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

#481

Post by beagle3 » Wed, May 02, 2018, 7:50 PM UTC

fastball wrote: post #469

beagle3 wrote: post #414

Earlier quoted context omitted.

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.

You can't definitively conclude anything about example B from the results of example A if the two examples are different. That's not what I'm saying though. All I'm asking is for you to show me how you will mitigate the problems that will crop up when you try to implement a similar system to the UKs at the scale of the US, because the US has 5x the population of the UK. That's not a negligible difference in scale, an…

You assert that problems will crop up, but fail to mention which problems. You are arguing that any data anyone brings up is irrelevant, without bringing up any data.

You keep comparing the UK to the US, but a much more apt comparison is e.g. UK to CA, and the entire EU to the entire US. UK has twice the population of CA, and better bang/buck and health outcomes. EU compares similarly to the entire US.

The EU is at this point in time, a federation slightly more disjoint but ultimately of similar structure to the US.

Why not build an independent single payer healthcare system in each US state, with reciprocity among them? That is directly comparable to the european system, and has been shown to scale and work efficiently and well.

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

#482

Post by ordinaryperson » Wed, May 02, 2018, 7:54 PM UTC

gremlinsinc wrote: post #477

ordinaryperson wrote: post #18

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…

By your comment then we should get rid of social security and Medicare as well, would you agree?

Uh, what?

Where in my comment did I write the government should provide no financial benefits for its citizens?

No idea where you're coming from with that.

The question is: should the government pay for everyone's healthcare? Universal health care sounds amazing except no one has a plan to pay for it, at least in the U.S. where our system is outrageously expensive.

If your plan is just to tax a small group of earners to pay these astronomical fees, good luck with that.

More realistically we have to bring the costs of healthcare down, but that seems to get little to no attention.

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

#483

Post by SideburnsOfDoom » Wed, May 02, 2018, 7:56 PM UTC

knz wrote: post #148

SideburnsOfDoom wrote: post #39

Earlier quoted context omitted.

But other countries can do this. So the hard question then is, why is the US government so uniquely bad at doing things that it doesn't want to do?

Is the issue the US government? Or the lobbying to protect special interest groups?

From a far enough distance, they look like interconnected parts of the same system.

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

#484

Post by dragonwriter » Wed, May 02, 2018, 8:00 PM UTC

ordinaryperson wrote: post #482

gremlinsinc wrote: post #477

Earlier quoted context omitted.

By your comment then we should get rid of social security and Medicare as well, would you agree?

Uh, what? Where in my comment did I write the government should provide no financial benefits for its citizens? No idea where you're coming from with that. The question is: should the government pay for everyone's healthcare? Universal health care sounds amazing except no one has a plan to pay for it, at least in the U.S. where our system is outrageously expensive. If your plan is just to tax a small group of earners…

> More realistically we have to bring the costs of healthcare down

Given that places where government pays for everyone's healthcare, in the developed world, get compsrsvle outcomes at much lower per capita and per GDP cost than the US system, I don't see that an idea opposed to universal healthcare so much as a motivation for it.

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

#485

Post by ordinaryperson » Wed, May 02, 2018, 8:00 PM UTC

throwawayjava wrote: post #424

ordinaryperson wrote: post #171

Earlier quoted context omitted.

Yes, the problem is American universities, like hospitals, are severely overpriced. There are many reasons for this, but it's easier for Finland to pay collectively for higher education when the tuition is reasonable. Just like my healthcare argument -- if we could bring down the cost of higher education then subsidizing it for everyone would be less controversial.

You're missing the entire thesis of the article. The thesis is that Finland (et al)'s education and healthcare systems are more efficient because they are socialized. Given one binary comparison between condition A and condition B (Finland vs. US), some causal speculation is justified. Given dozens of such comparisons, all coming out to the same result, your case becomes anti-empirical. soru's comment on this thread…

> Given dozens of such comparisons, all coming out to the same result, your case becomes anti-empirical.

As others in this thread have pointed out, Finland vs. US is not a good comparison, Europe vs the US would be. We can socialize medicine in individual states with good results (see: MA) but US-wide? With 332+ million people? With all the differences in costs of living in different parts of the country?

When the EU rolls out a single-payer system for the entire Eurozone then we'll have something to compare against but the entire nation of Finland has less people (5.7 million) than New York City (8 million) and is a monoculture, to boot.

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

#486

Post by sykh » Wed, May 02, 2018, 8:02 PM UTC

Andre_Wanglin wrote: post #472

sykh wrote: post #438

Earlier quoted context omitted.

In the absence of Medicare/Medicaid there would not be universal coverage for the elderly. The elderly do not advocate dismantling this coverage. The coverage is a government program. We are in agreement that a U.S. government program can cover lots of people and maintain the property that those people don’t want to the program to be dismantled. It’s not, then, hard to imagine everyone being covered by such a program…

I did not support the ACA but I use the healthcare exchange because it is in my best interest to do so. I get free money from others to pay for my family's health insurance. In fact, I get a 100% subsidy. But the reason I get a 100% subsidy is because I am affluent enough to live comfortably on only a small portion of my income and funnel the rest into tax-advantaged accounts that reduce my AGI to a fraction of my ac…

I feel sorry for you that you think this way. There’s a reason Medicare came into being. It simply isn’t profitable to treat people near the end of their lives. One illness, calamity is enough to wipe out a lifetime of savings and leave one penniless. The absence of a government program for providing healthcare to the elderly would be horrific and immoral. Some things ought not be profit driven. You wish to make our already horrible system into something worse.

I’m glad your view does not prevail. I would hate to live in a country in which the majority shared this opinion.

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

#487

Post by ordinaryperson » Wed, May 02, 2018, 8:03 PM UTC

DanBC wrote: post #30

ordinaryperson wrote: post #18

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…

> Universal health care is a euphemism for the poor and sick getting their medical care subsidized by the wealthy and healthy. You might have a point if the US system didn't cost taxpayers more for worse care. The US government pays more per capita for health care than other systems, but doesn't provide universal coverage. https://www.ons.gov.uk/peoplepopulationandcommunity/healthan... Universal coverage provides mor…

UHC does provide more levers to control costs, sure. But it's not some huge fix to the underlying problem. One example: https://www.cnn.com/2018/02/10/health/uk-nhs-universal-healt...

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

#488

Post by ordinaryperson » Wed, May 02, 2018, 8:06 PM UTC

dragonwriter wrote: post #484

ordinaryperson wrote: post #482

Earlier quoted context omitted.

Uh, what? Where in my comment did I write the government should provide no financial benefits for its citizens? No idea where you're coming from with that. The question is: should the government pay for everyone's healthcare? Universal health care sounds amazing except no one has a plan to pay for it, at least in the U.S. where our system is outrageously expensive. If your plan is just to tax a small group of earners…

> More realistically we have to bring the costs of healthcare down Given that places where government pays for everyone's healthcare, in the developed world, get compsrsvle outcomes at much lower per capita and per GDP cost than the US system, I don't see that an idea opposed to universal healthcare so much as a motivation for it.

You're assuming they have much lower costs because of socialized medicine -- that's not necessarily the case.

But my broader point is just that universal health care is not an honest description of what it is, and our costs are so great we're unlikely to ever implement such a wealth transfer.

It's a lot less pie-in-the-sky IMHO to focus on bringing costs down. UHC could help in some ways but it's a broad assumption to make that if say Medicare paid for everything prices would just automatically start to drop.

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

#489

Post by throwawayjava » Wed, May 02, 2018, 8:06 PM UTC

Consultant32452 wrote: post #418

moorhosj wrote: post #393

Earlier quoted context omitted.

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 o…

Start with the data!

> there are still fewer medical schools today than there were 100 years ago... it may get the number right or it may get the number wrong... And it's a major part of the explanation why US doctors make 2x+ what their counterparts in countries like Germany make.

http://www.nationmaster.com/country-info/stats/Health/Physic...

> 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.

https://obesity.procon.org/view.resource.php?resourceID=0043...

> 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.

Except, of course, in the countries where it didn't spread like wildfire. Why all this crazy post-hoc history-building when you can just... empirically observe how the natural experiment played out?

Your modus operandi in this thread is the start with an ideology and then derive conclusions that are often wholly inconsistent with observed reality. There's nothing wrong with premises or theory-building, but when the data flatly contradict your conclusions... well, that's the difference between reality and fantasy.

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

#490

Post by ordinaryperson » Wed, May 02, 2018, 8:07 PM UTC

Vi0 wrote: post #380

ordinaryperson wrote: post #18

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.

Exactly. It's also not a tax mandated by the state, which is the key difference between insurance and universal health care.

If America wants to introduce UHC, great, but let's be honest about what it is, and let's understand it's going to be prohibitively expensive unless we bring costs down first.