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I don't understand why people like you keep ranting about "universal healthcare" when obviously about 50% of your country so strongly opposes it that I think it

by tomp 6y ago

I don't understand why people like you keep ranting about "universal healthcare" when obviously about 50% of your country so strongly opposes it that I think it's sooner that hell freezes than US getting social healthcare. Instead, why don't you propose alternative solutions? E.g. in Switzerland, it's illegal for your healthcare to be paid by the company, and also it's obligatory to have healthcare insurance (probably the country pays for it if you're poor). That way, you establish a thriving and competitive health insurance market, forcefully eliminate all the benefits corporations get that are unavailable to individuals, and also align interests (because individuals will be in the middle of money flow, they'll have a vested interest in getting fairly- and transparently-priced health services). This would solve most of the problems US healthcare system has, while not triggering any anti-big-government sentiments.

DoreenMichele 6y ago
I have, at times, suggested alternatives. Such as "We should start by expanding existing military benefits to cover all former military personnel." I'm not ranting. Studies show that access to affordable health coverage helps prevent homelessness, for example. It's a known best practice that works in a number of developed countries. I worked in insurance. I'm really not for an insurance-based universal coverage system.
graeme 6y ago
North america is rather insular. I live in canada. We basically only compare our health system to the us. And americans, if they compare to anyone at all, really only look at us or the uk. and we both have a version of medicare for all effectively. I reckon the bulk of americans would be surprised to learn that europe does not have medicare for all as their solution or that the private sector has a substantial role. A substantial amount of america’s dysfunction is due to entrenched tax code provisions (health insurance not being a taxable benefit, mortgage interest deduction, govt mortgage market insurance backstops, etc), and this is mostly invisible as the discourse focusses on government spending only.
wil421 6y ago
You are looking at the healthcare coverage problem and you think it’s the only issue. Coverage is a big problem for some but not the biggest problem. The biggest issue is arguably billing and pricing. You have no idea how much something will cost until it’s done. Medicade is paying over 80% more for prescription drugs than the EU. > In 2016 the U.S. spent 18% of its GDP on healthcare, whereas the next highest country (Switzerland) devoted 12% of its GDP to healthcare. The average amount spent on healthcare per person in comparable countries ($5,198) is half that of the U.S. ($10,348). > The average price per coronary bypass surgery in the U.S is 129% more than Switzerland’s next-highest average. > In 2014, the U.S. performed more MRI exams than most similarly wealthy countries at an average price of $1,119 per MRI. This was 42% more than the average price in the United Kingdom, 122% more than the average price in Switzerland, and 420% more than the average price in Australia. > While fewer appendectomies are performed on average in the United Kingdom compared to the U.S., the price per surgery in the U.S. is $15,930 – nearly double the price in the United Kingdom. Meanwhile, in Australia and Switzerland, where far more appendectomies are performed on average than in comparable countries, the price of each surgery is even less, at only $3,814 in Australia and $6,040 in Switzerland. https://www.healthsystemtracker.org/chart-collection/how-do-healthcare-prices-and-use-in-the-u-s-compare-to-other-countries/#item-the-average-price-of-an-angioplasty-or-bypass-in-the-u-s-is-higher-than-in-comparable-countries https://www.healthsystemtracker.org/chart-collection/how-do-...
- tomp 6y ago
  Au contraire, I think my proposed solution solves pricing as well. As I wrote, it aligns interests between consumers (patients) and producers (doctors), and removes one step between them - patients will be much more directly impacted by their choice of insurer (now this is handled by their companies, consumers have no real choice), so they'll be shopping around for the optimal price/performance provider. The alternative solution often proposed, Medicaid/Medicare for all (socialized medicine), actually has no solution to this problem (except sweeping it under the rug even more, then it will be the government overpaying for medicine so people will care even less).
  - wil421 6y ago
thedufer 6y ago
> I don't understand why people like you keep ranting about "universal healthcare" when obviously about 50% of your country so strongly opposes it that I think it's sooner that hell freezes than US getting social healthcare. Maybe you mean something different than what I think of when I hear "universal healthcare" - could you share some data on that? The proposed Medicare For All policy, for example, is supported by around 70% of the US, including a (admittedly thin) majority of Republicans[1]. The problem isn't popular support, it's getting politicians to do what their constituents want. [1] https://www.reuters.com/investigates/special-report/usa-election-progressives/ https://www.reuters.com/investigates/special-report/usa-elec...
totalZero 6y ago
The particular HN user to whom you refer as "people like you" has a unique experience with homelessness and that's why she has a unique perspective on some issues related to the topic. I used to butt heads with her on certain comment threads until I Googled her and understood that. I think it's kind of cool that someone in this forum can present those views in the way that she does. Regarding healthcare, there is no shortage of alternative solutions proposed for the improvement of the American health insurance system. If one party's leaders close their eyes, put their fingers in their ears, and say "la la la la I can't hear you," that doesn't mean the rest of the country has failed to propose reasonable solutions.
- DoreenMichele 6y ago
  I used to butt heads with her I don't remember this at all, so you must not have ever really upset me.
theonemind 6y ago
Nothing will change with our healthcare system no matter what anyone proposes or thinks. Our healthcare problems are only a symptom of a bigger problem an this point. Our country is in the pocket of large moneyed interests and they essentially make our laws and at the least, can keep anything in their favor in place as the status quo. Our healthcare industry is huge and they won't let anything shift against their favor.

by tomp 6y ago

DoreenMichele 6y ago

I have, at times, suggested alternatives. Such as "We should start by expanding existing military benefits to cover all former military personnel." I'm not ranting. Studies show that access to affordable health coverage helps prevent homelessness, for example. It's a known best practice that works in a number of developed countries. I worked in insurance. I'm really not for an insurance-based universal coverage system.

graeme 6y ago

North america is rather insular. I live in canada. We basically only compare our health system to the us. And americans, if they compare to anyone at all, really only look at us or the uk. and we both have a version of medicare for all effectively. I reckon the bulk of americans would be surprised to learn that europe does not have medicare for all as their solution or that the private sector has a substantial role. A substantial amount of america’s dysfunction is due to entrenched tax code provisions (health insurance not being a taxable benefit, mortgage interest deduction, govt mortgage market insurance backstops, etc), and this is mostly invisible as the discourse focusses on government spending only.

wil421 6y ago

You are looking at the healthcare coverage problem and you think it’s the only issue. Coverage is a big problem for some but not the biggest problem. The biggest issue is arguably billing and pricing. You have no idea how much something will cost until it’s done. Medicade is paying over 80% more for prescription drugs than the EU. > In 2016 the U.S. spent 18% of its GDP on healthcare, whereas the next highest country (Switzerland) devoted 12% of its GDP to healthcare. The average amount spent on healthcare per person in comparable countries ($5,198) is half that of the U.S. ($10,348). > The average price per coronary bypass surgery in the U.S is 129% more than Switzerland’s next-highest average. > In 2014, the U.S. performed more MRI exams than most similarly wealthy countries at an average price of $1,119 per MRI. This was 42% more than the average price in the United Kingdom, 122% more than the average price in Switzerland, and 420% more than the average price in Australia. > While fewer appendectomies are performed on average in the United Kingdom compared to the U.S., the price per surgery in the U.S. is $15,930 – nearly double the price in the United Kingdom. Meanwhile, in Australia and Switzerland, where far more appendectomies are performed on average than in comparable countries, the price of each surgery is even less, at only $3,814 in Australia and $6,040 in Switzerland. https://www.healthsystemtracker.org/chart-collection/how-do-healthcare-prices-and-use-in-the-u-s-compare-to-other-countries/#item-the-average-price-of-an-angioplasty-or-bypass-in-the-u-s-is-higher-than-in-comparable-countries https://www.healthsystemtracker.org/chart-collection/how-do-...

tomp 6y ago
Au contraire, I think my proposed solution solves pricing as well. As I wrote, it aligns interests between consumers (patients) and producers (doctors), and removes one step between them - patients will be much more directly impacted by their choice of insurer (now this is handled by their companies, consumers have no real choice), so they'll be shopping around for the optimal price/performance provider. The alternative solution often proposed, Medicaid/Medicare for all (socialized medicine), actually has no solution to this problem (except sweeping it under the rug even more, then it will be the government overpaying for medicine so people will care even less).
- wil421 6y ago

thedufer 6y ago

> I don't understand why people like you keep ranting about "universal healthcare" when obviously about 50% of your country so strongly opposes it that I think it's sooner that hell freezes than US getting social healthcare. Maybe you mean something different than what I think of when I hear "universal healthcare" - could you share some data on that? The proposed Medicare For All policy, for example, is supported by around 70% of the US, including a (admittedly thin) majority of Republicans[1]. The problem isn't popular support, it's getting politicians to do what their constituents want. [1] https://www.reuters.com/investigates/special-report/usa-election-progressives/ https://www.reuters.com/investigates/special-report/usa-elec...

totalZero 6y ago

The particular HN user to whom you refer as "people like you" has a unique experience with homelessness and that's why she has a unique perspective on some issues related to the topic. I used to butt heads with her on certain comment threads until I Googled her and understood that. I think it's kind of cool that someone in this forum can present those views in the way that she does. Regarding healthcare, there is no shortage of alternative solutions proposed for the improvement of the American health insurance system. If one party's leaders close their eyes, put their fingers in their ears, and say "la la la la I can't hear you," that doesn't mean the rest of the country has failed to propose reasonable solutions.

DoreenMichele 6y ago
I used to butt heads with her I don't remember this at all, so you must not have ever really upset me.

theonemind 6y ago

Nothing will change with our healthcare system no matter what anyone proposes or thinks. Our healthcare problems are only a symptom of a bigger problem an this point. Our country is in the pocket of large moneyed interests and they essentially make our laws and at the least, can keep anything in their favor in place as the status quo. Our healthcare industry is huge and they won't let anything shift against their favor.