6 ms·

I think of a single payer system as infrastructure like roads, electrical supply, water... It collectively takes the risk from the individual and provides for

I think of a single payer system as infrastructure like roads, electrical supply, water... It collectively takes the risk from the individual and provides for everyone. A business no long gets distracted with pension, drug, medical... and focuses on the business of making money. They pay tax and that is it. In an ideal world.

throwaway_xx9 10y ago
> In an ideal world. You mean, every other country in the Western world, except the USA.
crazy1van 10y ago
>A business no long gets distracted with pension, drug, medical Unless that business was in the pension, drug, or medical industries. My point is that it's not super clear where to draw the line between common public services and businesses, and people's perspective is usually determined by the nature of their own business. For example, provide gov't healthcare and pensions so my smartphone company can focus on making great devices instead of worrying about health care. Or... provide gov't smartphones so my social media app company can focus on making great apps rather than worrying about what mobile OS to support. Or... provide gov't social media apps so my independent media company can focus on generating content rather than worrying about distributing it across many social media platforms.
- dalke 10y ago
  There are still companies involved with "roads, electrical supply, water", even when they are part of the public infrastructure. It's not like there are no drug or medical companies in Switzerland. The evidence doesn't need to be "super clear." The numbers are pretty solid that universal healthcare is more efficient than the current system the US has. That is, the US government spending alone, on a per capita and GDP basis, is higher than the combined public+private spending in most countries with universal health care. Yet the public+private funding in the US doesn't result in a higher quality of health care, by most measures. Even sticking to the US, we can get an idea from Medicare and the VA system of the advantages to single payer systems. Those comparison numbers don't exist for the proposals you mentioned, and there is no reason or experience to suggest they make sense in the current market. (But, consider France's Minitel in the 1980s, when it did make sense.) Also, the failure costs in health care are much higher than the failure costs in choosing the wrong mobile OS. The worst case for the former is an nation-wide epidemic. The worst case for your company is ... you run out of money and need to get a job.
jomamaxx 10y ago
Health Care is not like building roads. I live in Quebec, Canada and the healthcare here is among the worst in the civilized world. Also - it's illegal to pay a doctor to fix you. Canada is the only place in the world where it's illegal to pay someone to cure you of something. It's basically communist. The American system is untenable, but 'single payer' is not the solution. Successful countries that do it are tiny. Sweden is smaller than Los Angeles. Swtizerland does it at the cantonal level, which on average is 800 000 citizens. Can you imagine your entire hospital and insurance system being in blocks of 800 000? Maybe at the state level, subsidies, regulating drug prices etc. etc. - but full-on national level 'single payer' would be a huge disaster, beyond contemplation. Also in many single payer systems - the guy who snuck across the border illegally gets the exact same healthcare as you, working professional, paid a million in taxes, dutiful citizen etc.. I think there should be coverage for everyone, but single-payer is not the path.
- icebraining 10y ago
  Not a word about the UK's NHS?
- jomamaxx 10y ago
  You can vote me down if you want, but I live in a system where I cannot get a doctor. And it's illegal to pay for one. I' forced by the government, to use local clinics where they don't have my records, I don't have a relationship with the doctor, they can't make longer term prognosis, and frankly, the care is sub-par. I once had an ailment that was difficult to diagnose, the doctors at the clinics, used to seeing people for coughs and colds could give a shit. I ended up having to pay a few grand for an American entity operating barely within the bounds of legality in Canada (the Cleveland Clinic). I can assure you that it's a pretty desperate feeling when you are locked out of the system. Notre Dame Hospital in Montreal is lined with people in beds in the hallways, broken chairs, broken, leaking water fountains in the waiting room, broken / discarded beds in the waiting room - I thought I was in Cuba. The doctor was actually nice but the facilities were crazy. A well run McDonald's has more visible operating efficiency. It's far from optimal.
  - 10y ago

throwaway_xx9 10y ago

> In an ideal world. You mean, every other country in the Western world, except the USA.

crazy1van 10y ago

>A business no long gets distracted with pension, drug, medical Unless that business was in the pension, drug, or medical industries. My point is that it's not super clear where to draw the line between common public services and businesses, and people's perspective is usually determined by the nature of their own business. For example, provide gov't healthcare and pensions so my smartphone company can focus on making great devices instead of worrying about health care. Or... provide gov't smartphones so my social media app company can focus on making great apps rather than worrying about what mobile OS to support. Or... provide gov't social media apps so my independent media company can focus on generating content rather than worrying about distributing it across many social media platforms.

dalke 10y ago
There are still companies involved with "roads, electrical supply, water", even when they are part of the public infrastructure. It's not like there are no drug or medical companies in Switzerland. The evidence doesn't need to be "super clear." The numbers are pretty solid that universal healthcare is more efficient than the current system the US has. That is, the US government spending alone, on a per capita and GDP basis, is higher than the combined public+private spending in most countries with universal health care. Yet the public+private funding in the US doesn't result in a higher quality of health care, by most measures. Even sticking to the US, we can get an idea from Medicare and the VA system of the advantages to single payer systems. Those comparison numbers don't exist for the proposals you mentioned, and there is no reason or experience to suggest they make sense in the current market. (But, consider France's Minitel in the 1980s, when it did make sense.) Also, the failure costs in health care are much higher than the failure costs in choosing the wrong mobile OS. The worst case for the former is an nation-wide epidemic. The worst case for your company is ... you run out of money and need to get a job.

jomamaxx 10y ago

Health Care is not like building roads. I live in Quebec, Canada and the healthcare here is among the worst in the civilized world. Also - it's illegal to pay a doctor to fix you. Canada is the only place in the world where it's illegal to pay someone to cure you of something. It's basically communist. The American system is untenable, but 'single payer' is not the solution. Successful countries that do it are tiny. Sweden is smaller than Los Angeles. Swtizerland does it at the cantonal level, which on average is 800 000 citizens. Can you imagine your entire hospital and insurance system being in blocks of 800 000? Maybe at the state level, subsidies, regulating drug prices etc. etc. - but full-on national level 'single payer' would be a huge disaster, beyond contemplation. Also in many single payer systems - the guy who snuck across the border illegally gets the exact same healthcare as you, working professional, paid a million in taxes, dutiful citizen etc.. I think there should be coverage for everyone, but single-payer is not the path.

icebraining 10y ago
Not a word about the UK's NHS?
jomamaxx 10y ago
You can vote me down if you want, but I live in a system where I cannot get a doctor. And it's illegal to pay for one. I' forced by the government, to use local clinics where they don't have my records, I don't have a relationship with the doctor, they can't make longer term prognosis, and frankly, the care is sub-par. I once had an ailment that was difficult to diagnose, the doctors at the clinics, used to seeing people for coughs and colds could give a shit. I ended up having to pay a few grand for an American entity operating barely within the bounds of legality in Canada (the Cleveland Clinic). I can assure you that it's a pretty desperate feeling when you are locked out of the system. Notre Dame Hospital in Montreal is lined with people in beds in the hallways, broken chairs, broken, leaking water fountains in the waiting room, broken / discarded beds in the waiting room - I thought I was in Cuba. The doctor was actually nice but the facilities were crazy. A well run McDonald's has more visible operating efficiency. It's far from optimal.
- 10y ago