5 ms·

From a European point of view I have a hard time understanding your opinion. In other countries, regulated/public healthcare works better and is more efficient

From a European point of view I have a hard time understanding your opinion. In other countries, regulated/public healthcare works better and is more efficient than your system, it's hard to deny it... I don't see how doubling down on cutting regulations would solve anything. In a way it reminds me of the gun control issue: the idea that deregulating gun ownership and carrying will make everybody safer seems so absurd from abroad... I guess it's cultural.

closeparen 8y ago
Regulating a service and providing it at public expense are completely separate concepts. Europeans do not have cheap healthcare as a result of price controls on private medical practices (regulation), but as a result of redistribution and subsidy (spending).
- etiennemarcel 8y ago
  At least in France, it's both. The cost for the patient is usually low thanks to the health insurance, but also because of price control. A GP visit is 25 euros by law, covered from 70 to 100% depending on your insurance. Doctors can choose to charge more but then patients need better private insurances to be reimbursed. You can find the price lists here: * https://www.ameli.fr/paris/medecin/exercice-liberal/facturation-remuneration/tarifs-generalistes/tarifs-metropole https://www.ameli.fr/paris/medecin/exercice-liberal/facturat... * https://www.ameli.fr/paris/medecin/exercice-liberal/facturation-remuneration/tarifs-specialistes/metropole https://www.ameli.fr/paris/medecin/exercice-liberal/facturat...
  - madmulita 8y ago
    How many visits does it take to get a simple prescription? We have something similar, I've been appointed consultations only to be asked how I felt.
    - daleco 8y ago
      You can get a simple prescription at the first consultation. For what I remember 10yrs ago, to see a specialist, you need to go to you general practitioner first. Then he will decide if you need a referral. Edit: you can go directly to a specialist or not follow the « health path », you will just get less reimbursed. Some specialist can be seen without referral (gyn, psy...)
  - closeparen 8y ago
    If doctors can choose to charge more to willing patients, that doesn't seem to actually be a price control. Perhaps 25 euros is the amount that the insurance system will reimburse?
    - etiennemarcel 8y ago
      The French system is fairly complex, it's not single payer. To sum up, for "everyday" health issues the public health insurance reimburses 70%. For grave long-term illnesses, you're covered 100%. You're supposed to have a private health insurance (it's now mandatory for all employees) that reimburses the remaining 30% and all extra costs. That includes some dental and optical work, but also stuff like single-bed rooms in the hospital. Your additional private insurance also covers doctors charging more than the "official" price.
- Emma_Goldman 8y ago
  No, the per capita cost of healthcare in the US is astronomically greater than Western European countries, including both private and public spend. In the UK the NHS is a socialised service that is free at the point of use. If that's not 'regulation' then I don't know what is.
  - yawboakye 8y ago
    It's not a regulation of a private industry. It's a law on the people to pay for public health. If we still want to call it a regulation then it's a regulation on individuals instead of the health business.
  - closeparen 8y ago
    To regulate an industry is to make rules about how its participants may behave. This worlds away from government participating in the industry directly. Public housing is a public service; rent control is regulation. Public transit is a public service; fuel efficiency standards are regulation. Medicare is a public service; the medical licensing regime is regulation.
triviatise 8y ago
Europeans have cheap healthcare because most of the R&D is subsidized by the US paying list prices. Europeans can spend such a huge amount (16% of govt budget vs 10% in the US) partially because the US is subsidizing their defense. The US will eventually go to socialized medicine and then you will see the pace of medical advancement slow. Unfortunately it will be impossible to see because it is unknowable what would have been invented with a capitalist system.
mhh__ 8y ago
The argument is that although the U.S healthcare system - based off of some metric - underperforms compared to a system which makes no claim of being based on a free market, the U.S. healthcare is also not a free market by any means. Lightly regulated it is not. Also, you combine "works better" and efficiency: This is slightly unheplful, as although (let's say) the NHS is very cost efficient is - however - not anywhere near as impressive when it comes to patient outcomes. I am not well-versed in the topic to provide a well thought out counterexample however I believe that the Swiss system would be a suitable example? Comparing the deregulation of businesses with guns is fallacious if not ridiculous: However, being British etc, I do share your fears as to healthcare deregulation.

closeparen 8y ago

Regulating a service and providing it at public expense are completely separate concepts. Europeans do not have cheap healthcare as a result of price controls on private medical practices (regulation), but as a result of redistribution and subsidy (spending).

etiennemarcel 8y ago
At least in France, it's both. The cost for the patient is usually low thanks to the health insurance, but also because of price control. A GP visit is 25 euros by law, covered from 70 to 100% depending on your insurance. Doctors can choose to charge more but then patients need better private insurances to be reimbursed. You can find the price lists here: * https://www.ameli.fr/paris/medecin/exercice-liberal/facturation-remuneration/tarifs-generalistes/tarifs-metropole https://www.ameli.fr/paris/medecin/exercice-liberal/facturat... * https://www.ameli.fr/paris/medecin/exercice-liberal/facturation-remuneration/tarifs-specialistes/metropole https://www.ameli.fr/paris/medecin/exercice-liberal/facturat...
- madmulita 8y ago
  How many visits does it take to get a simple prescription? We have something similar, I've been appointed consultations only to be asked how I felt.
  - daleco 8y ago
    You can get a simple prescription at the first consultation. For what I remember 10yrs ago, to see a specialist, you need to go to you general practitioner first. Then he will decide if you need a referral. Edit: you can go directly to a specialist or not follow the « health path », you will just get less reimbursed. Some specialist can be seen without referral (gyn, psy...)
- closeparen 8y ago
  If doctors can choose to charge more to willing patients, that doesn't seem to actually be a price control. Perhaps 25 euros is the amount that the insurance system will reimburse?
  - etiennemarcel 8y ago
    The French system is fairly complex, it's not single payer. To sum up, for "everyday" health issues the public health insurance reimburses 70%. For grave long-term illnesses, you're covered 100%. You're supposed to have a private health insurance (it's now mandatory for all employees) that reimburses the remaining 30% and all extra costs. That includes some dental and optical work, but also stuff like single-bed rooms in the hospital. Your additional private insurance also covers doctors charging more than the "official" price.
Emma_Goldman 8y ago
No, the per capita cost of healthcare in the US is astronomically greater than Western European countries, including both private and public spend. In the UK the NHS is a socialised service that is free at the point of use. If that's not 'regulation' then I don't know what is.
- yawboakye 8y ago
  It's not a regulation of a private industry. It's a law on the people to pay for public health. If we still want to call it a regulation then it's a regulation on individuals instead of the health business.
- closeparen 8y ago
  To regulate an industry is to make rules about how its participants may behave. This worlds away from government participating in the industry directly. Public housing is a public service; rent control is regulation. Public transit is a public service; fuel efficiency standards are regulation. Medicare is a public service; the medical licensing regime is regulation.

triviatise 8y ago

Europeans have cheap healthcare because most of the R&D is subsidized by the US paying list prices. Europeans can spend such a huge amount (16% of govt budget vs 10% in the US) partially because the US is subsidizing their defense. The US will eventually go to socialized medicine and then you will see the pace of medical advancement slow. Unfortunately it will be impossible to see because it is unknowable what would have been invented with a capitalist system.

mhh__ 8y ago

The argument is that although the U.S healthcare system - based off of some metric - underperforms compared to a system which makes no claim of being based on a free market, the U.S. healthcare is also not a free market by any means. Lightly regulated it is not. Also, you combine "works better" and efficiency: This is slightly unheplful, as although (let's say) the NHS is very cost efficient is - however - not anywhere near as impressive when it comes to patient outcomes. I am not well-versed in the topic to provide a well thought out counterexample however I believe that the Swiss system would be a suitable example? Comparing the deregulation of businesses with guns is fallacious if not ridiculous: However, being British etc, I do share your fears as to healthcare deregulation.