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>"Average life expectancy is a really flawed metric to measure the effectiveness of healthcare systems, because there are a ton of non-healthcare related confou

>"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.

bhupy 6y ago
Again, it's debatable, but as I continued in my comment, even when charitably accepting your premise, your argument loses its strength. A fully socialized healthcare system is one of many implementations of universal healthcare in the developed world today, and you'll have to find an answer for why the most efficient system in the world is the one that just happens to rely the most on consumer-driven market mechanisms.
- BasedCode 6y ago
  Perhaps but then you also have to consider that Singapore is such an outlier that maybe comparing with them is overlooking what universal healthcare system is more likely to really be possible to politically implement. Chasing that vision of efficency that Singapore shines a light on likely only serves to distract from other universal systems that are more commonly provided that are more realistically achievable. Singapore is so far off the scale close to Hong Kong that it suggests they have political, social, geographical conditions that can not be replicated. Don't let the perfect be the enemy of the good.
  - bhupy 6y ago
    That’s not what “outlier” means. If every country attempted to implement Singapore’s system, and only Singapore succeeded, then you would be correct that it is an outlier. Instead, other nations settled for different systems and are generally satisfied. There lacks a political will to move out of the local optima. Singapore’s path to its current system wasn’t by accident. It tried an NHS style system, which failed due to overuse, then tried a US-style system, which failed for obvious reasons, and then settled onto the system it has today. The US is in the unique position that someone else has tried this model and we have enough data to prove its superiority. There also appears to be enough political will to reform the current system. There’s no point in settling for local optima when we have more than enough information to be able to go all the way... There’s actually no evidence whatsoever that it “cannot be replicated”, there is little about Singapore, geographically that uniquely lends it to such a system. Suggesting otherwise is just ignoring an inconvenient data point. You’re also conveniently ignoring Switzerland, the Netherlands, and Germany which have a significant degree of privatization in their healthcare systems. Pure socialization isn’t the only way, it’s not even the best way.
    - BasedCode 6y ago
      So then what are the friction points of the Singaporean healthcare model that prevents other countries from adopting it? If it were a Bill up for a vote by politicians in the US then what issues would they have with it? Also comparing healthcare costs of Germany, Netherlands, and Switzerland with the UK from the links I posted earlier clearly shows that socialised healthcare is more efficient. The per capita cost in Germany ia 32% higher than the UK, Netherlands it is 28% higher, and in Switzerland it is a whopping 88% higher compared to the UK. Even France and Greece which are more socialist than the UK and both also have national insurance schemes are much better value than their private counterparts.

bhupy 6y ago

Again, it's debatable, but as I continued in my comment, even when charitably accepting your premise, your argument loses its strength. A fully socialized healthcare system is one of many implementations of universal healthcare in the developed world today, and you'll have to find an answer for why the most efficient system in the world is the one that just happens to rely the most on consumer-driven market mechanisms.

BasedCode 6y ago
Perhaps but then you also have to consider that Singapore is such an outlier that maybe comparing with them is overlooking what universal healthcare system is more likely to really be possible to politically implement. Chasing that vision of efficency that Singapore shines a light on likely only serves to distract from other universal systems that are more commonly provided that are more realistically achievable. Singapore is so far off the scale close to Hong Kong that it suggests they have political, social, geographical conditions that can not be replicated. Don't let the perfect be the enemy of the good.
- bhupy 6y ago
  That’s not what “outlier” means. If every country attempted to implement Singapore’s system, and only Singapore succeeded, then you would be correct that it is an outlier. Instead, other nations settled for different systems and are generally satisfied. There lacks a political will to move out of the local optima. Singapore’s path to its current system wasn’t by accident. It tried an NHS style system, which failed due to overuse, then tried a US-style system, which failed for obvious reasons, and then settled onto the system it has today. The US is in the unique position that someone else has tried this model and we have enough data to prove its superiority. There also appears to be enough political will to reform the current system. There’s no point in settling for local optima when we have more than enough information to be able to go all the way... There’s actually no evidence whatsoever that it “cannot be replicated”, there is little about Singapore, geographically that uniquely lends it to such a system. Suggesting otherwise is just ignoring an inconvenient data point. You’re also conveniently ignoring Switzerland, the Netherlands, and Germany which have a significant degree of privatization in their healthcare systems. Pure socialization isn’t the only way, it’s not even the best way.
  - BasedCode 6y ago
    So then what are the friction points of the Singaporean healthcare model that prevents other countries from adopting it? If it were a Bill up for a vote by politicians in the US then what issues would they have with it? Also comparing healthcare costs of Germany, Netherlands, and Switzerland with the UK from the links I posted earlier clearly shows that socialised healthcare is more efficient. The per capita cost in Germany ia 32% higher than the UK, Netherlands it is 28% higher, and in Switzerland it is a whopping 88% higher compared to the UK. Even France and Greece which are more socialist than the UK and both also have national insurance schemes are much better value than their private counterparts.