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The fact that other countries have effective health care systems run by the government suggests that the conclusion we should draw from the VA fiasco is that ei

The fact that other countries have effective health care systems run by the government suggests that the conclusion we should draw from the VA fiasco is that either the U.S. government is particularly incompetent or the incompetence is local and limited to a specific department(s). I'm inclined to believe the latter. That being the case, a further conclusion I would end up drawing is that both largely private and largely public health care systems work well, but that the U.S. suffers from running a health care system that takes no opinion as to which form it should take.

deburo 7y ago
Our "effective health care systems" might not be so effective in the U.S. Some of your states have big immigration problems.
ars 7y ago
It's neither of those two. The actual problem is the huge number of people employed by the industry. The US government is incapable of fixing anything because it would require firing huge numbers of people. That's obviously a non-starter for any politician. This situation can only be fixed by giving power to an entity that doesn't care about firing people, that only cares about the bottom line. And by the time people realize what's happening it'll be too late to change it. Basically private insurance companies that are not monopolies. There was a plan I remember from years ago about allowing people to buy health insurance from any state. In my opinion that's the best option. It would also be necessary to get rid of employer based insurance because employees don't get to pick. I have zero expectation of this ever happening.
jjeaff 7y ago
Seems obviously a problem of size. Can you point to a working healthcare system in any other country that has a population anywhere close to the US? Comparing us to countries that are hardly as populous as one US state is not a fair comparison. As anyone in the tech industry should know, there are a lot of unforeseen issues that popup when scaling something. It's rarely as easy as adding more CPUs or more people for that matter.
- jariel 7y ago
  "Seems obviously a problem of size. Can you point to a working healthcare system in any other country that has a population anywhere close to the US?" Healthcare in the US is run at the state level, moreover, in Canada it's also run at the Provincial level. Germany's healthcare 'system' is bigger than NY and California combined. In Switzerland, insurance is at the cantonal level. Scale is not the issue - in fact, scale should mean lower prices. There actually is not a lot of competition for Medical services in the US, you have very powerful guilds with power handed to them by the gov. It's almost Mercantilist in a way.
- computer 7y ago
  If that were true, then solve the problem state by state.
  - jjeaff 7y ago
    That is what should likely happen and is already the case to a point. Much of the existing programs are funded at the state level. But the federal government is already meddling so you can't exactly do what works best for you. You have to follow the federal ACA rules no matter what you implement at this point.
- anongraddebt 7y ago
  I've always considered that a fair objection. If there is a bottleneck at scale, though, it'd be nice to know what exactly it is. This also doesn't detract from my broader point that U.S. healthcare seems to intentionally exist in a no mans land.
  - jjeaff 7y ago
    And scale I think is only part of the issue. The problem of scale is compounded with 50 different states, all with their own laws, unique geography, and demographics. Then add to that the very high levels of diversity in the U.S. population. There is a diversity of races, religions, and income that doesn't exist in most of these other countries that have been able to implement universal healthcare. (For example, the U.K. is something like 86% white.)
qnsi 7y ago
Holland doesnt have government run healthcare. Which country does? UK has a lot of problems with their NHS

deburo 7y ago

Our "effective health care systems" might not be so effective in the U.S. Some of your states have big immigration problems.

ars 7y ago

It's neither of those two. The actual problem is the huge number of people employed by the industry. The US government is incapable of fixing anything because it would require firing huge numbers of people. That's obviously a non-starter for any politician. This situation can only be fixed by giving power to an entity that doesn't care about firing people, that only cares about the bottom line. And by the time people realize what's happening it'll be too late to change it. Basically private insurance companies that are not monopolies. There was a plan I remember from years ago about allowing people to buy health insurance from any state. In my opinion that's the best option. It would also be necessary to get rid of employer based insurance because employees don't get to pick. I have zero expectation of this ever happening.

jjeaff 7y ago

Seems obviously a problem of size. Can you point to a working healthcare system in any other country that has a population anywhere close to the US? Comparing us to countries that are hardly as populous as one US state is not a fair comparison. As anyone in the tech industry should know, there are a lot of unforeseen issues that popup when scaling something. It's rarely as easy as adding more CPUs or more people for that matter.

jariel 7y ago
"Seems obviously a problem of size. Can you point to a working healthcare system in any other country that has a population anywhere close to the US?" Healthcare in the US is run at the state level, moreover, in Canada it's also run at the Provincial level. Germany's healthcare 'system' is bigger than NY and California combined. In Switzerland, insurance is at the cantonal level. Scale is not the issue - in fact, scale should mean lower prices. There actually is not a lot of competition for Medical services in the US, you have very powerful guilds with power handed to them by the gov. It's almost Mercantilist in a way.
computer 7y ago
If that were true, then solve the problem state by state.
- jjeaff 7y ago
  That is what should likely happen and is already the case to a point. Much of the existing programs are funded at the state level. But the federal government is already meddling so you can't exactly do what works best for you. You have to follow the federal ACA rules no matter what you implement at this point.
anongraddebt 7y ago
I've always considered that a fair objection. If there is a bottleneck at scale, though, it'd be nice to know what exactly it is. This also doesn't detract from my broader point that U.S. healthcare seems to intentionally exist in a no mans land.
- jjeaff 7y ago
  And scale I think is only part of the issue. The problem of scale is compounded with 50 different states, all with their own laws, unique geography, and demographics. Then add to that the very high levels of diversity in the U.S. population. There is a diversity of races, religions, and income that doesn't exist in most of these other countries that have been able to implement universal healthcare. (For example, the U.K. is something like 86% white.)

qnsi 7y ago

Holland doesnt have government run healthcare. Which country does? UK has a lot of problems with their NHS