6 ms·

There is one case where quality might improve and definitely cost: nationalize them all into a single system.

asn0 7y ago
Since the OP is about studying outcomes ... I'm curious -- are there any reputable studies about the likely outcomes of nationalizing healthcare?
- ggm 7y ago
  https://assets.publishing.service.gov.uk/media/57a08d91e5274a31e000192c/The-history-and-development-of-the-UK-NHS.pdf https://assets.publishing.service.gov.uk/media/57a08d91e5274...
- gnopgnip 7y ago
  There were many studies done in Australia. It happened about 35 years ago
  - casmclas 7y ago
    Hospitals are run and funded by each state in Australia. I think a decade ago the federal government started to run a hospital in Tasmania, but they pulled out of it because it was ridiculous. There are also numerous private hospitals. GPs and specialists are largely privately operated. Comparing Medicare to a single nationalised hospital system is not accurate — it's more like a national health insurance system with membership fees paid by the tax system. Obviously having a single purchaser of so many services allows them a large degree of control, but it isn't even a single payer system, since many health services require extra funds (even a routine doctor's visit requires out of pocket costs for many people, like $30 — that isn't cheap) although that's a recent change. There's also private health insurance and extra fees you can pay for nice service (like a room of your own).
seibelj 7y ago
Many on the left despise mergers and consolidation, and anything that has a hint of monopoly power. Except when it comes to government, education, and healthcare! Doesn’t a single centralized monopoly providing everyone’s healthcare seem like a bad idea? Why is it so bad in business and so good for health?
- karlshea 7y ago
  > Doesn’t a single centralized monopoly providing everyone’s healthcare seem like a bad idea? Why is it so bad in business and so good for health? Because health shouldn't be run like a business, just like the fire department shouldn't be run like a business. The only metrics that should matter are patient outcomes and cost.
  - seibelj 7y ago
    I think the problem with never-ending healthcare costs is that it isn’t run enough like a business. Any normal business decreases costs to survive. It appears healthcare is at 20% of GDP and rising forever.
    - MereInterest 7y ago
      There are three options. I'll call them options E, S, and G. Option E is to run healthcare entirely as a business. Payment up front, and refusal to treat anyone without payment. Option S is to take option E, but avoid immediately attributable deaths. Treat somebody at the emergency room, even if they don't have a line of credit with them. Patch them up enough to walk out the door, but don't treat the underlying issues without additional payment. Option G is to treat patients before they reach death's door, when it is cheaper to do so. To give the preventative care that keeps costs down, even if somebody isn't able to pay for it. To treat public health as a public good, rather than as a series of purchases. Option E is evil, to let people die unnecessarily. Option S isn't openly evil, but is stupid. It is where the US is now, and inflates the costs tremendously. Option G is to actually be good.
      - 7y ago
systemtest 7y ago
The two best healthcare systems in Europe are in Switzerland and the Netherlands. They went from nationalised to privatised. Nationalised healthcare systems tend to rank lower on the quality index. And while the Swiss system is expensive, can you really put a price on your health? I'd rather have a good system (Switzerland) than a cheap system (UK).
- skummetmaelk 7y ago
  The Swiss system is reasonable because there are government set limits on deductibles and co-pay. Insurance providers are also prohibited from discriminating based on previously existing conditions. The services are also much cheaper than the US in general, even though Switzerland has some of the highest costs of living in the world. A routine visit at your doctor will cost at most a couple hundred dollars. Your deductible may be ~1000-2000 dollars and co-pay 10% up to ~7000 dollars after which your insurance must cover everything. Swiss insurance will only cover you outside of your home canton up to twice the cost of having the procedure done in that canton, and only in emergencies. For that reason Swiss people are warned about needing emergency procedures in the US and Japan because it can bankrupt them.

asn0 7y ago

Since the OP is about studying outcomes ... I'm curious -- are there any reputable studies about the likely outcomes of nationalizing healthcare?

ggm 7y ago
https://assets.publishing.service.gov.uk/media/57a08d91e5274a31e000192c/The-history-and-development-of-the-UK-NHS.pdf https://assets.publishing.service.gov.uk/media/57a08d91e5274...
gnopgnip 7y ago
There were many studies done in Australia. It happened about 35 years ago
- casmclas 7y ago
  Hospitals are run and funded by each state in Australia. I think a decade ago the federal government started to run a hospital in Tasmania, but they pulled out of it because it was ridiculous. There are also numerous private hospitals. GPs and specialists are largely privately operated. Comparing Medicare to a single nationalised hospital system is not accurate — it's more like a national health insurance system with membership fees paid by the tax system. Obviously having a single purchaser of so many services allows them a large degree of control, but it isn't even a single payer system, since many health services require extra funds (even a routine doctor's visit requires out of pocket costs for many people, like $30 — that isn't cheap) although that's a recent change. There's also private health insurance and extra fees you can pay for nice service (like a room of your own).

seibelj 7y ago

Many on the left despise mergers and consolidation, and anything that has a hint of monopoly power. Except when it comes to government, education, and healthcare! Doesn’t a single centralized monopoly providing everyone’s healthcare seem like a bad idea? Why is it so bad in business and so good for health?

karlshea 7y ago
> Doesn’t a single centralized monopoly providing everyone’s healthcare seem like a bad idea? Why is it so bad in business and so good for health? Because health shouldn't be run like a business, just like the fire department shouldn't be run like a business. The only metrics that should matter are patient outcomes and cost.
- seibelj 7y ago
  I think the problem with never-ending healthcare costs is that it isn’t run enough like a business. Any normal business decreases costs to survive. It appears healthcare is at 20% of GDP and rising forever.
  - MereInterest 7y ago
    There are three options. I'll call them options E, S, and G. Option E is to run healthcare entirely as a business. Payment up front, and refusal to treat anyone without payment. Option S is to take option E, but avoid immediately attributable deaths. Treat somebody at the emergency room, even if they don't have a line of credit with them. Patch them up enough to walk out the door, but don't treat the underlying issues without additional payment. Option G is to treat patients before they reach death's door, when it is cheaper to do so. To give the preventative care that keeps costs down, even if somebody isn't able to pay for it. To treat public health as a public good, rather than as a series of purchases. Option E is evil, to let people die unnecessarily. Option S isn't openly evil, but is stupid. It is where the US is now, and inflates the costs tremendously. Option G is to actually be good.
    - 7y ago

systemtest 7y ago

The two best healthcare systems in Europe are in Switzerland and the Netherlands. They went from nationalised to privatised. Nationalised healthcare systems tend to rank lower on the quality index. And while the Swiss system is expensive, can you really put a price on your health? I'd rather have a good system (Switzerland) than a cheap system (UK).

skummetmaelk 7y ago
The Swiss system is reasonable because there are government set limits on deductibles and co-pay. Insurance providers are also prohibited from discriminating based on previously existing conditions. The services are also much cheaper than the US in general, even though Switzerland has some of the highest costs of living in the world. A routine visit at your doctor will cost at most a couple hundred dollars. Your deductible may be ~1000-2000 dollars and co-pay 10% up to ~7000 dollars after which your insurance must cover everything. Swiss insurance will only cover you outside of your home canton up to twice the cost of having the procedure done in that canton, and only in emergencies. For that reason Swiss people are warned about needing emergency procedures in the US and Japan because it can bankrupt them.