5 ms·

It's complicated. The US spends more per capita (PPP) than any other country by good margin [1]. Of that, the US government pays roughly 50% of the total cost [

by nhebb 7y ago

It's complicated. The US spends more per capita (PPP) than any other country by good margin [1]. Of that, the US government pays roughly 50% of the total cost [2]. The net effect is that the US government already pays as much per capita as many European countries with socialized medicine. In short, we have a cost problem that's not being tackled. Pharmaceuticals are often targeted, but they're about 8% of our total healthcare costs. We really need politicians that will tackle the other aspects of cost. The countries that finance public healthcare have tax systems that are considered regressive by US standards. Some states have sales taxes, but we have no national VAT. As I understand it, some countries like Sweden have income taxes on lower income workers, whereas in the US, roughly 45% of households pay no federal income tax. You can only squeeze so much money out of the wealthy, but the numbers don't add up to cover the projected costs of nationalized healthcare in the US. Taxes would need to be raised across the board. It's easy for campaigning politicians to propose pie-in-the-sky plans, but proposing a financially plausible one would be political suicide. [1] https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita https://en.wikipedia.org/wiki/List_of_countries_by_total_hea... [2] https://en.wikipedia.org/wiki/List_of_countries_by_health_expenditure_covered_by_government https://en.wikipedia.org/wiki/List_of_countries_by_health_ex...

axlee 7y ago
They are are already paying twice as much as any other developed nation with a "free-market" approach to healthcare. I do not understand the mental gymnastics to reach the conclusion that citizens as a whole would pay more in a single-payer system. They might pay more taxes indeed, but their private insurance costs would disappear overnight. As for healthcare costs inflation, that would quickly disappear with the transparency mandated by a single-payer system. One of the arguments explaining the always-rising healthcare costs in the US is a complete darkness from the consumer side on the actual price of the healthcare they are getting, thus allowing gouging at every level.
- dsfyu404ed 7y ago
  >I do not understand the mental gymnastics to reach the conclusion that citizens as a whole would pay more in a single-payer system The reasoning goes like this: The entrenched well funded (and money loosely translates to political power) interests influence the legislators doing the implementing in order to ensure a regulatory capture that allows them to continue swindling people at their current level but because it is now proxied through the additional overhead of government the net cost to the citizenry is greater than the current "get swindled directly" system and we have little/no net change in outcomes. Basically people don't trust the government to not screw it up so badly that it actually costs more. I'm sure the cost would come down over time but with the high cost and uncertainty involved that's a tough sell.
- someguydave 7y ago
  >I do not understand the mental gymnastics Everyone who works in healthcare now would become a low-paid government employee. That seems like your source of opposition.
  - tapland 7y ago
    Socialized healthcare doesn't mean doctors are a government employees. It's still private profit driven companies running their businesses. It's just the government instead of your insurance company paying.
    - someguydave 7y ago
      So if I'm a contractor with one a single legal client, does that make me that client's employee?
bart_spoon 7y ago
A good deal of that cost is due to private insurance. The free market approach has resulted in middlemen inserting themselves into the healthcare pipeline and leech dollars from consumers. It isn't the only reason, but it is one of the biggest.
- lotsofpulp 7y ago
  A good deal is that doctors and healthcare providers in other countries don’t make well into the $300k+ range. There’s a lot of money to be made in the US versus other countries. Without the insurance companies, who would have the power negotiate pricing with the providers? Americans don’t find government intervention palatable unless the person is over 65.
  - bart_spoon 7y ago
    > Without the insurance companies, who would have the power negotiate pricing with the providers? Healthcare costs have skyrocketed because of the negotiators. PBMs are the middlemen who negotiate healthcare prices between insurance companies and providers. I can't speak for hospitals and procedures, but in the pharmaceutical industry, it actually has led to a system where insurers and PBMs both benefit from drug prices increasing as opposed to decreasing. They aren't driving costs down, they are directly contributing to driving costs up.
    - lotsofpulp 7y ago
      Negotiation does not cause costs to rise, it’s because of lack of price transparency that let’s insiders play games. Make all the prices public, and watch all the excuses disappear. No insurance company will be able to answer the government or employer when they find out another insurance company was able to obtain the same medicine or healthcare for a lower price.
      - ajmurmann 7y ago
        I posted a link in a parallel thread to a surgical center that has all their prices on their website. Insurance companies refuse to work with them, supposedly for the reasons you state. So you are correct.

by nhebb 7y ago

axlee 7y ago

They are are already paying twice as much as any other developed nation with a "free-market" approach to healthcare. I do not understand the mental gymnastics to reach the conclusion that citizens as a whole would pay more in a single-payer system. They might pay more taxes indeed, but their private insurance costs would disappear overnight. As for healthcare costs inflation, that would quickly disappear with the transparency mandated by a single-payer system. One of the arguments explaining the always-rising healthcare costs in the US is a complete darkness from the consumer side on the actual price of the healthcare they are getting, thus allowing gouging at every level.

dsfyu404ed 7y ago
>I do not understand the mental gymnastics to reach the conclusion that citizens as a whole would pay more in a single-payer system The reasoning goes like this: The entrenched well funded (and money loosely translates to political power) interests influence the legislators doing the implementing in order to ensure a regulatory capture that allows them to continue swindling people at their current level but because it is now proxied through the additional overhead of government the net cost to the citizenry is greater than the current "get swindled directly" system and we have little/no net change in outcomes. Basically people don't trust the government to not screw it up so badly that it actually costs more. I'm sure the cost would come down over time but with the high cost and uncertainty involved that's a tough sell.
someguydave 7y ago
>I do not understand the mental gymnastics Everyone who works in healthcare now would become a low-paid government employee. That seems like your source of opposition.
- tapland 7y ago
  Socialized healthcare doesn't mean doctors are a government employees. It's still private profit driven companies running their businesses. It's just the government instead of your insurance company paying.
  - someguydave 7y ago
    So if I'm a contractor with one a single legal client, does that make me that client's employee?

bart_spoon 7y ago

A good deal of that cost is due to private insurance. The free market approach has resulted in middlemen inserting themselves into the healthcare pipeline and leech dollars from consumers. It isn't the only reason, but it is one of the biggest.

lotsofpulp 7y ago
A good deal is that doctors and healthcare providers in other countries don’t make well into the $300k+ range. There’s a lot of money to be made in the US versus other countries. Without the insurance companies, who would have the power negotiate pricing with the providers? Americans don’t find government intervention palatable unless the person is over 65.
- bart_spoon 7y ago
  > Without the insurance companies, who would have the power negotiate pricing with the providers? Healthcare costs have skyrocketed because of the negotiators. PBMs are the middlemen who negotiate healthcare prices between insurance companies and providers. I can't speak for hospitals and procedures, but in the pharmaceutical industry, it actually has led to a system where insurers and PBMs both benefit from drug prices increasing as opposed to decreasing. They aren't driving costs down, they are directly contributing to driving costs up.
  - lotsofpulp 7y ago
    Negotiation does not cause costs to rise, it’s because of lack of price transparency that let’s insiders play games. Make all the prices public, and watch all the excuses disappear. No insurance company will be able to answer the government or employer when they find out another insurance company was able to obtain the same medicine or healthcare for a lower price.
    - ajmurmann 7y ago
      I posted a link in a parallel thread to a surgical center that has all their prices on their website. Insurance companies refuse to work with them, supposedly for the reasons you state. So you are correct.