4 ms·

I feel sorry for my American friends living with their health care system :( I’m based in Australia, I can change jobs, be unemployed, and walk into a public h

by plasma 5y ago

I feel sorry for my American friends living with their health care system :( I’m based in Australia, I can change jobs, be unemployed, and walk into a public hospital for important care without concern for a bill. I really hope you switch the system, but I don’t see it happening any time soon.

boringg 5y ago
The australian system is an interesting one. It has a public level of service and then once you reach a certain income level they push you into private health care and off the publics balance sheet. Ive always been curious if there exists to levels of care. Either way getting health care without paying the bill has its perks. I do think absolutely free health care allows for abuse of the system. Small copay might make sense (for people who can afford it). Not to dissimilar to tech companies charging a nominal fee for food at lunch to reduce waste.
- spaetzleesser 5y ago
  " I do think absolutely free health care allows for abuse of the system" Americans are always concerned about people abusing the system but if you look at other countries this is simply not the case except maybe a few isolated cases. What are you going to do if health care is cheap or free? Get surgery for the fun of it? Or have a tooth pulled every few weeks? Right now the american system is abused big time by providers and insurers. that's what you should be concerned about. I don't see how patients would abuse a system.
  - boringg 5y ago
    I don't disagree with you about the American system and that the insurers and private investors have messed up the incentives. What you misunderstand on my comment is that there is value in adding some level of negligible cost to each transaction. A quick internal spot check if they really need to see a specialist/doctor etc. Don't equate my comment as proof that the American system works. And just because you can't see it doesn't mean it doesn't happen.
    - spaetzleesser 5y ago
      But why bring up a tangential point that's not an issue in the real world? The whole discussion about health care in the US is littered with distracting issues. In the end the real problem is tying health insurance to employment and the lack of transparency which allows a lot of parties to charge outrageous prices and get away with it.
      - boringg 5y ago
        Its not tangential - its a comparison of systems in an ad hoc way. My point is that a lot of people assume that the canadian / australian / british model is the gold standard - I just think we can aim for better than those models. And our key points were about how the incentive systems are misaligned - in the US one and in the "free" care model - in different ways.
- danielheath 5y ago
  The private system is better for some things (especially wait times). In general the public system is extremely good if somewhat overloaded. RE abuse of the system - many clinics charge a fee on top of the government subsidy, but you can always find one that doesn't. You still have to make an appointment, show up, wait in a room full of sick people, etc. It may not cost you money, but it's far less desirable than eating free food. In practice it doesn't seem to be an issue.
  - boringg 5y ago
    In the country I reside they don't charge a fee, the wait times are ridiculous. One person I know needed a angioplasty to decrease his high risk of a heart attack - they said to wait a year before he could get one and to not do any strenuous activity until then. Another person needed a hip replaced because they can't walk properly - they need to wait 3 months before their case gets put in front of tribunal who will then decide if they can get their hip replaced in a years time. In both cases they don't pay for the service - which is great - but also that kind of delay is slightly insane (at least to me). To your points - theres lots of people who think a free health care system is a cure all. It isn't - it is full of trade offs. Some are good, some aren't as good.
- bryanlarsen 5y ago
  What kind of abuse? Very few people go to a hospital if they don't have to, they're unpleasant places. Even in countries with free medical care, they still have to heavily encourage people to go more often to discover problems while they're still cheap to fix rather than waiting for them to become extremely acute.

by plasma 5y ago

boringg 5y ago

The australian system is an interesting one. It has a public level of service and then once you reach a certain income level they push you into private health care and off the publics balance sheet. Ive always been curious if there exists to levels of care. Either way getting health care without paying the bill has its perks. I do think absolutely free health care allows for abuse of the system. Small copay might make sense (for people who can afford it). Not to dissimilar to tech companies charging a nominal fee for food at lunch to reduce waste.

spaetzleesser 5y ago
" I do think absolutely free health care allows for abuse of the system" Americans are always concerned about people abusing the system but if you look at other countries this is simply not the case except maybe a few isolated cases. What are you going to do if health care is cheap or free? Get surgery for the fun of it? Or have a tooth pulled every few weeks? Right now the american system is abused big time by providers and insurers. that's what you should be concerned about. I don't see how patients would abuse a system.
- boringg 5y ago
  I don't disagree with you about the American system and that the insurers and private investors have messed up the incentives. What you misunderstand on my comment is that there is value in adding some level of negligible cost to each transaction. A quick internal spot check if they really need to see a specialist/doctor etc. Don't equate my comment as proof that the American system works. And just because you can't see it doesn't mean it doesn't happen.
  - spaetzleesser 5y ago
    But why bring up a tangential point that's not an issue in the real world? The whole discussion about health care in the US is littered with distracting issues. In the end the real problem is tying health insurance to employment and the lack of transparency which allows a lot of parties to charge outrageous prices and get away with it.
    - boringg 5y ago
      Its not tangential - its a comparison of systems in an ad hoc way. My point is that a lot of people assume that the canadian / australian / british model is the gold standard - I just think we can aim for better than those models. And our key points were about how the incentive systems are misaligned - in the US one and in the "free" care model - in different ways.
danielheath 5y ago
The private system is better for some things (especially wait times). In general the public system is extremely good if somewhat overloaded. RE abuse of the system - many clinics charge a fee on top of the government subsidy, but you can always find one that doesn't. You still have to make an appointment, show up, wait in a room full of sick people, etc. It may not cost you money, but it's far less desirable than eating free food. In practice it doesn't seem to be an issue.
- boringg 5y ago
  In the country I reside they don't charge a fee, the wait times are ridiculous. One person I know needed a angioplasty to decrease his high risk of a heart attack - they said to wait a year before he could get one and to not do any strenuous activity until then. Another person needed a hip replaced because they can't walk properly - they need to wait 3 months before their case gets put in front of tribunal who will then decide if they can get their hip replaced in a years time. In both cases they don't pay for the service - which is great - but also that kind of delay is slightly insane (at least to me). To your points - theres lots of people who think a free health care system is a cure all. It isn't - it is full of trade offs. Some are good, some aren't as good.
bryanlarsen 5y ago
What kind of abuse? Very few people go to a hospital if they don't have to, they're unpleasant places. Even in countries with free medical care, they still have to heavily encourage people to go more often to discover problems while they're still cheap to fix rather than waiting for them to become extremely acute.