[larksimian]

I'd add that old people still vote, so the state or more exactly some political parties will still have a massive incentive to keep people alive as long as possible.

Regardless of age, healthcare scandals are a huge political risk so governments will always overspend to avoid them.

The comment you're responding to is like a singularity of wrong.

[Gravityloss]

I was first thinking "private healthcare can fix this gap". But in Canada there's no private healthcare alternative. Here in Finland we have all the alternatives: public healthcare (municipal and government level), employment health care benefit, health insurance and then even private pay cash immediately healthcare. It's got some side effects.

In a bizarre twist, the city of Espoo, which has about the highest GDP per capita in the country, is struggling with their municipal public healthcare absolutely overwhelmed and in crisis. People come to the emergency room for ailments that could have been remedied way earlier in non-urgent regular booked office hours medical center visits. But the budget for those has not been there, you couldn't get an appointment.

Why is this happening? Certainly they would have the money - it looks like they aren't acting rationally. One theory is that since most of the voters in Espoo have good jobs with a great health care benefit, they don't vote for politicians that would put money to public healthcare.

The Canadian system of there being only the public healthcare system would actually "fix" that.

[larksimian]

I think private options just cannibalize and parasitize public health services. I see it where I live in the UK and where I'm from in Romania.

In Romania it's just outright graft: public hospital doctors direct patients for cheap procedures to their private clinics and toss anything expensive back into the public system. The government pays for all treatments anyway, but public hospital budgets end up being harmed since 'profitable' treatments are being siphoned to the public sector(and doctors outright steal stuff from the public hospital).

In the UK it's a similar selection bias in what's treated privately leading to adverse selection effects for the public sector. Combined with consultant-cancer draining tons of money in order to figure out how to save money(hint: the money-saving solution is never firing the consultants). Society is getting older faster and the government is trying to cut costs on one of the cheapest healthcare systems in the OECD. Basically sabotage from the top down.

Similar effect happens with charter schools in the US, almost impossible to prevent adverse selection effects leading to increased problem-student concentration in the public schools.