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Germany is one of very few countries with a robust public insurance scheme which also allows private insurance, but I wouldn't expect that to last too much long

by TillE 9y ago

Germany is one of very few countries with a robust public insurance scheme which also allows private insurance, but I wouldn't expect that to last too much longer - there's a growing consensus (57.6% in a recent poll) around the idea that receiving faster or better care because you can pay more is fundamentally unfair. People need the health care that they need. Unless we're talking about small things like your own private bed in a hospital, there's no room in a just society for a "basic service" which does not provide the best possible care.

jedberg 9y ago
> there's no room in a just society for a "basic service" which does not provide the best possible care. Unfortunately health care is still a finite resource, and you can't give everyone the best care. You either give some the best care and everyone else good care, or you give everyone pretty good care, but no one gets the best care. Each has its merits, but my personal feeling is if no one gets "the best care", then we as a society will forget how to give such care, and medical innovation will become stagnant. There is a reason that the health systems with at least some private participation (USA, France, Germany) also have the most innovation. We need a balance so there can still be a motive for innovation.
- gbacon 9y ago
  If everyone is super, then no one is.
ascorbic 9y ago
The UK has similar. Single payer rather than public insurance, but people can buy private insurance if they want. It's certainly a small minority who do: it's largely a perk for some senior jobs, along with the BMW. It's relatively cheap (around £50/month for a non-smoker in their 30s), because all of the basic stuff is already covered by the NHS. The private insurance is mostly about getting shorter waiting times for elective surgery, and maybe a nice room.
philwelch 9y ago
So, for example: should the government provide free LASIK for everyone who wants it, or should they make it outright illegal to even pay for LASIK out of pocket? What about vasectomies? Abortions? What if it's something my doctor and I agree would be a good course of treatment, but the health care bureaucrats don't agree with?
conanbatt 9y ago
> (57.6% in a recent poll) around the idea that receiving faster or better care because you can pay more is fundamentally unfair. Gross.
disprove 9y ago
> receiving faster or better care because you can pay more is fundamentally unfair It's considered fair exactly the for reasons you have mentioned: you pay more for a premium product. > there's no room in a just society for a "basic service" which does not provide the best possible care. A regulated market that denies individual differences and enforces the same salary for different talents is incompatible with a "just society". In this case, healthcare workers with above-average talent would emigrate to a country where they can get a fair salary. If you are worried about fairness, please consider the other side, the healthcare professional who provides the service. Patients who pay basic fees are not entitled for the "best possible care". The provider of the "best possible care" can raise the price anytime. There is no economic justification for price rigging.
gbacon 9y ago
… the idea that receiving faster or better care because you can pay more is fundamentally unfair. Is it unfair because it’s health care specifically or because of something else? Premium service offerings abound: priority mail delivery; first class passage; reddit gold; ongoing memberships or subscriptions to movie theaters, golf courses, publications, and podcasts; “freemium” model web services, and Amazon Prime. … there's no room in a just society for a "basic service" which does not provide the best possible care. Basic service and best possible care are at different ends of the spectrum for whatever good or service we’re talking about. What did you mean by this remark?

by TillE 9y ago

jedberg 9y ago

> there's no room in a just society for a "basic service" which does not provide the best possible care. Unfortunately health care is still a finite resource, and you can't give everyone the best care. You either give some the best care and everyone else good care, or you give everyone pretty good care, but no one gets the best care. Each has its merits, but my personal feeling is if no one gets "the best care", then we as a society will forget how to give such care, and medical innovation will become stagnant. There is a reason that the health systems with at least some private participation (USA, France, Germany) also have the most innovation. We need a balance so there can still be a motive for innovation.

gbacon 9y ago
If everyone is super, then no one is.

ascorbic 9y ago

The UK has similar. Single payer rather than public insurance, but people can buy private insurance if they want. It's certainly a small minority who do: it's largely a perk for some senior jobs, along with the BMW. It's relatively cheap (around £50/month for a non-smoker in their 30s), because all of the basic stuff is already covered by the NHS. The private insurance is mostly about getting shorter waiting times for elective surgery, and maybe a nice room.

philwelch 9y ago

So, for example: should the government provide free LASIK for everyone who wants it, or should they make it outright illegal to even pay for LASIK out of pocket? What about vasectomies? Abortions? What if it's something my doctor and I agree would be a good course of treatment, but the health care bureaucrats don't agree with?

conanbatt 9y ago

> (57.6% in a recent poll) around the idea that receiving faster or better care because you can pay more is fundamentally unfair. Gross.

disprove 9y ago

> receiving faster or better care because you can pay more is fundamentally unfair It's considered fair exactly the for reasons you have mentioned: you pay more for a premium product. > there's no room in a just society for a "basic service" which does not provide the best possible care. A regulated market that denies individual differences and enforces the same salary for different talents is incompatible with a "just society". In this case, healthcare workers with above-average talent would emigrate to a country where they can get a fair salary. If you are worried about fairness, please consider the other side, the healthcare professional who provides the service. Patients who pay basic fees are not entitled for the "best possible care". The provider of the "best possible care" can raise the price anytime. There is no economic justification for price rigging.

gbacon 9y ago

… the idea that receiving faster or better care because you can pay more is fundamentally unfair. Is it unfair because it’s health care specifically or because of something else? Premium service offerings abound: priority mail delivery; first class passage; reddit gold; ongoing memberships or subscriptions to movie theaters, golf courses, publications, and podcasts; “freemium” model web services, and Amazon Prime. … there's no room in a just society for a "basic service" which does not provide the best possible care. Basic service and best possible care are at different ends of the spectrum for whatever good or service we’re talking about. What did you mean by this remark?