3 ms·

You can’t throw a stone without hitting a nurse in the US, but I’m guessing they’re paid far better here as well just as doctors are. I know Germany has a mixe

You can’t throw a stone without hitting a nurse in the US, but I’m guessing they’re paid far better here as well just as doctors are. I know Germany has a mixed system but it seems to me that socialized medicine keeping costs down slowly erodes care. The increase in costs in the US is also unsustainable. There might be a happy medium in there but it might be too early to tell.

scohesc 5y ago
> I know Germany has a mixed system but it seems to me that socialized medicine keeping costs down slowly erodes care. You can see this happening in Canada too. We have a hybrid system in healthcare where the majority of critical care is paid for via taxes/government subsidies however secondary/tertiary stuff is either out of pocket or through insurance agencies (prescriptions, out-patient care like physiotherapy, etc). Over the past 20-30 years, our system has seen the typical government thought process of throwing more money at problems but not actually having someone be accountable for the actions of the government over decades. You end up with a bunch of overpaid, under-worked management at the top while the actual front-line workers suffer with low staffing, not enough beds, budget cuts for the front line but raises for management etc. etc. Not to mention the number of students coming here for health education (doctor, nurse, specialist) - then immediately saying sayonara for another country like the US or in the case of foreign students, their home country. I don't understand why we keep cutting healthcare budgets - one possible reason could be because corporations have slowly been taking over every aspect of society as they move faster and make smarter decisions than government officials.
marton78 5y ago
This is accurate. The socialized health care system in Germany worked fine for multiple decades, until a few years ago our government decided to reimburse hospitals not based on days a patient spends there (which created perverse incentives, agreed) but rather based on diagnosis. So, a hospital earns X euros for every patient with condition X, creating other perverse incentives, and resulting in less money for the hospitals, which of course trickled down to nurses.
- piva00 5y ago
  The same happens here in Sweden. Since the implementation of more neoliberalist policies on healthcare, allowing more private clinics and paying clinics based on diagnosis created a perverse incentive to overdiagnose patients. There was a case of a clinic that performed unnecessary surgeries and procedures just to rake in more tax money. The problem isn't socialised medicine per se, it's trying to mash a socialised medicine system with "market forces", it's the ideology of the Third Way [1] to appease to these neoliberalist policy desires that is crumbling the Swedish healthcare (and welfare) system for the past 2 decades. [1] https://en.wikipedia.org/wiki/Third_Way https://en.wikipedia.org/wiki/Third_Way

scohesc 5y ago

> I know Germany has a mixed system but it seems to me that socialized medicine keeping costs down slowly erodes care. You can see this happening in Canada too. We have a hybrid system in healthcare where the majority of critical care is paid for via taxes/government subsidies however secondary/tertiary stuff is either out of pocket or through insurance agencies (prescriptions, out-patient care like physiotherapy, etc). Over the past 20-30 years, our system has seen the typical government thought process of throwing more money at problems but not actually having someone be accountable for the actions of the government over decades. You end up with a bunch of overpaid, under-worked management at the top while the actual front-line workers suffer with low staffing, not enough beds, budget cuts for the front line but raises for management etc. etc. Not to mention the number of students coming here for health education (doctor, nurse, specialist) - then immediately saying sayonara for another country like the US or in the case of foreign students, their home country. I don't understand why we keep cutting healthcare budgets - one possible reason could be because corporations have slowly been taking over every aspect of society as they move faster and make smarter decisions than government officials.

marton78 5y ago

This is accurate. The socialized health care system in Germany worked fine for multiple decades, until a few years ago our government decided to reimburse hospitals not based on days a patient spends there (which created perverse incentives, agreed) but rather based on diagnosis. So, a hospital earns X euros for every patient with condition X, creating other perverse incentives, and resulting in less money for the hospitals, which of course trickled down to nurses.

piva00 5y ago
The same happens here in Sweden. Since the implementation of more neoliberalist policies on healthcare, allowing more private clinics and paying clinics based on diagnosis created a perverse incentive to overdiagnose patients. There was a case of a clinic that performed unnecessary surgeries and procedures just to rake in more tax money. The problem isn't socialised medicine per se, it's trying to mash a socialised medicine system with "market forces", it's the ideology of the Third Way [1] to appease to these neoliberalist policy desires that is crumbling the Swedish healthcare (and welfare) system for the past 2 decades. [1] https://en.wikipedia.org/wiki/Third_Way https://en.wikipedia.org/wiki/Third_Way