The reality is that that so many people in this country have bought into some kind of Capitalist Calvinism, where the suffering is not only pre-ordained by "market forces," but considered salutary itself, that it's sickened our culture beyond the capacity for reason. We'd really rather watch our friends, families, and neighbors die in sickness and poverty, than admit the failure of the grotesque just-world fallacy that is our economic ideology.
The reason why the US system is so expensive is because of perverse incentives given to the industry.
As long as you can afford it I would rather be treated in the US system than the French or Danish system.
So does the US, they just use one's wealth as a proxy to arrive at demonstrably worse results for everyone overall.
If you want to have a system where one's income determines their ability to survive because you have enough money and that works for you right now, go ahead. But at least drop the pretense that it's in any way just or moral.
You can be of the opinion that everyone should get access to the same treatment or you can be of the opinion that they shouldn't and that people who can afford better treatment should be able to.
All I was doing was point out that a single payer system has it's own issues as well.
Whether you are a fan of one or the other is more a political discussion.
Most (but not all) single payer systems coexist with private payer.
In England you can get all your care on the NHS, or you can mix and match with NHS or private care.
"The reason why the US system is so expensive" - Is because an individual with a health condition is in a poor position to negotiate the price of a treatment for themselves. To the extent a private company could give fair prices, they would have to be regulated heavily.
"As long as you can afford it I would rather be treated in the US" - You believe this because much of the massive profit margins goes into advertising.
On the other hand, you will likely have been on the receiving end of millions in advertising, and since your 'opinion' is in line with that advertising... its a good bet it is the result of it.
if you are interested in some conflicting 'studies of one' have a watch; https://www.youtube.com/watch?v=thkBLpRwdSM
I know the documentary but what does that have to do with whether the US system have access to more advanced healthcare than most other places.
I don't need a documentary to tell me the many issues with the US system just like I don't need one to tell me the many issues with the Danish system.
The US system isn't better it's different. The inflated prices aren't due to it being more privately driven but because of lobbying which can be dealt with.
The problem with healthcare is that you can never spend enough money on it. There are always methods, never and better machines. In a singlepayer system the taxpayers pay for that which means there need to be political mandate behind the budgetting. You can only spend money in a singlepayer system.
In a system more driven by market you can actually make money.
It's finding the right balance between those two I consider the most interesting part of this discussion. Unfortunately it's impossible to have this discussion because people either see you as a singlepayer proponent or a 100% marketdriven proponent.
"you can never spend enough money on it" - i say again, 'enough' is defined differently, a 'socialist enough' is enough to please the people; where a 'capitalist enough' is the smallest number that can sustain profit. these 'enough's are radically different.
"In a system more driven by market you can actually make money." - only by denying treatment. this is the cornerstone of the market model, those who can't pay don't matter.
"It's finding the right balance between those two" - In the UK, we are bringing private companies into contracts within the NHS, its always been a disaster, costing much more money that the services needed to cost, the inefficiency inherent in private companies (from bloated wages of CEOs to dividends) drag the whole system into financial crisis. The people who pay for the profits at the top are always the poor users of the service.
If you get more and more treatments available and what people consider being part of healthcare and you are running a cost center then your system gets more and more expensive.
No enough here is meant as there will always be things you can spend to make your system better than it is. It's not a matter of opinion it's a matter of what kind of treatments are available compared to how many you can offer.
The single payer system is also denying treatment exactly because it can't pay if everyone used it. It's just another way to say some people don't matter enough.
In the UK system is also deciding which drugs it will prioritize and which it wont.
You are mixing two things together. Yes there are plenty of issues with the US system but the single payer system have issues too and they are not the same.
'cost center' Vs 'profit center' <why would the profit center be cheaper? its the same as a 'cost center' with an added money drain and incentive to inflate prices..
'[denying treatment] because it can't pay if everyone used it' - This is just false, moneys going into a countries nationalized health system is high return (due to taxes), its also cheaper (due to group union prices). So long as its a healthy part of a healthy GDP (12%) it should have capacity for everyone in the country. compared to the US system which costs over 40% of your GDP and still does not have capacity for all your citizens.
'which drugs it will prioritize' - true, but this is done mostly on evidence of usefulness, not price.
I largely agree with your last statement, but whatever problems a socialist system has, they pale in comparison to the misery caused by Laissez-faire in our health system.
Switzerland has universal healthcare but it's based on private insurance. In other words it's not that simple.
In general I find this discussion hard to have because you are assuming so many things about what I say or mean, that simply aren't true.
I am not saying that a profit center is cheaper than a cost center I am saying that its able to make money which gives it flexibility.
The incentives that drives the US healthcare system are pretty shitty but they aren't incentives which are unique to a private system. On top of that in the public healthcare systems you see more and more new public management to hold down cost, which itself is expensive. But it's not something that's set in stone. It's not a property of the system it can be changed.
Changing the US healthcare system to patient outcomes incentives would do a lot to fix the incentives and there is an active program trying to do that.
And no it's not false that there are limits to a public healthcare system. Believe me I have lived in one and it doesn't only get realized by not doing certain treatments it also reflect in waiting time for operations, to see a specialist etc.
In Denmark if you go to the dermatologist you have to wait 3 week. In the US I went straight in.
In Denmark my biopsy had to be done at the hospital. In the US they made it right away at the dermatologist the same day.
With regards to drugs it's actually based on the cost, the rarity of the decease etc. I think it's in the UK where they have a list in order to prioritize.
Switzerland has very heavy regulations, everyone is covered by a national insurance system like other EU countries, but the very fact that its private companies that carries out the health care show in the stats, they pay almost twice the GDP of the UK for about the same outcomes, same with Germany, which has a similar system, its about 18% of GDP (and their GDP is higher per person).
"I am saying that its able to make money which gives it flexibility" - if this is really what you are trying to say, then you should have started with "Private, profit driven health care is fine for rich people", which i would have agreed with.
"waiting time for operations, to see a specialist" - this is a bad example, how many Americans wait all there lives for an operation, or never see a specialist because of the price. if you factored this in the average waiting times in a private unregulated system would dwarf a socialist waiting list(which by definition includes everyone).
"With regards to drugs" - in England we have 'NICE' which is a public board mandated to approve drugs and procedures on the NHS, with the fist stipulation that the drugs or procedures are shown through proper trials to work. This system is not perfect, but its a hell of a lot better than a private board incentivized to approve any BS treatment on profit basis alone.
"In Denmark if you go to the dermatologist you have to wait 3 week. In the US I went straight in." Try to put your personal feelings aside and look at the stats; http://www.nationmaster.com/country-info/compare/Denmark/Uni...
It's either socialist or Laise-Faire, Switzerland is heavly regulated, Public boards are based on rationality, private boards are based on greed alone.
No a taxpayer paid healthcare system does not make it a socialist system anymore than a taxpayer police force or army does. And the US system isn't laissez faire just because it's broken in many ways. Most economies are mixed economies.
So I am not sure what you are trying to prove here. The fact remains that public healthcare has it's own issues regardless of whether you personally think they are better issues to have and any honest dive into those the countries systems will show you that. You can't both have your cake and eat it. Switzerland is heavy regulated you claim (which is wrong) but they pay twice the GDP for about the same outcome. So what is it? A system governed by the state, a system that's private or something in between? With regards to Germany most of their insurance is covered by public healthcare 80% if not more. So why is that?
Furthermore the US is a huge country with hundreds of millions of citizens and millions of illegal immigrants and spread out over a huge area. Based on it's circumstances it's not doing too shabby regardless of the statistics.
It's just not as simply as you would like to paint it in those extreme corners.
There is an interesting discussion around Medicaid vs. private insurance in the US you can read about here:
https://www.forbes.com/sites/sallypipes/2014/08/14/no-really...
My point was never to say one thing was better than the other yet thats what we are really discussing here.
My point was that there are tradeoffs in both systems.
Its also important to remember that in for - profit healthcare, its operated as a profit center and thus has profit margins that are corporately mandated and not determined by need, at least not directly.
This leads to a massive inflation of price and decrease of quality of service, medicine, machines etc.
Not saying the EU system is better, but then that depends whether you are a shareholder or a patient.