Both in rich and poor countries, universal health care brings huge benefits • Hacker News Board

Re: Both in rich and poor countries, universal health care brings huge benefits

#211

Post by creep » Wed, May 02, 2018, 3:36 PM UTC

ubi_now wrote: post #55

kingkawn wrote: post #19

Earlier quoted context omitted.

No need to fight over which one gets to be called number 1. Both are components of a whole vision; a healthy, thriving populace, building off the successes of one another to create a better experience for everyone, rich and poor alike.

You don't need government programs to do that.

It's important to have a central, regulated allocation of some resources for a society as large as America-- and for that matter, any society. The point of group living (where any society is group living) is that everyone has a safe place to return to and can count on at least most of the other members of the group to help them out when they need it. The point of universal healthcare is that you pool your money with everyone else so that when you get sick, you get care, and when your neighbor gets sick, he doesn't spread his infectious disease to you, and when someone else in your work place gets sick, you spend less time making up for their missing days.

Re: Both in rich and poor countries, universal health care brings huge benefits

#212

Post by stevenwoo » Wed, May 02, 2018, 3:37 PM UTC

austincheney wrote: post #191

mikeash wrote: post #122

Earlier quoted context omitted.

Seems like you have the cart before the horse. Universal health care would be a way to address those inefficiencies and solve those financial and administrative problems.

That very well may be, but I have not seen any research suggesting this.

Does the healthcare marketplace of every civilized country of the world outside of the United States not count as research or an experiment in real life consequences?

Re: Both in rich and poor countries, universal health care brings huge benefits

#213

Post by Frondo » Wed, May 02, 2018, 3:37 PM UTC

conanbatt wrote: post #196

sykh wrote: post #140

Earlier quoted context omitted.

The services could be worse but aren’t necessarily worse. It’s foolish to think that any government service is worse than a private one. Also, universal healthcare doesn’t necessarily mean government run.

It's foolish to believe the state is more efficient that private actors, that is just contrary to real life experience.

It's foolish to believe that private actors can by definition ever be as efficient as the state.

Private actors, by definition, must extract something from any service to pay themselves.

The government has no overhead. It can run with absolutely no profit and that is its intended model.

A private health care company that returns zero profit to its shareholders? Shut 'er down.

A private transit company that returns zero profit to its shareholders? Shut 'er down.

And yet, government services can run indefinitely at break-even because they're not beholden to the market.

Only government can be so efficient--the private sector always loses efficiency through someone scraping something off the top.

Re: Both in rich and poor countries, universal health care brings huge benefits

#214

Post by rwj » Wed, May 02, 2018, 3:37 PM UTC

ekianjo wrote: post #200

clarkevans wrote: post #94

Earlier quoted context omitted.

> It seems the public interest is subordinate to private interests and often times with immoral consequences. This perspective of public vs private interest is rather puzzling to me -- it's more a matter of short-term vs long-term thinking. In the long-term, it's in the private interest of those having sustainable companies to have a broad base of educated and healthy workers to employ. The short-term interest of any…

> The goal of government, in my opinion, is to focus on long-term objectives: ensuring a sustainable healthy and educated population. You can't ensure health unless you have wealth in the first place. You can see that things moved in that order in the past 300 years: the more wealthy a country was, the longer people lived and the better they could face different conditions. The greatest strides against mortality were…

You should read the article more carefully. Poorer countries are working under difficult constraints, but leaving $1 on the table because you don't want to spend 10 cents is not helpful. There is a line of thought poorer countries are poor because they don't invest in healthcare, education, infrastructure, ... and that the real problem is governance.

Re: Both in rich and poor countries, universal health care brings huge benefits

#215

Post by [deleted] » Wed, May 02, 2018, 3:38 PM UTC

Consultant32452 wrote: post #173

rogerb wrote: post #131

Earlier quoted context omitted.

There's a simple thought experiment that helps: - an american citizen break his leg, he is not insured. Do you A: let him die B: take care of him ? if your answer is A - you are a terrible person, but you hold a consistent position. if your answer is B - the only question that remains is what is the most economic, efficient way to take care of this person ? b is universal health care. if you think you can do A with e…

The most economically efficient way to pay for B is to allow the free market to drive the cost of care so low that the person is either able to pay for it, or the cost through charity is trivial. This has the double benefit of not attempting to rectify one moral wrong (person does not receive care) by committing another (violent coercion by the state).

[deleted]

Re: Both in rich and poor countries, universal health care brings huge benefits

#216

Post by throwawayjava » Wed, May 02, 2018, 3:38 PM UTC

Consultant32452 wrote: post #173

rogerb wrote: post #131

Earlier quoted context omitted.

There's a simple thought experiment that helps: - an american citizen break his leg, he is not insured. Do you A: let him die B: take care of him ? if your answer is A - you are a terrible person, but you hold a consistent position. if your answer is B - the only question that remains is what is the most economic, efficient way to take care of this person ? b is universal health care. if you think you can do A with e…

The most economically efficient way to pay for B is to allow the free market to drive the cost of care so low that the person is either able to pay for it, or the cost through charity is trivial. This has the double benefit of not attempting to rectify one moral wrong (person does not receive care) by committing another (violent coercion by the state).

The point of this report is that the empirical evidence contradicts your hypothesis. These sorts of broad-strokes, ultra-rationalist arguments should be set aside whenever data is available.

Re: Both in rich and poor countries, universal health care brings huge benefits

#217

Post by Pica_soO » Wed, May 02, 2018, 3:38 PM UTC

Consultant32452 wrote: post #173

rogerb wrote: post #131

Earlier quoted context omitted.

There's a simple thought experiment that helps: - an american citizen break his leg, he is not insured. Do you A: let him die B: take care of him ? if your answer is A - you are a terrible person, but you hold a consistent position. if your answer is B - the only question that remains is what is the most economic, efficient way to take care of this person ? b is universal health care. if you think you can do A with e…

The most economically efficient way to pay for B is to allow the free market to drive the cost of care so low that the person is either able to pay for it, or the cost through charity is trivial. This has the double benefit of not attempting to rectify one moral wrong (person does not receive care) by committing another (violent coercion by the state).

https://www.health-tourism.com/medical-tourism/usa-research/

The ultimate market victory - completely avoiding the destroyed free market healthcare system and travel abroad to parasite on universal healthcare.

Re: Both in rich and poor countries, universal health care brings huge benefits

#218

Post by mter » Wed, May 02, 2018, 3:39 PM UTC

maxsilver wrote: post #185

Fomite wrote: post #100

Earlier quoted context omitted.

For a large number of different outcomes, the VA is superior to private care. It has a disproportionate footprint because "The VA does something bad!" is national news, while "SmallSizeMidwestCity Memorial does something bad!" isn't. It's not perfect, by any means, and struggles with cost constraints (veterans are sympathetic, but sympathetic doesn't mean well supported), but many of its quality outcomes are superior…

Your getting downvoted for this, and I have no idea why. Have other folks actually stepped inside a VA facility? Many of them are old/outdated/underfunded it's true. But some of them truly do offer superior care to a typical private hospital (in staff, facilities, and outcomes). The VA system could use significant improvement, absolutely. But if the fear-mongering 'worst case scenario' is that everyone gets VA levels…

> But some of them truly do offer superior care to a typical private hospital

Which ones? Because that has not been my experience at the hawaii facility. From my appointment time being written down on a piece of paper then they send me my actual appointment date a few months later to the doctor being an hour+ late, my personal experiences have been subpar.

Add in how doctors/nurses at multiple hospitals do comically incompetent things like reusing insulin pens/colonoscopy bags/not washing equipment, the general sense of incompetence when they lose my records every few years, or talking to my buddies who got out and ended up working at the VA and have told me that they'll never get treated there, and I do not have the same sense of "superior care" that you're talking about.

If I want hep C, I'll go to the VA. If I want medical care, I'll go anywhere else or just not go to a doctor.

Re: Both in rich and poor countries, universal health care brings huge benefits

#219

Post by petermcneeley » Wed, May 02, 2018, 3:40 PM UTC

fbunau wrote: post #60

In my country we do have single payer health care, but I wouldn't step foot into a state hospital unless I would have a terminal disease. The infrastructure is old and crumbling, people get infections during operations and walk out more sick than they entered. Sometimes you are asked to bring your own medicine, and basic medical supplies because hospitals don't provide you with anything. The system is overcrowded and…

"I think a good culture makes shit work, not the process itself" Ya this is genius. I also think this is why no finite amount of laws can solve corruption issues.

Re: Both in rich and poor countries, universal health care brings huge benefits

#220

Post by chiefalchemist » Wed, May 02, 2018, 3:41 PM UTC

Yes, health care is important, if not morally necessary in the 21st century.

That said, it's also (imo) a proxy. The more accurate metrics are things like infant mortality rate (IMR), longevity, etc. KPIs that measure actual health and health outcomes. Access isn't necessarily the key.

Take for __example__ the USA. We now have the vast majority of the population covered. We spend more and more (and more)on healthcare. Yet, IMR is climbing. It's predicted that the current generation(s) will die younger. And finally, obesity is so widespread it's been mentioned as a threat to nation security.

Point being, (as stated) healthcare is a proxy (even for the countries that have it). I would imagine there are 5 to 10 KPI's that measure __health and wellness__ that would be more accurate (and likely paint a different impression).

Healthcare isn't a panacea. Yes, it's necessary. But benefits come from health (and wellness / prevention) and not just care.

Editorial: Discussing health care without also discussing (personal) health is a fool's errand. Championing healthcare is great for buying votes, but it's only part of the picture.