5 ms·

Esther’s situation is problematic, but extending socialized benefits to non-citizens is a nonstarter and isn’t the case in any of the other Western societies th

Esther’s situation is problematic, but extending socialized benefits to non-citizens is a nonstarter and isn’t the case in any of the other Western societies that supporters of single-payer universal healthcare would like to model the US system on. I am not going to enumerate all the reasons why it’s a nonstarter, but at least one is that it massively increases the cost of any such social program to a point it becomes both practically and politically untenable. I’ve visited and used healthcare services in many of those other Western countries as a foreigner, and every single time I was required to file paperwork and pay a deposit in cash (or rarely by card) before receiving services. I would not have expected any differently, as I’m not a tax-paying citizen in those countries. On a mostly unrelated note, I write this while currently residing in San Antonio (as used in your example scenario).

cheerlessbog 6y ago
I assume you mean “non legal residents” as typically universal healthcare covers legal residents. Do you have evidence that it makes financial sense to leave unauthorized residents (likely) untreated? One might imagine they’re disproportionately young and healthy and not suffering from terminal cancer if they came here to work in fields. Going to the ER uninsured is very expensive for society.
- tristor 6y ago
  I was legally in every country I’ve been in, including several where I became temporarily resident. In every case as a non-citizen I was obligated to pay and was not covered under the social medicine scheme. I know the rules on non-citizen permanent residents are different in most countries however. I would believe it’s more financially sensible in the larger scheme of things to cover the cost of healthcare for illegal residents, but I haven’t seen any evidence that demonstrates that, and even with such evidence its still politically untenable. My point is that such a scheme is so politically untenable that even existing Western universal healthcare countries do not have such a scheme. It’s far more radical than what is typically advocated in the US.
rayiner 6y ago
Spain has free healthcare for people who immigrated illegally. It’s notable in being the only OECD country to extend non-emergency universal healthcare to such people.
- tristor 6y ago
  Interesting, I was unaware of that. I spent 53 days in Spain in 2016 (which was awesome by the way) that started off with me going directly to the hospital on arrival because a prior case of bronchitis had escalated into severe pneumonia (more severe than I realized). I was hospitalized for just shy of a week and had to pay a 3000 EUR deposit up front to be admitted and receive treatment. I don’t remember the exact amount of my total bill, but I got the bulk of my deposit back in the end. Maybe they’ve changed the rules since then, but at least my personal experience was the flow was to establish whether I was a Spanish or EU citizen, as I was not I was obligated to pay a sizeable deposit before even being seen for triage. There was certainly no indication any other foreigner would have been treated differently.
  - tialaramex 6y ago
    There's usually a distinction drawn between residents and mere visitors. That is, between people who ordinarily live in the country and those who are just here temporarily. That distinction can be in addition to, but will more often wholly replace a distinction between citizens and non-citizens. You can make a purely economic rationale for this if you want: Residents pay tax, and non-residents don't (in the US some non-residents still pay tax but that's not usual for any other country). If your universal healthcare is largely paid for as an "insurance" scheme, such residents are probably obliged to join the scheme, so it makes sense they'd also get the benefits.
  - refurb 6y ago
    I was reading another website about Spain. From what I gather (not sure the accuracy), but if you're in Spain illegally, you can convert to legal status if you show continued residence, employment, no trouble with the law. Maybe it's that type that gets non-emergency healthcare? I assume if you're in Spain, with no proof of residence you'll be asked to pay?
Xixi 6y ago
Single-payer universal healthcare is, as far as I know, never based on citizenship, but rather on residency. More pragmatically, it's based on where you pay your taxes. Example: I'm covered in Japan where I live and work, although I'm not a Japanese citizen. And the other way around: I'm a French citizen, but I'm not entitled to any coverage in France since I don't live/work/pay taxes there. So you probably meant non-residents and illegal immigrants. I'm not aware of non-residents (tourists, mostly) being covered anywhere. As for illegal immigrants, it depends: France has at least some free coverage, so has Spain and I'm sure some other countries. In France it's called the AME (Aide Médicale d'État). Like any system it's being gamed and abused, hence why it's being reformed and should not be copied as-is. But at 1 billion EUR/year the benefits certainly outweigh the cost.
- kaybe 6y ago
  If you are a member of one of (some of) the national healthcare systems in Europe you are also covered in many other European countries (not just the EU) as if you were part of their system, even when you're just a tourist. (The back of your card in Germany has the international information.)
foldr 6y ago
>extending socialized benefits to non-citizens is a nonstarter and isn’t the case in any of the other Western societies that supporters of single-payer universal healthcare As others have pointed out, I don't think any of these societies limit benefits to citizens. In the UK, emergency care is free for everyone, and there are few checks on other forms of care in practice. I seriously doubt that someone who was in the country illegally would have any problem registering their child with a GP. Doctors aren't trained to perform immigration checks, and are not usually interested in doing so.
gvjddbnvdrbv 6y ago
Slighlty pedantic correction... Citizenship is irrelevant in any national health system I've encountered. The person must be enrolled in the country's national health insurance scheme. A prerequisite of that is of course being a legal resident.

cheerlessbog 6y ago

I assume you mean “non legal residents” as typically universal healthcare covers legal residents. Do you have evidence that it makes financial sense to leave unauthorized residents (likely) untreated? One might imagine they’re disproportionately young and healthy and not suffering from terminal cancer if they came here to work in fields. Going to the ER uninsured is very expensive for society.

tristor 6y ago
I was legally in every country I’ve been in, including several where I became temporarily resident. In every case as a non-citizen I was obligated to pay and was not covered under the social medicine scheme. I know the rules on non-citizen permanent residents are different in most countries however. I would believe it’s more financially sensible in the larger scheme of things to cover the cost of healthcare for illegal residents, but I haven’t seen any evidence that demonstrates that, and even with such evidence its still politically untenable. My point is that such a scheme is so politically untenable that even existing Western universal healthcare countries do not have such a scheme. It’s far more radical than what is typically advocated in the US.

rayiner 6y ago

Spain has free healthcare for people who immigrated illegally. It’s notable in being the only OECD country to extend non-emergency universal healthcare to such people.

tristor 6y ago
Interesting, I was unaware of that. I spent 53 days in Spain in 2016 (which was awesome by the way) that started off with me going directly to the hospital on arrival because a prior case of bronchitis had escalated into severe pneumonia (more severe than I realized). I was hospitalized for just shy of a week and had to pay a 3000 EUR deposit up front to be admitted and receive treatment. I don’t remember the exact amount of my total bill, but I got the bulk of my deposit back in the end. Maybe they’ve changed the rules since then, but at least my personal experience was the flow was to establish whether I was a Spanish or EU citizen, as I was not I was obligated to pay a sizeable deposit before even being seen for triage. There was certainly no indication any other foreigner would have been treated differently.
- tialaramex 6y ago
  There's usually a distinction drawn between residents and mere visitors. That is, between people who ordinarily live in the country and those who are just here temporarily. That distinction can be in addition to, but will more often wholly replace a distinction between citizens and non-citizens. You can make a purely economic rationale for this if you want: Residents pay tax, and non-residents don't (in the US some non-residents still pay tax but that's not usual for any other country). If your universal healthcare is largely paid for as an "insurance" scheme, such residents are probably obliged to join the scheme, so it makes sense they'd also get the benefits.
- refurb 6y ago
  I was reading another website about Spain. From what I gather (not sure the accuracy), but if you're in Spain illegally, you can convert to legal status if you show continued residence, employment, no trouble with the law. Maybe it's that type that gets non-emergency healthcare? I assume if you're in Spain, with no proof of residence you'll be asked to pay?

Xixi 6y ago

Single-payer universal healthcare is, as far as I know, never based on citizenship, but rather on residency. More pragmatically, it's based on where you pay your taxes. Example: I'm covered in Japan where I live and work, although I'm not a Japanese citizen. And the other way around: I'm a French citizen, but I'm not entitled to any coverage in France since I don't live/work/pay taxes there. So you probably meant non-residents and illegal immigrants. I'm not aware of non-residents (tourists, mostly) being covered anywhere. As for illegal immigrants, it depends: France has at least some free coverage, so has Spain and I'm sure some other countries. In France it's called the AME (Aide Médicale d'État). Like any system it's being gamed and abused, hence why it's being reformed and should not be copied as-is. But at 1 billion EUR/year the benefits certainly outweigh the cost.

kaybe 6y ago
If you are a member of one of (some of) the national healthcare systems in Europe you are also covered in many other European countries (not just the EU) as if you were part of their system, even when you're just a tourist. (The back of your card in Germany has the international information.)

foldr 6y ago

>extending socialized benefits to non-citizens is a nonstarter and isn’t the case in any of the other Western societies that supporters of single-payer universal healthcare As others have pointed out, I don't think any of these societies limit benefits to citizens. In the UK, emergency care is free for everyone, and there are few checks on other forms of care in practice. I seriously doubt that someone who was in the country illegally would have any problem registering their child with a GP. Doctors aren't trained to perform immigration checks, and are not usually interested in doing so.

gvjddbnvdrbv 6y ago

Slighlty pedantic correction... Citizenship is irrelevant in any national health system I've encountered. The person must be enrolled in the country's national health insurance scheme. A prerequisite of that is of course being a legal resident.