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

#231

Post by dnomad » Wed, May 02, 2018, 3:46 PM UTC

chimeracoder wrote: post #195

Symmetry wrote: post #68

Earlier quoted context omitted.

The VA is far from perfect and is really noticeably worse than many other country's nationalized health systems. But it's not obviously worse than private health insurance in the US and generally veterans are as happy with their health care as other people. I think the VA example tends to dispel the notion that single payer would save that much money but it works about as well as other approaches, of which the US has…

> The VA is far from perfect and is really noticeably worse than many other country's nationalized health systems. But it's not obviously worse than private health insurance in the US and generally veterans are as happy with their health care as other people If you want to convince people to support a single-payer system, this is quite possibly the worst argument you could use. Any veteran or anybody who has had any…

> The VA is, on the whole, atrocitous. There are a couple of regions which do relatively well, because the system is federated, but on the whole, it's almost universally considered to be a disaster, even by people who are supportive of the program's existence.

Yeah, this is bullshit. The VA and its effectiveness has been studied quite a bit. Its quality has been found to generally exceed the quality of private hospitals. The media and conservatives paint this idea that the VA is "atrocious" but it has no basis in reality.

The scientific evidence for universal healthcare is overwhelming. The only "controversy" -- exactly like the "controversy" around climate change -- exists within people who have carefully decided to ignore the evidence and buy into the propaganda. The problem here is not the VA. The problem here is that many Americans have abandoned reality.

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

#232

Post by [deleted] » Wed, May 02, 2018, 3:46 PM UTC

SamReidHughes wrote: post #146

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…

What if they're not an American citizen? What if they're also in a different country?

[deleted]

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

#233

Post by austincheney » Wed, May 02, 2018, 3:46 PM UTC

stevenwoo wrote: post #212

austincheney wrote: post #191

Earlier quoted context omitted.

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?

No, I don't think these alternate examples are relevant. I suspect, and this is not my field of expertise, the largest differentiator is history. The US has been developing its health care system, uninterrupted, longer than other nations.

It is much easier, politically, to build a great system if you start from scratch and have excellent examples at hand of what not to do as compared to modifying a deeply entrenched system in current operation.

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

#234

Post by conanbatt » Wed, May 02, 2018, 3:47 PM UTC

Frondo wrote: post #213

conanbatt wrote: post #196

Earlier quoted context omitted.

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 ze…

> The government has no overhead

Realz.

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

#235

Post by sykh » Wed, May 02, 2018, 3:47 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 enterprise is always more efficient than a government run program and it’s foolish to think that government is always more efficient. One should not live in a world of such extremes.

Sometimes government is the efficient solution. Sometimes private enterprise is.

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

#236

Post by newfoundglory » Wed, May 02, 2018, 3:48 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…

Why is the age of the expression relevant?

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

#237

Post by creaghpatr » Wed, May 02, 2018, 3:49 PM UTC

java_script wrote: post #182

patrickmay wrote: post #24

Universal health care doesn't require government coercion. Many more people in the US would have access to health care, including insurance for catastrophic events, if the state and federal governments stopped interfering in the supply side. The same groups that use force to prevent new hospitals being built, restrict the number of doctors, prevent nurses and nurse practitioners from treating many problems they're mo…

Wow good points. I’m sure those tens of thousands of people a year who die due to lack of health insurance are so glad nobody got coerced into helping them out. What a useful definition of liberty, that allows the richest country on earth & in history to deny its citizens preventative care so that they end up dying of easily preventable diseases. We have the liberty to beg on GoFundMe! Health insurance companies have…

You should consider refuting his argument instead of countering with a rant.

>Many more people in the US would have access to health care, including insurance for catastrophic events, if the state and federal governments stopped interfering in the supply side.

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

#238

Post by analog31 » Wed, May 02, 2018, 3:49 PM UTC

dv_dt wrote: post #224

SamReidHughes wrote: post #146

Earlier quoted context omitted.

What if they're not an American citizen? What if they're also in a different country?

Care for them under the universal system, but bill the cost of the universal system directly.

My mom got injured while hiking in a country with universal care. She hobbled to the next town, found a clinic, and got treated. Then she wanted to pay. First, the person at the clinic said: "What do you mean, you don't pay for health care." My mom explained that she was from another country. It turned out they didn't even have the means to take her money.

Treating a few foreigners for free might actually be cheaper than setting up a billing system.

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

#239

Post by fulafel » Wed, May 02, 2018, 3:50 PM UTC

announcerman wrote: post #65

Universal healthcare is not a silver bullet, in certain Eastern European Countries we pay a large amount of our salary in taxes so that we have universal healthcare and yet you still have to give "gifts" to every nurse and doctor that treats you unless you want the bare minimum treatment and care. Doctors can also intentionally botch surgeries if you fail to pay up. Not so much that it can be called malpraxis though.

How big are the bribes compared to co-pays or ER bills in the US?

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

#240

Post by programmarchy » Wed, May 02, 2018, 3:51 PM UTC

kbcool wrote: post #82

programmarchy wrote: post #22

If you get cancer, would you rather be treated in the US or Europe? Survival rates are significantly higher in the US, so I know what I'd choose. And yeah, I'll pay more, too, because I want high quality doctors.

Europe these days, at least I'd be treated like a human being and not a cash cow. Survival rates in the USA were better in the 1960s but most of the OECD now has much lower mortality rates from a diagnosis of cancer than the USA. One exception is the UK but the margin is very narrow. What the USA is good at is over-treatment which can extend life expectancy of a cancer patient a little bit (days, weeks on average) bu…

I can understand that perspective.

But are you really treated more humanely in Europe? Instead of a cash cow, you're a statistical number that determines where you will get placed in the queue and how long you'll wait. In the US, you at least have the potential for autonomy to pay the best doctor you can find you to treat you as soon as possible. That autonomy (or illusion thereof if you're a cynic) is a core component of the American identity. That feels more human to me.

However, I do agree spending is completely out of control. A big reason is because Americans are extremely unhealthy. Many are obese, don't exercise, and eat like shit. I think those people should be punished with large insurance premiums, instead of being treated equally to someone who proactively takes care of their health and has a higher chance of long-term survival. What's left of the insurance market does still respond to those incentives. There's some fits and starts with this in insurance (e.g. step trackers) but these are values and habits that need to be instilled in people from youth. That is an area I can see the state stepping in, and something they're better equipped to handle than a complex healthcare system.

Genetic diseases are a different case, and should be treated differently. There is a huge opportunity for prevention through genetics, but everyone raises a stink because of the "eugenics" bogeyman. This is an area where I agree with the transhumanist types in that we should really be taking a close look at our genetics and taking a scientific approach to improving them for longevity. I'd love to see a Manhattan Project for life extension.

The main problem I see with universal healthcare, besides the stupid communistic utopianism, is that it doesn't really fix the underlying problems with the incentive structure. I think we could agree that the incentive structure should revolve around proactive physical fitness and the early prediction and prevention of disease, not pills and palliative care. From my perspective, it looks like European governments are struggling and failing with their systems. They're slow to treat people and are not innovating in medicine at a high level. Yes, corporations want to extract wealth from individuals with high prices but so do government agencies with high taxes. And governments have much less incentive to innovate; they tend to ossify.

My point is, Americans have other options other than universal healthcare. I think we should not settle for the European-style socialist system because it relies on a religious holdover manifest in a secular world: that if we treat everyone equally we'll all be magically saved. Instead, Americans should draw from our founding principals of individual autonomy and manifest destiny to form a healthcare system that embodies our ideal future.