7 ms·

The same in Fiji. We have universal health care, but anyone is of course free to forego that and pay (or use their private insurance) for a private room rather

The same in Fiji. We have universal health care, but anyone is of course free to forego that and pay (or use their private insurance) for a private room rather than a ward, or just go to a private hospital instead. I don't understand the debate about this in the US. It's as if the rich assume that things will change for the worse for them if universal health care is enacted.

prime_factor 7y ago
What about middle class people who can't afford private care but fear that the socialized healthcare system will be of worse quality than what they currently have?
- virmundi 7y ago
  They have a hard decision. Unlike the US they are allowed to be an adult.
- bpfrh 7y ago
  You can look at austria to see that that doesn't happen. An MRI cost me about 0€. A 4000€ test which tests for nearly any rheutmatic diseases markers and the visit to the hospital for that test cost me 0€, both things got done within two weeks. Even if you are poor and want to go to a private doctor it will cost you not nearly as much as in the usa. For me it was about 100€, for one visit and that was on the higher end. Socialized healthcare is always cheaper.
  - vxNsr 7y ago
    I can buy an out of pocket (uninsured) MRI test in the US for less than $500. With a little bit of negotiation I could probably get it down to $300. An insured MRI can be free too depending on the plan. My mom is a doctor, she worked ICU, ER, etc, board certified in 10 states and holds a medical license in 3 countries(yes, she did residency three times, it's a long fascinating story for another time). Eventually she decided to open a private practice for family medicine bec it was less stress, but she's got tons of experience, and is highly regarded, and she charged less than $40 a visit for the uninsured. She would spend ages talking patients out of procedures that were harmful or simply unnecessary. You got high end care from her each time. The gist of this is: you have no idea what you're talking about and individual anecdotes don't prove one system is better then another. I'll just add as food for thought: nothing is free, avg effective tax rate in EU is 50% Avg ETR in the US is less than 30%.
- markdown 7y ago
  Perhaps they should be taught about capitalism. If there is demand for private healthcare affordable to the middle class, the demand will be met with supply. And if that fails, they should be taught about democracy. That if it turns out that socialised healthcare doesn't work for most Americans most of the time, then the country can revert to the system it currently has.
- specialist 7y ago
  The bulk of the (public) opposition is from people who like their employer provided insurance. We'll soon learn if the mood changes, due to pandemic induced high unemployment.
  - pasquinelli 7y ago
    It doesn't matter if the mood changes. Democratic voters are in the mood for medicare for all already and biden is the democratic candidate. This is america, the public mood isn't a factor.
    - int_19h 7y ago
      Last I looked at the polls - before coronavirus stole all the attention - Democratic primary voters were split roughly evenly between single payer (M4A) and public option, in polls where the distinction was highlighted.
- op00to 7y ago
  It’s not that their care will get worse, it’s because their care gets worse due to “those people” getting better care. Source: my in-laws.
bmelton 7y ago
> It's as if the rich assume that things will change for the worse for them if universal health care is enacted. Well, it depends on the implementation, but Bernie Sanders has been on record numerous times as stating that his Medicare-for-All proposal would absolutely ban private insurance. Elizabeth Warren is another Democratic front-runner who indicated that she's on board with that, though her proposals didn't necessarily reflect it. For what it's worth, the M4A _plan_ from Bernie's camp that I've seen didn't actually specify that it would eliminate private insurance, but he's also been keen on reminding us that he wrote it, and knows best what's in it. So while it seems unlikely to me that political reality in America would prohibit banning private insurance, there are definitely those who espouse banning it for the greater good, so perhaps that fear isn't wholly unwarranted.
- duckMuppet 7y ago
  For what purpose would they not ban it?
  - bmelton 7y ago
    To be clear, I misspoke in my closing sentence, and intended to say "It seems likely to me that the political reality in America would prohibit banning private insurance" -- but got mixed up in my negatives and now it's too late to edit. That said, answering your question, they would presumably not ban it because a) the aforementioned arguments upthread make it pretty silly to do, and because b) it seems impossible to me that banning a wholly legal service just because it competes with the government would ever be deemed as constitutional. Well, not ever -- but not today, and not with the direction that the Supreme Court has been taking for decades now in regards to government power. Licensure seems possible, but I think even prohibitive licensure intended to dissuade private entities from competing with the government would be tossed out, and we already have such programs for insurance providers anyway.
- pmiller2 7y ago
  It's a slight misstatement to say that any of the M4A plans would have "banned private insurance." None of them prohibit supplemental coverage that would be secondary to Medicare.
philwelch 7y ago
Part of it is because the “Medicare for All” proposal outlaws private insurance.
- ineedasername 7y ago
  No, it does no such thing. Because there isn't one single "Medicare for All" proposal. There are a variety of plans proposed under that title, and only some would do away with private insurance. Many are some flavor of opt-in, granting access to the ability to buy into Medicare in the same way current Medicare recipients choose their level of coverage and pay accordingly, while leaving private insurance intact.
- erentz 7y ago
  M4A gives everyone, rich or poor, the same base standard of coverage. And if you want coverage for other things that aren’t included under Medicare then you can get supplemental private insurance for it. That’s absolutely not outlawed.
  - austhrow743 7y ago
    If that's the case then they really screwed up with the term "single payer", and a lot of Bernie's own supporters were wrong. Lot of crap all over reddit about ending private insurance for the last year.
    - philwelch 7y ago
      It’s not the case, but it’s apparently still not worth engaging with the Bros.
Consultant32452 7y ago
The big difference between the two camps that I see is that one side recognizes the cost benefit of their position and the other side doesn't. Price controls on healthcare (socialization) has positive and negative impacts. The positive impact is universality. Everyone gets approximately the same basic level of care. In some countries you might be able to pay for a nicer room, or quicker service, but generally speaking it's all the same. The downside is that price controls stifle innovation. That's just basic mainstream economics and is the case in every industry, not just healthcare. The trick about stifling innovation is you don't feel it immediately. On day 1 of the price controls, the rich are about the same but the poor are better off. On year 50 of the price controls, everyone is worse off because of all of the innovation that never came to fruition. I never hear advocates of universal healthcare have an adult conversation that they are trading long term benefits for short term gains. I think that's a reasonable position to hold, but if we just pretend that it's all benefits and no cost we're not having an adult discussion. It's not as if one side is right and one side is wrong. Once we accurately discuss the economics, it's easier to understand that this is a very difficult moral decision and not the trivial one that is sometimes portrayed in the political sphere. My speculation is that the rich people you refer to are more likely to be trained in economics (formally or otherwise) and are more likely to have a long term mindset regarding cost benefit tradeoffs.
- watwut 7y ago
  1.) Your theory assumes that the cost difference at the hospital goes toward innovation. It ignores role of public money that goes into research. It is also not analyzing where the money are actually going. 2.) With this theory, if it is true, you are basically volunteering American patients to pay for innovation worldwide. That is quite a bad deal for quite a lot of American people. 3.) > My speculation is that the rich people you refer to are more likely to be trained in economics (formally or otherwise) and are more likely to have a long term mindset regarding cost benefit tradeoffs. They have also different interests. Good cost benefit tradeoffs for one group is often very bad deal for another group.
  - Consultant32452 7y ago

prime_factor 7y ago

What about middle class people who can't afford private care but fear that the socialized healthcare system will be of worse quality than what they currently have?

virmundi 7y ago
They have a hard decision. Unlike the US they are allowed to be an adult.
bpfrh 7y ago
You can look at austria to see that that doesn't happen. An MRI cost me about 0€. A 4000€ test which tests for nearly any rheutmatic diseases markers and the visit to the hospital for that test cost me 0€, both things got done within two weeks. Even if you are poor and want to go to a private doctor it will cost you not nearly as much as in the usa. For me it was about 100€, for one visit and that was on the higher end. Socialized healthcare is always cheaper.
- vxNsr 7y ago
  I can buy an out of pocket (uninsured) MRI test in the US for less than $500. With a little bit of negotiation I could probably get it down to $300. An insured MRI can be free too depending on the plan. My mom is a doctor, she worked ICU, ER, etc, board certified in 10 states and holds a medical license in 3 countries(yes, she did residency three times, it's a long fascinating story for another time). Eventually she decided to open a private practice for family medicine bec it was less stress, but she's got tons of experience, and is highly regarded, and she charged less than $40 a visit for the uninsured. She would spend ages talking patients out of procedures that were harmful or simply unnecessary. You got high end care from her each time. The gist of this is: you have no idea what you're talking about and individual anecdotes don't prove one system is better then another. I'll just add as food for thought: nothing is free, avg effective tax rate in EU is 50% Avg ETR in the US is less than 30%.
markdown 7y ago
Perhaps they should be taught about capitalism. If there is demand for private healthcare affordable to the middle class, the demand will be met with supply. And if that fails, they should be taught about democracy. That if it turns out that socialised healthcare doesn't work for most Americans most of the time, then the country can revert to the system it currently has.
specialist 7y ago
The bulk of the (public) opposition is from people who like their employer provided insurance. We'll soon learn if the mood changes, due to pandemic induced high unemployment.
- pasquinelli 7y ago
  It doesn't matter if the mood changes. Democratic voters are in the mood for medicare for all already and biden is the democratic candidate. This is america, the public mood isn't a factor.
  - int_19h 7y ago
    Last I looked at the polls - before coronavirus stole all the attention - Democratic primary voters were split roughly evenly between single payer (M4A) and public option, in polls where the distinction was highlighted.
op00to 7y ago
It’s not that their care will get worse, it’s because their care gets worse due to “those people” getting better care. Source: my in-laws.

bmelton 7y ago

> It's as if the rich assume that things will change for the worse for them if universal health care is enacted. Well, it depends on the implementation, but Bernie Sanders has been on record numerous times as stating that his Medicare-for-All proposal would absolutely ban private insurance. Elizabeth Warren is another Democratic front-runner who indicated that she's on board with that, though her proposals didn't necessarily reflect it. For what it's worth, the M4A _plan_ from Bernie's camp that I've seen didn't actually specify that it would eliminate private insurance, but he's also been keen on reminding us that he wrote it, and knows best what's in it. So while it seems unlikely to me that political reality in America would prohibit banning private insurance, there are definitely those who espouse banning it for the greater good, so perhaps that fear isn't wholly unwarranted.

duckMuppet 7y ago
For what purpose would they not ban it?
- bmelton 7y ago
  To be clear, I misspoke in my closing sentence, and intended to say "It seems likely to me that the political reality in America would prohibit banning private insurance" -- but got mixed up in my negatives and now it's too late to edit. That said, answering your question, they would presumably not ban it because a) the aforementioned arguments upthread make it pretty silly to do, and because b) it seems impossible to me that banning a wholly legal service just because it competes with the government would ever be deemed as constitutional. Well, not ever -- but not today, and not with the direction that the Supreme Court has been taking for decades now in regards to government power. Licensure seems possible, but I think even prohibitive licensure intended to dissuade private entities from competing with the government would be tossed out, and we already have such programs for insurance providers anyway.
pmiller2 7y ago
It's a slight misstatement to say that any of the M4A plans would have "banned private insurance." None of them prohibit supplemental coverage that would be secondary to Medicare.

philwelch 7y ago

Part of it is because the “Medicare for All” proposal outlaws private insurance.

ineedasername 7y ago
No, it does no such thing. Because there isn't one single "Medicare for All" proposal. There are a variety of plans proposed under that title, and only some would do away with private insurance. Many are some flavor of opt-in, granting access to the ability to buy into Medicare in the same way current Medicare recipients choose their level of coverage and pay accordingly, while leaving private insurance intact.
erentz 7y ago
M4A gives everyone, rich or poor, the same base standard of coverage. And if you want coverage for other things that aren’t included under Medicare then you can get supplemental private insurance for it. That’s absolutely not outlawed.
- austhrow743 7y ago
  If that's the case then they really screwed up with the term "single payer", and a lot of Bernie's own supporters were wrong. Lot of crap all over reddit about ending private insurance for the last year.
  - philwelch 7y ago
    It’s not the case, but it’s apparently still not worth engaging with the Bros.

Consultant32452 7y ago

The big difference between the two camps that I see is that one side recognizes the cost benefit of their position and the other side doesn't. Price controls on healthcare (socialization) has positive and negative impacts. The positive impact is universality. Everyone gets approximately the same basic level of care. In some countries you might be able to pay for a nicer room, or quicker service, but generally speaking it's all the same. The downside is that price controls stifle innovation. That's just basic mainstream economics and is the case in every industry, not just healthcare. The trick about stifling innovation is you don't feel it immediately. On day 1 of the price controls, the rich are about the same but the poor are better off. On year 50 of the price controls, everyone is worse off because of all of the innovation that never came to fruition. I never hear advocates of universal healthcare have an adult conversation that they are trading long term benefits for short term gains. I think that's a reasonable position to hold, but if we just pretend that it's all benefits and no cost we're not having an adult discussion. It's not as if one side is right and one side is wrong. Once we accurately discuss the economics, it's easier to understand that this is a very difficult moral decision and not the trivial one that is sometimes portrayed in the political sphere. My speculation is that the rich people you refer to are more likely to be trained in economics (formally or otherwise) and are more likely to have a long term mindset regarding cost benefit tradeoffs.

watwut 7y ago
1.) Your theory assumes that the cost difference at the hospital goes toward innovation. It ignores role of public money that goes into research. It is also not analyzing where the money are actually going. 2.) With this theory, if it is true, you are basically volunteering American patients to pay for innovation worldwide. That is quite a bad deal for quite a lot of American people. 3.) > My speculation is that the rich people you refer to are more likely to be trained in economics (formally or otherwise) and are more likely to have a long term mindset regarding cost benefit tradeoffs. They have also different interests. Good cost benefit tradeoffs for one group is often very bad deal for another group.
- Consultant32452 7y ago