I don't understand these comments. I lived in Italy for a long time, with high quality public healthcare for everyone even in a country which is not doing so well economically after the financial crisis. Yes, if you have something not risky you have wait-times for exams of 1-3 weeks (even here you can go private if you want and I assure you costs are BY FAR lower than in the US... like a full low abd eco costed me 40e to have it done in the next hour, just because I had to travel), but if you have ANYTHING risky there is no wait time, you get your exams and surgeries asap the same day if needed. The system works that well exactly because is not the amount you pay that put you in the front of the list, but the seriousness of your condition after the first medical evaluations.

> I don't understand these comments.

It's cognitive dissonance. They have not experienced a quality public health care first hand, so they cannot admit that it works without contradicting their core economical beliefs.

I get sick; I go to my doctor today and get treated. A system that makes me wait for weeks for something 'not serious' meaning almost everything, is a broken system. Sure it costs less in Europe etc; its not doing anything useful. Id've gotten better (or died) on my own by the time I got seen with wait times like that.

It's not cognitive dissonance (unless on the part of public-health-is-better folks). Its a different metric. If cost is the only measure, then sure, 3 week wait for a free aspirin is 'good'. If its timeliness, then other systems win hands down.

I should point out that the private option exists in the UK as well, if you have money and don't want to wait. And of course there's a normal range of OTC drugs including aspirin - unless you're in Scotland it's cheaper to buy it yourself than pay the £7 flat prescription charge.

NHS triage is pretty effective: stuff that might actually kill you gets seen to immediately. Chronic conditions get managed long-term. The vast majority of the long waits are for things like hip operations, which will improve quality of life but aren't particularly urgent.

The US system is not without waits: https://www.nytimes.com/2014/07/06/sunday-review/long-waits-...

What is more broken: a system where everyone has to wait some weeks and get attended, or one where some can be atended in a day, and others will never be attended?

> What is more broken: a system where everyone has to wait some weeks and get attended, or one where some can be atended in a day, and others will never be attended?

The latter.

By what metric are we measuring? Total healthcare delivered in a timely fashion? Then the system that delivers at least some timely care wins again.

Not if all urgent healthcare is delivered to all in a timely manner, and it's only non-urgent healthcare which gets delays.

In this case, the system which can get urgent attendance to all users wins over the one which does it only for a subset, even in terms of timeliness.

Urgent care is a fair metric.

A system than turns non-urgent care (a cold or the flu) into urgent care (pneumonia) is going to 'stuff the ballot box' in its favor however.

If you were to live the rest of your life with a new healthcare system, which of the following would you prefer?

- a) one where you would be randomly assigned to one of two groups: one which gets timely attendance for urgent and non-urgent needs; and the other one which gets no attendance at all, of any kind.

- b) one where all users get attended with an equal 3 weeks delay for non-urgent needs, and 0 delay for urgent needs.

Nonsense - triaging and urgency prioritization is used in medicine everywhere in the world since centuries.

But with 'private health' I can pay and go to a doctor today. For a cold or whatever. Its a curious fact the 'public health' equates to 'rationed medicine'.

Lucky you. There are some who need to skip several meals to go to a doctor.

...and that's an interesting problem. I maintain the solution is not to try to give it away free to everybody. Because that fails in major ways, as we've discussed.

It works quite well in most countries in Europe. I've heard that it's way better than the US system for a majority of people, except for some revolutionary treatments that reach only a really small amount of uber-rich users.

Public healthcare differs a lot between countries.

> if you have something not risky you have wait-times for exams of 1-3 weeks

In Canada that's closer to 3-6 months.

> if you have ANYTHING risky there is no wait time, you get your exams and surgeries asap the same day if needed

In Canada, average wait times in emergency rooms are 20+ hours.

Considering that France has the best healthcare in the world and is very much socialised, I think it really does work very well.

Also, in the UK, you won't die waiting. Someone else who doesn't have a serious illness will just have to wait a little longer. They do understand how to triage you know. In fact, they probably do it better since people get treating according to need rather than what kind of insurance they have.

By what objective metric does France have the best healthcare in the world?

Because french people believe everything is best about France, including the healthcare system :) I wished my comment was just sarcasm, but it's not. Even newspapers in France always entertain the idea "le systeme de sante que le monde nous envie". No facts needed.

German socialist health care saved my life without bankrupting me (I've seen the bills) - so: I take my chances.

And US health insurance does the same without the high taxes. What is your point?

1. Good insurance is unavailable to many, many people in the US.

2. Good insurance is extremely expensive. If your premiums for good insurance are low, that just means your employer is paying a lot. I don't see much substantive difference between paying high premiums and paying high taxes.

How much does good insurance cost?

Anecdata: most of my employers have offered good (but not the best) insurance. If you didn't use it, the employer and employee contributions together were probably something like $10k-$15k. If you did use it, the employee contribution would be capped at something like $20k-$30k, but the employer contribution would be uncapped. Somewhat famously, the CEO of AOL (?) talked about spending $1,000,000+ on an employee's neonatal care.

...except when it kicks you to the curb, and forces you to fight over what they'll cover while your family's in the middle of the hardest time of their life and has negative energy to spare.

Our healthcare/insurance system is miles better than nothing, but that's no reason to stick our heads in the sand and insist that it's especially good by modern standards.

How about if you had the bad luck of having pre existing conditions which no insurer will touch. Here you still get all the help you need. What happens over there? I ask as I do not know, however, if I see comments here I think you are screwed. Which is not fair Imho.

That still seems like a problem that the market can solve somehow without nationalizing an obscene amount of the US economy. We need to look at the insurance industry from the standpoint of how they are growing profits, who is getting the big paydays for it, and how much lobbying is done on their behalf. Because I recall as a kid growing up in the 1980s that health insurance was not that big of a deal to my parents who were of modest income and so there must be a reason why. I think that reason is that insurance, like every place a big pot of money exists, was "financialized" by the usual suspects.

But how can insurance not be perverse? If it is not nationalized then it is a private company that needs to make profits. And when you have that incentive, it is all about stats and risk. I find it a difficult problem to mix with capitalism. I have been raised in Europe and for me it is natural that one can go to the doctor 'for free' (if you cannot pay for it); I am trying to reason how insurance would ever work unless (like in NL) insurers must accept everyone no matter what happened before. How would that work? Is it not better for the insurance company to have people without money die? How can that fit?

Source? If true, why does the UK have a longer life expectancy than the US?

https://en.wikipedia.org/wiki/List_of_countries_by_life_expe...

That has nothing to do with that question at all. Lifestyle diseases do a lot more damage than access to treatment. Obesity for example can make your life expectancy take a dive, and it's not like the US and the UK are comparable at all in that sense.

Instead of providing a source for your original claim, you just made an additional unsourced claim.

Actually, the US and the UK are quite comparable when it comes to obesity.

That's quite a statement, do you have any references to back it up?

Easy: http://www.dailymail.co.uk/news/article-3158591/Hospital-wai...

That article doesn't actually back up your claim. ("The waiting lines in the UK for surgeries make it more likely you die before you get it in time if you have anything remotely serious.")

At best, it has a speculative quote or two.

Here's a little tip, when trying to find a source for some BS about the NHS, try not linking to the daily fail, who are well known for printing mistruths and on occasion, outright made up stories about things like the NHS.

They reference their numbers from several other organizations, so I'd put a little more weight in that article than in usual daily mail stuff.

It works best for those who pay the least towards it.