4 ms·

How does this rhyme with the fact that many countries have well functioning, tax financed healthcare systems?

by geysersam 4y ago

WalterBright 4y ago
Just because it's "free" doesn't mean you aren't paying plenty for it.
- geysersam 4y ago
  > tax financed Of course people still pay. It's not provided by magic fairies. However, it's not automatically inefficient just because it's publicly funded.
  - WalterBright 4y ago
    Yes, it is automatically inefficient. It's just not obvious because there are no free market health care systems left to compare it to. It's inefficient because nobody is as careful spending other peoples' money as they are with their own money.
- ceejayoz 4y ago
  Public+private spending on healthcare in the US is 2-3x that of public+private spending on healthcare in the rest of the OECD. See the chart at https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthres/health-spending.htm; we pay more in taxes than any other OECD nation does total for healthcare, and then pile individual spending on top of that.
  - WalterBright 4y ago
    The US government does a lot to increase health care costs. For one example, the government empowers the AMA to strictly limit the number of seats in medical schools, the purpose being to limit the supply of doctors to keep their fees high.
    - ceejayoz 4y ago
      You're skipping off to a different argument. You asserted "Just because it's 'free' doesn't mean you aren't paying plenty for it", but the places where it's "free" are paying less. You're highlighting issues specific to the American system in an apparent attempt to argue against European-style systems, which is... odd.
      - WalterBright 4y ago
        The US does not have a free market in health care.
        ceejayoz 4y ago
        Again, an entirely different argument, but what country does that you'd like to emulate? We've tried the "no regulation" thing in our past; it's where the term "snake oil salesman" comes from. "Free market healthcare" is just the right's version of "communism would work if it weren't for human nature".
        WalterBright 4y ago
        Again, the US before 1968.
        ceejayoz 4y ago
        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4193636/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4193636/ > Of the members of the general population who reported they had “pains in the heart,” 25 percent did not see a physician (Andersen and Anderson, 1967). Sounds awesome. The article makes a pretty good case for your 1968 date being an attribution error - that years before it, the rise of things like transplants, ICUs, demographic changes, etc. were already messing up costs.
        WalterBright 4y ago
  - collegeburner 4y ago
    and we hear a lot of stories of ppl from other "free healthcare" OECD countries having to come here for decent care. i'd rather a system where i can get better by paying more than a system where i'm at the mercy of some bureaucrat or waiting list. if you want to reduce costs: 1. stop giving the AMA a monopoly. ban state and local regulations on how much healthcare can be built and where. 2. require posting prices and give it teeth. 3. make it easier to import cheap generics from other countries. 4. enable nurse practitioners to do more stuff. 5. enable more clinics with clear prices for stuff like this one where i can go their site and see it's $6215 for a bilteral knee arthroscopy: https://surgerycenterok.com/?procedure_category=knee#jump https://surgerycenterok.com/?procedure_category=knee#jump because very few of the healthcare $ are spent on emergency procedures where ppl don't have time to choose and information is how you make markets efficient.
    - ceejayoz 4y ago
      > and we hear a lot of stories of ppl from other "free healthcare" OECD countries having to come here for decent care You'll hear that in both directions, to the point where the CDC has a page for Americans seeking care abroad, typically due to exorbitant costs here. https://wwwnc.cdc.gov/travel/page/medical-tourism https://wwwnc.cdc.gov/travel/page/medical-tourism > i'd rather a system where i can get better by paying more than a system where i'm at the mercy of some bureaucrat or waiting list. There are very few countries in which this is the case; you can opt for private healthcare in Europe, Australia, etc. if you like. There's simply also a specific, reasonable level of care available to all. (The idea that the US lacks bureaucrats and waiting lists is, incidentally, funny to most folks who've tried to see a specialist on short order, or had insurance deny coverage for something.)
      - collegeburner 4y ago
        yeah but notice it's not people traveling to OECD free healthcare countries. it's mostly going to cheaper developing countries with clinics a lot like the oklahoma one i linked that specialize in procedures and offer them at reasonable prices. private care over there just isn't the same. and yeah i dealt with insurance and specialists before and it sucks but at least money makes a difference and more money makes more difference and it's not just "lol get on the list and stfu"
- MattPalmer1086 4y ago
  Healthcare efficiency costs in the US are huge. https://www.bloomberg.com/graphics/infographics/most-efficient-health-care-around-the-world.html https://www.bloomberg.com/graphics/infographics/most-efficie... We certainly pay for healthcare in the UK through taxation. It's pretty efficient. Hospitals aren't nice and shiny and medical people get paid a lot less though. I'll take that trade off myself anyday.

How does this rhyme with the fact that many countries have well functioning, tax financed healthcare systems?

WalterBright 4y ago

Just because it's "free" doesn't mean you aren't paying plenty for it.

geysersam 4y ago
> tax financed Of course people still pay. It's not provided by magic fairies. However, it's not automatically inefficient just because it's publicly funded.
- WalterBright 4y ago
  Yes, it is automatically inefficient. It's just not obvious because there are no free market health care systems left to compare it to. It's inefficient because nobody is as careful spending other peoples' money as they are with their own money.
ceejayoz 4y ago
Public+private spending on healthcare in the US is 2-3x that of public+private spending on healthcare in the rest of the OECD. See the chart at https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthres/health-spending.htm; we pay more in taxes than any other OECD nation does total for healthcare, and then pile individual spending on top of that.
- WalterBright 4y ago
  The US government does a lot to increase health care costs. For one example, the government empowers the AMA to strictly limit the number of seats in medical schools, the purpose being to limit the supply of doctors to keep their fees high.
  - ceejayoz 4y ago
    You're skipping off to a different argument. You asserted "Just because it's 'free' doesn't mean you aren't paying plenty for it", but the places where it's "free" are paying less. You're highlighting issues specific to the American system in an apparent attempt to argue against European-style systems, which is... odd.
    - WalterBright 4y ago
      The US does not have a free market in health care.
      - ceejayoz 4y ago
        Again, an entirely different argument, but what country does that you'd like to emulate? We've tried the "no regulation" thing in our past; it's where the term "snake oil salesman" comes from. "Free market healthcare" is just the right's version of "communism would work if it weren't for human nature".
        WalterBright 4y ago
        Again, the US before 1968.
        ceejayoz 4y ago
        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4193636/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4193636/ > Of the members of the general population who reported they had “pains in the heart,” 25 percent did not see a physician (Andersen and Anderson, 1967). Sounds awesome. The article makes a pretty good case for your 1968 date being an attribution error - that years before it, the rise of things like transplants, ICUs, demographic changes, etc. were already messing up costs.
        WalterBright 4y ago
- collegeburner 4y ago
  and we hear a lot of stories of ppl from other "free healthcare" OECD countries having to come here for decent care. i'd rather a system where i can get better by paying more than a system where i'm at the mercy of some bureaucrat or waiting list. if you want to reduce costs: 1. stop giving the AMA a monopoly. ban state and local regulations on how much healthcare can be built and where. 2. require posting prices and give it teeth. 3. make it easier to import cheap generics from other countries. 4. enable nurse practitioners to do more stuff. 5. enable more clinics with clear prices for stuff like this one where i can go their site and see it's $6215 for a bilteral knee arthroscopy: https://surgerycenterok.com/?procedure_category=knee#jump https://surgerycenterok.com/?procedure_category=knee#jump because very few of the healthcare $ are spent on emergency procedures where ppl don't have time to choose and information is how you make markets efficient.
  - ceejayoz 4y ago
    > and we hear a lot of stories of ppl from other "free healthcare" OECD countries having to come here for decent care You'll hear that in both directions, to the point where the CDC has a page for Americans seeking care abroad, typically due to exorbitant costs here. https://wwwnc.cdc.gov/travel/page/medical-tourism https://wwwnc.cdc.gov/travel/page/medical-tourism > i'd rather a system where i can get better by paying more than a system where i'm at the mercy of some bureaucrat or waiting list. There are very few countries in which this is the case; you can opt for private healthcare in Europe, Australia, etc. if you like. There's simply also a specific, reasonable level of care available to all. (The idea that the US lacks bureaucrats and waiting lists is, incidentally, funny to most folks who've tried to see a specialist on short order, or had insurance deny coverage for something.)
    - collegeburner 4y ago
      yeah but notice it's not people traveling to OECD free healthcare countries. it's mostly going to cheaper developing countries with clinics a lot like the oklahoma one i linked that specialize in procedures and offer them at reasonable prices. private care over there just isn't the same. and yeah i dealt with insurance and specialists before and it sucks but at least money makes a difference and more money makes more difference and it's not just "lol get on the list and stfu"
MattPalmer1086 4y ago
Healthcare efficiency costs in the US are huge. https://www.bloomberg.com/graphics/infographics/most-efficient-health-care-around-the-world.html https://www.bloomberg.com/graphics/infographics/most-efficie... We certainly pay for healthcare in the UK through taxation. It's pretty efficient. Hospitals aren't nice and shiny and medical people get paid a lot less though. I'll take that trade off myself anyday.