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This kind of projects are totally alien for me, because of the paid-by-taxes Healthcare I have in my European country. Aren’t there any initiatives in some US

This kind of projects are totally alien for me, because of the paid-by-taxes Healthcare I have in my European country. Aren’t there any initiatives in some US states to make socialized healthcare?

hythyt 5y ago
why is comment this downvoted?
- Kosirich 5y ago
  Perhaps because it makes an bad faith statement/argument using the standard meme of "We in Europe are so advanced with our free health care vs. you Americans that have to (over) pay for everything" that is overused in any almost any discussion about healthcare cost on HN by some Europeans.
  - antman 5y ago
    Pointing out that it addresses a artificially created political problem is unpleasant but hardly be classified as a “bad faith statement”.
    - deleted 5y ago
      [deleted]
  - deleted 5y ago
    [deleted]
  - elnatro 5y ago
    Well, it’s not that we (Europeans) are “advanced”. It’s more that having a socialized healthcare program is common sense for us. A for-profit company cannot be left in charge of treating patients as there are few patients that could need expensive treatments. No company would want to treat this people. Other point I would like to make is that our healthcare is not “free”. It’s paid by high taxes be are obligated to pay to the government (the taxes are as high that I don’t even want to know the exact amount in my case but is around 25-30% of my salary).
    - LadyCailin 5y ago
      The thing is though, taxes in the US aren’t any lower, if you include healthcare premiums as “tax”, at least for middle class people.
      - refurb 5y ago
        Depends where.
      - vimacs2 5y ago
        I wonder how well would things turn out if people were given the choice to opt out of public healthcare. You don't get taxed on it but also cannot use it (except in ER situations obviously). I'd imagine that most people would stay signed on but it does give people who either distrust public institutions or just don't feel like they would benefit from a public option a choice. Full disclosure: I am firmly on the side of socialised medicine.
        peytn 5y ago
        We have public hospitals already. People happily opt out. They’d opt out even harder if there was a tax break.
        vimacs2 5y ago
        Yes but that's not really the same thing as real nationwide public healthcare. Going by my experiences in the UK at least, people tend to have a lot of pride with them even if they also will complain about issues with it. It's considered political suicide to even openly discuss dismantling the NHS which is why even the Tories continue to tip toe around the issue even after having been in control of government for more than a decade at this point.
    - lbruder 5y ago
      As a concrete example, German programmer here. 16% of my income go to taxes, another 12% go to mandatory insurances (excluding healthcare), and about 6% go to health insurance. So about a third of my income goes to mandatory stuff and taxes, but when my son broke his arm in the schoolyard, the treatment was completely free for us. Not sure how those numbers transfer to the US, though.
sbuk 5y ago
Initially, I had the same thought, then it (embarrassingly) struck me that this could help people across the globe that don't have access to inulin. It's an amazing initiative that I will donate to, but it genuinely disgust me that it had to come to this. The greed involved by the global healthcare industry that led to someone having to create this project is unconscionable.
dragonwriter 5y ago
> Aren’t there any initiatives in some US states to make socialized healthcare? Some initiatives have been put forth at the state level, but it's essentially impractical for US states to do it without active federal cooperation (which itself is practically unlikely without the same faction controlling the federal levers of power that would federally implement socialized medicine, making the state programs unnecessary.)
antman 5y ago
Same here. I does not cost much even if you get it yourself but I guess some US law exists that forbids sending from EU to the states.
- pas 5y ago
  You can sell, but you need FDA marketing approval. Also you need to be clear of patents. Currently FDA exclusive marketing approvals and patents are the big hammer that keep the market uncompetitive. (The FDA grants exclusive approval for first movers, for a few years. It's not exactly great, but that's usually the smaller problem. The bigger is the patents.) Also, currently due to the enormous money in US healthcare (the medicine market very much included) a lot of R&D costs are recouped there using these exclusivity strategies. The biggest problem is that there are many effectively uninsured people in the US, and they are the sufferers of the aforementioned emergent system. (Even if there many "state pharmaceutical assistance programs", many people who would need it don't know about it, and even if they do the paperwork burden is substantial, and obviously it's just a stopgap measure.)
JumpCrisscross 5y ago
Walmart sells insulin for $25 per vial [1]. There are cheaper offers, still. The problem is there are newer formulations with advantages in terms of convenience, safety and durability. These require R&D to develop and are not universally available. (Diabetic friend had trouble finding his preferred formulation outside the U.S., U.K. and Sweden, for instance.) We have huge problems with healthcare in America. But the insulin meme is misleading to the point of derailing discussions about legitimate reform. [1] https://diabetesstrong.com/walmart-insulin/ https://diabetesstrong.com/walmart-insulin/
- unglaublich 5y ago
  "Diabetic friend had trouble finding his preferred formulation outside the U.S." In European countries, there are about 20 formulations available, all well below 10 USD per vial of which 100% is compensated by the obligatory health-insurance. There is no market for marginal improved, extremely overpriced medicine outside of pharma-marketing heavens.
  - JumpCrisscross 5y ago
    > is no market for marginal improved, extremely overpriced medicine outside of pharma-marketing heavens I am sure someone could have said that about the twenty-odd formulations you mention when they were novel and not yet manufactured at scale.
  - gdy 5y ago
    "There is no market for marginal improved, extremely overpriced medicine outside of pharma-marketing heavens." There is, in Russia for example. But the most expensive I could find (Tresiba) costs 12 usd per cartridge (3ml x 100 units) [0]. [0] https://apteka.ru/product/tresiba-flekstach-609a3db8c93e31dd14f98e54/ https://apteka.ru/product/tresiba-flekstach-609a3db8c93e31dd...
- andi999 5y ago
  How many vials per day or month does a typical diabetic person need?
Popegaf 5y ago
There probably are, but with a First Past The Post / Winner Takes All system, it's really hard to get it introduced. Politically, one would require a majority of voters in BOTH parties to want socialized healthcare, due to the division of powers, gerrymandering, the broken presidential election system, and so on. You could have 70% of the population being pro-socialized healthcare, but if the majority of those rest in one party and in certain regions, there still wouldn't be enough to get the majority in the house AND senate. If other things are more important, voters might even be for it, but not even show up to the polls or vote for candidates that are all about that issue, because some other, bigger issue (in the eyes of the voters) needs to be addressed. Climate change is a good example in Europe. Depending on country, you can get the majority of people who say they care about it, but come election time they will: - vote for a populist party that doesn't give two farts about it - vote for the old, "stable" option that is closer to their core values but never actually does anything about climate change - decide not to vote at all for whatever reason The minority actually votes for a green party. That might slowly be changing, but change doesn't come quickly from within unless forced (COVID being a good example).
- freemint 5y ago
  To be fair it's uncommon that any party get's the majority of votes in Europe and for example the German green party this election cycle is going take >2x of the votes they did last round hovering around 20%.
- lovemenot 5y ago
  >> but change doesn't come quickly from within unless forced Yes. In Britain (and I suppose in mainland Europe too) the jolt came at the end of World War II. Society in general - and returning service-people in particular - refused to accept the status quo ante. Supported by our American friends' economic largesse / self-interest, there emerged a social and geo-political revolution. In that moment, amongst many other societal improvements, the NHS and decolonisation became firmly established.
tobyhinloopen 5y ago
Note that EU healthcare isn’t perfect either. For example, in the Netherlands, many diabetic care products offered by national healthcare is of the cheapest kind. My wife had these things that shoot a needle for a droplet of blood, and they were awful and crude, usually leaving a much larger hole than needed. She just bought her own to avoid having holes in her fingers. There’s also that thing you can put on your arm and read your blood sugar which is a great invention, but guess what: you have to pay for it yourself. The “free” healthcare is great, but it’s not free comfortable healthcare. IIRC the expensive insulin is the comfortable kind, that works better. The cheap insulin Americans can buy is the uncomfortable kind.
- cartoonworld 5y ago
  I know so many people who are or have been walking around with health conditions they either can't, don't think they can, or are literally afraid to fix because they don't want to ruin their family's financial prospects or go bankrupt. Most recently, I ran into an old acquaintance with a back problem that sounds like a slipped disc, and this poor dude doesn't have the coverage to get the surgery and treatments needed not to be in constant pain all day. Hey, maybe he's wrong and its a $300 quick fix, but he's walking around with the free uncomfortable treatment we have in America. Personally, I think healthcare is worth it. We should just pay for it and reap the incalculable benefits of a more effective society that is much less burdened by disease and chronic injury.
betwixthewires 5y ago
Yes there are initiatives, it's just that most Americans don't want it. We acknowledge problems with our healthcare system and want to fix them, but we just don't want that, which is a big part of the problem also, the only solution some people seem to be willing to accept is socialized medicine.
- deleted 5y ago
  [deleted]
tootie 5y ago
Yes, but it's been a tough road. Part of the Obama health care reform plan was to allow specific states to opt out of federal requirements if they could provide universal coverage at the state level. It's been started and abandoned in a few states. It's currently working it's way through the legislature in New York which has liberal majorities across the board, but it's still going slowly.
PragmaticPulp 5y ago
> Aren’t there any initiatives in some US states to make socialized healthcare? Sort of. The conversations are mostly about expanding our existing socialized healthcare plans that cover over 1/3 of the population already. Americans over 65 and those with some disabilities are covered by Medicare: https://en.m.wikipedia.org/wiki/Medicare_(United_States) https://en.m.wikipedia.org/wiki/Medicare_(United_States) This includes about 60 million people. People with low income or some other qualifications are covered by Medicaid: https://en.m.wikipedia.org/wiki/Medicaid https://en.m.wikipedia.org/wiki/Medicaid This includes about 75 million people and reportedly pays for about half of all births. The affordable care act also subsidized health insurance plans for those with incomes up to 400% of the poverty level: https://www.healthinsurance.org/obamacare/the-acas-cost-sharing-subsidies/ https://www.healthinsurance.org/obamacare/the-acas-cost-shar... These subsidies go to another 9 million people or so. There are gaps and I agree 100% that we need to continue closing such gaps, but the US actually does have a significant amount of socialized healthcare. Some of the proposals include simply expanding some of these programs to cover the remaining 8-9% of the population without healthcare. The idea that the US doesn’t have any socialized healthcare is a bit of a myth. The reality is that we do have socialized health care, it just doesn’t cover everyone. The headlines about insulin costing thousands of dollars per month are also misleading. Insulin is $25/vial at Walmart and you don’t even need a prescription from a doctor to get it. The expensive products are more recent, patented insulin analogs that are longer lasting but obviously shouldn’t be prescribed to someone without insurance who can’t afford them. The $25/vial insulin is equivalent to the generics you read about in headlines like this one.
kube-system 5y ago
It’s important to make a distinction between “socialized” care, “free” care, and “universal” care. A healthcare plan that is described by one of those terms is not necessarily described by all of them (even outside of the US) The US has a large number of socialized healthcare programs, several free healthcare programs, but nothing that is 100% universal. Americans don’t have any reservations about paying for healthcare for the poor, elderly, veterans, etc. People in the US generally hate the idea of anyone qualifying who makes more money than they do, which is one of the reasons why universal plans don’t go over well. The other reason is that a truly universal plan would probably uproot the existing health insurance system, which scares some people who are satisfied with the status quo. Our existing systems are mainly a result of compromise: > “let’s have a healthcare plan that covers everyone” > “you want to tax the working class American to pay for healthcare for the rich? And bankrupt they insurance companies that insure our middle class? And kill jobs?” > “ok, let’s compromise. Let’s make a plan that covers [insert group of people that voters will feel sorry for]” And repeat about every decade or so. That’s how America’s fragmented healthcare system was born.
- CRConrad 5y ago
  > > “you want to tax the working class American to pay for healthcare for the rich? This is where America should have answered "Yup, you betcha!" Because, you'd be taxing the rich even more, but since they'd also benefit from it, they'd have much less grounds to protest against it. In places like Sweden, billionaires receive the same universal child benefit as everyone else, largely for this exact reason.

This kind of projects are totally alien for me, because of the paid-by-taxes Healthcare I have in my European country. Aren’t there any initiatives in some US states to make socialized healthcare?

hythyt 5y ago

why is comment this downvoted?

Kosirich 5y ago
Perhaps because it makes an bad faith statement/argument using the standard meme of "We in Europe are so advanced with our free health care vs. you Americans that have to (over) pay for everything" that is overused in any almost any discussion about healthcare cost on HN by some Europeans.
- antman 5y ago
  Pointing out that it addresses a artificially created political problem is unpleasant but hardly be classified as a “bad faith statement”.
  - deleted 5y ago
    [deleted]
- deleted 5y ago
  [deleted]
- elnatro 5y ago
  Well, it’s not that we (Europeans) are “advanced”. It’s more that having a socialized healthcare program is common sense for us. A for-profit company cannot be left in charge of treating patients as there are few patients that could need expensive treatments. No company would want to treat this people. Other point I would like to make is that our healthcare is not “free”. It’s paid by high taxes be are obligated to pay to the government (the taxes are as high that I don’t even want to know the exact amount in my case but is around 25-30% of my salary).
  - LadyCailin 5y ago
    The thing is though, taxes in the US aren’t any lower, if you include healthcare premiums as “tax”, at least for middle class people.
    - refurb 5y ago
      Depends where.
    - vimacs2 5y ago
      I wonder how well would things turn out if people were given the choice to opt out of public healthcare. You don't get taxed on it but also cannot use it (except in ER situations obviously). I'd imagine that most people would stay signed on but it does give people who either distrust public institutions or just don't feel like they would benefit from a public option a choice. Full disclosure: I am firmly on the side of socialised medicine.
      - peytn 5y ago
        We have public hospitals already. People happily opt out. They’d opt out even harder if there was a tax break.
        vimacs2 5y ago
        Yes but that's not really the same thing as real nationwide public healthcare. Going by my experiences in the UK at least, people tend to have a lot of pride with them even if they also will complain about issues with it. It's considered political suicide to even openly discuss dismantling the NHS which is why even the Tories continue to tip toe around the issue even after having been in control of government for more than a decade at this point.
  - lbruder 5y ago
    As a concrete example, German programmer here. 16% of my income go to taxes, another 12% go to mandatory insurances (excluding healthcare), and about 6% go to health insurance. So about a third of my income goes to mandatory stuff and taxes, but when my son broke his arm in the schoolyard, the treatment was completely free for us. Not sure how those numbers transfer to the US, though.

sbuk 5y ago

Initially, I had the same thought, then it (embarrassingly) struck me that this could help people across the globe that don't have access to inulin. It's an amazing initiative that I will donate to, but it genuinely disgust me that it had to come to this. The greed involved by the global healthcare industry that led to someone having to create this project is unconscionable.

dragonwriter 5y ago

> Aren’t there any initiatives in some US states to make socialized healthcare? Some initiatives have been put forth at the state level, but it's essentially impractical for US states to do it without active federal cooperation (which itself is practically unlikely without the same faction controlling the federal levers of power that would federally implement socialized medicine, making the state programs unnecessary.)

antman 5y ago

Same here. I does not cost much even if you get it yourself but I guess some US law exists that forbids sending from EU to the states.

pas 5y ago
You can sell, but you need FDA marketing approval. Also you need to be clear of patents. Currently FDA exclusive marketing approvals and patents are the big hammer that keep the market uncompetitive. (The FDA grants exclusive approval for first movers, for a few years. It's not exactly great, but that's usually the smaller problem. The bigger is the patents.) Also, currently due to the enormous money in US healthcare (the medicine market very much included) a lot of R&D costs are recouped there using these exclusivity strategies. The biggest problem is that there are many effectively uninsured people in the US, and they are the sufferers of the aforementioned emergent system. (Even if there many "state pharmaceutical assistance programs", many people who would need it don't know about it, and even if they do the paperwork burden is substantial, and obviously it's just a stopgap measure.)

JumpCrisscross 5y ago

Walmart sells insulin for $25 per vial [1]. There are cheaper offers, still. The problem is there are newer formulations with advantages in terms of convenience, safety and durability. These require R&D to develop and are not universally available. (Diabetic friend had trouble finding his preferred formulation outside the U.S., U.K. and Sweden, for instance.) We have huge problems with healthcare in America. But the insulin meme is misleading to the point of derailing discussions about legitimate reform. [1] https://diabetesstrong.com/walmart-insulin/ https://diabetesstrong.com/walmart-insulin/

unglaublich 5y ago
"Diabetic friend had trouble finding his preferred formulation outside the U.S." In European countries, there are about 20 formulations available, all well below 10 USD per vial of which 100% is compensated by the obligatory health-insurance. There is no market for marginal improved, extremely overpriced medicine outside of pharma-marketing heavens.
- JumpCrisscross 5y ago
  > is no market for marginal improved, extremely overpriced medicine outside of pharma-marketing heavens I am sure someone could have said that about the twenty-odd formulations you mention when they were novel and not yet manufactured at scale.
- gdy 5y ago
  "There is no market for marginal improved, extremely overpriced medicine outside of pharma-marketing heavens." There is, in Russia for example. But the most expensive I could find (Tresiba) costs 12 usd per cartridge (3ml x 100 units) [0]. [0] https://apteka.ru/product/tresiba-flekstach-609a3db8c93e31dd14f98e54/ https://apteka.ru/product/tresiba-flekstach-609a3db8c93e31dd...
andi999 5y ago
How many vials per day or month does a typical diabetic person need?

Popegaf 5y ago

There probably are, but with a First Past The Post / Winner Takes All system, it's really hard to get it introduced. Politically, one would require a majority of voters in BOTH parties to want socialized healthcare, due to the division of powers, gerrymandering, the broken presidential election system, and so on. You could have 70% of the population being pro-socialized healthcare, but if the majority of those rest in one party and in certain regions, there still wouldn't be enough to get the majority in the house AND senate. If other things are more important, voters might even be for it, but not even show up to the polls or vote for candidates that are all about that issue, because some other, bigger issue (in the eyes of the voters) needs to be addressed. Climate change is a good example in Europe. Depending on country, you can get the majority of people who say they care about it, but come election time they will: - vote for a populist party that doesn't give two farts about it - vote for the old, "stable" option that is closer to their core values but never actually does anything about climate change - decide not to vote at all for whatever reason The minority actually votes for a green party. That might slowly be changing, but change doesn't come quickly from within unless forced (COVID being a good example).

freemint 5y ago
To be fair it's uncommon that any party get's the majority of votes in Europe and for example the German green party this election cycle is going take >2x of the votes they did last round hovering around 20%.
lovemenot 5y ago
>> but change doesn't come quickly from within unless forced Yes. In Britain (and I suppose in mainland Europe too) the jolt came at the end of World War II. Society in general - and returning service-people in particular - refused to accept the status quo ante. Supported by our American friends' economic largesse / self-interest, there emerged a social and geo-political revolution. In that moment, amongst many other societal improvements, the NHS and decolonisation became firmly established.

tobyhinloopen 5y ago

Note that EU healthcare isn’t perfect either. For example, in the Netherlands, many diabetic care products offered by national healthcare is of the cheapest kind. My wife had these things that shoot a needle for a droplet of blood, and they were awful and crude, usually leaving a much larger hole than needed. She just bought her own to avoid having holes in her fingers. There’s also that thing you can put on your arm and read your blood sugar which is a great invention, but guess what: you have to pay for it yourself. The “free” healthcare is great, but it’s not free comfortable healthcare. IIRC the expensive insulin is the comfortable kind, that works better. The cheap insulin Americans can buy is the uncomfortable kind.

cartoonworld 5y ago
I know so many people who are or have been walking around with health conditions they either can't, don't think they can, or are literally afraid to fix because they don't want to ruin their family's financial prospects or go bankrupt. Most recently, I ran into an old acquaintance with a back problem that sounds like a slipped disc, and this poor dude doesn't have the coverage to get the surgery and treatments needed not to be in constant pain all day. Hey, maybe he's wrong and its a $300 quick fix, but he's walking around with the free uncomfortable treatment we have in America. Personally, I think healthcare is worth it. We should just pay for it and reap the incalculable benefits of a more effective society that is much less burdened by disease and chronic injury.

betwixthewires 5y ago

Yes there are initiatives, it's just that most Americans don't want it. We acknowledge problems with our healthcare system and want to fix them, but we just don't want that, which is a big part of the problem also, the only solution some people seem to be willing to accept is socialized medicine.

deleted 5y ago
[deleted]

tootie 5y ago

Yes, but it's been a tough road. Part of the Obama health care reform plan was to allow specific states to opt out of federal requirements if they could provide universal coverage at the state level. It's been started and abandoned in a few states. It's currently working it's way through the legislature in New York which has liberal majorities across the board, but it's still going slowly.

PragmaticPulp 5y ago

> Aren’t there any initiatives in some US states to make socialized healthcare? Sort of. The conversations are mostly about expanding our existing socialized healthcare plans that cover over 1/3 of the population already. Americans over 65 and those with some disabilities are covered by Medicare: https://en.m.wikipedia.org/wiki/Medicare_(United_States) https://en.m.wikipedia.org/wiki/Medicare_(United_States) This includes about 60 million people. People with low income or some other qualifications are covered by Medicaid: https://en.m.wikipedia.org/wiki/Medicaid https://en.m.wikipedia.org/wiki/Medicaid This includes about 75 million people and reportedly pays for about half of all births. The affordable care act also subsidized health insurance plans for those with incomes up to 400% of the poverty level: https://www.healthinsurance.org/obamacare/the-acas-cost-sharing-subsidies/ https://www.healthinsurance.org/obamacare/the-acas-cost-shar... These subsidies go to another 9 million people or so. There are gaps and I agree 100% that we need to continue closing such gaps, but the US actually does have a significant amount of socialized healthcare. Some of the proposals include simply expanding some of these programs to cover the remaining 8-9% of the population without healthcare. The idea that the US doesn’t have any socialized healthcare is a bit of a myth. The reality is that we do have socialized health care, it just doesn’t cover everyone. The headlines about insulin costing thousands of dollars per month are also misleading. Insulin is $25/vial at Walmart and you don’t even need a prescription from a doctor to get it. The expensive products are more recent, patented insulin analogs that are longer lasting but obviously shouldn’t be prescribed to someone without insurance who can’t afford them. The $25/vial insulin is equivalent to the generics you read about in headlines like this one.

kube-system 5y ago

It’s important to make a distinction between “socialized” care, “free” care, and “universal” care. A healthcare plan that is described by one of those terms is not necessarily described by all of them (even outside of the US) The US has a large number of socialized healthcare programs, several free healthcare programs, but nothing that is 100% universal. Americans don’t have any reservations about paying for healthcare for the poor, elderly, veterans, etc. People in the US generally hate the idea of anyone qualifying who makes more money than they do, which is one of the reasons why universal plans don’t go over well. The other reason is that a truly universal plan would probably uproot the existing health insurance system, which scares some people who are satisfied with the status quo. Our existing systems are mainly a result of compromise: > “let’s have a healthcare plan that covers everyone” > “you want to tax the working class American to pay for healthcare for the rich? And bankrupt they insurance companies that insure our middle class? And kill jobs?” > “ok, let’s compromise. Let’s make a plan that covers [insert group of people that voters will feel sorry for]” And repeat about every decade or so. That’s how America’s fragmented healthcare system was born.

CRConrad 5y ago
> > “you want to tax the working class American to pay for healthcare for the rich? This is where America should have answered "Yup, you betcha!" Because, you'd be taxing the rich even more, but since they'd also benefit from it, they'd have much less grounds to protest against it. In places like Sweden, billionaires receive the same universal child benefit as everyone else, largely for this exact reason.