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

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

#371
post #345

Earlier quoted context omitted.

> 2. I can get an MRI in the USA within 3-5 days (sometimes next day), virtually anywhere in the country. Not if you don't have insurance, like a few million Americans. But fuck those guys, right? At least my MRI is fast!

You have a few percent of the overall American population waiting vs. 41% of Ontario.

No, 41% of patients of Ontario who needed an MRI, which is a small subset of the population. Meanwhile in 2016 you had 28 million Americans under 65, that's 10.4% uninsured [0]. I'm sure 10% less people would cut the waiting lines in Ontario a bit.

So yeah, fuck those 28 million, they're not rich, let them suffer if they get ill!

[0] https://www.cdc.gov/nchs/fastats/health-insurance.htm

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

#372

Earlier quoted context omitted.

Why are toll roads not close to efficient? In my state the toll roads are by far the nicest best maintained roads and the tolls are extremely reasonable and collected without having to slow down or stop at a booth.

Who collects the tolls? Is it a private company or a government body with motive different than maximum profit? For example in Poland we got the most expensive toll motorways in Europe because a private company owns them and continues to demands exorbitant prices for passage with nobody to stop it.

> Who collects the tolls? Is it a private company or a government body with motive different than maximum profit?

Private company with motive different than maximum profit. Motive: not to get subsumed and punished by the government allowing them to do this...then second motive is maximum profit. That primary motive one is an important one in all of these non-competitive industries, and can't even have a private vs public discussion without including it. Otherwise, it's just corruption/apathy and it's a different problem.

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

#373
post #337

Earlier quoted context omitted.

> 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. That's certainly one way to summarize the research around the VA, but it's a highly misleading one. It's easy to cherry-pick the metrics on which the VA performs well, but they're not representative of the big problems that the VA has…

Your response to scientific studies that demonstrate the VA actually provides better care than private counter parts is to dismiss them all as dishonest cherry picking. You offer up no studies or data of your own. You have no evidence for your claims except vacuous appeals to personal anecdote. You've somehow reached the conclusion that the entire VA, a $200 billion dollar program that cares cares for ten million of…

> Your response to scientific studies that demonstrate the VA actually provides better care than private counter parts is to dismiss them all as dishonest cherry picking. You offer up no studies or data of your own.

To be entirely honest, you alluded to research around the VA (but did not offer up any studies or data of your own). I responded by alluding to research around the VA which provides a different conclusion (but did not offer up studies or data either, although I did at least state the actual metrics used to draw said conclusion).

> Until people like you are willing to even look at the evidence -- and the evidence for universal healthcare is overwhelming at this point -- real discussion is pointless.

We're not discussing scientific evidence here. At best we're discussing your interpretation of (possibly-scientific) research that you've seen in the past but haven't actually named.

There is one point on which we do agree, though: that it's pointless to continue. It's pointless for me to continue a discussion with someone who starts a thread with bold claims and no supporting data, and then criticizes someone who responds in kind for the exact same thing. To be honest, it's also pointless to continue discussions of healthcare policy on Hacker News beyond a certain point too, because of the inherent political makeup of the site. Even the most well-researched comments which reference primary sources alongside research published in peer-reviewed journals are routinely downvoted because they express skepticism of monopsonic healthcare models. Instead, the top comments are usually low-effort criticisms that contain no rigor, depth, research, or citations, but do contain witty, biting criticisms of US healthcare and political soapboxing. In that sort of environment, there's not much of an incentive for people with domain knowledge who've studied these issues to participate in earnest.

So I guess that's one thing we can agree on: the futility of continuing this comment subthread.

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

#374
post #100

Earlier quoted context omitted.

If you think the private healthcare system is immoral, you should take a look at the 100% government ran healthcare system that is the VA. You literally couldn't make up worse things than their administration has been caught doing with little or to consequence. If the VA is the best the US government can do, with some of the most sympathetic citizens, then it is incapable of doing better than our private system.

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…

My dad is a veteran and now uses the VA for everything he can now.

His first experiences weren't that great, but you could easily tell it was because they were understaffed and underfunded.

Once they got to the point where he could start seeing specialists and whatnot, everything since then was a breeze.

He had a surgery on his stomach. It wasn't life threatening, but he was in some pain. The VA was able to get him an appointment with a Dr. and schedule the surgery within a few days to a week or so.

He also needed eye surgery. This one he had to wait for his eye to get to a certain point before surgery. The VA was able to get him to see an eye Dr the same day he went in for something else. Then less than a month later he was going to go in for surgery but something came up so he had to have it rescheduled. They were able to reschedule the surgery for the following week.

I would consider this a success story. He was hesitant on getting the eye surgery because of costs that were told to him by the previous company, but the VA told him he would not be paying anything, and he didn't.

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

#375

In these kinds of discussions I like to promote this interesting TEDx talk: https://www.youtube.com/watch?v=A9UmdY0E8hU "Where in the world is it easiest to get rich?" Spoiler: the talk shows that statistically the Nordic countries lead the world in millionaires and billionaires / capita, and in rags-to-riches. The talker offers the opinion that this is because its of the strong social safety net, education and healt…

I've about given up on per-capita studies whose results rely on cultural differences too (but of course can't account for them). We have to accept places are different in more ways than population size. It's like saying where in the world is it easiest to have blonde hair.

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

#376

Earlier quoted context omitted.

The fact that some people or nations behave in a particular way does not in any way determine whether that behavior is moral.

States in and of themselves aren’t moral under your framework because they can only exist by threat and use of force. But some of us are interested in solutions for the real world instead of the debating the merits of unfeasible utopias. I, too, would enjoy a stateless peaceful utopia of equitable commerce, but that has zero bearing on how we should decide public policy. Foraging for utopias is the same kind of naïve…

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

#377
post #284

I've lived in countries that have socialized medicine and ones without and my experience was dramatically different. I was always taught that socialized medicine was better. However I never got half decent care until I bought private health insurance. My whole life I've been on government healthcare plans, across various countries. Imagine my shock when the first time I called my private health insurance provider at…

I don't know where you live now but private insurance is much cheaper in countries with universal healthcare. Probably because the insurance company only pays for "extras" that the existing system doesn't. They don't pay for ambulance rides for example.

Also, universal healthcare does not mean private insurance does not exist.

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

#378

When the issue of universal health care comes up with regards to US policy I often see those emotional arguments pulling on the heart strings. Unfortunately, this is a distraction. I know this sounds cold, but it comes down to money. Healthcare in America is expensive. The problems appear to be commonly identified by various forms of research and including things like pricing inefficiencies of drugs, malpractice insu…

Good point. Totally remove the profit motive from healthcare. Establish a monopsony on medicine through the US government.

Hang the ghouls that enrich themselves by throwing families into lifetimes of debt only to further enrich themselves.

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

#379
post #367

Earlier quoted context omitted.

Fun fact that most Americans don't know: We _ALREADY_ spend more than enough on healthcare as a nation to fully fund healthcare for everybody. It's just that, unlike in other countries, our current system routes that spending to various for profit entities that don't involve actually providing care. tldr; Lack of funding is not a legitimate argument against providing healthcare to Americans.

But that also means that if you could fix the cost bloat, it would be much easier to provide universal coverage, and that trying to do the latter before addressing the former is bound to fail.

Costs are high, largely, because we have a fragmented mess of a system rather than a single payer.

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

#380

Universal health care is a euphemism for the poor and sick getting their medical care subsidized by the wealthy and healthy. Morally, caring for the sick seems like the right thing to do, but it's like when I hear Bernie Sanders call for "free college education": he doesn't mean free, he means the wealthy subsidizing it for others. Universal health care implies just distributed costs, but the focus should be on bring…

Insurance is inherently about distributed costs. That's the whole point. People who don't suffer whatever event they're insured for end up paying for those who do.
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