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Yes and we need to avoid the nirvana fallacy. I live in a country with public health care and every so ofter people are sent home to die from scheduled surgery

Yes and we need to avoid the nirvana fallacy. I live in a country with public health care and every so ofter people are sent home to die from scheduled surgery because there aren't doctors or other staff available. My dad had 99% clogged heart arteries before he got treatment. My brother works in the US and prefer their system, but then he's got a good job - still a data point for the discussion.

XorNot 6y ago
So, how rich is your dad? Because unless it was "can drop quarter of a million dollars or more" rich, then no, in the US he would've just been sent home to die. The existence of a public healthcare system running at capacity is not evidence the US system "doesn't have this problem". Being denied treatment because you can't afford it is objectively worse then being denied treatment because the system is busy. One problem is fixable. EDIT: And also, unless your brother has had a major health event, then the reality is he has no idea whether his insurance is any good.
- BoardsOfCanada 6y ago
  Well my point was to not compare with rainbows and unicorns but how it works in the real world. Also I'm not saying the US has a better system. But just to entertain this discussion (big mistake), the problem is that you can't pay for surgery even if you're rich, which means that useful price signals for how to allocate resources are missing. You'll perhaps say: "Well it shouldn't be like that". I agree but there is a reason it ended up like this. My brother doesn't need a serious health event to know (for a reasonable definition of "know") because he has a brain and people to talk to with direct and indirect experience of the system.
  - simonh 6y ago
    >the problem is that you can't pay for surgery even if you're rich, ... Yes you absolutely can, here in the UK I've had private health insurance from my employers for the last 23 years of my career. I'm not aware of any country that outlaws paying for private treatment.
    - s1artibartfast 6y ago
      This is the case for some provinces in Canada, and is used as a healthcare boogie man in the USA. At the same time, US politicians for a single payer refuse to state whether private supplemental insurance would be allowed. This mixes up debate between universal coverage and eliminating private insurance entirely. https://www.vox.com/health-care/2019/2/12/18215430/single-payer-private-health-insurance-harris-sanders https://www.vox.com/health-care/2019/2/12/18215430/single-pa...
- dfgdghdf 6y ago
  Perhaps there's another way to put this. In an ineffective public healthcare system, people are denied treatment because the public body has determined it is not worth the cost. In an ineffective private healthcare system, people are denied treatment because they cannot afford to pay. > Being denied treatment because you can't afford it is objectively worse then being denied treatment because the system is busy. Is it? I am fortunate enough to not be in this position, but I'm not sure how much I would care about the reasons why if I were.
  - XorNot 6y ago
    And it will matter just as little if you can't afford to pay. The problem is, you seem to think you'd be able to - but that is statistically improbable. The cost of heart bypass surgery in the US (literally the highest in the world) as of 2019 was USD$123,000 - https://www.statista.com/statistics/189966/cost-of-a-heart-bypass-in-various-countries/ https://www.statista.com/statistics/189966/cost-of-a-heart-b.... That's not including the costs of follow up treatment, the increased cost of your insurance after an event which changes your risk category, or the byzantine system by which your job will be gently encouraged to let go of a "significant risk factor" because it will reduce the cost of them providing health insurance. And in reality - people in socialized healthcare systems aren't denied life saving treatment. The availability of treatment is a priority list for "elective" surgery - that is, surgery not immediately necessary to save one's life. And this also does not affect the availability of private care - in Australia you always have the option to pay for private treatment, but controversy over waiting times exists precisely because the vast majority cannot afford to pay. And our costs are cheaper then US to start with if you do. Hence the original question of how rich the OP's father was: because the reality is, if he wanted surgery right away he most likely could have got it. That he didn't is telling - because he actually couldn't afford it. Couldn't afford to fly to the US and have it done either. The US would have "denied" them treatment just as assuredly. And they did eventually get it where they were.
    - dfgdghdf 6y ago
      I want to be clear that I do not think the US system is a good one. However, we should not be blind to limitations of a UK style system. There are also in-between alternatives, such as in Germany or to a lesser extent Japan.
- Ygg2 6y ago
  > One problem is fixable. Both are fixable. Given enough money. But if not fixed the results will be the same.
- bumby 6y ago
  >Because unless it was "can drop quarter of a million dollars or more" rich, then no, in the US he would've just been sent home to die. Not trying to be argumentative, but what is this based on? I’ve known people who received major heart surgeries without insurance and certainly didn’t have that kind of money.

XorNot 6y ago

So, how rich is your dad? Because unless it was "can drop quarter of a million dollars or more" rich, then no, in the US he would've just been sent home to die. The existence of a public healthcare system running at capacity is not evidence the US system "doesn't have this problem". Being denied treatment because you can't afford it is objectively worse then being denied treatment because the system is busy. One problem is fixable. EDIT: And also, unless your brother has had a major health event, then the reality is he has no idea whether his insurance is any good.

BoardsOfCanada 6y ago
Well my point was to not compare with rainbows and unicorns but how it works in the real world. Also I'm not saying the US has a better system. But just to entertain this discussion (big mistake), the problem is that you can't pay for surgery even if you're rich, which means that useful price signals for how to allocate resources are missing. You'll perhaps say: "Well it shouldn't be like that". I agree but there is a reason it ended up like this. My brother doesn't need a serious health event to know (for a reasonable definition of "know") because he has a brain and people to talk to with direct and indirect experience of the system.
- simonh 6y ago
  >the problem is that you can't pay for surgery even if you're rich, ... Yes you absolutely can, here in the UK I've had private health insurance from my employers for the last 23 years of my career. I'm not aware of any country that outlaws paying for private treatment.
  - s1artibartfast 6y ago
    This is the case for some provinces in Canada, and is used as a healthcare boogie man in the USA. At the same time, US politicians for a single payer refuse to state whether private supplemental insurance would be allowed. This mixes up debate between universal coverage and eliminating private insurance entirely. https://www.vox.com/health-care/2019/2/12/18215430/single-payer-private-health-insurance-harris-sanders https://www.vox.com/health-care/2019/2/12/18215430/single-pa...
dfgdghdf 6y ago
Perhaps there's another way to put this. In an ineffective public healthcare system, people are denied treatment because the public body has determined it is not worth the cost. In an ineffective private healthcare system, people are denied treatment because they cannot afford to pay. > Being denied treatment because you can't afford it is objectively worse then being denied treatment because the system is busy. Is it? I am fortunate enough to not be in this position, but I'm not sure how much I would care about the reasons why if I were.
- XorNot 6y ago
  And it will matter just as little if you can't afford to pay. The problem is, you seem to think you'd be able to - but that is statistically improbable. The cost of heart bypass surgery in the US (literally the highest in the world) as of 2019 was USD$123,000 - https://www.statista.com/statistics/189966/cost-of-a-heart-bypass-in-various-countries/ https://www.statista.com/statistics/189966/cost-of-a-heart-b.... That's not including the costs of follow up treatment, the increased cost of your insurance after an event which changes your risk category, or the byzantine system by which your job will be gently encouraged to let go of a "significant risk factor" because it will reduce the cost of them providing health insurance. And in reality - people in socialized healthcare systems aren't denied life saving treatment. The availability of treatment is a priority list for "elective" surgery - that is, surgery not immediately necessary to save one's life. And this also does not affect the availability of private care - in Australia you always have the option to pay for private treatment, but controversy over waiting times exists precisely because the vast majority cannot afford to pay. And our costs are cheaper then US to start with if you do. Hence the original question of how rich the OP's father was: because the reality is, if he wanted surgery right away he most likely could have got it. That he didn't is telling - because he actually couldn't afford it. Couldn't afford to fly to the US and have it done either. The US would have "denied" them treatment just as assuredly. And they did eventually get it where they were.
  - dfgdghdf 6y ago
    I want to be clear that I do not think the US system is a good one. However, we should not be blind to limitations of a UK style system. There are also in-between alternatives, such as in Germany or to a lesser extent Japan.
Ygg2 6y ago
> One problem is fixable. Both are fixable. Given enough money. But if not fixed the results will be the same.
bumby 6y ago
>Because unless it was "can drop quarter of a million dollars or more" rich, then no, in the US he would've just been sent home to die. Not trying to be argumentative, but what is this based on? I’ve known people who received major heart surgeries without insurance and certainly didn’t have that kind of money.