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As an Australian I always struggle with the idea that healthcare would cost money above a couple of dollars for things that aren't essential. But almost every

As an Australian I always struggle with the idea that healthcare would cost money above a couple of dollars for things that aren't essential. But almost every American I've ever spoken to who hasn't experienced decent national healthcare seem to have a bizzare view that "if it's free then obviously it will be abused", not realising that it's just as open to abuse as a system where end customer are also involved because shockingly customers arent usually the ones committing the fraud. It genuinely feels like theres a view that some people might not "deserve" healthcare, and the way we determine who "deserves" healthcare is not the very humane "well they need it, therefore they deserve it" but rather "capitalism. Definitely the answer." Makes me a little sad, but I guess when you have nothing else to compare it to...

sjwright 8y ago
Also Australian. The concept of abuse seems hilarious. What abuse? That people might visit their local doctor more frequently? That's a good thing! Many ailments get more expensive to treat the longer they are left untreated. Once you come to terms with the fact it's permanently cheap/free, the psychological incentive to be wasteful ("use it or lose it") disappears completely. By comparison the American capitalist health system continually reinforces the notion that healthcare has monetary value, which means failing to take advantage of it feels wasteful.
- gaius 8y ago
  The concept of abuse seems hilarious. What abuse? That people might visit their local doctor more frequently? That's a good thing! In the UK A&E is flooded with people with minor ailments that could have been treated at home with a first aid kit, or people who are just drunk. The system is definitely taken for granted. People even call ambulances for a ride to an appointment, not even an emergency. Source: once spent 5 hours waiting to be seen in A&E, sitting on a plastic chair with a broken leg, while kids with grazed knees and people with minor colds were seen before me. If I needed the bathroom or a glass of water, I had to get up and hobble there on my broken leg. The NHS were great once I actually got seen, but they are swamped with idiots demanding unnecessary medical attention, because it's free.
  - KineticLensman 8y ago
    Also UK. Some 'abuse' of A&E happens because people cannot alway get access to a local surgery as opposed to driving to a nearby hospital, especially at weekends.
    - therealidiot 8y ago
      This. I had half of my face stop working and had recently moved (and not yet registered with a new GP.) I went to my previous GP and they turned me away (no longer in the catchment area) so I eventually ended up in A&E. It doesn't help that the local ones near me at the time seem to live in the past... No call queuing or online scheduling, have to call within a 1 hour slot for appointments (so that's an hour of busy tones, oh well let's try again tomorrow)
      - sjwright 8y ago
        Why does the NHS have catchment areas? Surely you should be allowed to visit any GP anywhere. People do travel after all.
        gaius 8y ago
        Surely you should be allowed to visit any GP anywhere A GP practice is a private business, usually all the GPs are partners just as lawyers or accountants would be, and the staff such as receptionists are not NHS employees, they work for the practice. If they can't bill the NHS for their services because you're not on their books, they aren't interested. It is surprising perhaps, but many people in the UK are unaware of this, they think the GPs surgery is directly a branch of the main NHS, and get angry about "privatisation" without realising that GPs have always been private.
        sjwright 8y ago
        Right, but why are private practices artificially limited for whom they can bill the NHS? That seems like pointless, unnecessary bureaucracy that comes back to bite them with more A&E visits.
mikeash 8y ago
There is a massive propaganda machine pushing against any sort of universal health care here. The idea that not everyone deserves care is definitely one of the angles they push. Another angle is that socialized medicine is garbage, a view which tends to confuse people who have lived with it.

sjwright 8y ago

Also Australian. The concept of abuse seems hilarious. What abuse? That people might visit their local doctor more frequently? That's a good thing! Many ailments get more expensive to treat the longer they are left untreated. Once you come to terms with the fact it's permanently cheap/free, the psychological incentive to be wasteful ("use it or lose it") disappears completely. By comparison the American capitalist health system continually reinforces the notion that healthcare has monetary value, which means failing to take advantage of it feels wasteful.

gaius 8y ago
The concept of abuse seems hilarious. What abuse? That people might visit their local doctor more frequently? That's a good thing! In the UK A&E is flooded with people with minor ailments that could have been treated at home with a first aid kit, or people who are just drunk. The system is definitely taken for granted. People even call ambulances for a ride to an appointment, not even an emergency. Source: once spent 5 hours waiting to be seen in A&E, sitting on a plastic chair with a broken leg, while kids with grazed knees and people with minor colds were seen before me. If I needed the bathroom or a glass of water, I had to get up and hobble there on my broken leg. The NHS were great once I actually got seen, but they are swamped with idiots demanding unnecessary medical attention, because it's free.
- KineticLensman 8y ago
  Also UK. Some 'abuse' of A&E happens because people cannot alway get access to a local surgery as opposed to driving to a nearby hospital, especially at weekends.
  - therealidiot 8y ago
    This. I had half of my face stop working and had recently moved (and not yet registered with a new GP.) I went to my previous GP and they turned me away (no longer in the catchment area) so I eventually ended up in A&E. It doesn't help that the local ones near me at the time seem to live in the past... No call queuing or online scheduling, have to call within a 1 hour slot for appointments (so that's an hour of busy tones, oh well let's try again tomorrow)
    - sjwright 8y ago
      Why does the NHS have catchment areas? Surely you should be allowed to visit any GP anywhere. People do travel after all.
      - gaius 8y ago
        Surely you should be allowed to visit any GP anywhere A GP practice is a private business, usually all the GPs are partners just as lawyers or accountants would be, and the staff such as receptionists are not NHS employees, they work for the practice. If they can't bill the NHS for their services because you're not on their books, they aren't interested. It is surprising perhaps, but many people in the UK are unaware of this, they think the GPs surgery is directly a branch of the main NHS, and get angry about "privatisation" without realising that GPs have always been private.
        sjwright 8y ago
        Right, but why are private practices artificially limited for whom they can bill the NHS? That seems like pointless, unnecessary bureaucracy that comes back to bite them with more A&E visits.

mikeash 8y ago

There is a massive propaganda machine pushing against any sort of universal health care here. The idea that not everyone deserves care is definitely one of the angles they push. Another angle is that socialized medicine is garbage, a view which tends to confuse people who have lived with it.