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As a Scandinavian I find this an odd take on the situation. To me it seems like the US has a very, very, broken healthcare system that you’ve chosen to have by

by devjab 3y ago

As a Scandinavian I find this an odd take on the situation. To me it seems like the US has a very, very, broken healthcare system that you’ve chosen to have by electing politicians who aren’t going to reform it into something reasonable. My wife and I presently had twins, and we spent 7 days living in the hospital with a lot of help from nurses and so on, and it cost us $130. Which was me paying for 3 days of living there because the 3 days was the max you had to pay. Sure I pay 39% in taxes on the first $120k of my yearly income and then around 55% on anything above this (well except for a bunch of sort of loop holes to invest before taxes), but it’s basically still pretty nice to have that sort of healthcare system. I’m bipolar type 2 and I have ADHS. Now in case you don’t know, this involved a lot of trial and error with a psychiatrist to find the best medication for me. During this I learned that many prescription medications which are “normal” in the US are illegal or at least only used in extremely severe cases here in Denmark, because of how dangerous the side effects are. This is due to heavy government regulation, because we don’t elect politicians the way you do. We don’t have a winners takes all system which tends to lead to conservative governments which are heavily influenced by the private sector. Hell, you can even see it in our own local “opioid crisis” which was caused by deregulation by right leaning government (though to be fair, Danish conservatives would probably be considered communists by US standards). As I understand it, you Americans have the ability to both influence national and stateside policies. So that if your national government fails you, then you can still regulate your local laws. Which probably should have meant voting for politicians who would regulate your healthcare system in your states and ban medicine that is clearly a threat to public health. That you chose to not do this, and then blame your costal elites is just baffling to me. But maybe I just don’t understand your country well enough?

matwood 3y ago
Healthcare has to be fixed at the state and national level. There's not much that can be done at a lower level. There are a lot of rules around what states can do to regulate interstate commerce. There's also the situation we're in with pot, where it's legal in many state, but still illegal at the federal level. The other big issue, is like a lot of things in the US, if someone has money healthcare is great. It's probably the best in the world. Those who get elected have money and don't personally feel the healthcare issue. Heck, politicians at the federal level have their own healthcare system making them even further removed. One of the biggest voting blocks is seniors, and they have already have access to what many say could be a step towards universal healthcare if opened to everyone. So they are also not inclined to think about it too much. All in all, it's complicated.
chasil 3y ago
Yes, our country is a mess. I don't think that the states currently have the power to oppose and reverse the directives of the FDA. That will shortly come to a head with the abortion drugs. Fun fact... many people know that Coca-Cola originally included cocaine as an ingredient, but fewer are aware that 7-Up was originally made with lithium. "The product, originally named "Bib-Label Lithiated Lemon-Lime Soda", was launched two weeks before the Wall Street Crash of 1929. It contained lithium citrate, a mood-stabilizing drug, until 1948... Its name was later shortened to "7 Up Lithiated Lemon Soda" before being further shortened to just "7 Up" by 1936." https://en.m.wikipedia.org/wiki/7_Up https://en.m.wikipedia.org/wiki/7_Up
emptysongglass 3y ago
As a fellow Dane, you must also know how close our public healthcare is to crumbling, how long wait times are for care, our record highest cancer rate in the world of any nation, and a policy of treating only acute conditions (no cancer screenings deemed "unnecessary" etc.) I have been misdiagnosed a number of times and was finally treated in the US for a major condition the doctors missed here in Denmark. We get a number of privileges for our very high tax: childcare is cheap, education is free, and births cost us virtually nothing but let's not try and overstate the value of our system to theirs. Ours too is broken, it's just a matter of degrees and where. Our middle-class, in return, gets taxed to high heaven while our income disparity between rich and poor continues to widen.
- objektif 3y ago
  This is a good point but you really need to have a comparison when you say your healthcare is crumbling. Are you talking about specialized care? I think healthcare in the US is beyond messed up. In my area which is a large city in the North East US it is very difficult to be able to get into ER because rooms are filled with people who are trying to get non-urgent care. These people have no money, no insurance and their only way to get care is to go to ER. System is rotten to the core. I also did not get your last paragraph are you talking about the US or Denmark? I would be shocked to hear income inequality problem is worse in Denmark.
  - emptysongglass 3y ago
    I'm talking about general and specialist care in the public system. Our private system is pretty good but you either need to pay insurance for it or, if the public wait-list extends beyond 6 months for surgical treatment, our public healthcare will pay for you to be referred to a private hospital. The less said about our mental healthcare the better. > I also did not get your last paragraph are you talking about the US or Denmark? I would be shocked to hear income inequality problem is worse in Denmark. I was shocked too when I first heard it but live here long enough and it's very obvious. Income inequality has increased over the last thirty years with a Gini coefficient of 30 [1] in 2022. [1] https://www.dst.dk/en/Statistik/emner/arbejde-og-indkomst/indkomst-og-loen/indkomstulighed https://www.dst.dk/en/Statistik/emner/arbejde-og-indkomst/in...
nobodyandproud 3y ago
Yes, every reason why we don't have universal healthcare comes down to voting in politicians that are against it, but what outsiders and party hardliners fail to appreciate is where the resistance comes. When the Democrats controlled the presidency and both houses, we failed to push out any reasonable form of universal healthcare and that is due to several specific interests that have a hold on the Democrat party then and today. I would love a Medicare for all, because that's the most cost-effective system we can possibly get short of having no system at all. It'd also increase job mobility--nobody tied to their jobs for "benefits"--and put a sane check the price of basic-level care. However not all countries with public healthcare are drug-free--Portugal just manages, not solves, its problem despite 50 years of public health--and that's because the incentives to both sell and use these powerful painkillers don't merely go away with a public system. Medical doctors were also complicit; or the more responsible ones, yanked-away the prescription out of caution but unintentionally drove their patients to the black market. I'll concede that a streamlined system would have helped alert the powers that be sooner, but I'm not convinced that the powers-that-be would have done anything concrete until it became a crisis.
- gWPVhyxPHqvk 3y ago
  It’s wild that you blame Democrats for the failure to pass universal health care.
  - nobodyandproud 3y ago
    It's wild that you don't understand why Democrat squabbling was what contributed to the failure.
- armitron 3y ago
  Universal healthcare is a disaster in every country similar to the US (UK, Canada). The Scandinavian model is an exception, and would never work here given social factors such as population makeup and numbers. I'll keep my reasonable tax rates and absolutely top notch health care I receive through my employer, thank you very much.
jterrys 3y ago
>But maybe I just don’t understand your country well enough? You really don't. You live in a country that is either 11 million or 6 million people with fully enforceable border controls and immigration controls. You can control who comes into you country. You can control the goods that come into your country. Your population rivals one of the larger metropolitan areas of the USA. Problems don't scale linearly. At 6 million people you can afford to fund pensions through nothing but an oil extracting operation out of your country. 7.7% Unemployment at 11 million people is, believe it or not, much less debilitating than 4% unemployment at 332 million people. There are more unemployed persons than the entire population of Sweden. And these populations cluster, and they depress local economies, and they drain their local workforce and social services. Then crime happens, and populations move, and housing prices fluctuate, and then this spreads. But here's the trick: You only need so much space to live. So much money to eat. So much space to grow food. You only have so many hours in the day you can work. Any doctor can see 20 patients a day, spending 30 minutes on each consultation. You don't need that many doctors to meet that demand at 6 million people. You need a lot more doctors to meet that demand at 332 million. Costs and living standards are relatively fixed beyond a tolerable level of comfort. Scandinavian countries achieved this comfort. But this comfort doesn't scale. Because problems don't scale linearly. Back to borders and immigration: You control your borders. You can say that drugs don't enter your country. And they won't (at scale, at least). In the USA that's not enforceable because the country is so large. Illinois can say that they ban guns. But that doesn't stop them from going to Indiana and getting them. Or Kentucky. Or Missouri. Your local change can only accomplish so much when you are against the tide of your neighbors. You can say that you want to control your borders. But your neighbors disagree. So they go around you controls and infiltrate your economy anyway. And you don't know how bad it really is. Because statistics are an approximation of a segment of a population that doesn't want to be tracked. But these people still get sick. And some costs are fixed. So your publicly funded hospitals still need money to cover their costs by people who will flee and not pay. So you privatize and offset the burden on the patient. Because people can pay for themselves to get a blood test. You relieve your burden on the system, for the moment. But now companies charge more because they also know that certain costs are fixed and people are willing to tolerate more costs for a relatively inexpensive service. And of course, they optimize. Because there's nothing stopping them. Since you can't tell them not to do something when you can't solve the problem yourself. And here we are.
hollerith 3y ago
We are having a discussion about opiate addiction, and you have failed to explain why the US's broken healthcare system is an important contributor to that problem. I certainly don't see how your experience with childbirth is relevant -- or bipolar disorder or ADHD. Do you imagine for example that the non-broken healthcare systems of the world are what is preventing opiate addiction there from becoming as severe as it is in the US?
- rsynnott 3y ago
  I mean, if medical care were expensive and difficult to access, you’d certainly expect more use of opioids, because they’re a cheap solution to chronic pain relative to more measured approaches. And it certainly does seem that the US opioid crisis was worst in extremely poor areas with limited medical care available.
  - hollerith 3y ago
    Sure, but opioids are also a cheap solution to loneliness and to a chronic feeling of alienation and of "not belonging" caused by living in a society optimized for individual freedom and economic efficiency. I have yet to see reasons in this comment section to believe that access to healthcare specifically is the human need whose lack is driving most of the cases addiction in the US. Most young adults have no pressing need for healthcare except possibly birth-control pills for the young women (since those require a prescription in the US) and if the millions of young adults in the US who have become addicts during this crisis had unmet health-care needs at a significantly higher rate than their counterparts who did not become addicts, addiction researchers would almost certainly have noticed by now, and I probably would've heard about it from journalists who cover the issue.
    - rsynnott 3y ago
      > . I have yet to see reasons in this comment section to believe that access to healthcare specifically is the human need whose lack is driving most of the cases addiction in the US. Oh, yeah, I’m not saying that healthcare is the only factor or even the most important factor, just that it is relevant (and it does seem to be where the US opioid crisis _started_; oxycodone and similar were made available in ludicrous quantities as a substitute for actual medical care). Granted, it is probably much harder to put the genie back in the bottle now it’s out there.
badpun 3y ago
Also, since USA is a Union of States, it's weird that no single state managed to set up a state-wide socialized health-care. Is there some reason why it hadn't happened?

by devjab 3y ago

matwood 3y ago

Healthcare has to be fixed at the state and national level. There's not much that can be done at a lower level. There are a lot of rules around what states can do to regulate interstate commerce. There's also the situation we're in with pot, where it's legal in many state, but still illegal at the federal level. The other big issue, is like a lot of things in the US, if someone has money healthcare is great. It's probably the best in the world. Those who get elected have money and don't personally feel the healthcare issue. Heck, politicians at the federal level have their own healthcare system making them even further removed. One of the biggest voting blocks is seniors, and they have already have access to what many say could be a step towards universal healthcare if opened to everyone. So they are also not inclined to think about it too much. All in all, it's complicated.

chasil 3y ago

Yes, our country is a mess. I don't think that the states currently have the power to oppose and reverse the directives of the FDA. That will shortly come to a head with the abortion drugs. Fun fact... many people know that Coca-Cola originally included cocaine as an ingredient, but fewer are aware that 7-Up was originally made with lithium. "The product, originally named "Bib-Label Lithiated Lemon-Lime Soda", was launched two weeks before the Wall Street Crash of 1929. It contained lithium citrate, a mood-stabilizing drug, until 1948... Its name was later shortened to "7 Up Lithiated Lemon Soda" before being further shortened to just "7 Up" by 1936." https://en.m.wikipedia.org/wiki/7_Up https://en.m.wikipedia.org/wiki/7_Up

emptysongglass 3y ago

As a fellow Dane, you must also know how close our public healthcare is to crumbling, how long wait times are for care, our record highest cancer rate in the world of any nation, and a policy of treating only acute conditions (no cancer screenings deemed "unnecessary" etc.) I have been misdiagnosed a number of times and was finally treated in the US for a major condition the doctors missed here in Denmark. We get a number of privileges for our very high tax: childcare is cheap, education is free, and births cost us virtually nothing but let's not try and overstate the value of our system to theirs. Ours too is broken, it's just a matter of degrees and where. Our middle-class, in return, gets taxed to high heaven while our income disparity between rich and poor continues to widen.

objektif 3y ago
This is a good point but you really need to have a comparison when you say your healthcare is crumbling. Are you talking about specialized care? I think healthcare in the US is beyond messed up. In my area which is a large city in the North East US it is very difficult to be able to get into ER because rooms are filled with people who are trying to get non-urgent care. These people have no money, no insurance and their only way to get care is to go to ER. System is rotten to the core. I also did not get your last paragraph are you talking about the US or Denmark? I would be shocked to hear income inequality problem is worse in Denmark.
- emptysongglass 3y ago
  I'm talking about general and specialist care in the public system. Our private system is pretty good but you either need to pay insurance for it or, if the public wait-list extends beyond 6 months for surgical treatment, our public healthcare will pay for you to be referred to a private hospital. The less said about our mental healthcare the better. > I also did not get your last paragraph are you talking about the US or Denmark? I would be shocked to hear income inequality problem is worse in Denmark. I was shocked too when I first heard it but live here long enough and it's very obvious. Income inequality has increased over the last thirty years with a Gini coefficient of 30 [1] in 2022. [1] https://www.dst.dk/en/Statistik/emner/arbejde-og-indkomst/indkomst-og-loen/indkomstulighed https://www.dst.dk/en/Statistik/emner/arbejde-og-indkomst/in...

nobodyandproud 3y ago

Yes, every reason why we don't have universal healthcare comes down to voting in politicians that are against it, but what outsiders and party hardliners fail to appreciate is where the resistance comes. When the Democrats controlled the presidency and both houses, we failed to push out any reasonable form of universal healthcare and that is due to several specific interests that have a hold on the Democrat party then and today. I would love a Medicare for all, because that's the most cost-effective system we can possibly get short of having no system at all. It'd also increase job mobility--nobody tied to their jobs for "benefits"--and put a sane check the price of basic-level care. However not all countries with public healthcare are drug-free--Portugal just manages, not solves, its problem despite 50 years of public health--and that's because the incentives to both sell and use these powerful painkillers don't merely go away with a public system. Medical doctors were also complicit; or the more responsible ones, yanked-away the prescription out of caution but unintentionally drove their patients to the black market. I'll concede that a streamlined system would have helped alert the powers that be sooner, but I'm not convinced that the powers-that-be would have done anything concrete until it became a crisis.

gWPVhyxPHqvk 3y ago
It’s wild that you blame Democrats for the failure to pass universal health care.
- nobodyandproud 3y ago
  It's wild that you don't understand why Democrat squabbling was what contributed to the failure.
armitron 3y ago
Universal healthcare is a disaster in every country similar to the US (UK, Canada). The Scandinavian model is an exception, and would never work here given social factors such as population makeup and numbers. I'll keep my reasonable tax rates and absolutely top notch health care I receive through my employer, thank you very much.

jterrys 3y ago

>But maybe I just don’t understand your country well enough? You really don't. You live in a country that is either 11 million or 6 million people with fully enforceable border controls and immigration controls. You can control who comes into you country. You can control the goods that come into your country. Your population rivals one of the larger metropolitan areas of the USA. Problems don't scale linearly. At 6 million people you can afford to fund pensions through nothing but an oil extracting operation out of your country. 7.7% Unemployment at 11 million people is, believe it or not, much less debilitating than 4% unemployment at 332 million people. There are more unemployed persons than the entire population of Sweden. And these populations cluster, and they depress local economies, and they drain their local workforce and social services. Then crime happens, and populations move, and housing prices fluctuate, and then this spreads. But here's the trick: You only need so much space to live. So much money to eat. So much space to grow food. You only have so many hours in the day you can work. Any doctor can see 20 patients a day, spending 30 minutes on each consultation. You don't need that many doctors to meet that demand at 6 million people. You need a lot more doctors to meet that demand at 332 million. Costs and living standards are relatively fixed beyond a tolerable level of comfort. Scandinavian countries achieved this comfort. But this comfort doesn't scale. Because problems don't scale linearly. Back to borders and immigration: You control your borders. You can say that drugs don't enter your country. And they won't (at scale, at least). In the USA that's not enforceable because the country is so large. Illinois can say that they ban guns. But that doesn't stop them from going to Indiana and getting them. Or Kentucky. Or Missouri. Your local change can only accomplish so much when you are against the tide of your neighbors. You can say that you want to control your borders. But your neighbors disagree. So they go around you controls and infiltrate your economy anyway. And you don't know how bad it really is. Because statistics are an approximation of a segment of a population that doesn't want to be tracked. But these people still get sick. And some costs are fixed. So your publicly funded hospitals still need money to cover their costs by people who will flee and not pay. So you privatize and offset the burden on the patient. Because people can pay for themselves to get a blood test. You relieve your burden on the system, for the moment. But now companies charge more because they also know that certain costs are fixed and people are willing to tolerate more costs for a relatively inexpensive service. And of course, they optimize. Because there's nothing stopping them. Since you can't tell them not to do something when you can't solve the problem yourself. And here we are.

hollerith 3y ago

We are having a discussion about opiate addiction, and you have failed to explain why the US's broken healthcare system is an important contributor to that problem. I certainly don't see how your experience with childbirth is relevant -- or bipolar disorder or ADHD. Do you imagine for example that the non-broken healthcare systems of the world are what is preventing opiate addiction there from becoming as severe as it is in the US?

rsynnott 3y ago
I mean, if medical care were expensive and difficult to access, you’d certainly expect more use of opioids, because they’re a cheap solution to chronic pain relative to more measured approaches. And it certainly does seem that the US opioid crisis was worst in extremely poor areas with limited medical care available.
- hollerith 3y ago
  Sure, but opioids are also a cheap solution to loneliness and to a chronic feeling of alienation and of "not belonging" caused by living in a society optimized for individual freedom and economic efficiency. I have yet to see reasons in this comment section to believe that access to healthcare specifically is the human need whose lack is driving most of the cases addiction in the US. Most young adults have no pressing need for healthcare except possibly birth-control pills for the young women (since those require a prescription in the US) and if the millions of young adults in the US who have become addicts during this crisis had unmet health-care needs at a significantly higher rate than their counterparts who did not become addicts, addiction researchers would almost certainly have noticed by now, and I probably would've heard about it from journalists who cover the issue.
  - rsynnott 3y ago
    > . I have yet to see reasons in this comment section to believe that access to healthcare specifically is the human need whose lack is driving most of the cases addiction in the US. Oh, yeah, I’m not saying that healthcare is the only factor or even the most important factor, just that it is relevant (and it does seem to be where the US opioid crisis _started_; oxycodone and similar were made available in ludicrous quantities as a substitute for actual medical care). Granted, it is probably much harder to put the genie back in the bottle now it’s out there.

badpun 3y ago

Also, since USA is a Union of States, it's weird that no single state managed to set up a state-wide socialized health-care. Is there some reason why it hadn't happened?