7 ms·

It's astoundingly clear we need a single payer system in the US (like every other developed country). We simply pay more for the same (or worse) quality as othe

• armitron 2y ago
  Having lived in a number of European countries with single payer systems some of which are in a state of collapse, that's not even remotely true. I would characterize the level of care I receive in the US (fully paid by my employer) as absolutely top notch.
  • barbazoo 2y ago
    > fully paid by my employer A privilege not everyone enjoys
    • JumpCrisscross 2y ago
      > privilege not everyone enjoys 55% of Americans [1], and, I’d guess, a commanding majority of likely voters. [1] https://www.census.gov/library/publications/2020/demo/p60-271.html https://www.census.gov/library/publications/2020/demo/p60-27...
      • ryandrake 2y ago
        I don't see anything in that link about "fully paid" so the number of people with employer-provided health insurance fully paid by the employer is probably much lower. > In 2019, the percentage of people with employer-provided coverage at the time of interview was slightly higher than in 2018, from 55.2 percent in 2018 to 55.4 percent in 2019
        • JumpCrisscross 2y ago
          > don't see anything in that link about "fully paid" so the number of people with employer-provided health insurance fully paid by the employer is probably much lower You’re right. Tough to find statistics, in part because “fully paid” is ambiguous. (Saw this [1].) The figure I should have referred to is 72% of Americans being happy with their own healthcare [2]. You’re not going to get single payer without convincing them they’re trading up. [1] https://www.peoplekeep.com/blog/what-percent-of-health-insurance-is-paid-by-employers https://www.peoplekeep.com/blog/what-percent-of-health-insur... [2] https://news.gallup.com/poll/468176/americans-sour-healthcare-quality.aspx https://news.gallup.com/poll/468176/americans-sour-healthcar...
      • sadboi31 2y ago
        In my city (Pittsburgh) over half of the workers who work at our largest healthcare provider surveyed have some kind of debt to that same entity. My own mother is one of those people and she has been climbing for years. Funny how that works. https://www.beckershospitalreview.com/finance/union-raises-concerns-over-medical-debt-of-upmc-workers.html https://www.beckershospitalreview.com/finance/union-raises-c...
      • reaperman 2y ago
        I am included in that 55% but my deductible and OOP max are too high for my salary so i still can’t go to the doctor because i don’t have an extra $8k per year to spend on it.
        • ahmeneeroe-v2 2y ago
          You can't go to the doctor for your free annual visit because your OOP max is too high?
          • olliej 2y ago
            [flagged]
          • reaperman 2y ago
            What is the point of limiting the scope of discussion to a single visit per year? Am I missing some context from the article that makes this relevant to things like the expense of follow-up visits to confirm/treat complex diagnoses such as secondary hypoaldosteronism, discussed in the article? In my case, I have multiple conditions that require expensive monthly or annual visits, which I’ve severely lapsed on.
      • aidenn0 2y ago
        I'm counted in that group but still pay several thousand a year out-of-pocket.
      • olliej 2y ago
        So 45% do not, and that’s ok? Or the huge percentage of that 55% where their coverage is high deductible, so it’s functionally just a “you won’t be instantly bankrupted if you have a heart attack” not basic healthcare? The bizarrely antisocial and frankly sociopathic “I’ve got mine, other people can get fucked” attitude people like you have is sickening.
        • relativ575 2y ago
          You are very hostile in this thread. The GP didn't say anywhere that it was ok for people to be uninsured. Neither did they say they were among the 55% figure. Secondly, it's easy to find some official figures - [0] From January through June 2023, among people of all ages, 7.4% were uninsured, 40.7% had public coverage, and 60.8% had private coverage at the time of interview And: The percentage of adults who were uninsured decreased from 14.7% in 2019 to 10.7% in the first 6 months of 2023. Public coverage increased from 2019 (20.4%) through the first 6 months of 2023 (23.6%). No significant trend in private coverage was observed between 2019 (66.8%) and the first 6 months of 2023 (67.7%) In other words, the majority of people in the US (> 90%) have insurance -- private, public, or both. [0] - https://www.cdc.gov/nchs/data/nhis/earlyrelease/insur202312.pdf https://www.cdc.gov/nchs/data/nhis/earlyrelease/insur202312....
      • ojbyrne 2y ago
        In my experience in the US,”employer-provided” is not the same as “fully paid for by my employer.” Generally there is an employee-paid portion of the monthly premiums.
    • ahmeneeroe-v2 2y ago
      That is true. It's just not clear to me that we need a system where everyone has "free" (taxpayer-funded) healthcare.
      • spzb 2y ago
        Maybe you should ask the people who currently aren't covered if it's a good idea
      • Ekaros 2y ago
        So why not make everyone pay full economic cost? Ban employers from giving out insurance. Make everyone pay for their own fully.
  • IOT_Apprentice 2y ago
    I’d wager you have a copay, a deductible and a maximum amount your plan will cover. And if you are laid off you have nothing unless you sign up for COBRA which charges huge amounts monthly. The European single payer systems are underfunded intentionally by “conservatives” who want to skim off the top by privatization and loath offering it to the poor & working class.
  • aidenn0 2y ago
    I don't really follow European health-care policies, but the friends of mine who do seem to think public health care with a private-option (e.g. France) is better than single-payer. I've also heard that the German system works reasonably well, which is also not a single-payer system.
• atemerev 2y ago
  I don’t know, is Switzerland civilized country? We don’t have single payer. Neither are most of Europe (except Nordics).
  • avidiax 2y ago
    Switzerland is paying 70% as much for healthcare as the US. They are #2 in the world on healthcare spending. What they have is essentially Obamacare, that is, mandatory health insurance. But insurance doesn't care about limiting healthcare costs. Increased healthcare costs just leads to increased premiums, which is really increased revenue for an insurance company.
• ahmeneeroe-v2 2y ago
  There are no high-quality single payer systems that are currently functioning at or above American health care quality. This is doubly true if you're looking for a 300M+ person system. It is true that other countries achieve their broken health systems at a lower cost than the US does.
  • spzb 2y ago
    What makes you think the US health system is of a superior quality to that of any other in the world?
    • ahmeneeroe-v2 2y ago
      Nope. The GP asserted something without evidence so I am engaging with that same standard. What makes you think "every other developed nation" has higher quality (and single-payer) healthcare systems?
      • blactuary 2y ago
        Again, every other developed nation has roughly the same outcomes as the US, but at a much lower cost per person. And a substantial portion of our population has no access to health care, which is not true in those other countries. This is not a policy prescription or advocacy for anything, it's simply factually describing the situation.
    • blackeyeblitzar 2y ago
      In my opinion, more innovations (which the rest of the world’s public systems do benefit from), better customer service, better patient care (far fewer rude or abusive nurses and doctors), higher standards (quality of facilities and attention to detail and time spent with patient), flexibility (between providers, in scheduling, and even in the care/procedures you receive), etc. Oh and the ability to receive the care you are willing to pay for at all, instead of being denied. I do think there are lots of flaws too but feel they’re addressable with targeted legislation instead of some massive change.
  • 2y ago
• blackeyeblitzar 2y ago
  I am not sure about this. Government healthcare has longer wait times, less flexibility, less quality due to reduced talent levels, and less incentive for innovation. I absolutely hate dealing with the government healthcare workers who think they’re above patients - some aren’t just rude but abusive, which I have direct knowledge of (at least in parts of Europe and Asia). I do think the US healthcare system is expensive and sometimes fraudulent (overcharging for supplies, extra billing codes, etc). But we can fix these things with tweaks like forcing transparent pricing for healthy competition, creating transparency and consequences for billing or Medicare fraud, and other such ideas. I don’t think it requires as big a change as a single payer system.
  • blactuary 2y ago
    Transparent pricing/competition is not going to move the needle. The overwhelming majority of costs come from a small percentage of people (80% of costs from 20% of people) whose overall medical spending is so high that they are far beyond any notion of shopping. Those people are well beyond their OOP Max and not even responsible for the costs anymore, and have serious conditions where any incentive to shop is basically non-existent anyway. We also have gobs of data showing that people associate price with quality and often don't want to be price-conscious consumers in the first place (the classic "if your kid gets cancer are you going to the cheapest cancer treatment center, or looking for the best?" You will pay the same 10k OOP max either way). The types of health care that could be price-sensitive are a tiny percentage of overall spending.
• gruez 2y ago
  Isn't medicare effectively a single payer, because the rates are mandated and can't be negotiated?