[mindslight]

Have you been to a US doctor for anything more than a check up? Ten minute appointments, most of which gets spent on mechanical questions and memorized explanations is not decent care. Being pushed out through gradual ramping up of social pressure after your "allowed" one or two questions, so the doctor can move onto the next semantic billing event, is not decent care. Continually hearing, in every single setting, that everything is someone else's responsibility is not decent care. If decent healthcare gets provided in the US, it's in spite of the system, and those individual doctors/nurses/etc going above and beyond inevitably end up burning out. Lather, rinse, repeat.

I'm not a proponent of single payer because I don't think it addresses the root problem of the absolutely broken anti-patient incentives of a system that has long ago been destroyed by bureaucracy. But I'm not an opponent of single payer either - I just don't think it's the panacea people think it is.

[pyuser583]

> I'm not a proponent of single payer because I don't think it addresses the root problem of the absolutely broken anti-patient incentives of a system that has long ago been destroyed by bureaucracy. But I'm not an opponent of single payer either - I just don't think it's the panacea people think it is.

I totally agree. Payment isn’t the problem.

But I’ve had similar experiences with doctors in European and ex-European nations.

If I could make one change to the healthcare system, it would be a universal healthcare records system.

It’s nuts this is treated like it’s proprietary data.

[mindslight]

I can't speak about Europe, but I don't think the healthcare records alone would actually help care in the US. Once again the problem is the base incentives - a doctor doesn't actually want to have access to your whole medical history, as it would mean they would have to spend time reading it or otherwise possibly be liable for some detail in it. My experience is that staying at the same practice, even one with its own EMR, they basically ask you to complete a new patient health questionnaire every single year and self-enumerate all of your health concerns. Presumably it's the same incentive of not wanting to have to read, understand, integrate, and synthesize everything from the past.

My problem with your previous comment is that you just baselessly asserted that healthcare standards would go down with single payer, which is a common political talking point that completely ignores how the industry has already been captured and destroyed by private corporate bureaucracy (ie we already have "death panels", only they each consist of a single malpracticing doctor with a computer algorithm and an autosigner). Payment isn't the underlying problem of why healthcare is so bad, but it's certainly another problem for many people who go receive (shoddy) healthcare, and then afterwards end up at the pointy end of fraudulent billing shakedowns.