4 ms·

This is the main problem I see with American politics. Too afraid to fully make something public, so we end up with a half baked public/private hybrid that is

This is the main problem I see with American politics. Too afraid to fully make something public, so we end up with a half baked public/private hybrid that is disastrous. I think healthcare should be fully public or fully private. What we have now is a joke and leads to massively bloated healthcare costs. Exact same with education. Thanks to government loans and subsidies tuition costs have exploded. Either make it public or private. The public/private hybrid takes taxpayer money and enriches the private corporations offering near-monopoly services of poor quality.

refurb 3y ago
I think healthcare should be fully public or fully private. What we have now is a joke and leads to massively bloated healthcare costs. Why? The only country I can think of that is fully public is Canada. And even then, there is a small amount of private. Every other country has a mix of public and private. Why do you feel that making healthcare public only is the solution? What are you basing that one?
- solardev 3y ago
  I think this is a disingenuous way of painting the healthcare situation in most developed countries, where the overwhelming population uses the good enough public default. What America has is uniquely nightmarish, and not at all similar to other countries.
  - TMWNN 3y ago
    >I think this is a disingenuous way of painting the healthcare situation in most developed countries, where the overwhelming population uses the good enough public default. Not true! Having the public option be the "overwhelming default" is not the norm among developed countries. Neither is there being a public option at all! Nor is anything else the norm, so great is the variety of approaches. What is true is that the Canadian/British approach of completely or almost completely free at delivery is not the norm. The US's approach post-Obamacare is closest to the DACH countries, with a variety of nonprofit and profit plans. The US differs in a) having Medicare as the normal public option for the elderly (and having it be completely government run[1]), and b) not making getting a plan mandatory, while the DACH norm is for the government to pick one for you and send you the bill if you don't choose one first. [1] Although I suppose Medicare Advantage is similar to the nonprofit plans available through the German GKV
- ffgjgf1 3y ago
  Some countries are fully private, like Switzerland and I think Netherlands.
  - com 3y ago
    The Netherlands is an insurance health system, delivered by a mix of different types of organisations, private, non-profit, religious etc. The insurance market is very regulated and all residents have cover - it’s compulsory. If you are poor, your municipality makes sure you have an insurance policy. Most people get a window once a year to change plans and insurers, but the policies aren’t all that different (physiotherapy and alternative medicine options, as well as own-risk components seem to be where most of the difference lies). This regulated market isn’t very “private” - and it’s not very capitalist either. Outcomes are ok, but as always could be better, which is at least as much cultural as how it’s all funded.
    - Projectiboga 3y ago
      I survived a majorly serious illness during 2001 in the Netherlands. I am a type 1 diabetic and had a staff infection spread into both my lungs. I was on a ventilator for 17 days and spent around 30 days in the hospital total. The entire bill was under 20K Euros when EUR/USD was about even. The bill in the USA would have been insane but there they just did it for just costs. Any system would be better than here in the USA. From what I've heard the issue in Canada is they under spend and that creates logjams with the tech heavy things like MRI and elective surgeries.
  - oceanofsolaris 3y ago
    Basic health insurance in Switzerland is “private” but very regulated: All companies offer completely exchangeable plans and are only allowed to take age, municipality and desired copay into account when calculating your premium. Every resident of Switzerland is also obligated to have this basic health insurance (if you don’t, the government just picks a random insurance for you and signs you up retroactively). I would say it’s a great system…but Swiss health care costs are also among the highest in the world (and rising steeply), so it’s not a silver bullet. To be fair, this particular system is probably not to blame for the high costs, but it also didn’t prevent them (though it leads to a bit of innovation around e.g. telemedicine, which is great).
- snapplebobapple 3y ago
  As a Canadian, I can say healthcare up here is a slow motion train wreck and we shouldn't be emulated by anyone. Everything is triage/lowest level of care so most things lack any sort of bedside manner and/or take forever and involves way more suffering than is necessary. Look at places like Singapore or some of the scandinavian countries where they have pretty effectively used the private sector to discipline the public sector and vice versa, as it seems to have way better outcomes and is certainly far less time consuming and painful for the individual going through the system. I especially like the Scandinavian countries that give the public sector 90 days to get something done before the patient has the right to use the private system at government cost, maybe Sweden? That's a great system that stops the utter bullshit of months to years of waiting for treatments that probably won't save your life but will make your life a hell of a lot better like joint replacements. Both the USA and Canada should be held up as examples of how not to do health care and all eyes should be elsewhere for better ideas.
- mschuster91 3y ago
  The fully-public NHS prior to Thatcher and friends gutting it was widely beloved and is now seriously missed - to the tune that (empty) promises to get it back to former glory were a major propaganda point in Brexit [1]. Germany, while it has historically been a mixture of public and private insurances (mostly due to state servants, clergy and entrepreneurs not being allowed in the public system [2]), has about 90% of its population covered by the public insurance [3] and there's regular discussions on getting rid of private insurances entirely - about once every year or two. [1] https://conversion-uplift.co.uk/brexit/the-boris-johnson-brexit-bus-lie-of-350m/ https://conversion-uplift.co.uk/brexit/the-boris-johnson-bre... [2] https://de.wikipedia.org/wiki/Krankenversicherung_in_Deutschland https://de.wikipedia.org/wiki/Krankenversicherung_in_Deutsch... [3] https://www.vdek.com/presse/daten/b_versicherte.html https://www.vdek.com/presse/daten/b_versicherte.html

refurb 3y ago

I think healthcare should be fully public or fully private. What we have now is a joke and leads to massively bloated healthcare costs. Why? The only country I can think of that is fully public is Canada. And even then, there is a small amount of private. Every other country has a mix of public and private. Why do you feel that making healthcare public only is the solution? What are you basing that one?

solardev 3y ago
I think this is a disingenuous way of painting the healthcare situation in most developed countries, where the overwhelming population uses the good enough public default. What America has is uniquely nightmarish, and not at all similar to other countries.
- TMWNN 3y ago
  >I think this is a disingenuous way of painting the healthcare situation in most developed countries, where the overwhelming population uses the good enough public default. Not true! Having the public option be the "overwhelming default" is not the norm among developed countries. Neither is there being a public option at all! Nor is anything else the norm, so great is the variety of approaches. What is true is that the Canadian/British approach of completely or almost completely free at delivery is not the norm. The US's approach post-Obamacare is closest to the DACH countries, with a variety of nonprofit and profit plans. The US differs in a) having Medicare as the normal public option for the elderly (and having it be completely government run[1]), and b) not making getting a plan mandatory, while the DACH norm is for the government to pick one for you and send you the bill if you don't choose one first. [1] Although I suppose Medicare Advantage is similar to the nonprofit plans available through the German GKV
ffgjgf1 3y ago
Some countries are fully private, like Switzerland and I think Netherlands.
- com 3y ago
  The Netherlands is an insurance health system, delivered by a mix of different types of organisations, private, non-profit, religious etc. The insurance market is very regulated and all residents have cover - it’s compulsory. If you are poor, your municipality makes sure you have an insurance policy. Most people get a window once a year to change plans and insurers, but the policies aren’t all that different (physiotherapy and alternative medicine options, as well as own-risk components seem to be where most of the difference lies). This regulated market isn’t very “private” - and it’s not very capitalist either. Outcomes are ok, but as always could be better, which is at least as much cultural as how it’s all funded.
  - Projectiboga 3y ago
    I survived a majorly serious illness during 2001 in the Netherlands. I am a type 1 diabetic and had a staff infection spread into both my lungs. I was on a ventilator for 17 days and spent around 30 days in the hospital total. The entire bill was under 20K Euros when EUR/USD was about even. The bill in the USA would have been insane but there they just did it for just costs. Any system would be better than here in the USA. From what I've heard the issue in Canada is they under spend and that creates logjams with the tech heavy things like MRI and elective surgeries.
- oceanofsolaris 3y ago
  Basic health insurance in Switzerland is “private” but very regulated: All companies offer completely exchangeable plans and are only allowed to take age, municipality and desired copay into account when calculating your premium. Every resident of Switzerland is also obligated to have this basic health insurance (if you don’t, the government just picks a random insurance for you and signs you up retroactively). I would say it’s a great system…but Swiss health care costs are also among the highest in the world (and rising steeply), so it’s not a silver bullet. To be fair, this particular system is probably not to blame for the high costs, but it also didn’t prevent them (though it leads to a bit of innovation around e.g. telemedicine, which is great).
snapplebobapple 3y ago
As a Canadian, I can say healthcare up here is a slow motion train wreck and we shouldn't be emulated by anyone. Everything is triage/lowest level of care so most things lack any sort of bedside manner and/or take forever and involves way more suffering than is necessary. Look at places like Singapore or some of the scandinavian countries where they have pretty effectively used the private sector to discipline the public sector and vice versa, as it seems to have way better outcomes and is certainly far less time consuming and painful for the individual going through the system. I especially like the Scandinavian countries that give the public sector 90 days to get something done before the patient has the right to use the private system at government cost, maybe Sweden? That's a great system that stops the utter bullshit of months to years of waiting for treatments that probably won't save your life but will make your life a hell of a lot better like joint replacements. Both the USA and Canada should be held up as examples of how not to do health care and all eyes should be elsewhere for better ideas.
mschuster91 3y ago
The fully-public NHS prior to Thatcher and friends gutting it was widely beloved and is now seriously missed - to the tune that (empty) promises to get it back to former glory were a major propaganda point in Brexit [1]. Germany, while it has historically been a mixture of public and private insurances (mostly due to state servants, clergy and entrepreneurs not being allowed in the public system [2]), has about 90% of its population covered by the public insurance [3] and there's regular discussions on getting rid of private insurances entirely - about once every year or two. [1] https://conversion-uplift.co.uk/brexit/the-boris-johnson-brexit-bus-lie-of-350m/ https://conversion-uplift.co.uk/brexit/the-boris-johnson-bre... [2] https://de.wikipedia.org/wiki/Krankenversicherung_in_Deutschland https://de.wikipedia.org/wiki/Krankenversicherung_in_Deutsch... [3] https://www.vdek.com/presse/daten/b_versicherte.html https://www.vdek.com/presse/daten/b_versicherte.html