[rglullis]

I live in Germany. No such thing as public hospitals. And I pay close to 1200€/month in health insurance to the public insurance company.

I quick visit to the dermatologist to check for some tiny bumps that showed up in my forehead: 60€, out of pocket, because the insurer doesn't cover it.

[rbanffy]

Sad to hear about that. Ireland is much better in that regard - you can pay for private healthcare and it'll provide you a broader network, but you might as well go for public health, where you'll be prioritized based on how life-threatening is your condition.

[rglullis]

Yeah, I make it sound worse than it seems. The problem of the public insurance is that you pay based on your revenue instead of your actuarial risk, so in the end it should be treated as an extra form of revenue tax. I could go for the private insurance if I wanted to pay less, but then I'd have to switch my kids to the private insurer as well.

All in all, my point was only that the amount of taxes that people pay and quality of services are not necessarily related. Germany has high taxes and expensive-but-adequate healthcare. Greece has high taxes and expensive-and-inadequate healthcare. Switzerland has low taxes and universal/cheap healthcare (max. $5000/year deductible, max charge per hospitalization of $700).

[rbanffy]

> you pay based on your revenue instead of your actuarial risk

That's how public health works. It's the same as mortgage insurance in Brazil (where I come from), which is mandatory, and, since it's mandatory, it doesn't consider actuarial risk.

[rglullis]

Doesn't make it right or morally virtuous.

[rbanffy]

There’s nothing virtuous in letting people die because they can’t afford medication or healthcare.

BTW, “right” and “wrong” are human constructs, so you are totally free to organise a society around the survival of the richest. It’s just not a society you’ll like living in.

[rglullis]

You took a false dichotomy and jumped to an absurd conclusion. It makes you seem more concerned about an ideological position than thinking the problem through.

There are other ways to properly fund universal healthcare that does not involve creating artificial taxes:

- Increase the actual income taxes.

- Policies that mandate the allocation of revenue from vice and environmental taxes (alcohol, smoking, gambling, fossil fuels) to the health system.

- Social security reform. Pensions should not be an investment, only insurance. Turn pensions into an UBI program that has a hard cap.

- Supplemental and voluntary insurance plans to work on top of the existing public network. This might be risky as it can introduce a dual-class system, but (a) it's already the reality in most countries anyway and (b) could be avoided if the system is built around a "cafe sopezzo" [0] mechanism (the priority is given to you when you use the service, but redirected to non-paying members for the months when you don't)

[0]: https://en.wikipedia.org/wiki/Caff%C3%A8_sospeso

[throw-the-towel]

Wow, 60 euro is cheap! Here in France it would be more like 150.

[rbanffy]

Ireland is in the same ballpark if you go private (insurance usually covers most of those €60).

If you go public, it’s free, but you’ll be in line based on the risk to your life, so it might be a long while. You really don’t want to check in to a public hospital and get an MRI right away because that means whatever you have is really, really bad.