[sneak]

Because not everyone wants to pay for the same class of service.

The lowest common denominator is something like the NHS, with its well documented problems.

Many people wish to pay the minimum possible, and many people wish to pay for higher service and lower wait times. There must be some way of deciding who is prioritized for access to limited resources, and incentivizing increasing supply.

[vel0city]

> Because not everyone wants to pay for the same class of service.

You can still have choice for more service if you want even if there is a public option.

And even then, it's not like the current employment-tied plans really offer much choice. I either take the 1-2 plans my employer offers or I can go pay a fortune in the marketplace. Imagine if those 1-2 plans were not tied to employment, and if employers weren't expected to directly shoulder all that cost to have employees in the US

[InsideOutSanta]

"Because not everyone wants to pay for the same class of service."

Countries with socialized healthcare systems usually mandate a basic level of service, but you can then buy additional insurance on top of that. That's what the NHS is, it's the basic mandatory service everybody has to have. But it's not all you have access to. You can get better healthcare if you want to.

In the UK, this type of additional healthcare is also sometimes provided as part of a job benefit.

[rich_sasha]

Actually, having a national service + private insurance is quite good. That's what the UK does (well, except the NHS is possibly going bust).

Because in principle the state insurer provides you with every service, just possibly not very well or in appropriate time, the private insurers have to compete with it and demonstrate some added value.

Ironically, as the NHS is going downhill, the insurers in the UK, IME, are getting Americanised too.

[Gud]

Frankly this doesn’t sound so great to me. “Not very well and too late” sounds like something you should expect from a poor country?

[rich_sasha]

As I say, it is now breaking down.

But say in 2019, you could expect from the totally free, universal provider to treat anything: broken bones, medical emergencies, teeth, bad back, headaches, cancer, dementia, mental health... Even some cutting edge treatments were available. And yes, you'd wait longer than you'd like, but it would come in decent time. The hospital food would be so-so and you'd probably share a room with lots of people, but it would be free - you could spend not a penny.

Then the private insurers were cheap-ish and had to have good customer care. Now, the NHS is in disarray, private healthcare effectively doesn't have any competition and IME stopped trying.

[SketchySeaBeast]

You're defining it in terms of "wants" and "wishes", which seems disingenuous. People aren't choosing not to get better health care.

[salawat]

You have to understand that after a certain point, the internal narrative has to shift for some people in a capitalist economy to one in which people who can't afford something because the price is too high means they simply don't want it enough. This allows the price setter to ignore their own part in the manufacturing of the suffering of another.

That there is such a thing as a base necessity that should be baked into the human condition is basically anathema to the theoretical worldview. This worldview tends to persist as long as one is lucky enough to never pick up one of those meddlesome chronic conditions of existence whereby one has to rely on others to merely exist.

I'm convinced the United States has attracted a type of psychopath that just thinks money is the end all be all of existence, instead of social cohesion, and we're all suffering for it.

[pfdietz]

People choose this all the time, if it saves them money. It's like some people will choose a risky job, or a job that comes with predictable negative health implications, if they can make sufficiently more money.

[skirge]

you can choose between paracetamol or health transplant, or hearth transplant which is too risky because of reasons and not covered by public system