[meowface]

True. The central problem described in the article is that he has cancer and doesn't want to go bankrupt from the medical bills.

I'm not a socialist and am broadly pro-capitalism, but for decades I've held a firm belief that healthcare should have a public option and people should have the ability to get high-quality medical care for $0, no matter how realistic that would be.

[vidarh]

The father of universal healthcare by way of a state supported insurance system was Bismarck, who was far right by modern standards, and argued for it based on Christian morality, not socialism, though he was "accused" of being a "state socialist" over it, and embraced that label because it fit well with his struggle to limit the growing appeal of the actual socialists.

In European history, a lot of welfare reforms subsequently came down to Christian democrats (typically centre right to right by European standards) or cooperation between them and socialists and social democrats.

This just makes the US situation weirder - by the time socialists and trade unions gained much real power in Europe, universal healthcare was mostly already uncontroversial and settled or close to it as a result of the support of Christian groups on the right, with a couple of exceptions such as the UK, where the right wing rhetoric leading up to the NHS got pretty extreme.

[znkr]

Bismarck was afraid of workers unionizing and transformed a working healthcare system owned by workers into a state owned one. That move significantly reduced the utility of worker unions, which was the goal behind it.

[vidarh]

A working healthcare system is dramatically overstating it, and his system - like the current German one - had relatively speaking low state involvement. The German system remains one of the least state controlled universal healthcare systems to this day.

I do agree with you that a lot of his motivation was to counter the socialists and unions though.

Though I'll note that already before Bismarck, the socialists largely didn't oppose state involvement - Marx famously lambasted the Gotha program of what became the SPD in part for their willingness to trust the state.

[koolba]

> True. The central problem described in the article is that he has cancer and doesn't want to go bankrupt from the medical bills.

What bills? He’s 79 so he’d have been on Medicare for the past 14 years. Sure there’s the Medicare premiums, but that’s peanuts.

[hiddencost]

You're deeply confused about the average American experience.

[koolba]

No, I’m deeply confused why he would have massive medical bills when he’s covered by Medicare. Medicare covers 80% of bills and Medigap plans cover the other 20%. I think some recent changes obviate their need too by capping the annual out of pocket to (I think) $2,000.

I don’t think he has any such bills. From the article:

> He has said he intends to use the proceeds to help manage medical expenses for possible health crises, and to fund programs for people with disabilities.

He doesn’t need the money to pay for some treatments for himself. He wants the money to give it away to others.

[petesergeant]

Tell us then, many of us are not Americans

[zie]

My mom's insurance with medicare generally covers 80%, she gets to pay the leftover 20%. So uh bills with medicare is totally a thing.

[typpilol]

My dad has medigap that covered all that

He pays like 140 a month extra for it though. But he had all his cancer treatments covered

[alwahi]

guessing your father doesn't have cancer?

[typpilol]

He had tonsil cancer but it's gone now.

[dyauspitr]

What about maximum out of pocket maximums? All expenses are capped at like $15k per year right?

[lostlogin]

> capped at like $15k per year right?

That’s a lot of money for most retirees.

[dyauspitr]

It’s not that much money considering the crazy amount of hospital time and advanced treatments administered. That’s 25% of the average annual salary in the United States and you should be able to pay that for once in a lifetime treatments.

[dragonwriter]

> That’s 25% of the average annual salary in the United States

It's about 25% of the median annual full-time salary (but only ~70-75% of those employed in any given year are employed full-time for the whole year.)

More to the point, since salary doesn't tell you what people have lying around for emergencies, its more than double the median household total savings.

Even more to the point, population medians or avergaes for things like salary are not really applicable to subsets of the population like “retirees”.

[lostlogin]

I’m surprised how high the average wage is, but despite that, many have little in savings.

Around a third of Americans have less than $1000.

https://www.forbes.com/advisor/banking/savings/average-ameri...

[olelele]

for a majority of ppl on earth even

[buckle8017]

The simple reality is that advanced medical care is expensive.

Access to advanced medical care can either by gated by one person's wealth or by the average wealth of many people.

At the end of the day though, someone is paying and the only way to actually cost reduce is too have worse treatment.

[hvb2]

> the only way to actually cost reduce is too have worse treatment.

So tell me, why is random blood work billed for over 400$? Just to analyze the sample?

Part of the problem is definitely inflated pricing and no real transparency.

Unless you need that rockstar surgeon for that super specialty treatment that only the US can offer, the US healthcare system is just overpriced, broken and a money grab

[vidarh]

In most of the world, private treatment is far cheaper than equivalent private treatments in the US. To the point where even to a high cost location like London, it can be cheaper to fly to London from the US to have things done at a high end private hospital.

Medicare+Medicaid in the US costs about the same person taxpayer as NHS costs per UK taxpayer. The NHS could be better, but we get universal care for a similar price than what leaves most Americans still needing private care to have any cover at all.

That strongly suggests that the US could at a minimum do far better at providing cost effective care - both public and private.

[KingMob]

> the only way to actually cost reduce is too have worse treatment.

This is absolutely incorrect in the American system. Insurance companies introduce massive amounts of overhead for little benefit. Every study comparing them to Medicare finds that Medicare is way more efficient.

[baq]

Basic blood test should be $5. 99% of the more advanced ones shouldn’t cost more than $50.

Most medical care does not need to be advanced. It needs to be effective, but it doesn’t need to be expensive. It needs to be expensive to generate a hefty profit, though, especially when you have a serious condition - you then become a forced buyer and the market does what the market does with forced buyers without special regulations.

[vlovich123]

Or more effective treatment and not paying for ineffective ones. And less regulation and gatekeeping of which there’s a lot in the US (like needing insane levels of doctor oversight for buying medications)

[sixothree]

> the only way to actually cost reduce is too have worse treatment

If you cut out profit motive, you can _definitely_ make it cheaper. Your statement is incorrect.

[fsckboy]

>the only way to actually cost reduce is too have worse treatment

but also the cost of treatments generally decreases with time, while the efficacy increases as techniques are refined, disseminated, etc.

[createaccount99]

The actual reason is that you'll have people going to see the doctor because their cheek's itchy (they're lonely, or clueless).

[lostlogin]

Mental health issues would ideally be addressed too.

[wredcoll]

This is such a minor concern in the grand scheme of things but the solution is empowering nurses and doctors.

[dingnuts]

there wouldn't be any way to compete with tax pre-paid $0 point of sale health care, so there would be no option. the term "public option" is a weasel word. there would be no private option because nobody is going to choose to pay out of pocket in addition to their taxes that already pay for care.

advocate for whatever but use honest terms. you're advocating for a single payer system and there's no evading that.

[riffraff]

Fwiw, a lot of European healthcare has both a public and private option. You may pick the private options because they are "better" in some ways (e.g. more modern clinics, shorter waiting times, or sometimes just better care) which still leaves some wealth gap, but usually means no one goes bankrupt to cure cancer.

[carlob]

Usually the medical part of it all is strictly worse in the private sector (at least in my country) because the public system has a pretty strict competitive exam to get in, whereas profit driven private companies hire the cheapest doctor they can get.

Not everybody realizes that and they often fall for the single room in the hospital.

Shorter waiting times is definitely a thing though, especially for non life threatening conditions.

[riffraff]

It's quite country dependent. For example in Hungary my understanding is that many doctors have both private and public practices, but private clinics often don't have expensive machines. Doctors in public hospitals are severely underpaid so they have strong incentives to move you to private practice.

In Italy doctors also have public and private roles but can practice privately in public hospitals, which is weird but was an attempt to avoid losing them to private clinics, for the same reason. You also have private clinics administering public healthcare with a minor markup paid by the patient, and the base rate paid by the state, which isn't a thing in Hungary for example.

It is in general for non-life threatening conditions that there's such competition tho, I agree.

[vidarh]

In the UK a large proportion of the doctors are the same. Sometimes even using NHS operating theatres, or with NHS trusts running the clinics, as they are allowed to run for profit services to supplement their budgets...

[vidarh]

The UK has both universal healthcare and private options that are far cheaper than the US.

Most universal healthcare systems coexist with private options paid separately. Some are provided by private healthcare providers, and then too tend to coexist with privately paid services.

[collingreen]

It's silly to say "having options but you probably won't choose them" is the same as "no option".

There's probably a decent point nearby about subsidized (or tarriffed) work messing with the benefits of free market pressure but it isn't this silly overstatement.

[petesergeant]

> there would be no private option because nobody is going to choose to pay out of pocket in addition to their taxes that already pay for care

Every wealthy country besides Canada that provides public care is a counterpoint to this.

[lostlogin]

You realise that the impossible situation you describe is present in various places? Public and private healthcare systems existing in tandem.

[hvb2]

You only rely on social security? No 401k for example?

Because that's the public option in retirement and you can have private options like 401k on top