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> Healthcare is the great equalizer By income redistribution I mean most progressive proposals aim to heavily tax high earners to fund healthcare for lower inc

> Healthcare is the great equalizer By income redistribution I mean most progressive proposals aim to heavily tax high earners to fund healthcare for lower income individuals. That money would otherwise be used by those earners to buy their first home, build retirement wealth, etc. Ever heard of HENRYs? > MediCal is set up to be punitive to the poors like all Medicaid programs. A Medicare system isn't. Citation is needed here. A lot of good doctors in my area won't take Medicare patients because Medicare reimbursements are too low. We also know from European systems that because everything is triaged based on need that wait times end up being very long if you don't have a life threatening condition. You also need to consider that American doctors make substantially more than European ones. If you compare the pay of specialty doctors in the NHS to ones in the US the difference is something like 5x. > What getting everyone on the system does is it makes the political class beholden to the needs of the individuals That is your perspective, and I think it's a naive one. I think it would prevent reforms that drive efficiency. Think of what happens when anyone talks about making Medicare more efficient: they get attacked as anti-elderly and portrayed as wanting to cut benefits. Or the same for military spending. At least the free market (which healthcare is not right now, but it could be) is ruthless about creating efficiency. > Socialized medicine is no more a partisan issue in most countries than a socialized fire department or sidewalks. Funny that the UK argues about NHS funding a lot then.

arcticbull 5y ago
> By income redistribution I mean most progressive proposals aim to heavily tax high earners to fund healthcare for lower income individuals. As someone who would be on the giving end of that, I'm fine with it, honestly. I won't always be on top. > We also know from European systems that because everything is triaged based on need that wait times end up being very long if you don't have a life threatening condition. We don't know that at all. Triaging based on need is a feature, not a bug - and a super easy way to save a ton of money! All of these criticisms were made up by the marketing department at insurers to fleece Americans. That's not hyperbole, and don't take my word for it. Here's an interview with one of the Cigna guys admitting to doing it, and apologizing. [1] "Here's the truth. Our industry PR and lobbying group, AHIP, supplied my colleagues and me with cherry-picked data and anecdotes to make people think Canadians wait endlessly for their care. It's a lie. And I'll always regret the disservice I did to folks on both sides of the border" > You also need to consider that American doctors make substantially more than European ones. If you compare the pay of specialty doctors in the NHS to ones in the US the difference is something like 5x. Ok, and they shouldn't. I'm sorry. It's not sustainable, it's not affordable. They're taking pay cuts. Nobody is entitled to a certain salary, standard or lifestyle in perpetuity no matter how unsustainable. BMWs for doctors while 10% of Americans are told to die or pick their favorite finger after an accent is unconscionable. America pays more than anyone else anyways, and would still after cuts, where would they go? However, this is also simply not true for every system. Most similar countries socialize malpractice insurance which is a huge cost for US doctors. US OBGYNs pay up to $200,000 per year in malpractice insurance. In Canada, $40,000CAD. In the UK I think it's 0GBP handled by the CNST. That goes a long way to balancing out pay differentials. In the US anesthesiologists make 400K USD median, in Canada 335K CAD median. > Funny that the UK argues about NHS funding a lot then. They argue about funding and prioritization and all sorts of stuff, sure, but it's not a partisan matter that the NHS should exist and be the status quo. The NHS was literally in the opening ceremonies of the 2012 olympics. 87% of British folks are proud of the NHS. [2] Canada's Conservatives support single-payer medicine too. [1] https://www.npr.org/2020/06/27/884307565/after-pushing-lies-former-cigna-executive-praises-canadas-health-care-system https://www.npr.org/2020/06/27/884307565/after-pushing-lies-... [2] https://yougov.co.uk/topics/politics/articles-reports/2018/07/04/nhs-british-institution-brits-are-second-most-prou https://yougov.co.uk/topics/politics/articles-reports/2018/0...
- b9a2cab5 5y ago
  > As someone who would be on the giving end of that, I'm fine with it, honestly. I won't always be on top. And I and many others are not. You should recognize that this is a _political_ issue where there is no objectively better outcome. Higher taxation has long run drags on innovation and wealth building. The tradeoff is yes, we don't have universal healthcare. I'm okay with that if it means I have more job opportunities and ability to build my wealth. > In the US anesthesiologists make 400K USD median, in Canada 335K CAD median Just because the gap isn't 5x doesn't mean there still isn't a huge gap. $335K CAD is $235K USD. And Canada has comparable CoL to major US cities so you're losing real purchasing power there. > That's not hyperbole, and don't take my word for it Take a look for yourself at the data in Table 4 [1] sourced directly from each country's government reporting infrastructure and decide for yourself whether you would accept those wait times. I wouldn't accept a 2 month average wait time for something as simple as cataract removal, that's for sure. The quality of life loss in that time is immense. > Ok, and they shouldn't. I'm sorry. It's not sustainable, it's not affordable. They're taking pay cuts. Good luck passing any legislation over the lobbying of the AMA then. You're suggesting fundamentally untenable legislation that will never pass in the US. Aka bikeshedding. This is exactly the reason progressives can't get any legislation passed in Congress. [1]: https://www.sciencedirect.com/science/article/pii/S0168851013001759 https://www.sciencedirect.com/science/article/pii/S016885101...
- arcticbull 5y ago
  > And I and many others are not. You should recognize that this is a _political_ issue where there is no objectively better outcome Luckily the rich are a minority and this is a majority rule system :) There is 100% an objectively better outcome. Better care for more people, fewer people falling through the cracks is objectively better. There are objective rankings of healthcare system quality. > Higher taxation has long run drags on innovation and wealth building. And not dying if a small business owner gets sick has a long run boost to the economy. Individuals being able to take risks without fear of death and pestilence has a long run boost to the economy. A carpenter having all their fingers re-attached instead of just some of them has a long-run boost to the economy. Small and mid-size businesses not having to administer health plans is a boost to the economy. > I'm okay with that if it means I have more job opportunities and ability to build my wealth. You'll still have your chance lol. > I wouldn't accept a 2 month average wait time for something as simple as cataract removal, that's for sure. Cataracts develops slowly over a period of years. It's explicitly one of the lowest priority surgeries you can get for that reason. It took you 10 years to develop you don't need it out by Monday, late February is fine. (NOTE: In some provinces your data shows you can get it out in 2 days in Canada). It's nuts to think that you should be able to pay more to get your decades old cataract out by Monday so that someone who was in a car accident can get in line lol. So yeah you absolutely would, and you wouldn't care at all. Either way, America will almost certainly land on a two-tier system where you can still get your way. > The quality of life loss in that time is immense. This is exactly the reason progressives can't get any legislation passed in Congress. It's simply not. Sorry. Data and satisfaction surveys disagree, but also - only for the few who can afford to jump the queue. There's very few of those so they're not really represented in surveys. > Good luck passing any legislation over the lobbying of the AMA then. Single payer in Canada passed explicitly against the wishes of the entire North American medical establishment. "The organized medical establishment was not nearly so reticent and mounted a ferocious propaganda campaign fronted by the local College of Physicians and Surgeons with the support of the Canadian Medical Association (CMA), the AMA, the local economic elite and most of the media in the province." [1] We got it done before, we'll get it done again. You've been fed a crock. Sorry. [1] https://canadiandimension.com/articles/view/the-birth-of-medicare https://canadiandimension.com/articles/view/the-birth-of-med...
Talanes 5y ago
> By income redistribution I mean most progressive proposals aim to heavily tax high earners to fund healthcare for lower income individuals. That money would otherwise be used by those earners to buy their first home, build retirement wealth, etc. This is the most transparently selfish thing I've read in a while. Congratulations.

arcticbull 5y ago

> By income redistribution I mean most progressive proposals aim to heavily tax high earners to fund healthcare for lower income individuals. As someone who would be on the giving end of that, I'm fine with it, honestly. I won't always be on top. > We also know from European systems that because everything is triaged based on need that wait times end up being very long if you don't have a life threatening condition. We don't know that at all. Triaging based on need is a feature, not a bug - and a super easy way to save a ton of money! All of these criticisms were made up by the marketing department at insurers to fleece Americans. That's not hyperbole, and don't take my word for it. Here's an interview with one of the Cigna guys admitting to doing it, and apologizing. [1] "Here's the truth. Our industry PR and lobbying group, AHIP, supplied my colleagues and me with cherry-picked data and anecdotes to make people think Canadians wait endlessly for their care. It's a lie. And I'll always regret the disservice I did to folks on both sides of the border" > You also need to consider that American doctors make substantially more than European ones. If you compare the pay of specialty doctors in the NHS to ones in the US the difference is something like 5x. Ok, and they shouldn't. I'm sorry. It's not sustainable, it's not affordable. They're taking pay cuts. Nobody is entitled to a certain salary, standard or lifestyle in perpetuity no matter how unsustainable. BMWs for doctors while 10% of Americans are told to die or pick their favorite finger after an accent is unconscionable. America pays more than anyone else anyways, and would still after cuts, where would they go? However, this is also simply not true for every system. Most similar countries socialize malpractice insurance which is a huge cost for US doctors. US OBGYNs pay up to $200,000 per year in malpractice insurance. In Canada, $40,000CAD. In the UK I think it's 0GBP handled by the CNST. That goes a long way to balancing out pay differentials. In the US anesthesiologists make 400K USD median, in Canada 335K CAD median. > Funny that the UK argues about NHS funding a lot then. They argue about funding and prioritization and all sorts of stuff, sure, but it's not a partisan matter that the NHS should exist and be the status quo. The NHS was literally in the opening ceremonies of the 2012 olympics. 87% of British folks are proud of the NHS. [2] Canada's Conservatives support single-payer medicine too. [1] https://www.npr.org/2020/06/27/884307565/after-pushing-lies-former-cigna-executive-praises-canadas-health-care-system https://www.npr.org/2020/06/27/884307565/after-pushing-lies-... [2] https://yougov.co.uk/topics/politics/articles-reports/2018/07/04/nhs-british-institution-brits-are-second-most-prou https://yougov.co.uk/topics/politics/articles-reports/2018/0...

b9a2cab5 5y ago
> As someone who would be on the giving end of that, I'm fine with it, honestly. I won't always be on top. And I and many others are not. You should recognize that this is a _political_ issue where there is no objectively better outcome. Higher taxation has long run drags on innovation and wealth building. The tradeoff is yes, we don't have universal healthcare. I'm okay with that if it means I have more job opportunities and ability to build my wealth. > In the US anesthesiologists make 400K USD median, in Canada 335K CAD median Just because the gap isn't 5x doesn't mean there still isn't a huge gap. $335K CAD is $235K USD. And Canada has comparable CoL to major US cities so you're losing real purchasing power there. > That's not hyperbole, and don't take my word for it Take a look for yourself at the data in Table 4 [1] sourced directly from each country's government reporting infrastructure and decide for yourself whether you would accept those wait times. I wouldn't accept a 2 month average wait time for something as simple as cataract removal, that's for sure. The quality of life loss in that time is immense. > Ok, and they shouldn't. I'm sorry. It's not sustainable, it's not affordable. They're taking pay cuts. Good luck passing any legislation over the lobbying of the AMA then. You're suggesting fundamentally untenable legislation that will never pass in the US. Aka bikeshedding. This is exactly the reason progressives can't get any legislation passed in Congress. [1]: https://www.sciencedirect.com/science/article/pii/S0168851013001759 https://www.sciencedirect.com/science/article/pii/S016885101...
arcticbull 5y ago
> And I and many others are not. You should recognize that this is a _political_ issue where there is no objectively better outcome Luckily the rich are a minority and this is a majority rule system :) There is 100% an objectively better outcome. Better care for more people, fewer people falling through the cracks is objectively better. There are objective rankings of healthcare system quality. > Higher taxation has long run drags on innovation and wealth building. And not dying if a small business owner gets sick has a long run boost to the economy. Individuals being able to take risks without fear of death and pestilence has a long run boost to the economy. A carpenter having all their fingers re-attached instead of just some of them has a long-run boost to the economy. Small and mid-size businesses not having to administer health plans is a boost to the economy. > I'm okay with that if it means I have more job opportunities and ability to build my wealth. You'll still have your chance lol. > I wouldn't accept a 2 month average wait time for something as simple as cataract removal, that's for sure. Cataracts develops slowly over a period of years. It's explicitly one of the lowest priority surgeries you can get for that reason. It took you 10 years to develop you don't need it out by Monday, late February is fine. (NOTE: In some provinces your data shows you can get it out in 2 days in Canada). It's nuts to think that you should be able to pay more to get your decades old cataract out by Monday so that someone who was in a car accident can get in line lol. So yeah you absolutely would, and you wouldn't care at all. Either way, America will almost certainly land on a two-tier system where you can still get your way. > The quality of life loss in that time is immense. This is exactly the reason progressives can't get any legislation passed in Congress. It's simply not. Sorry. Data and satisfaction surveys disagree, but also - only for the few who can afford to jump the queue. There's very few of those so they're not really represented in surveys. > Good luck passing any legislation over the lobbying of the AMA then. Single payer in Canada passed explicitly against the wishes of the entire North American medical establishment. "The organized medical establishment was not nearly so reticent and mounted a ferocious propaganda campaign fronted by the local College of Physicians and Surgeons with the support of the Canadian Medical Association (CMA), the AMA, the local economic elite and most of the media in the province." [1] We got it done before, we'll get it done again. You've been fed a crock. Sorry. [1] https://canadiandimension.com/articles/view/the-birth-of-medicare https://canadiandimension.com/articles/view/the-birth-of-med...

Talanes 5y ago

> By income redistribution I mean most progressive proposals aim to heavily tax high earners to fund healthcare for lower income individuals. That money would otherwise be used by those earners to buy their first home, build retirement wealth, etc. This is the most transparently selfish thing I've read in a while. Congratulations.