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

economist.com

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

#411

Post by DanBC »

fortythirteen wrote: post #297
rflrob wrote: post #108

Earlier quoted context omitted.

If you don’t get cancer, where would you rather live? Life expectancy is significantly higher in Europe for lower average cost of medical care. There’s not necessarily a conflict between checkups and chemo, and surely some of the difference is due to population-level differences in poverty, diet, and lifestyle. But it’s worth remembering that it can be rational to trade slightly worse specialty care for better genera…

> Lower average cost of medical care All derived from figures that don't account for how much more you pay in taxes for that "free or cheap" healthcare.

You know the US government pays more per capita for health care than most other governments, right?

There's a huge US tax spend on a health care system that doesn't provide universal coverage and has worse outcomes across a range of measures.

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

#412

Post by beagle3 »

fastball wrote: post #316
beagle3 wrote: post #259

Earlier quoted context omitted.

That's true, but since there is an example (tens of them, actually) where it does work well, then the prior should be that it could and should work in the US, and if one thinks it wouldn't work in the US, it should come with an explanation.

The explanation is that the US is huge and UK/Germany/Sweden/whoever is not. Efficiency doesn't scale proportionally to size, unfortunately.

The US has less than 400M people, the EU has more than 500M, so you are factually wrong.

The EU is divided to states, just like the US; healthcare is locally managed with reciprocity between the EU members. Which gives you a model for a scalable US implementation if you desire.

You are entitled to your own opinion, but you are arguing against facts. The US is smaller population wise.

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

#413

Post by RobertoG »

Consultant32452 wrote: post #376
ordinaryradical wrote: post #279

Earlier quoted context omitted.

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…

[flagged]

Fair enough. What is that minimum?

The proposed minimum is always to grant the needed power to cover unlimited property rights, but not universal healthcare.

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

#414

Post by beagle3 »

fastball wrote: post #406
sykh wrote: post #354

Earlier quoted context omitted.

That, even if true, does not support your argument. You need to show that the inefficiency in a universal care system in a country as large as the U.S is greater than the current system that we have. The evidence is that this is not true.

I don't need to show that, as I am not the one advocating a fundamental restructuring of the status quo. You need to show that the policies implemented in other countries will continue to work efficiently at the scale of the US, as you are the one advocating that course of action. "This policy worked well in [some place that is not the US]" just isn't good enough.

This claim, taken ad absurdum, is equivalent to “you can never conclude anything from prior examples because conditions are different”.

And you have, in fact, gone ad absurdum.

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

#415

Post by chimeracoder »

monocasa wrote: post #382
chimeracoder wrote: post #369

Earlier quoted context omitted.

> First off, the VA isn't as bad as you're making it out to be. From your own link, which is a press release by the firm which sponsored the research: > Researchers say there were few studies [included in this meta-analyis] to evaluate equity, efficiency and patient-centeredness, and that the quality of the available studies vary. Incidentally, those are three of the four main issues for which people typically critic…

> From your own link, which is a press release by the firm which sponsored the research: I mean, it's the Rand Corporation. It's not like it's some fly by night 'you pay us and we'll say whatever you want' firm. The link to the real study is right there. > Incidentally, those are three of the four main issues for which people typically criticize the VA. That statement was for the whole study, including the private si…

> I mean, it's the Rand Corporation. It's not like it's some fly by night 'you pay us and we'll say whatever you want' firm.

...okay? The point is that the primary reference itself shows that the study isn't relevant to this conversation at all: by its own account, it doesn't attempt to investigate the issues that we're talking about. It doesn't attempt to study the issues that make the VA a bad model for healthcare (and have since the 60s).

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

#416

Post by DanBC »

fortythirteen wrote: post #407
AstralStorm wrote: post #357

Earlier quoted context omitted.

Actually it is a perfectly visible item in budget. We pay less for whole of medical care than total US budget for just VA. Someone is paying for this in tax.

I think you misunderstand the statement. I wasn't referencing the comparison of the tax costs of different public healthcare systems. But while we're on that subject, I'm willing to bet that your VA comparison isn't per capita, or placed against GDP, rendering it useless. What I was referencing was the per capita or per household total cost of healthcare . The comparisons that say western countries with universal hea…

The US government pays a huge amount on healthcare. This is whether you do it by total; by GDP; per capita.

https://www.ons.gov.uk/peoplepopulationandcommunity/healthan...

If you include private insurance:

> As a percentage of GDP, the UK spent less on healthcare than USA, Japan, France and Germany and a similar percentage to Canada. The USA spent the most on healthcare as a percentage of GDP at 16.6%.

If you exclude private insurance the US still pays a lot, at about 8.2%

The US has by far the largest spend per capita, yet has average life expectancy.

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

#417

Post by rflrob »

fortythirteen wrote: post #297
rflrob wrote: post #108

Earlier quoted context omitted.

If you don’t get cancer, where would you rather live? Life expectancy is significantly higher in Europe for lower average cost of medical care. There’s not necessarily a conflict between checkups and chemo, and surely some of the difference is due to population-level differences in poverty, diet, and lifestyle. But it’s worth remembering that it can be rational to trade slightly worse specialty care for better genera…

> Lower average cost of medical care All derived from figures that don't account for how much more you pay in taxes for that "free or cheap" healthcare.

The OECD reports numbers that include public expenditures. I'm not sure where I'd even look to find the precise methodology, but at some point you have to trust that the experts know what they're doing and are reasonably impartial. And sure, Sweden's overall tax rate is probably a lot higher, but they are providing a lot more services than the US government with that money beyond just healthcare. So the choice probably isn't between ~30% tax rate with private healthcare[2] and ~60% tax rate with public healthcare; even if the full ~$10,000 health care expenditures per capita were spent on taxes instead, that's only about a 17 percentage point increase on the per capita income of $60k.

[1] https://en.wikipedia.org/wiki/List_of_countries_by_total_hea...

[2] http://thehill.com/policy/finance/238735-average-us-worker-p...

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

#418

Post by Consultant32452 »

moorhosj wrote: post #393
Consultant32452 wrote: post #274

Earlier quoted context omitted.

Data is available on rapid price inflation that coincides with central planning initiatives in the US. Data also exists showing the systemic risks to nations created by these systems, such as the looming global demographic crisis created by the combination of social welfare systems and the baby boom.

We aren't talking about those abstract ideas, we are talking about health care and it's associated access and cost. As such, the data shows us the United States fares worse than similar countries on the measures of access and cost (both to the individual and the state)[1]. The United States also has the most "free market-like" system of comparable countries. How can it be that costs are so high and outcomes are no be…

Causes of price inflation and the looming demographic crisis are not "abstract ideas."

For literally decades the US did not open a single medical school due to lobbying from the medical industry. Even though we've tried to reverse the trend since the 90s, there are still fewer medical schools today than there were 100 years ago. When the government decides how many doctors there will be, it may get the number right or it may get the number wrong. But that's nothing akin to "free market-like." And it's a major part of the explanation why US doctors make 2x+ what their counterparts in countries like Germany make.

During the New Deal era regulations wage caps were put on workers in the hopes of staving off inflation. Employers, wanting to entice good employees to work for them sought to get around these wage caps by offering health insurance. This then spread like wildfire, coincides with the time healthcare inflation separated from general inflation, and began the trend towards a lack of price transparency.

Most of the differences in outcomes between us and other wealthy nations amount to lifestyle/culture much more-so than affordability and availability. Americans are very obese. Not having to pay a copay to visit the doctor is not going to change that. But obesity means we'll have more problems with newborns, lower life expectancy, etc.

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

#419

Post by ScottBurson »

chimeracoder wrote: post #323
Clubber wrote: post #300

Earlier quoted context omitted.

They supplement it, I don't believe they are leaving it, unless they are wealthy and can afford to pay out of pocket because they want to use a doctor that is not participating in the medicare program. Do you have a cite?

> They supplement it, I don't believe they are leaving it, unless they are wealthy and can afford to pay out of pocket because they want to use a doctor that is not participating in the medicare program. Do you have a cite? No, this is wrong. Private Medicare plans fully replace Original Medicare. If you are on a privately-managed Medicare plan, you receive none of your benefits from Original Medicare (the government…

> No, this is wrong. Private Medicare plans fully replace Original Medicare.

Uh, no. "Medicare pays a fixed amount for your care each month to the companies offering Medicare Advantage Plans." [0] So although the Advantage plans are privately managed, the premiums are subsidized. I don't think this counts as "leaving" Medicare.

[0] https://www.medicare.gov/sign-up-change-plans/medicare-healt...

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

#420

Post by throwaway84742 »

rogerb wrote: post #131
sykh wrote: post #6

When a person gets a life threatening disease they ought not worry about whether or not their treatment will leave their family in penury. This is especially so in a nation as wealthy as the U.S. The American healthcare system is immoral and I hope it drastically changes. Americans need to change their underlying notions of what it means to be a society. An author was once made fun of for suggesting that it takes a v…

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…

That person will not be denied care. It will cost a lot, but nobody is in any danger of dying in this situation.
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