -- are we willing to accept them for the potential upsides?

3) Rank the options by expected utility. Which one comes out on top?

Ironically, you may find that universal healthcare is not the top-ranking option or that we have not yet come up with a high-expected-utility option.

[arcticbull]

The WHO and OECD did exactly that and disagree.

[1] https://en.wikipedia.org/wiki/World_Health_Organization_rank...

[2] https://www.oecd.org/unitedstates/Health-at-a-Glance-2017-Ke...

[conanbatt]

That's not utility, but health outcomes.

What I truly don't get about M4A advocates or believers is why they don't tolerate a public option. Just let the state compete in the open market, and if you like state run , you have your and thats it.

[arcticbull]

Totally fine with it, it’s the MO for many European states, including France. Australia too. The issue for me isn’t puritanical, I don’t need single payer, what I want is everyone’s basic needs met.

That said if health outcomes aren’t the utility of a medical system what on Earth is?

[conanbatt]

> That said if health outcomes aren’t the utility of a medical system what on earth is?

i.e. You can improve health outcomes and decrease utility by banning tobacco.

[arcticbull]

Right, I don’t disagree. I’m still not sure how the utility of the health system isn’t health outcomes. You can make a case that they are interlinked, smoking and health, but that doesn’t really answer my question. If anything, to me, you're making the case that (abuse of) substances such as alcohol, cigarettes and all 'illicit' narcotics should be under the full control of the health system and not the criminal justice system. Similar to how Portugal handles it.

FWIW the big issue is that private companies don't want to compete with the state because the goal of the state is to provide quality care, not to maximize profit. None of the private insurers are lobbying for two-tier universal healthcare so they can show off their sheer superiority are they? You'd think if they were actually superior they'd love, or at least be neutral to, the introduction of an inferior competitor.

If you're so sure private cover is better why push back against the introduction of a public option at all? Welcome all comers with open arms.

[conanbatt]

Insurance companies should abhor any kind of state competition, regardless of the case for it, its in their interest. But being an interested party does not make you evil.

Government also has an interest, in fact a huge interest. If healthcare were socialized entirely, dollar-per-dollar it would increase the federal government's size by ~ 10% of GDP. Currently its 21%! It would mean 50% bigger government!!

And that means HUGE cash, and HUGE political boons. Sanders could become president by promising people a healthcare service he does not pay for or he is not responsible for its failure. And the government now will have some omnipotent ways to levvy taxes and then short-change constitutents by cutting health spending or quality.

The government is also an interested party, and it's stands to gain more power than ever with such a ploy.

I also urge not to believe that the state "does thing for the people" because it either fails to do so or it just is plain false. Please look at the real results of public education: it has terrible results even though "its in the interest of the state to provide quality education".

[throwaway34241]

Most of the high ranking health care systems would probably be considered "universal healthcare", in that everyone has access to care. Many of them are not single payer though (in the sibling comment's WHO ranking link, France, a multi-payer system, was ranked #1 for "overall system performance").

But I agree generally with this approach. Nearly every developed country has dramatically lower costs for the level of health outcomes, but they do it in a variety of different ways. There are clearly possible affordability improvements (even if we only try to catch-up to where other countries are at). But certain approaches may be more feasible to implement or may have less downside if things don't go perfectly.