[suture]

Assuming by free you mean universal coverage that is (almost) free at the point of usage then this is a solved problem. What the United States lacks in order to realize a solution is political willpower and an electorate that is savvy enough to know that wanting such a system does not make one a communist. (And that being a communist does not make one an evil person.)

[thr0wawayf00]

...also the fact that the electorate generally can't out-compete the big money interests that lobby heavily to keep healthcare a private venture.

It's so easy to blame voters but the reality is that politics is about messaging, and how is the electorate supposed be savvy enough when these companies can spend unlimited amounts of money to keep us fighting each other about this stuff? Make no mistake, Google benefits from this depravity too.

[scarface74]

It’s not the lobbyist. There is still a lot of people who don’t want universal healthcare because it might benefit “those lazy people who don’t want to work” and older people on Medicare who “want to keep the government out of healthcare”.

[suture]

I don’t disagree in general with what you wrote. On the bogeyman of “socialism” I do blame the electorate. The irrational fear of anything remotely related to “socialism” in America has been going on far too long.

[thr0wawayf00]

And that fear is stoked from the top down. You hear it all the time from the leadership of a certain political party. It's not just something that people fear naturally, it's driven home explicitly by the political messaging of those that benefit the most from our current system.

[suture]

Yes, I know this. However, in this age of easy information and knowledge about other societies readily available it becomes more a matter of willful ignorance than being duped by propaganda.

[klyrs]

You aren't familiar with the propaganda if you think folks duped by it would consider "other societies" with anything other than fear hatred and contempt. The problem with "do your own research" is confirmation bias.

[denkmoon]

What is the alternative? Counter-propaganda, my propaganda is better than your propaganda because mine is "right"?

I don't have a good answer to this question, I'm wondering if others do.

[suture]

Well, as I said, in my opinion people can be blamed given the readily available information and in regard to the multi-decade irrational fear of socialism. Willful ignorance is a thing.

[refurb]

Canada has "free" universal healthcare, but to call it a "solved problem" seems pretty naive.

[suture]

The naivety is in thinking that if it doesn’t work in Canada then it must not be a solved problem. The naivety is in thinking that if you can find anecdotal evidence that in a particular instance Canada’s system worked worse than the U.S. system then it must be the case that Canada’s system is worse.

The U.S. per capita spends far more on healthcare than any other OECD country. We don’t get correspondingly better outcomes or coverage. Universal healthcare is a solved problem within the context that every system necessarily involves some sort of rationing since there aren’t enough medical resources in any country to do otherwise.

If you don’t want to use the phrase “solved system” then don’t but don’t pretend the U.S. is any way better other than in anecdotal instances. Below is a source for information on per capita spending for OECD nations. You can easily find information on health our outcomes, life expectancy, teen pregnancies, infant mortality, etc.

https://www.oecd-ilibrary.org/sites/876d99c3-en/index.html?i...

[refurb]

Sir, this is a Wendy’s.

I’m not sure how your reply has anything to do with what I said.

“Better than the US” is not some hurdle that makes a problem “solved”.

Canada is likely better at snow removal but that doesn’t make it a “solved problem”.

[suture]

It’s a solved problem as far as one can get given the constraints involved. As I said, if you don’t want to use that phrase then don’t. I’m not going to quibble over semantics. Human societies are far more complex than programming and the notion of “solved” means something different in the former than in the latter. Use whatever phrase you want. Just don’t think the U.S. system is in any way better. You are the one who brought up an anecdotal experience in favor of the U.S. system over Canada’s system.

[refurb]

You keep talking about the US, but as a former resident of Canada I know that’s the country’s favorite measuring stick. “We’re not as bad as the US so stop complaining” is the favorite ring of politicians.

Doesn’t do much for the people disabled from pain on a 3 year wait list for a hip transplant or my buddy’s cousin’s kid who doesn’t get access to the standard of care of CF.

It’s not solved in the least, every country struggles, so using the word “solved” is, as I said, naive.

[suture]

Perhaps you don’t understand how words work. Words can have different meanings/connotations depending on situation and context. As I said repeatedly, for me it is correct to say “solved” given the constraints involved. Human societies are complex and one can nitpick the world “solved” and say nothing is solved when it come policies of complex societies. So don’t use that word when it comes to societal issues. I and many others do use that word for certain issues. It’s naive of you to have your pedantic nitpicking on the word and not reflect on what it says about you. Obviously I keep bringing up the U.S. because that’s the context of my starting comment way above. And you yourself have brought up the U.S.

What goal do you wish to accomplish your pedantic nitpicking? You want to get others to believe that my views on national health policies are naive? You want me to realize that in a strict, mathematical sense of the word saying “solved” is incorrect? These are rhetorical questions because I’m not going to read your response. You clearly don’t know much about policy issues and what it means for a society have essentially “solved” an issue (or have found a decent enough solution that it isn’t a dire problem anymore so that some non pedantic people will say it is solved).

Carry forth Don Quixote on your quest to eradicate incorrect usage of what you think “solved” means.

[bruce511]

It's a solved problem in the sense that it exists, and works[1] and it is available in a lot more places than Canada.

[1] "works" is an interesting point because it isn't clearly defined, and usually means different things to different people.

Ever experience of the system is "unique" - there is this mix of human patient with human provider with finite resources with medical knowledge with time. So there are plenty of examples of long waits, bad service, unfavorable outcomes, even death. It's not hard to cherry pick bad experiences here.

No health system will make everyone live forever. Death comes to us all sooner or late. But universal healthcare works in many places in raising the overall standard of public health, without bankrupting people in the process.

Given that its always spending limited money, and only scales at human rates, its far from perfect. But, at least for some, its better than a "health care level based on your wealth" system.

[refurb]

But the US isn't "healthcare based on your wealth".

You have Medicaid for the poor, heavily subsidized Obamacare for the people who don't get it through their employer (hello $100/month plan!) and Medicare for the retired.

I mean my cousin in the US whose kid has cystic fibrosis get better care through Medicaid than our other cousin in Canada who can't even get access to the latest drugs.

[Sohcahtoa82]

> heavily subsidized Obamacare for the people who don't get it through their employer (hello $100/month plan!)

That $100/month plan will include high deductibles and copays. A weekend visit to an urgent care for a kidney stone will still cost a couple hundred dollars out of pocket.

[wyre]

I don't think anyone that says this has actually been poor and needed medical care.

[lotsofpulp]

You just have to stay very poor. If you do anything to move up a little bit in life, the benefits stop and you are on your own.

https://www.verywellhealth.com/your-assets-magi-and-medicaid...

[Am4TIfIsER0ppos]

Being a communist absolutely makes you an evil person. About 5 times more evil than the group of people they fought against in a war.

As for socialized medicine it makes doctors another arm of the government. In the UK last week (or the week before) one arm of the government ordered another arm of the government to kill a 9 year old. We are also just outside a 2 year stretch of tyranny of governments all over the world giving that arm of government near unilateral power over our freedom at the point of a gun.

[suture]

I hope you can break from the the intellectual shackles that bind you. I hope you can visit other countries and read from sources of information outside your comfort zone. Subscribing to a belief about which system of economics you prefer does not make one evil.

[Sohcahtoa82]

> Being a communist absolutely makes you an evil person.

Tell me you don't know what communism is without telling me you don't know what communism is.

Yes, every known communist country has been rife with fascism, authoritarianism, and corruption. But those are orthogonal with communism as an economic model. It's like saying socialism is evil because the Nazis were socialist (they really weren't) just because "Socialist" is part of "Nationalist Socialist Party" .

> In the UK last week (or the week before) one arm of the government ordered another arm of the government to kill a 9 year old.

[citation needed], because this sounds like an extremely gross misinterpretation of a situation, likely done deliberately in bad faith.

[1986]

The Viet Cong were 5 times more evil than the USA?

[systemvoltage]

I'm not convinced, even with the best of intentions. In fact, I am convinced of the opposite: A) Universal Health program would result in terrible quality health care B) It would lead to longer wait times, and less choices C) It would be insanely costly to fund. We've been busy printing a lot of $. Increased the Federal deficit from $21T to $30 since COVID and there isn't a good way to fund a bloated system in USA, comparisons with smaller nations is ridiculous and misleading.

We already have free health for the poor: https://en.wikipedia.org/wiki/Medicaid

> Medicaid is the largest source of funding for medical and health-related services for people with low income in the United States, providing free health insurance to 74 million low-income and disabled people (23% of Americans) as of 2017, as well as paying for half of all U.S. births in 2019.

What we should be doing is to fight the regulatory and bigpharma capture of US health system along with the horrible hospital + insurance racket. Google is now going to take advantage of the moat built by Big Gov and never ever allow anyone to compete.

[jholman]

Regarding (A) and (C), this is the obligatory reminder that:

* The US spends more public money on health care, per capita, than other wealthy nations, while also spending much much more private money than other wealthy nations

* By many measures, the US gets worse outcomes (e.g. life expectancy)

The conclusion that many draw from this is that perhaps a single-payer health care system in the US could dramatically lower private spending, also lower public spending, and perhaps improve outcomes. I don't personally know if that follows, but it's not implausible.

This is counter-intuitive to many, thus comments like your (A) through (C) are common, but might not be correct.

That said, I'm not aware of evidence that your (B) is wrong. That might be part of the trade-off.

As a non-American from America's hat, who has had a few (bigco-insurance-funded) run-ins with US Healthcare, my observations were that

* emergency health care at the no-expenses-spared level in the US was nicer than emergency healthcare up here, and I wouldn't want to pit my doctors vs those US doctors in a quality competition

* US doctors seemed really eager to waste money, like really eager, like it was creepy

[the_d3f4ult]

> US doctors seemed really eager to waste money, like really eager, like it was creepy

Your last point is purely a function of the liability culture in the states. US physicians are quite aware of what's appropriate and what's inappropriate testing wise. However, as long as a physician can be held personally liable for any oversight - meaning that the results of an entire career can be lost - they're going to over-test.

[jholman]

Purely a function of liability culture? That seems like an extraordinary claim, your claim that there are no other causes. Do you have extraordinary evidence?

I'll note that I do have a few different bits of modest evidence to the contrary. But I wanted to focus my comment on concrete observations (both the large-scale statistical kind, and the personal anecdotal kind), rather than on speculation.

[Sohcahtoa82]

> * US doctors seemed really eager to waste money, like really eager, like it was creepy

I'd much rather a doctor "waste money" on a test than come up with an incorrect diagnoses based on symptoms only.

[heavyset_go]

Wait times are just as bad in the US, and often worse, than other first world nations.

[bluedino]

Maybe because the 2/3rds of the population is overweight or obese. It's like the education system in the US, you can spend all the money you want but if the participants aren't actively trying to improve...

[heavyset_go]

> We already have free health for the poor: https://en.wikipedia.org/wiki/Medicaid

There are tens of millions of people who have no access to Medicaid because states chose not to expand it under the ACA, and there are plenty of poor people who make more than ~$16k a year, which is the cut-off for Medicaid.

[Apocryphon]

> C) It would be insanely costly to fund.

How could it be even more expensive than our current inefficient, half-baked, worst of both worlds system, which is more expensive than socialized systems in other nations? And more expensive per capita, not simply overall.

[heavyset_go]

More expensive per capita and still excludes millions of people who need healthcare but can't afford it.

[dragonwriter]

> We already have free health for the poor:

No, we have free health insurance for some of the poor (states that have no accepted the ACA expansion have basically no coverage for adults without dependents.)

Medicaid is not (as a generality) free health care (it can be, in some states, for some recipients). It is free health insurance, which can have copayments, coinsurance, deductibles, etc.

[moomoo11]

I’m a bit confused on the choice part. Can you explain?

I think if someone can afford better, private care they should be able to. For example I would probably go to the universal healthcare family doctor but if I need a specific surgery I would like to be able to go to the best care I can get.