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> People should never have to worry whether they can financially manage to go and see a doctor when they are in need of one. Doesn't care if you've broken your

> People should never have to worry whether they can financially manage to go and see a doctor when they are in need of one. Doesn't care if you've broken your arm, am expecting a child or if you're chronically ill. I live in Sweden. Sweden has socialised health care so in theory it should be possible to go and see a doctor when [I am] in need of one. That's right, in theory. In practice the waiting times can be so astronomical that many people - my partner included - are on private health care insurances to make sure they actually go and see a doctor when they need one instead of in 4 months time, if you're lucky. This does mean they pay twice for health care, once through provincial ('landsting') taxes, once through the private health care insurance. It is the latter which ends up paying the bill, the question is where the former money goes. When she needed to see a doctor a few months ago she first tried to go the normal route through the public health care system. The response was 'we can book you for this-and-that date in 6 months time'. Right. When she called the private insurance it only took a few days. These waiting times accumulate, e.g. the doctor wants the patient to get a CT scan - wait for 2 months. MRI, wait 3 months, etc. The private insurance has bought (time on the) machines so they can offer a time next week. For acute problems the public health care system is still the go-to place even if waiting times in emergency rooms are now so long that some hospitals (e.g. Sunderby, between Luleå and Boden in Norrbotten) have called upon visitors to 'make sure to take food and any needed medications with them as the waiting time can exceed 24 hours'. So where to go from here? Public health care is affordable but often not available. Private health care is available but often not affordable. How can these two goals - affordability and availability - be met in one system?

martin_a 7y ago
> Public health care is affordable but often not available. Private health care is available but often not affordable. Well, we both know that those are the same in the end. It's not like there are seperate CT scanners for private insurance patients, but the later are treated with priority as they can be billed more. > How can these two goals - affordability and availability - be met in one system? I think this is a problem of prioritizing and financing. For one, I would immediately stop and forbild all private health insurances in Germany and make being member of one of the public health care insurances mandatory. Also public employees would have to pay their share for all social services. All of them, just like any other employee. This will right away stop this whole BS with prioritizing private patients over those with public healthcare and it will also fix lots of financing issues in the long run. Once that is done, pay the same money for everything at all places and also pay all (equally qualified) doctors the same. Obviously some kind of expert council will have to decide a fair price for everything, but in the end a CT scan should cost the same around the whole country. If we have established this, lots of problems will solve themselves: Doctors will move out to the rural areas too, because the money is the same. Also with more money, we can pay better prices, build up new medical infrastructure and what not. We provide and finance so much infrastructure because we find this to be a fundamental part of our society, but we fail so hard on medical infrastructure. That just doesn't fit together.
Youden 7y ago
I've lived in the US (fully private), Australia (universal healthcare) and Switzerland (a weird system somewhere in the middle of universal and fully private) and I've only had issues like you describe in the US. So based on this (very small) sample, it seems like there's little correlation between the funding system and the quality/access to care. I don't even think it's a matter of funding. For good care, Australia has relatively low spending, while Switzerland has quite high spending. For bad care, the US and Sweden both spend quite a lot (per OECD [0]). [0]: https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthres/health-spending.htm
shermozle 7y ago
Sounds like Sweden have fucked it up, not that public healthcare is a broken concept. You should try the British NHS. It's not perfect but it's pretty fucking good, and free. The problem in Australia is right-wing ideologues chipping away at public health to enrich their donors in the private health "insurance" scam industry, subsidising it and forcing people into it when it provides almost no benefit.

martin_a 7y ago

> Public health care is affordable but often not available. Private health care is available but often not affordable. Well, we both know that those are the same in the end. It's not like there are seperate CT scanners for private insurance patients, but the later are treated with priority as they can be billed more. > How can these two goals - affordability and availability - be met in one system? I think this is a problem of prioritizing and financing. For one, I would immediately stop and forbild all private health insurances in Germany and make being member of one of the public health care insurances mandatory. Also public employees would have to pay their share for all social services. All of them, just like any other employee. This will right away stop this whole BS with prioritizing private patients over those with public healthcare and it will also fix lots of financing issues in the long run. Once that is done, pay the same money for everything at all places and also pay all (equally qualified) doctors the same. Obviously some kind of expert council will have to decide a fair price for everything, but in the end a CT scan should cost the same around the whole country. If we have established this, lots of problems will solve themselves: Doctors will move out to the rural areas too, because the money is the same. Also with more money, we can pay better prices, build up new medical infrastructure and what not. We provide and finance so much infrastructure because we find this to be a fundamental part of our society, but we fail so hard on medical infrastructure. That just doesn't fit together.

Youden 7y ago

I've lived in the US (fully private), Australia (universal healthcare) and Switzerland (a weird system somewhere in the middle of universal and fully private) and I've only had issues like you describe in the US. So based on this (very small) sample, it seems like there's little correlation between the funding system and the quality/access to care. I don't even think it's a matter of funding. For good care, Australia has relatively low spending, while Switzerland has quite high spending. For bad care, the US and Sweden both spend quite a lot (per OECD [0]). [0]: https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthres/health-spending.htm

shermozle 7y ago

Sounds like Sweden have fucked it up, not that public healthcare is a broken concept. You should try the British NHS. It's not perfect but it's pretty fucking good, and free. The problem in Australia is right-wing ideologues chipping away at public health to enrich their donors in the private health "insurance" scam industry, subsidising it and forcing people into it when it provides almost no benefit.