6 ms·

If you want an extreme example of how bad a single payer system can get, look at Canada. Not only do we have a single-payer system, we've actually banned privat

by cal5k 5y ago

If you want an extreme example of how bad a single payer system can get, look at Canada. Not only do we have a single-payer system, we've actually banned private pay of any kind for "medically necessary" services. The net effect is predictable - Canada consistently ranks very poorly in international health system comparisons. We have far fewer ICU beds, doctors, imaging machines, etc. per capita than peer nations, and the entire country is in varying degrees of harsh lockdown because our hospitals were already overwhelmed during a normal flu season. What states should do is encourage more competition as a way to lower healthcare costs. Y'all actually have one of the best systems in the world, it's just way too expensive.

aaomidi 5y ago
> Y'all actually have one of the best systems in the world, Germany has more ICU beds than the US.
- sokoloff 5y ago
  > Germany has more ICU beds than the US. That would be shocking if true, which it does not appear to be. Germany has around 32K ICU beds. US has around 96K ICU beds. Germany has slightly more per-capita than the US. (387 vs 294 per million inhabitants) https://en.wikipedia.org/wiki/List_of_countries_by_hospital_beds https://en.wikipedia.org/wiki/List_of_countries_by_hospital_...
  - kirill5pol 5y ago
    To be fair per capita is the only relevant comparison.
  - pintxo 5y ago
    your "slightly" is a 30% difference ...
    - aaomidi 5y ago
      30%. which is the difference between hospitals shutting down vs hospitals being able to treat patients normally during times like this. Not sure what the original poster is talking about, but America's healthcare system is fucked. And it's not just fucked because it's expensive.
wbsss4412 5y ago
High costs are in healthcare are just rationing by a different name. I would love to see an international ranking that places Canada's system below that US that isn’t just coming out of some right wing think tank.
perrylaj 5y ago
> The net effect is predictable - Canada consistently ranks very poorly in international health system comparisons. Funny that despite this 'extreme example', Canadians have almost 3 years longer life expectancy than us in the US, are healthier throughout their lives, and have comparable or better outcomes with treatments. Where the US has better outcomes (e.g. - some forms of cancer, some organ transplants), it's only very marginally better (like 1% higher chance of surviving 5 years after colon cancer diagnosis when compared to Canada). And for that 1%, you're spending MUCH more money on your treatment. Basically nearly every measured outcome is better in Canada rather than the US, despite US paying twice as much on healthcare costs per capita when compared to Canada. > We have far fewer ICU beds, doctors, imaging machines, etc. per capita than peer nations, and the entire country is in varying degrees of harsh lockdown because our hospitals were already overwhelmed during a normal flu season. That may all be true, yet it's still better care than what the average US citizen gets, despite paying twice as much per capita. > What states should do is encourage more competition as a way to lower healthcare costs. They've been trying to 'encourage more competition' for decades now with healthcare costs only continuing to climb while affordable access falls (ignoring the gains that came and went with ACA). "Competition" doesn't exist in industries that are nearly impossible to enter due to regulatory capture and the insane entrenchment of giant healthcare organizations. The few that succeed in making any progress at all get rapidly acquired. Reality is that no-system is perfect, there will be complaints and tradeoffs. But the US system is broken for a huge proportion of residents, and it's not going to change without drastic measures. I'm all for torching the whole thing and trying single payer. There may be complains about single payer systems across the world, but according to most of the publications I've seen (probably all, but my memory is imperfect), the vast majority of those subject to it would never trade it for what the US has. Basic healthcare access in 'the richest country in the world' should be a fundamental right, not a for-profit industry.
- qwytw 5y ago
  > Canadians have almost 3 years longer life expectancy than us in the US, are healthier throughout their lives... Which is more likely caused by different lifestyle choices (e.g. 27% vs 42% obesity rate). Also if you take out all the southern states the gap get quite a bit smaller (e.g. 82.4 in Ontario vs 81.7 in California and 81.4 in New York).
beej71 5y ago
There is no free market for expensive, emergency care. You're not going to drive to Nevada to get cheaper care while you're having a heart attack. There's no free market for health insurance for the people who need care. Insurers don't want those people as customers, not from any state. They're money losers. What pressure is there to lower costs? Why would they charge less?
- conanbatt 5y ago
  Competition
  - beej71 5y ago
    Why would a competing insurer want to insure someone with cancer? They'd be guaranteed to lose money. Where is the competition?
    - conanbatt 5y ago
      To attract clients.

by cal5k 5y ago

aaomidi 5y ago

> Y'all actually have one of the best systems in the world, Germany has more ICU beds than the US.

sokoloff 5y ago
> Germany has more ICU beds than the US. That would be shocking if true, which it does not appear to be. Germany has around 32K ICU beds. US has around 96K ICU beds. Germany has slightly more per-capita than the US. (387 vs 294 per million inhabitants) https://en.wikipedia.org/wiki/List_of_countries_by_hospital_beds https://en.wikipedia.org/wiki/List_of_countries_by_hospital_...
- kirill5pol 5y ago
  To be fair per capita is the only relevant comparison.
- pintxo 5y ago
  your "slightly" is a 30% difference ...
  - aaomidi 5y ago
    30%. which is the difference between hospitals shutting down vs hospitals being able to treat patients normally during times like this. Not sure what the original poster is talking about, but America's healthcare system is fucked. And it's not just fucked because it's expensive.

wbsss4412 5y ago

High costs are in healthcare are just rationing by a different name. I would love to see an international ranking that places Canada's system below that US that isn’t just coming out of some right wing think tank.

perrylaj 5y ago

> The net effect is predictable - Canada consistently ranks very poorly in international health system comparisons. Funny that despite this 'extreme example', Canadians have almost 3 years longer life expectancy than us in the US, are healthier throughout their lives, and have comparable or better outcomes with treatments. Where the US has better outcomes (e.g. - some forms of cancer, some organ transplants), it's only very marginally better (like 1% higher chance of surviving 5 years after colon cancer diagnosis when compared to Canada). And for that 1%, you're spending MUCH more money on your treatment. Basically nearly every measured outcome is better in Canada rather than the US, despite US paying twice as much on healthcare costs per capita when compared to Canada. > We have far fewer ICU beds, doctors, imaging machines, etc. per capita than peer nations, and the entire country is in varying degrees of harsh lockdown because our hospitals were already overwhelmed during a normal flu season. That may all be true, yet it's still better care than what the average US citizen gets, despite paying twice as much per capita. > What states should do is encourage more competition as a way to lower healthcare costs. They've been trying to 'encourage more competition' for decades now with healthcare costs only continuing to climb while affordable access falls (ignoring the gains that came and went with ACA). "Competition" doesn't exist in industries that are nearly impossible to enter due to regulatory capture and the insane entrenchment of giant healthcare organizations. The few that succeed in making any progress at all get rapidly acquired. Reality is that no-system is perfect, there will be complaints and tradeoffs. But the US system is broken for a huge proportion of residents, and it's not going to change without drastic measures. I'm all for torching the whole thing and trying single payer. There may be complains about single payer systems across the world, but according to most of the publications I've seen (probably all, but my memory is imperfect), the vast majority of those subject to it would never trade it for what the US has. Basic healthcare access in 'the richest country in the world' should be a fundamental right, not a for-profit industry.

qwytw 5y ago
> Canadians have almost 3 years longer life expectancy than us in the US, are healthier throughout their lives... Which is more likely caused by different lifestyle choices (e.g. 27% vs 42% obesity rate). Also if you take out all the southern states the gap get quite a bit smaller (e.g. 82.4 in Ontario vs 81.7 in California and 81.4 in New York).

beej71 5y ago

There is no free market for expensive, emergency care. You're not going to drive to Nevada to get cheaper care while you're having a heart attack. There's no free market for health insurance for the people who need care. Insurers don't want those people as customers, not from any state. They're money losers. What pressure is there to lower costs? Why would they charge less?

conanbatt 5y ago
Competition
- beej71 5y ago
  Why would a competing insurer want to insure someone with cancer? They'd be guaranteed to lose money. Where is the competition?
  - conanbatt 5y ago
    To attract clients.