[codemiscreant]

As expected, the preponderance of comments claim US exceptionalism: why somehow it’s a unique snowflake and it just wouldn’t work there. Another comment with the classic “we pay for drug research“ fallback (ignoring that accounts for a vanishingly small percentage of the expenses).

The US population is so indoctrinated with baseless propaganda that it will take a century for it to move to a better model.

[curt15]

I've lived in Canada with its vaunted universal healthcare system. While it sounds great on paper, in practice it means you'll wait forever for appointments.

[hotpotamus]

Long wait times are a potential problem of public healthcare systems. The thing about private though is that if you don’t have any money (perhaps because you are too sick to work), then there isn’t even a wait time - you just don’t get treatment.

[analognoise]

How long does it take to get you appointments here? I have waited months for simple items. I'm already waiting as long as my Canadian friends for simple things, but paying way more.

[seanmcdirmid]

It takes around 6 months to get an appointment here in the USA also. And…it’s not even universal care.

[deburo]

Our better model (in Canada, Quebec) is increasingly disliked by our population. The private sector is getting more popular, enough so that our government is thinking about banning it.

[antisthenes]

Many European countries found a compromise where both public and private health cares coexist.

The overall point though is not to sit on the laurels and try to hammer in "one right way" of doing it, but to iterate until you find a legislative healthcare framework that works for your country and benefits most.

The lack of progress in US on health care front is an indictment of its political rigidity first and foremost.

[foldr]

Universal healthcare isn't guaranteed to work well. The point is that it at least can work well and you can see examples of countries where it is working well. I suspect that people would feel very differently about private healthcare if it was their only option rather than an additional option for those with the money to spare. For example, in the UK I am glad to be able to make use of private healthcare for small things when I need to, but I would hate to be in a situation where it was my only option. (And that's not because the NHS in the present moment is a particularly shining example of universal healthcare done right.)

[duck]

I use to work with a lot of Canadians and multiple of them traveled to the US for medical procedures in the year or so I worked with them. One older co-worker broke his arm while visiting family in Quebec and literally drove hours to cross the border to have his arm set there b/c of the wait time. I won't pretend to say I understand the systems in place in Canada nor have insight into why they did this, but I always found it really interesting.

[wholinator2]

Why do you think that's happening? It is just a huge propaganda campaign by moneyed interests or is there some actual benefit? Maybe just the grass is greener

[consumer451]

> The US population is so indoctrinated with baseless propaganda that it will take a century for it to move to a better model.

I used to be one of those people. We immigrated to the USA when I was very young, so as I grew up I went extra Right/libertarian, thinking that would make me "more American" somehow. I now realize that this is very common in US immigrants.

It was the US health system that showed me the undeniable faults in pure libertarianism. It all seems so obvious now:

In a government run health system, dollars put into the system which do not end up going to patient care is called waste, it is seen as a negative and we work to minimize it.

In a privatized for-profit health system, dollars put into the system which do not end up going to patient care is called profit, it is seen as a positive and we work to increase it.

It's that simple. For-profit-all-the-things is not ideal. The main lesson I learned is that stubborn ideological purity is fraught with issues, no matter the ideology.

[seanmcdirmid]

Not to be pedantic, but the majority of US healthcare hospital systems are actually non-profits, so they milk profit a bit differently since they aren’t allowed to have any (instead it goes to administration salaries and overheads).

Even some of the insurance systems are non-profits. It doesn’t take shareholder profit motive to make money evaporate.

[consumer451]

Pedanticism is one of my favorite things about this website.

In this case... while my specific terminology may be lacking, if we zoom out and just compare the US healthcare system to other countries' systems, we demonstrably see lower per-capita spending and better patient outcomes. [0]

If we could agree on those facts, can you help me use the correct words to describe the issue?

[0] https://www.commonwealthfund.org/publications/issue-briefs/2...

[seanmcdirmid]

Oh we are in total agreement in the outcome. But misidentifying the problem as a pursuit of profit might lead to a reform that doesn’t really fix our system. The issue is a lot of vested interests getting a cut of healthcare money, and without reforms to streamline that, we aren’t going to make progress in coming up with something better.

[ifyoubuildit]

I wouldn't call myself a libertarian, but I do find it bewildering when people caricature libertarianism like this.

For one thing, if you go through the exercise of examining the parts of the healthcare system and ask yourself "how much is the state involved in this", I think you may come to a different conclusion. I don't know what to call our trash heap of a system, but libertarian seems obviously not it.

[consumer451]

OK, this is interesting. Please help me correct my terminology.

On my part of the exchange, might I suggest that what you see as government involvement could also be called "regulatory capture"? [0]

What I mean is that the monied interests now have major influence on the government which regulates them, so they create "regulation," with the goal of perpetuating their own profit centers.

How can I do better from your point of view? If not libertarianism, what should we call the ideology or ideals that led to this healthcare system with an ever increasing chain of profit centers?

[0] https://en.wikipedia.org/wiki/Regulatory_capture

[ifyoubuildit]

Like I said, I don't know what to call it. Crony capitalism probably fits, which goes along with your link.

Libertarianism is about liberty, or individual freedoms. Are you free to purchase any drug or test or service or device that you want from whoever you want? Of course not, the state is heavily involved in making these decisions for you.

[consumer451]

Ok, so one of the killer apps that I have discovered with LLMs is to further my own personal political depolarization. ChatGPT will always make a solid argument for most any other side.

To help identify what the heck I am talking about here, here is ChatGPT Classic's take on "libertarianism vs capitalism vs crony capitalism vs anarcho capitalism" [0] I found it very good reading.

What I realize now is that I was only holding on to one aspect of "libertarianism."

> Free Markets: Supports the idea that a market free from government interference naturally leads to efficiency, innovation, and wealth creation.

If I may be introspective for a moment, I believe that the reason that I may have used libertarianism instead of capitalism, is because how polarizing "capitalism" has become in the US discourse. I feel like readers would assume that if I am making light of capitalism, then I must support communism or some equally obsolete ideology.

[0] https://chat.openai.com/share/c4f4cedf-a995-4cc5-8feb-268c7c...

[peyton]

> (ignoring that accounts for a vanishingly small percentage of the expenses)

Development and financing are the big killers. Play with some numbers on a spreadsheet—they get big.

[bitcharmer]

Sadly, you are 100% correct. Once our American brothers wake up the down-votes will start pouring in.

The numbers are inflated because you get charged hundreds of dollars for an aspirin tablet in an emergency room and thousands for a 10 minute ride in an ambulance. What is particularly sad is that to the rest of the world this is absolutely insane but if you try to explain this to Americans they'll tell you they don't want no stinking communism. It's fascinating how deeply indoctrinated this nation is.

[avidphantasm]

A century, or a major catastrophe like losing a major war…