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If you're a wealthy person anywhere in the world and you have a really terrible disease you're probably going to come to the US to get care. Why? Because we h

If you're a wealthy person anywhere in the world and you have a really terrible disease you're probably going to come to the US to get care. Why? Because we have the highest quality healthcare in the world. There's a reason why there was some mild drama over Danny Williams (Premier of Canadian province) hopped the border to have heart surgery in the US. We're the best. What we lack is healthcare access for the poor. Dampening the profitability of health care with single payer will reduce quality and increase access. That's an okay argument to make, just make sure you're stating both sides when you make an argument. Otherwise it's just disingenuous. Also, it's important not to be fooled by some of the comparative health stats. Many of our poor health stats are the more the result of culture than they are a lack of access to health care. Being able to go to the doctor without paying a copay doesn't matter much when you're 100 pounds overweight and don't follow the diabetic diet your doctor laid out for you.

and0 10y ago
I'd have to look into this, but I'd imagine the fact that the best doctors preside a.) in the richest country in the world with b.) the most lucrative health industry has a lot to do with the former as well as the latter. Danny Williams also claimed he traveled to the US to see a specific specialist, not because no one in his own province could do the surgery, although we can't know for sure. To make your arguments and not take all that into consideration also seems disingenuous. (I also can't imagine that heart surgery would become drastically more dangerous in the US under universal healthcare, certainly not enough to offset it's unavailability. Where exactly are these amazing doctors going to go, anyway?)
- Consultant32452 10y ago
  >the most lucrative health industry Yes, that's the whole point of my argument. We have the best because it's lucrative. The health care plans people tend to put forth to fix our system would make our healthcare system less lucrative. >Danny Williams also claimed he traveled to the US to see a specific specialist, not because no one in his own province could do the surgery, although we can't know for sure. Right, he went to where he believed the best specialist was. In the US. > not take all that into consideration also seems disingenuous. I didn't not take all that into consideration. In fact, it was the entirety of my consideration.
  - andreasklinger 10y ago
    Re lucrative: "Private" doctors exist also in single payer models. If you want the premium model pay for the premium model. There is just a good enough alternative available to everyone.
jpttsn 10y ago
Well said. I sometimes hear complaints that US healthcare is more expensive, that (perhaps just by mistaken reasoning) treat healthcare as a commodity. In Economics terms, that's a pretty hefty simplification: sort of like complaining that US phones are so much more expensive than Finnish phones.
ska 10y ago
Why? Because we have the highest quality healthcare in the world. This is one of those statements that kind-of true, but not in the sense that people bringing it up mostly mean. In fact "best in the world" care depends largely on disease, in many cases the best teams in the world are in the US, in others they are not. If you are (globally) rich, you go wherever the best care is. But that typically isn't "the US", that's far too broad. It is a particular team, at a particular hospital, in the US. Or maybe there are 3 to choose from. So sure, if you are rich enough to go anywhere, and have enough social capital to get in, you can have amazing care for most conditions in the US. And in some cases you would go to France, say, instead - because they were better for what you have. But that doesn't mean that the average person in the US in the average hospital, say, is getting the "best care". As far as we can see (and it's difficult) mostly what they are getting is roughly equivalent care for higher costs. It's a complicated issue as to why, of course. Particularly if you are looking at outcomes, rather than procedures. On top of that, access for 10's of millions of Americans is sub-par, in comparison to peer systems.
- Tenhundfeld 10y ago
  Exactly, the US has many of the leading (highest quality) medical specialists, which you would expect from the richest country with the best research university system. That does not mean the US has the highest quality healthcare in terms of health outcomes for the population. If anyone reading this believes we (the US) have the highest quality health outcomes, please do some research with an open mind. We're not terrible, just far worse than you'd expect given our wealth. We are actually great in some cases, e.g., certain types of cancer treatment (I think, don't have stats at hand). But in many, many categories, our outcomes are middle of the pack or towards the bottom for developed countries. For example, IIRC, we're quite middling/mediocre in life expectancy, infant mortality, heart attack mortality, % of diabetics with managed care, efficiency of spend, etc.
  - Consultant32452 10y ago
    > For example, IIRC, we're quite middling/mediocre in life expectancy, infant mortality, heart attack mortality, % of diabetics with managed care, efficiency of spend, etc. Life expectancy, infant mortality, and heart attack mortality are directly related to our culture more than access to health care. Go look at our obesity rates. Do you think not having to pay a copay to go to a doctor would fix that?
otterley 10y ago
Single-payer health care establishes a floor, not a ceiling of coverage. That in itself is a reason to do it, because it reduces overall costs due to the amortization effect of preventive medicine that people have a right to access. Single-payer coverage doesn't necessarily dry up the market for private insurance, either. Citizens of Canada and other countries have access to additional coverage that covers faster access to medical care and more expensive procedures. So yes, you can have your cake and eat it, too, if you set things up right.
- Consultant32452 10y ago
  >That in itself is a reason to do it, because it reduces overall costs due to the amortization effect of preventive medicine that people have a right to access. Reducing the over-all cost isn't necessarily the only goal. One goal could also be to have the highest quality care in the world, which we have today. >Single-payer coverage doesn't necessarily dry up the market for private insurance, either. Comparing the private insurance industry in the US and Canada or UK is laughable. The fact that it exists is not the same as saying it isn't dried up.
  - Tenhundfeld 10y ago
    The US has many of the "highest quality" specialists. The US population does not receive the highest quality healthcare in the world. If you are rich and sick, there's a decent chance that the world's leading specialist on your illness will be in the US. If you are poor and sick, you will receive higher quality healthcare in many other developed countries. These are not the same thing; you are conflating them, I assume to support an ideological point. Just look at any ranking of healthcare outcomes for developed nations.
    - Consultant32452 10y ago
      >Just look at any ranking of healthcare outcomes for developed nations. Yes, I addressed that. Look at our obesity rates. That has almost nothing to do with healthcare access and almost everything to do with our average lifespan.
DanBC 10y ago
> Why? Because we have the highest quality healthcare in the world. If we ignore the fact that the US is in the 10 OECD nations with lowest life expectancy. There's a bunch of over-testing, over-diagnosis, and over-treatment in the US. These make customers feel like they're getting good service, even though they're being harmed by it.
- Consultant32452 10y ago
  >If we ignore the fact that the US is in the 10 OECD nations with lowest life expectancy. We have among the lowest life expectancy because we have among the highest obesity. That has almost nothing to do with healthcare access. >There's a bunch of over-testing, over-diagnosis, and over-treatment in the US. These make customers feel like they're getting good service, even though they're being harmed by it. If you really believe that getting too much access to healthcare treatments is the big problem in our country, you might be in the wrong discussion.
  - cryptarch 10y ago
    Do you think obesity is not significantly increased by overmedication?
    - Consultant32452 10y ago
      It might be statistically significant, but it's definitely not the primary cause. Our government fed us HORRIBLE high carb nutrition guidelines for decades and continues to subsidize the sugar (mainly high fructose corn syrup) industry. Those are much bigger factors than whether or not you got a useless MRI.
cryptarch 10y ago
The US does not have a monopoly on high quality health care, and what use are the best experts if they're too expensive? It's not like you can have your pick of the US top experts as long as you're insured in the US. I live in the Netherlands and our healthcare system is pretty damned good. I pay €92 (~100 USD) a month for my healthcare plan, which covers most anything (I only sometimes have to pay ~€50 for dental checkups out of pocket, but dental/jaw surgery is insured again). It even covers eyewear and contraceptives! Our population is healthier, which probably helps keep costs down. I do wish our air quality was better, but there was only 10km's of road left that did not fulfill the EU maximum emission goals in 2015.
- Consultant32452 10y ago
  >The US does not have a monopoly on high quality health care, and what use are the best experts if they're too expensive? It's not like you can have your pick of the US top experts as long as you're insured in the US. Go do a google search for something like "best children's hospitals in the world." I challenge you to find a list that isn't at last 75% US hospitals. Most are over 90% US. If you have something that warrants it in the US, you're going to get into one of those hospitals and you're not going to pay anything. >Our population is healthier, which probably helps keep costs down. This not only keeps costs down, but also keeps health stats up. Your life expectancy is probably a lot better than ours, but you also have much lower obesity rates. People often cite our health outcomes with any context at all. Context matters. The fact that over a third of our population is obese matters. And not having to pay a copay isn't going to change that.
  - vacri 10y ago
    > Go do a google search for something like "best children's hospitals in the world." So I did that, and noticed something weird. Here's a list of '30 best' http://www.topmastersinhealthcare.com/30-most-technologically-advanced-childrens-hospitals-in-the-world/ http://www.topmastersinhealthcare.com/30-most-technologicall... So, the weird thing? They're all in English-speaking nations, with the exception of one that is in Israel (which has strong medico-political ties with the US and a lot of English speakers anyway). The whole of Europe outside the UK doesn't rate, not even Germany or Sweden. The problem with these kinds of lists is that they're so Americo-centric to begin with, most probably because they're written by Americans. It's like how the "World Series" in baseball has only a token attempt at including other countries.
vacri 10y ago
"We're the best for the 1%" != "We're the best", and it's incredibly disingenuous to argue that.

and0 10y ago

I'd have to look into this, but I'd imagine the fact that the best doctors preside a.) in the richest country in the world with b.) the most lucrative health industry has a lot to do with the former as well as the latter. Danny Williams also claimed he traveled to the US to see a specific specialist, not because no one in his own province could do the surgery, although we can't know for sure. To make your arguments and not take all that into consideration also seems disingenuous. (I also can't imagine that heart surgery would become drastically more dangerous in the US under universal healthcare, certainly not enough to offset it's unavailability. Where exactly are these amazing doctors going to go, anyway?)

Consultant32452 10y ago
>the most lucrative health industry Yes, that's the whole point of my argument. We have the best because it's lucrative. The health care plans people tend to put forth to fix our system would make our healthcare system less lucrative. >Danny Williams also claimed he traveled to the US to see a specific specialist, not because no one in his own province could do the surgery, although we can't know for sure. Right, he went to where he believed the best specialist was. In the US. > not take all that into consideration also seems disingenuous. I didn't not take all that into consideration. In fact, it was the entirety of my consideration.
- andreasklinger 10y ago
  Re lucrative: "Private" doctors exist also in single payer models. If you want the premium model pay for the premium model. There is just a good enough alternative available to everyone.

jpttsn 10y ago

Well said. I sometimes hear complaints that US healthcare is more expensive, that (perhaps just by mistaken reasoning) treat healthcare as a commodity. In Economics terms, that's a pretty hefty simplification: sort of like complaining that US phones are so much more expensive than Finnish phones.

ska 10y ago

Why? Because we have the highest quality healthcare in the world. This is one of those statements that kind-of true, but not in the sense that people bringing it up mostly mean. In fact "best in the world" care depends largely on disease, in many cases the best teams in the world are in the US, in others they are not. If you are (globally) rich, you go wherever the best care is. But that typically isn't "the US", that's far too broad. It is a particular team, at a particular hospital, in the US. Or maybe there are 3 to choose from. So sure, if you are rich enough to go anywhere, and have enough social capital to get in, you can have amazing care for most conditions in the US. And in some cases you would go to France, say, instead - because they were better for what you have. But that doesn't mean that the average person in the US in the average hospital, say, is getting the "best care". As far as we can see (and it's difficult) mostly what they are getting is roughly equivalent care for higher costs. It's a complicated issue as to why, of course. Particularly if you are looking at outcomes, rather than procedures. On top of that, access for 10's of millions of Americans is sub-par, in comparison to peer systems.

Tenhundfeld 10y ago
Exactly, the US has many of the leading (highest quality) medical specialists, which you would expect from the richest country with the best research university system. That does not mean the US has the highest quality healthcare in terms of health outcomes for the population. If anyone reading this believes we (the US) have the highest quality health outcomes, please do some research with an open mind. We're not terrible, just far worse than you'd expect given our wealth. We are actually great in some cases, e.g., certain types of cancer treatment (I think, don't have stats at hand). But in many, many categories, our outcomes are middle of the pack or towards the bottom for developed countries. For example, IIRC, we're quite middling/mediocre in life expectancy, infant mortality, heart attack mortality, % of diabetics with managed care, efficiency of spend, etc.
- Consultant32452 10y ago
  > For example, IIRC, we're quite middling/mediocre in life expectancy, infant mortality, heart attack mortality, % of diabetics with managed care, efficiency of spend, etc. Life expectancy, infant mortality, and heart attack mortality are directly related to our culture more than access to health care. Go look at our obesity rates. Do you think not having to pay a copay to go to a doctor would fix that?

otterley 10y ago

Single-payer health care establishes a floor, not a ceiling of coverage. That in itself is a reason to do it, because it reduces overall costs due to the amortization effect of preventive medicine that people have a right to access. Single-payer coverage doesn't necessarily dry up the market for private insurance, either. Citizens of Canada and other countries have access to additional coverage that covers faster access to medical care and more expensive procedures. So yes, you can have your cake and eat it, too, if you set things up right.

Consultant32452 10y ago
>That in itself is a reason to do it, because it reduces overall costs due to the amortization effect of preventive medicine that people have a right to access. Reducing the over-all cost isn't necessarily the only goal. One goal could also be to have the highest quality care in the world, which we have today. >Single-payer coverage doesn't necessarily dry up the market for private insurance, either. Comparing the private insurance industry in the US and Canada or UK is laughable. The fact that it exists is not the same as saying it isn't dried up.
- Tenhundfeld 10y ago
  The US has many of the "highest quality" specialists. The US population does not receive the highest quality healthcare in the world. If you are rich and sick, there's a decent chance that the world's leading specialist on your illness will be in the US. If you are poor and sick, you will receive higher quality healthcare in many other developed countries. These are not the same thing; you are conflating them, I assume to support an ideological point. Just look at any ranking of healthcare outcomes for developed nations.
  - Consultant32452 10y ago
    >Just look at any ranking of healthcare outcomes for developed nations. Yes, I addressed that. Look at our obesity rates. That has almost nothing to do with healthcare access and almost everything to do with our average lifespan.

DanBC 10y ago

> Why? Because we have the highest quality healthcare in the world. If we ignore the fact that the US is in the 10 OECD nations with lowest life expectancy. There's a bunch of over-testing, over-diagnosis, and over-treatment in the US. These make customers feel like they're getting good service, even though they're being harmed by it.

Consultant32452 10y ago
>If we ignore the fact that the US is in the 10 OECD nations with lowest life expectancy. We have among the lowest life expectancy because we have among the highest obesity. That has almost nothing to do with healthcare access. >There's a bunch of over-testing, over-diagnosis, and over-treatment in the US. These make customers feel like they're getting good service, even though they're being harmed by it. If you really believe that getting too much access to healthcare treatments is the big problem in our country, you might be in the wrong discussion.
- cryptarch 10y ago
  Do you think obesity is not significantly increased by overmedication?
  - Consultant32452 10y ago
    It might be statistically significant, but it's definitely not the primary cause. Our government fed us HORRIBLE high carb nutrition guidelines for decades and continues to subsidize the sugar (mainly high fructose corn syrup) industry. Those are much bigger factors than whether or not you got a useless MRI.

cryptarch 10y ago

The US does not have a monopoly on high quality health care, and what use are the best experts if they're too expensive? It's not like you can have your pick of the US top experts as long as you're insured in the US. I live in the Netherlands and our healthcare system is pretty damned good. I pay €92 (~100 USD) a month for my healthcare plan, which covers most anything (I only sometimes have to pay ~€50 for dental checkups out of pocket, but dental/jaw surgery is insured again). It even covers eyewear and contraceptives! Our population is healthier, which probably helps keep costs down. I do wish our air quality was better, but there was only 10km's of road left that did not fulfill the EU maximum emission goals in 2015.

Consultant32452 10y ago
>The US does not have a monopoly on high quality health care, and what use are the best experts if they're too expensive? It's not like you can have your pick of the US top experts as long as you're insured in the US. Go do a google search for something like "best children's hospitals in the world." I challenge you to find a list that isn't at last 75% US hospitals. Most are over 90% US. If you have something that warrants it in the US, you're going to get into one of those hospitals and you're not going to pay anything. >Our population is healthier, which probably helps keep costs down. This not only keeps costs down, but also keeps health stats up. Your life expectancy is probably a lot better than ours, but you also have much lower obesity rates. People often cite our health outcomes with any context at all. Context matters. The fact that over a third of our population is obese matters. And not having to pay a copay isn't going to change that.
- vacri 10y ago
  > Go do a google search for something like "best children's hospitals in the world." So I did that, and noticed something weird. Here's a list of '30 best' http://www.topmastersinhealthcare.com/30-most-technologically-advanced-childrens-hospitals-in-the-world/ http://www.topmastersinhealthcare.com/30-most-technologicall... So, the weird thing? They're all in English-speaking nations, with the exception of one that is in Israel (which has strong medico-political ties with the US and a lot of English speakers anyway). The whole of Europe outside the UK doesn't rate, not even Germany or Sweden. The problem with these kinds of lists is that they're so Americo-centric to begin with, most probably because they're written by Americans. It's like how the "World Series" in baseball has only a token attempt at including other countries.

vacri 10y ago

"We're the best for the 1%" != "We're the best", and it's incredibly disingenuous to argue that.