[echelon]

I hate to chime in with an ask, but does someone have a good read on healthcare in developed nations and mind commenting?

I always hear and read complaints that the US doesn't have a single player public option for health insurance, and that it makes our country one of the worst.

Other nations with "good health care" seem to pay their workers less, have higher taxes, have long wait times at the ER, weak militaries, etc. Something always seems to give.

How would you rank and quantify the various medical systems of the world? Where does the US fall? Why, and how could we make it better?

I'd like to be better informed about healthcare as a matter of policy and how it fits into the bigger scope of government spending.

[sofixa]

> Other nations with "good health care" seem to pay their workers less, have higher taxes, have long wait times at the ER, weak militaries, etc. Something always seems to give.

What is a "weak" military for you, and what does it have to do with healthcare? The UK has aircraft carriers and nuclear submarines (including 24/7 nuclear intercontinental ballistic missile patrols). Only an ignorant American (and maybe Russian) would consider that to be "weak", because they're so used to the militarised culture and massive spends that everything below blowing half the budget on tanks is "weak".

As has been said many times, the US spends more public money on healthcare, per capita and as % of GDP than everyone else, and had some of the worst outcomes (infant mortality, birth mortality, life expectancy, etc.) of all the developed world.

It's not a matter of how much, but how. The US system has middlemen to manage the middlemen and mind boggling prices and practices. Other systems are underfunded or with corruption here and there.

Would you prefer to wait 2 months to see a non-urgent specialist doctor for "free" or have it in a few days, but billed $60k hoping your insurance covers it? I know that most people prefer not being bankrupt over speedy non-urgent treatment. And US nurses are still paid shit for terrible working conditions, so it's not like it's them getting the extra money, it's mostly at middlemen and to a lesser extent doctors.

The solution to the problems exhibited in systems such as the NHS are more funding and focus (e.g. helping more students get to doctor/nurse positions to ease the burden).

[zoid_]

As someone working in the industry, I can say that unfortunately NHS funds are very poorly managed with lots of corruption within management. My believe is that a lot of the staff are passionate and hard-working, however at least an equal number of staff are worn-down, disillusioned and dispassionate due to years of managerial neglect and high public expectation.

There is also a believe that the NHS is a single national entity, which is not the case. Both Wales and Scottish have a national trust whereas England has 100's, totally 217 trusts as of April 2020 [1]. This does not allow for combined purchasing power, shared resources and causes duplicate effort in almost every area.

How about dentistry? Seems odd that for the most part that's not covered under the NHS. It wasn't until adulthood I understood all the jokes about British peoples teeth!

My hope is that we can move to another model that is directly free to the end user, reduce the eye watering waiting times and put the almost £200B annual funding to good use.

1. https://en.wikipedia.org/wiki/NHS_trust

[foldr]

Although dental coverage on the NHS sucks, British people actually have quite good overall oral health outcomes. If you google, you can find that some studies place British overall oral health ahead of the US.

For anyone who's spent a significant amount of time in the US this shouldn't be too much of a surprise. Middle and upper class Americans have access to excellent dental care, but if you spend some time in the poorer parts of town, you'll see plenty of people with missing teeth and other severe dental problems. NHS dentistry is poor, but it's better than nothing (which is what a lot of poor Americans effectively get).

There's also the aesthetic aspect of it. Europeans in generally tend to be culturally less interested in tooth straightening and whitening.

[kalleboo]

The biggest problem with state-managed health care is when you get ideologues in control who's ideology is "state-managed things can never work well", because it becomes a self-fulfilling prophecy. A lot of European countries have spent the past decade or two attempting to privative their health care to varying degrees, since the ideology says that will make it cheaper, but instead it has just gotten worse.

> does someone have a good read

The question is complicated enough that any writings on it will inherently have a bias since there are so many details that are easy to ignore in your favor

[411111111111111]

I think a lot of people aren't aware how greed as reduced the previously decently run healthcare systems in a lot of places.

Germany for example had pretty decent healthcare 10 yrs ago, then a few regulations were passed and it's been doing downhill at a staggering pace.

Nowadays hospitals prefer amputations over simple treatments in diabetes cases as a pretty well known example, as it's me profitable.

[nopinkglasses]

And let's not even start about their 2-speed healthcare system, where the privately insured can get immediate specialist appointments while the pleb can join the back of the queue on the 6 month waiting list. Oh, the privately insured also get access to the hospital department head, and private rooms with a second bed in case relatives need to sleep over.

[mcv]

This is the big problem with healthcare in capitalism. If everything is about profit, then healthcare also becomes about profit, and hospitals will decide on treatment based on what's profitable to them, instead of what's better for the patient and for society.

There's always going to be some trade-off of course, because resources are never infinite. But preventative healthcare is a lot cheaper and better for quality of life than waiting until limbs need to be lopped off.

[rich_sasha]

In general, UK system is hands down great i think. Other countries may have even better ones perhaps, but none of the horrors of US.

But in recent years, it's been struggling, certainly it wasn't high on the conservative govt funding list, and COVID caused extra burnout. Winters we're always tough, and this one is thought to be especially so.

It is unclear to me if it is a lack of money or poor spending.

[DanBC]

> Other nations with "good health care" seem to [...] have long wait times at the ER,

How are you measuring wait times? How are you defining Emergency Departments?

In England there's a 4 hour target for people to be seen, treated and then discharged (or for a decision to admit to be made). Currently the English NHS is meeting that target for 75% of all attendances. This has declined from a 95% rate a few years ago, and it's seen as a massive problem.

https://www.england.nhs.uk/statistics/statistical-work-areas...

[CogitoCogito]

> Other nations with "good health care" seem to pay their workers less, have higher taxes, have long wait times at the ER, weak militaries, etc.

Are these conclusions based upon some sort of systematic analysis of yours?

[foldr]

>have higher taxes

It bears repeating for the zillionth time that the US spends more public money on healthcare as a proportion of GDP than the UK.

[mcv]

They even spend about as much specifically on socialised medicine as the UK. They just don't receive the benefits of it.