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by systemvoltage 1457 days ago
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.

5 comments

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

> 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.

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.

> * 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.

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

> 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.

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

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.