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I get the impression you're idealising the free market. The numbers[1][2] speak for themselves in proving that universal healthcare is the most affordable way t

I get the impression you're idealising the free market. The numbers[1][2] speak for themselves in proving that universal healthcare is the most affordable way to provide good healthcare. [1] https://en.m.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita https://en.m.wikipedia.org/wiki/List_of_countries_by_total_h... [2] https://en.m.wikipedia.org/wiki/List_of_countries_by_life_expectancy https://en.m.wikipedia.org/wiki/List_of_countries_by_life_ex... In the UK the NHS (2016) per capita cost was $4,192 (PPP) and in the US the per capita cost was $9,892 (PPP). The OECD life expectancy average for the same year in the UK was 81.2 in the US it was 78.6. Comparable healthcare outcomes for vastly different costs. I don't know how the politics of healthcare and lobbying differ between the UK and the US but whatever they are the numbers show that Universal healthcare is better for everyone in spite of your (or really anyone's) arguments against it.

dlkf 6y ago
Same story for education [1]. I won't be moved by cries of "we're exceptional" until the US actually tries adopting the policies that have worked so well for Europe and Canada. [1] https://www.oecd.org/pisa/PISA%202018%20Insights%20and%20Interpretations%20FINAL%20PDF.pdf https://www.oecd.org/pisa/PISA%202018%20Insights%20and%20Int...
AnthonyMouse 6y ago
This is the same old tired argument again and again. "European countries have lower costs, therefore socialism is better than capitalism." There are two problems with it. First, the US system is completely broken. It isn't a free market system, it's a worst of both worlds compromised hellscape. It's like comparing the USSR to Colombian druglords as evidence that communism is a great system. The USSR isn't great, Colombian druglords are just awful. Second, the European systems rely on the US to fund world medical research through its high medical costs. We're subsidizing them. That makes us look bad, but they're the ones free riding on our system. And it's obviously not possible for the US to pay lower prices by doing the same thing and offloading its medical research costs onto the US. What we could do is make the EU pay more of the R&D somehow -- that could lower our costs for sure, or improve outcomes world-wide because there is more R&D. But what does that look like? Higher costs in Europe, right?
- BasedCode 6y ago
  Ultimately the problem with a private healthcare system is there is no incentive to provide appropriate affordable healthcare and every incentive to divide, marginalize, and monopolize markets in the aim of driving down competition and driving up profits. Now that the US healthcare industry has grown so rich and powerful it can lobby and win against any serious political efforts to either increase market competition or socialise healthcare. I.don't. Know how you could politically fix a system that is essentially "every man for himself" the incentive for corruption is far too high when payouts equal political power. I doubt the US is subsidizing medical research as much as you'd think. The Pharmaceutical industry for example is very profitable compared to other industries. A socialised healthcare service would enable more competitive prices eating into industry profits for these products due to market scale like we see in the UK due to the buying power of the NHS. "Among the largest 25 companies, annual average profit margin fluctuated between 15 and 20 percent. For comparison, the annual average profit margin across non-drug companies among the largest 500 globally fluctuated between 4 and 9 percent." https://www.gao.gov/mobile/products/gao-18-40 https://www.gao.gov/mobile/products/gao-18-40
  - robdachshund 6y ago
    Yet there are no aspects of public healthcare that are any more efficient. It could be largely worse because people have no options and are compelled to pay whatever the government stipulates for whatever coverage they end up with. There is no more incentive to lower prices at the doctor or hospital than there is with private insurance. Personally I think insurance should be done away with and you should pay strictly regulated costs directly to the doctor. However that's just another pipe dream. There is no single solution to healthcare.
bhupy 6y ago
Average life expectancy is a really flawed metric to measure the effectiveness of healthcare systems, because there are a ton of non-healthcare related confounding variables that impact average life expectancy. Anyone that dies early brings down the average life expectancy, and that includes suicides, homicides, drug overdoses, and car accidents. The US has more traffic fatalities per capita than any other Western European nation. The US has more opioid deaths per capita than any other Western European nation. The US has more gun-deaths per capita than any other Western European nation. While each of those problems have their own political causes...none of them have much to do with the underlying healthcare system, so using it as a metric to measure the quality of the healthcare system in question is ill-advised. All that being said, if we were to use this metric, for the sake of argument...these charts are quite illuminating, but not for the reasons you think. If you plot them on a graph, you'll find that the most efficient healthcare system is actually one closer to the "idealized market"...in Singapore[1]. Also the comment to which you are replying is strictly talking about "government insurance". "Government insurance" is not the only way to deliver universal healthcare. Germany, Switzerland, Netherlands, Singapore all have thriving multi-payer systems. In Switzerland and the Netherlands, ALL insurance is private. In Singapore, while the government covers catastrophic care, 70% of total health expenditures are private. Singapore's approach is actually the closest to what a system might look like if you replaced healthcare-specific targeted subsidies with a UBI — most health expenditure is through compulsory health savings accounts. The common theme is that there is some degree of government intervention/regulation and subsidy. Having the government be the sole payer is definitely an approach, but it's by no means the only approach, nor even the best approach. "Universal healthcare" just means that everyone has healthcare, it doesn't necessarily mean that the government provides it for everyone. We have pretty close to "universal food" in most of the developed world, and the vast majority of the food system is delivered through the open market. [1] https://www.bloomberg.com/graphics/infographics/most-efficient-health-care-around-the-world.html https://www.bloomberg.com/graphics/infographics/most-efficie...
- BasedCode 6y ago
  >"Average life expectancy is a really flawed metric to measure the effectiveness of healthcare systems, because there are a ton of non-healthcare related confounding variables that impact average life expectancy. Anyone that dies early brings down the average life expectancy, and that includes suicides, homicides, drug overdoses, and car accidents. The US has more traffic fatalities per capita than any other Western European nation. The US has more opioid deaths per capita than any other Western European nation. The US has more gun-deaths per capita than any other Western European nation. While each of those problems have their own political causes...none of them have much to do with the underlying healthcare system, so using it as a metric to measure the quality of the healthcare system in question is ill-advised." A socialised healthcare system forces government and the healthcare service to write and maintain policies that consider the health of the nation. Where as a private insurance based service doesn't. The US opoid crisis is a perfect example of this. Many of those addicts in the US moved on from prescription opoids that they had been prescribed unnecessarily to streets heroin because there was little concern of the wider public health implications. In the UK getting a prescription for addictive strength opoid pain killers has long been near impossible because the healthcare system has to be careful not to create another problem in trying to fix the first one because it's their responsibility to fix it which also means Doctors are not motivated to meet the patients wants (e.g pain free) and only fulfil their healthcare needs. This is why the UK didn't go through the same crisis So I say that life expectancy is a good measure of healthcare systems because it forces policy makers at all levels to consider the wider impact of public policy on public health.

dlkf 6y ago

Same story for education [1]. I won't be moved by cries of "we're exceptional" until the US actually tries adopting the policies that have worked so well for Europe and Canada. [1] https://www.oecd.org/pisa/PISA%202018%20Insights%20and%20Interpretations%20FINAL%20PDF.pdf https://www.oecd.org/pisa/PISA%202018%20Insights%20and%20Int...

AnthonyMouse 6y ago

This is the same old tired argument again and again. "European countries have lower costs, therefore socialism is better than capitalism." There are two problems with it. First, the US system is completely broken. It isn't a free market system, it's a worst of both worlds compromised hellscape. It's like comparing the USSR to Colombian druglords as evidence that communism is a great system. The USSR isn't great, Colombian druglords are just awful. Second, the European systems rely on the US to fund world medical research through its high medical costs. We're subsidizing them. That makes us look bad, but they're the ones free riding on our system. And it's obviously not possible for the US to pay lower prices by doing the same thing and offloading its medical research costs onto the US. What we could do is make the EU pay more of the R&D somehow -- that could lower our costs for sure, or improve outcomes world-wide because there is more R&D. But what does that look like? Higher costs in Europe, right?

BasedCode 6y ago
Ultimately the problem with a private healthcare system is there is no incentive to provide appropriate affordable healthcare and every incentive to divide, marginalize, and monopolize markets in the aim of driving down competition and driving up profits. Now that the US healthcare industry has grown so rich and powerful it can lobby and win against any serious political efforts to either increase market competition or socialise healthcare. I.don't. Know how you could politically fix a system that is essentially "every man for himself" the incentive for corruption is far too high when payouts equal political power. I doubt the US is subsidizing medical research as much as you'd think. The Pharmaceutical industry for example is very profitable compared to other industries. A socialised healthcare service would enable more competitive prices eating into industry profits for these products due to market scale like we see in the UK due to the buying power of the NHS. "Among the largest 25 companies, annual average profit margin fluctuated between 15 and 20 percent. For comparison, the annual average profit margin across non-drug companies among the largest 500 globally fluctuated between 4 and 9 percent." https://www.gao.gov/mobile/products/gao-18-40 https://www.gao.gov/mobile/products/gao-18-40
- robdachshund 6y ago
  Yet there are no aspects of public healthcare that are any more efficient. It could be largely worse because people have no options and are compelled to pay whatever the government stipulates for whatever coverage they end up with. There is no more incentive to lower prices at the doctor or hospital than there is with private insurance. Personally I think insurance should be done away with and you should pay strictly regulated costs directly to the doctor. However that's just another pipe dream. There is no single solution to healthcare.

bhupy 6y ago

Average life expectancy is a really flawed metric to measure the effectiveness of healthcare systems, because there are a ton of non-healthcare related confounding variables that impact average life expectancy. Anyone that dies early brings down the average life expectancy, and that includes suicides, homicides, drug overdoses, and car accidents. The US has more traffic fatalities per capita than any other Western European nation. The US has more opioid deaths per capita than any other Western European nation. The US has more gun-deaths per capita than any other Western European nation. While each of those problems have their own political causes...none of them have much to do with the underlying healthcare system, so using it as a metric to measure the quality of the healthcare system in question is ill-advised. All that being said, if we were to use this metric, for the sake of argument...these charts are quite illuminating, but not for the reasons you think. If you plot them on a graph, you'll find that the most efficient healthcare system is actually one closer to the "idealized market"...in Singapore[1]. Also the comment to which you are replying is strictly talking about "government insurance". "Government insurance" is not the only way to deliver universal healthcare. Germany, Switzerland, Netherlands, Singapore all have thriving multi-payer systems. In Switzerland and the Netherlands, ALL insurance is private. In Singapore, while the government covers catastrophic care, 70% of total health expenditures are private. Singapore's approach is actually the closest to what a system might look like if you replaced healthcare-specific targeted subsidies with a UBI — most health expenditure is through compulsory health savings accounts. The common theme is that there is some degree of government intervention/regulation and subsidy. Having the government be the sole payer is definitely an approach, but it's by no means the only approach, nor even the best approach. "Universal healthcare" just means that everyone has healthcare, it doesn't necessarily mean that the government provides it for everyone. We have pretty close to "universal food" in most of the developed world, and the vast majority of the food system is delivered through the open market. [1] https://www.bloomberg.com/graphics/infographics/most-efficient-health-care-around-the-world.html https://www.bloomberg.com/graphics/infographics/most-efficie...

BasedCode 6y ago
>"Average life expectancy is a really flawed metric to measure the effectiveness of healthcare systems, because there are a ton of non-healthcare related confounding variables that impact average life expectancy. Anyone that dies early brings down the average life expectancy, and that includes suicides, homicides, drug overdoses, and car accidents. The US has more traffic fatalities per capita than any other Western European nation. The US has more opioid deaths per capita than any other Western European nation. The US has more gun-deaths per capita than any other Western European nation. While each of those problems have their own political causes...none of them have much to do with the underlying healthcare system, so using it as a metric to measure the quality of the healthcare system in question is ill-advised." A socialised healthcare system forces government and the healthcare service to write and maintain policies that consider the health of the nation. Where as a private insurance based service doesn't. The US opoid crisis is a perfect example of this. Many of those addicts in the US moved on from prescription opoids that they had been prescribed unnecessarily to streets heroin because there was little concern of the wider public health implications. In the UK getting a prescription for addictive strength opoid pain killers has long been near impossible because the healthcare system has to be careful not to create another problem in trying to fix the first one because it's their responsibility to fix it which also means Doctors are not motivated to meet the patients wants (e.g pain free) and only fulfil their healthcare needs. This is why the UK didn't go through the same crisis So I say that life expectancy is a good measure of healthcare systems because it forces policy makers at all levels to consider the wider impact of public policy on public health.