5 ms·

I will never understand why so many US people want their health system as it is. Maybe it is because of neoliberalism or communism fear propaganda of big money

• s1artibartfast 5y ago
  Few are happy with the current status, but people differ on the solution.
  • srgpqt 5y ago
    Is this not a capitalist country? There should be multiple competing solutions for everyone to freely choose from. Nothing like this racketeering situation.
    • protomyth 5y ago
      Government prevents actual markets in the USA. The closest you get is elective surgeries. Hell, many states won't let you open a new hospital without getting the permission of existing hospitals. Not very capitalist.
      • maxerickson 5y ago
        Dental is pretty much a market. Even employer provided coverage usually has some relatively low annual limit.
        • Cryptonic 5y ago
          Dental expanses are pretty much capped. Unlikely that you have to pay in your life as much as these dental insurances cost over time.
      • MereInterest 5y ago
        The nature of medical emergencies prevents actual markets. If you have a chest pain, that's not the time to be comparison shopping and reading reviews of different hospitals. It's the time to get to the nearest ER while you can. Markets rely on well-informed buyers, which are just not possible in the circumstances.
        • pyuser583 5y ago
          That’s bull. I have a nasty medical condition that necessitates ER trips. I know all three ERs. There’s the good one, the OK one, and the terrible one. The problem is I don’t get to chose my own insurance. My employer does. I know exactly which doctors, specialists, and ERs are best for me. Doesn’t matter. My employer, who is remote and employs nobody else in the state, has determined who I can and can’t see. And they’ve done it completely blindly. It’s a messed up system. But the idea that people won’t avoid bad hospitals, including ERs, is untrue.
          • 5y ago
  • Cryptonic 5y ago
    The problem is that there are many ok solutions and most differ in details that could be worked on incrementally after implementation. But the problem in the US I think is that the society is so divided that it got stuck and certain powers want it exacly divided like that. With a totally polarized 50/50 population nothing important will ever change, everything is a big circus. I hope the best for the US citizens though. If the US continue their democratic downward spiral this all will end up in an even bigger crisis with even more individuals left behind.
    • mark-r 5y ago
      The problem is that the big insurers are some of the most profitable companies ever. Just look at the lists of highest paid CEOs. As long as they can afford the most and best lobbyists nothing will ever change.
      • Cryptonic 5y ago
        True, that's why I am a big fan of "liquid Democracy", there they would have to bribe the people directly, which es ok I think. Look at Island, it's a far superior democracy style opposed to 4 year period representative democracy.
• protomyth 5y ago
  Because I've experienced the USA doing a social health system in the form of Indian Health Service. If the USA is incapable of doing a great job with a small population then applying it to the population as a whole is suicidal. Watch "Don't get sick after June". Other family members have experienced the tender mercies of the VA. The whole argument that it will be better with everyone is absurd. You cannot point to other countries examples when we know what the US does. If advocates of changes in the current system cannot fix IHS or the VA then they are incapable of fixing the rest of it.
  • Cryptonic 5y ago
    Yes a copy paste solution might not work. My point was more about that everybody must be taken care of, nobody should be in constant fear of death or bancruptcy or having to choose because one, because of health issues. And that is is feasible, because fair public health insurance is applied in so many countries. The U.S. has capable people. The best academics in the world. It's making me sad to hear stories about citizens in such situations and the seeing other consequences. I thought about it a few times in my life. This is the number wrong reason to not move to the US. Despite all the chances you have there, you could die or go bancupt because of some fine print in a health insurance contract. Reason number two is I don't want to get shot by some (for other reasons) angry citizen for taking his parking lot accidently or similar...
• brailsafe 5y ago
  As a Canadian, but who's somewhat interested in living in Germany, could you elaborate on how you end up paying anything for public health care? We don't pay anything out of pocket for most things, but we do pay for drugs and dental if we don't have insurance. How does it work?
  • Cryptonic 5y ago
    In Germany there is a term called social insurance mandatory employment. This covers basically every non self employed situation. Where you can live from your capital alone you also do not apply. At soon as you have an employment you will have to pay a bit up to about 800€ for higher salary levels for public health insurance - half of which you never see in any calculation, payed silently by the employer and the other half reduced from your pay check. Additionally you pay mandatory retirement insurance, loss of work insurance and old age care taking insurance plus tax. (not sure about translations) So from 7500€ a month you will end up with about 4900€ after all this, if you are married otherwise you pay a bit more tax. If you cannot find work and cannot pay you have all the same benefits, except the retirement will be minimal. To sum up have social security with this. Every treatment is payed (sometimes you have to pay a little in top, let's say you want plastic instead of metal teeth fixes, basically for everything not mandatory in the eyes of the doctor you have do pay the difference). But mandatory stuff is completely covered, up to brain tumor removal with the particle accelerator in Heidelberg or so. Some fine print: If you and your wife work both pay for family insurance (so up to 1600 together if both earn very well). If one works alone and pays there is only one payment. Actually you can opt out op the public health insurance as soon as you reach the maximum. Then you can opt for a private insurance. To sum up again: with all this Germany is certainly not the place to become filthy rich by saving money from your income as employee. But for about third of your salary you get a a) good infrastructure (tax), b) mediocre but ok, bancruptcy protected retirement, 3) no need to fear health issues from financial side, d) job loss insurance for a year (pays on about 60% after that social security... much less like a flat for the family and 500€) and e) care of a certain degree when of old age. Quite a good deal for me. Still it's better to save also several 100k for retirement. To become rich here you need to start a business, be very creative or become a top manager or politican like everywhere else. P.S. 5AM here sorry for bad grammar, typos and information gaps =)
• samtho 5y ago
  I am not going to try to change your mind, in fact, I largely agree with what you're saying. It's a very complicated and contentious issue in the US. First, we have a strange relationship with taxes. The highest amounts are paid to the Federal Government (at the nation-level) and as you travel down the chain to state and then local (city/county), less tax money is owed to these places typically. Regardless of where someone sits on the political spectrum, it is widely accepted that the federal government does not efficiently spend the money, with citizens receiving no tangible value. For example, during the pandemic, many people got $1200 stimulus checks and a "good luck" even though taxpayers fork over thousands over the course of their lives. Stuff that actually affects our lives directly is often done at the local level, with roads, for example, funded by a tax on gas in California (and some federal dollars, too). Given the perception of how grossly incompetent, understaffed, or ill-prepared government offices are to deal with anything, people are not exactly lining up to have such an inefficient system provide them with insurance. We also have an accessibility problem in that every process that one must initiate to receive most government benefits, is rife with bureaucratic, over-reaching, and easy to mess-up paperwork designed by people who's goal it is to dish out as few benefits as possible. Having spent a bit of time in Germany myself, it's clear the attitude is different. Germans (and EU citizens) actually receive benefits from the taxes they pay that are both accessible and tangible. Having medical expenses paid by the state via taxation is ultimately what creates a more healthy society. Second is the fact that we allow large lobbies and organizations (like insurance companies) to influence what legislation gets passed. This is also so far removed from people's every day life that this sort of non-corruption, special-interest sway happens all the time. Insurance companies have a great thing going on for them, imagine being able to charge whatever you want and be wildly inept and unwilling to actually provide services (pay out) when your customer requires it as per the policy you sold them. They fund (behind the scenes) mass-marketing campaigns (yes, instead of paying actual claims) that spread propaganda about how bad healthcare is if left up to the government. There are other problems, but maybe this helps see why it's such a big social issue here. This is just my take on what I find to be two major ones.
  • Cryptonic 5y ago
    I see your point. It's easy to forget that a single state in the US is as large as an European country. And the federal government is more like our EU Government. Some far more distant institution to my daily life, where I also have some trust issues from time to time and less insight (still I feel like an EU citizen and don't want Germany to disband like some do, don't get me wrong). Anyways I hope the US society will find a solution that fixes this sad situation. It's sad to hear and see such stories and think about the victims of such political failiure (not that such failure would not happen here too, especially the lobby influence an corruption is a thing in Germany - sometimes it feels like our Country is run mostly by special interest). The US once was such an inspiring country, I really hope you find a way to overcome all this.
• dustintrex 5y ago
  I think few people want the system as is. It's a combination of a) thinking this doesn't affect you because you have good insurance (until it does, becase something like this happens), b) not realizing just how fucked you are because you don't have insurance but haven't gotten seriously sick yet, and c) simply not realizing things could be different/better. Particularly for the last point, socialized medicine is often weirdly spun as bureaucrats taking away your freedom of choice and preventing you from getting health care ("death panels" and all that). So people visualize the current fucked-up system, imagine what it would be like if they had even more obstructive bureaucracy dictating whether you're allowed to get surgery and how long you need to wait in line, and often course they think that sounds even worse -- although the reality is that would be better for most people than the status quo of only being able to get surgery if you can afford it, and still risking getting bankrupted in the process.
  • Cryptonic 5y ago
    I hope the US somehow gets over this phase, it would easily be affordable I think. Just a few companies and people would no longer fill their pockets just as much as they do now.
• javajosh 5y ago
  I lived under this system for 2 years and it was awesome. The lack of paperwork alone was...eye opening. The speed of service was astonishing. All you need is your insurance card (we used Die Teckniker) and you can see most doctors. And the doctors will just do the tests on you themselves, during the visit. The American system generates a tremendous amount of administrative work, and reduces the quality of care. If you've ever been in a doctors office, or a hospital in the US, they are constantly looking at the paperwork, not at you. Totally different in Germany. (Which was weird because in virtually every other respect Germans seem to love paperwork!) Like a fish that doesn't know what water feels like, it dawned on me how stressful all that paperwork is, and how much worse it makes you feel, when you are already feeling bad. And of course in the US any contact at all with the healthcare system is not just painful now, it could be painful for years. The reason we don't change is because people don't know or believe it could be better. And that, in turn, is because some of that huge money flowing through the healthcare system pays the salaries of professional sophists and lawyers who are very good at playing on the intellectual weaknesses of an American audience. They have lots of tools, but the two most effective seem to be an appeal to "American exceptionalism" - if we didn't invent it then its not good - and the classic strawman attack that anything that isn't the current system is communism. A foolish claim that has no merit, not least of which because none of those same people would assert that Germany is communist. It's a very sad state of affairs. The US is like a mean old grannie being robbed by a handsome and clever son-in-law who plays on her prejudices and ignorance. Even when other family members try to warn her, NO, she snaps, he tells me you are the monsters, and he is handsome and clever and better than you! There is a villain here, but it's hard to have much sympathy for the victim, either.
• clarkmoody 5y ago
  If you take quick stock, you'll notice that everything called a "system" is corrupt and absurdly dysfunctional. Then think about other areas of life that don't fall under a "system" and notice how they're not nearly as insane, and we often take them for granted, since they just work. We need fewer "systems."
  • Cryptonic 5y ago
    Yes the economic system is the worst when it goes unchecked in areas of market failure like health insurance in the US.
• cratermoon 5y ago
  Many people in the US are still under the mistaken belief that we have "the best healthcare in the world"[1], and the only reason for that is the for-profit "free market". Essentially a blind faith in capitalism married with ignorance of the facts. 1. U.S. health-care system ranks last among 11 high-income countries, researchers say https://www.washingtonpost.com/world/2021/08/05/global-health-rankings/ https://www.washingtonpost.com/world/2021/08/05/global-healt...
  • Cryptonic 5y ago
    If you can afford it, I'm sure the US offers the best medical treatment in the world. Eventually it's often mistaken with the health system.
    • cratermoon 5y ago
      > If you can afford it, I'm sure the US offers the best medical treatment in the world But it doesn't! At least not across the board. Yes, there are diseases and conditions for which the best treatment is given in American health care facilities, but it's not consistent. And certainly not for routine stuff. The truly wealthy travel to other countries to get treatment if that's where the best specialists work. Among the countries with better options for a variety of things are Canada, Singapore. Singapore, Japan, Spain, United Kingdom (yes, even with the much-disparaged NHS) Dubai, and Israel. Canada for drug and alcohol addiction treatment (the US is still mostly stuck in the addiction-as-moral-failing mode), Japan and Singapore for cancer treatments. And there's one other thing: it can actually be cheaper to fly to another country, get treated there, and fly back to the US, than to stay in the US and get stuck with a US healthcare bill. And there's nothing the rich love more than keeping their money.
• LargoLasskhyfv 5y ago
  Hrm. You know? I can remember times in .de where public healthcare was really free for everything! Meanwhile we have Zuzahlung/co-pay for more involved dental work and glasses. Not that I needed it so far, but I get that they can be massive, especially for anything dental. This tends to be funny every few years on routine checkups at the dentist when they try to sell this and that which isn't covered by anything, and I'm like: 'No, just the basics, dammit!'
  • Cryptonic 5y ago
    Yes plastic and gold teeth cost extra if you insist on it for example. There are certainly also problems with special fee medicaments that doctors subscribe because they get a nice business trip to Hawaii in exchange. Not perfect. But still you get basic needs covered in everything, even if it needs brain tumor treatment by Heidelbergs particle accelerator or similar expensive stuff if your doctor sees it as required. And you might pay extra 20€ for extra breakfast or so. At least it's not going to bankrupt you unexpetedly