A lot of people against socialized healthcare are perfectly aware of this cost shifting.
What most other countries are doing: Fund healthcare from tax money.
The middle class will anyway pay for the healthcare of those who can't pay for themselves. In other countries they pay in taxes, in the US they pay for it in their own higher medical bills.
This is a matter of an opinion of course. But most Europeans would opine that the American model is the unreasonable alternative.
People who self selected for free medical care didn't have much better health outcome than others who were not selected, except that they didn't go bankrupt.
So, the group that didn't get paid for didn't go to the ER, while the group that did get paid for went to the ER but didn't have better health outcomes than those that didn't. Surely that says something about the private, for profit institutions that run the ER business.
Then why do people in those same countries purchase additional insurance from the private sector?
> In other countries they pay in taxes, in the US they pay for it in their own higher medical bills.
Surely you have heard of Medicaid and Medicare before. Yes?
Same reason some people upgrade their coach-class airline tickets - they can afford a nicer, more personalized level of service.
There ARE a lot of alternatives to the current system. Canada, France, the Netherlands, and Singapore are good examples to look at--very different systems, all far more cost-effective than ours.
And then, don't allow the for-profit to loan or grant or shift any resources over to the not-for-profit. In fact, ensure they're not owned by the same parent corporation or even the same shareholders.
Keep the logistics consolidated—everything flows through the for-profit's buyer—but then, have the for-profit rent its facilities and machinery, and provide its pre-acquired drugs and materials, to the not-for-profit at market price.
And have the for-profit and not-for-profit hire the same employees and split their shifts; or perhaps, have the for-profit hire them, with the option to volunteer as many hours as they wish to the not-for-profit. (This would lower the expenses of the not-for-profit considerably.)
In other words, leave the not-for-profit "twisting in the wind", where it's still running but nobody's paying for it, so it's just running at more and more of a loss each year. Try to minimize its costs—in fact, have people working for the not-for-profit entirely dedicated to trying to minimize its costs (successful strategies for which can be rolled back into the for-profit.)
But also, treat the not-for-profit as a thing which needs to raise money, rather than just making revenue. A thing like a University, which has entire departments dedicated to getting funding from its alumni. Maybe even work with other not-for-profit hospitals in a Public Advocacy Coalition to build a social norm that if one of these not-for-profit hospitals saved your life, and you went on to great [monetary] success, you should donate to that hospital (and it will, in turn, privilege your family while pretending not to, just like Universities do.)
A fun effect of this is that the not-for-profit will now be a large, visible advocate for cost-minimization in the for-profit's purchasing—since those costs will be passed on to them (so they'll be incentivized to lower them), but they can't just lower them by buying cheaper themselves (because they don't have their own purchasing/facilities management/IT/etc. departments), they'll instead have to figure out how the hospital as a whole can lower costs, in order for them to save any money.
Essentially, this is doing the same thing that creating municipal vote districts along income lines does: the rich voters and the poor voters each get their own voices in how the city should be run, and so the poor voters (through their representative) get the chance to argue against proposals that would benefit the rich voters but hurt them. Right now, hospitals don't have any such representative for their "poor voters."
---
(Yes, I know that a lot of hospitals are already not-for-profits. They're still run on a model that tries to maximize revenue, though, because they need that money. If you split the unprofitable patients out, suddenly the for-profit hospital can lower its prices, while the not-for-profit is forced to lower its costs.)
Consider the aphorism "the squeaky wheel gets the grease." Why is this an aphorism? Because squeaky wheels are annoying. If the people who use the wheels have to hear them squeak, they'll soon oil them. So if you hear a squeaky wheel (for example, on a shopping cart), that's usually because the people with the oil don't ever have to get close enough to hear that squeak.
Proposals like Basic Income, or even welfare, basically translate to "greasing all the wheels on a regular schedule, whether you've heard them squeak or not"—i.e., fixing problems that aren't actually bothering you personally. It's nearly impossible to incentivize anyone to do that.
My proposal here is more in terms of "ensuring when manufacturing wheels that they will squeak as loudly as possible when they've begun failing." You want to solve the shopping-cart case, where the person with the oil isn't the person who has to use the cart. And the best way to do that is to ensure that the customers will be too irritated by the squeaking to actually use the carts; and therefore the carts will go disused; and therefore the customers will complain to the cashiers that there are no carts, and people will buy less than they would with a cart, and revenue will go down, and some stakeholder will notice, and gather information, and figure out that it's that all the carts are squeaking horribly, and so oil them.
Or, in other words, you want the squeak of "people not getting treated because they don't have the money" to be loud enough to actually make it all the way up to the hospital's CFO, where the squeaking will cause cost-cutting; and even further, to the city surrounding the hospital, where the squeaking will cause donating.
In fact, if you oil the carts regularly, you might not realize that your wheels are badly-made and are rusting prematurely; or that your parking lot needs a regular dust-blower-ing; or whatever else. Sensitive components—canaries in coal mines, or people with no money in poor health—show you where your system is weakest. If you eliminate them (by just providing UBI, or even just public healthcare), you eliminate the chance to observe where your system fails. In a country with more money than it knows what to do with, this is probably a sensible approach—it has fewer people suffer over the short term, after all, at the expense of a bloated, bureaucratic medical system. But if you're trying to figure out how to cut those costs, you need the squeaking.
Bawawahahaha. No. Non-profit is just a tax status that allows them not to pay income taxes or property taxes on enormous assets and enormous income.
2) Many shops in UK (especially London), run by Muslim or Seikh owners, have been feeding hungry people for years.
[1] https://read.oecd-ilibrary.org/social-issues-migration-healt...
Perhaps keep 3rd party insurance but ban it as an employment perk, that would incentivize the market to play to the greater public instead of just white collar salaried employees.
People with severe disabilities may not be profitable, but I'd still like them to have the option to live.
So, yes, the government. It may not be monetarily profitable but money shouldn't matter to build a humane society.
"It's crazy that I live in Canada, but now I'm looking at having to sell my house for coverage of my medication."[1]
[1]http://www.cbc.ca/news/canada/british-columbia/a-tale-of-2-f...
> Helen Anderson, provincial lead for systemic therapy for the BC Cancer Agency, said that Ibrance is currently under active review for coverage in B.C.
There are several expensive medications that the Canadian health system has elected not to cover.
Here is another example where if the husband didn't have drug coverage through his employer, he would have been on the hook for the entire cost. Eventually he had to shell out $3,000 per month.[1]
At first, he says, his company insurance covered the price of the drug. But years later – Gary’s employer changed insurers and he was now on the hook to pay more than $3,000 a month.
[1]https://globalnews.ca/news/1654757/canadian-patients-struggl...
No, but if that's the standard, I'm fairly certain we can find a lot more "no insurance, couldn't get treatment at all" stories in the US than we can "Canadian needs unusual, not-yet-approved medication" ones.
> There are several expensive medications that the Canadian health system has elected not to cover.
You'll find the American medical system does the same.
https://www.mercurynews.com/2007/12/21/teen-dies-hours-after...
https://www.today.com/news/man-battles-health-insurer-drug-c...
All medical systems will have rules and timelines for approval of drugs and procedures. Sometimes they'll lead to unfortunate situations.
In the US, though, approval's just the first step. You might then have to scrape together the $6k deductible for your family's bronze plan. You might have to wait until next year to switch insurers to one who covers that particular med.
Covered in Canada? Maybe never. And that's one of the best drugs out there to treat that type of cancer.
I'm not arguing the US system is better than Canada's. Just calling out there are trade offs with single payer systems. If American's think they can move to a single payer system and keep all the bells and whistles they have now, they will be deeply disappointed.
And your 2nd link actually proves my point. The drug in the article is not covered in many Canadian provinces at all. The guy in the article is being denied the drug because it's not approved for his mutation. Most people with the correct mutation do get coverage for that drug (again, a new, state of the art drug).
Sure, but that's true in the US here, too.
No insurance? No med. ERs aren't gonna give you it.
Can't make your $6k bronze plan deductible? No med. Maybe you'll qualify for a patient assistance program from the drug company, maybe not.
> If American's think they can move to a single payer system and keep all the bells and whistles they have now, they will be deeply disappointed.
It's entirely possible to have a supplemental private health insurance system for the experimental or unapproved stuff. You can get private coverage for stuff like IVF in Australia, for example.
A lot of America's bells and whistles are already inaccessible to a large portion of the population.
> And your 2nd link actually proves my point. The drug in the article is not covered in many Canadian provinces at all. The guy in the article is being denied the drug because it's not approved for his mutation. Most people with the correct mutation do get coverage for that drug (again, a new, state of the art drug).
As the article mentions, the insurer approved their sibling with the same mutation for the same medication. Private insurance can be just as capricious as a single-payer's approval system.
Government-funded health care suffers from all the same economic problems that privately financed health care suffers from, and the government is just as corrupt as any private organization, plus there tends to be little incentive for efficiency, so government programs tend to be extremely inefficient and wasteful.
I appreciate (and agree with) your concern for the disabled, but letting the government be in charge is a recipe for making everything worse.
Except the biggest one: the need to maximize the extraction and distribution of profit to shareholders, while funding the cheapest and least amount of care possible without jeopardizing that imperative.
Except we have pretty much the entire developed world's healthcare systems to debunk that claim. They have similar life expectancies, medical outcomes, infant mortality, access to care, wait times, etc. for half the cost.
* 31st for Life Expectancy [1]
* 32nd in infant mortality [2]
* 5th for colorectal cancer survival [3]
* 1st for breast cancer survival [3]
* 19th for cervical cancer survival [3]
* 7th for heart attack mortality [3]
The actual numbers are reasonably close, but the cost is also about 25% more per captia [4] than the second highest-spending country.
[1] https://en.wikipedia.org/wiki/List_of_countries_by_life_expe...
[2] https://en.wikipedia.org/wiki/List_of_countries_by_infant_an...
[3] https://en.wikipedia.org/wiki/List_of_countries_by_quality_o...
[4] https://en.wikipedia.org/wiki/List_of_countries_by_total_hea...
People such as scientist Stephen Hawking wouldn't have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.
Forgive me while I laugh uncontrollably
https://en.wikipedia.org/wiki/Investor%27s_Business_Daily#Er...
> In July 2009, an editorial in Investor's Business Daily claimed that physicist Stephen Hawking "wouldn't have a chance in the U.K., where the [British] National Health Service (NHS) would say the life of this brilliant man, because of his physical handicaps, is essentially worthless." Hawking has always lived in the United Kingdom and receives his medical care from the NHS.
I don't have a view on who should pay for it, but there are only 3 categories of payers in healthcare: 1 government and 2 private (insurance and self-pay). The compensation is funded by one of those sources.
The crippling healthcare costs borne by individuals entirely consist of rent-seeking. It's also important to say that a lot of that money comes back out in salaries for the massive workforce required for the unnecessary administrative overhead, adding to the economy, and of course in non-imported luxury goods purchased by the rent-seekers themselves.
So, what is it that you are actually trying to say?
>Is there a reasonable alternative? I'm not trolling, but letting people die of treatable maladies doesn't seem like the right move.
I answered a tautological statement with a tautological question based on the logic the poster omitted.
Can you tell me who besides the government or the market (ie consumers) will prevent people from 'dying in the streets'? Perhaps by kidnapping another country's doctors and compelling them to provide care...
>I'm not trolling
Free primary and preventative care along with dental and vision, and have a government subsidized insurance program for hospital/long term illness coverage akin to the public university system (along with the in-state discounts).
And allow for a parallel private system to exist for those who want to pay more and get allegedly better treatment.
EDIT: This does appear to be inflation adjusted. Here’s a federal source which is definitely inflation adjusted showing funding increasing in real terms by 27% from 1995-2013. [2]
[1] - http://apps.urban.org/features/education-funding-trends/
[2] - https://nces.ed.gov/programs/digest/d16/tables/dt16_235.10.a...
[0] http://www.in2013dollars.com/1995-dollars-in-2015?amount=100
Many of the country's best schools are public, especially at the college-level.
If the government will not allow treatment and there’s no way to pay and you can’t leave the country, you’re finished.
If insurance will not allow treatment and there’s no way to pay and you can’t leave the country, you’re finished.
Side note: private health insurance, private healthcare facilities, and paying out of your own pocket are all possible in countries with socialized healthcare.
Alfie is going to die. He has no brain. He was being kept "alive" on life support. The hospital want to end this life support because it's in his best intersts to do so - there's no hope of treatment, and keeping him alive is likely to be keeping him in pain. The parents disagreed with this, and so it had to go to court.
This means there is legal representation for the hospital; for the parents; and independent representation for the child. This is because the child is a human and has rights and his best interests need to be kept in mind.
The parents have rejected the findings of the court, and have made many appeals. They've gone to appeal court several times, the supreme court several times, and ECHR[1] a couple of times.
All the courts agree: it's in Alfie's best interests to let him die, rather than rpolong his suffering when there's no hope of treatment.
Also, all the courts agree that Alfie's parents (and latterly his father) have been given terrible legal advice.
This is causing some consternation in US right-wing nutjobs.
Here are some, but not all, of the court hearings. I might have got the ordering wrong.
http://www.bailii.org/cgi-bin/format.cgi?doc=/ew/cases/EWHC/...
http://www.bailii.org/cgi-bin/format.cgi?doc=/ew/cases/EWHC/...
http://www.bailii.org/cgi-bin/format.cgi?doc=/ew/cases/EWCA/...
http://www.bailii.org/cgi-bin/format.cgi?doc=/ew/cases/EWHC/...
https://www.supremecourt.uk/docs/in-the-matter-of-alfie-evan...
http://www.bailii.org/cgi-bin/format.cgi?doc=/eu/cases/ECHR/...
http://www.bailii.org/cgi-bin/format.cgi?doc=/eu/cases/ECHR/...
An example of the terrible legal advice (from a non-lawyer too!)
---begin
On 12th April 2018 the father went to the hospital with some other people who included a foreign doctor and air ambulance staff. The father had a letter written to him by Mr Pavel Stroilov of the Christian Legal Centre which, we were told, is a campaigning organisation. In the letter Mr Stroilov, who we have been told is not a lawyer, purported to give the father legal advice. He said that it would be lawful for the father to remove Alfie from the hospital and take him to any other place he chose. The previous order made by Hayden J was said not to have circumvented "your parental rights".
The letter, which was disseminated on social media (presumably with the knowledge and consent of Mr Stroilov), stated that:
"as a matter of law it is your right to come to (the) hospital with a team of medical professionals with their own life-support equipment and move Alfie to such other place as you consider is best for him. You do not need any permission from (the) Hospital or the court to do so".
This letter was misleading to the extent of giving the father false advice. We have been told that it had the most regrettable consequences in that it led to a confrontation in which Alfie was involved. The Police had to be called. An application had to be made as a matter of urgency to Hayden J.
The letter gave false advice because the previous decisions made by the courts in this case have directly addressed whether the parents have the right to decide what should happen to Alfie. The clear answer which has been given is that the parents' wishes are not determinative. The court has also expressly decided that removing Alfie from the hospital as the parents wanted was "irreconcilable with (his) best interests" and that his treatment and care "shall" be given by this hospital. To act inconsistently with or contrary to the court's determination and order would be to act without lawful authority. This includes the hospital which would have been acting in breach of the court's order if they had permitted Alfie to be removed from the hospital.
All the doctors (even the Italian doctors) agree: Alfie Evans is going to die, and soon. What they're offering in Italy is exactly the same palliative end-of-life care that he'd get in the UK, but with the addition of a long painful trip.
Alfie Evans has had the benefit of world class medical treatment - in the US he'd have been killed by the insurance company a long time ago. He's also had the benefit of free legal representation to make sure his best interests (because in the UK and Europe the best interests of the child are what's important) are looked after.
Here's a ranty English lawyer: https://twitter.com/BarristerSecret/status/98919501104352870...
I don't even trust the market to create an efficient system.
I trust the market to be adjusted by the wealthy to further enrich themselves.
I also trust the government to be the one organized group of people that can restrain that market, to give the rest of us a chance.
It's a voice backed with $3.7 trillion in total economic value per year (18.x% of the $20 trillion US economy). In terms of size, it would just about be the fourth largest economy on earth, comparable to Germany.
There are millions of very well paid hands in that pot of gold, from doctors & nurses to scientists and pharma sales reps, hospital admin and insurance industry employees. Consider for a moment that US drug costs - the most notorious example of abuse in US healthcare costs - are about 10-11% of the total US healthcare expenditure, and our per capita spending is about 2x what it should be: ie nearly everyone in healthcare is partaking in the plunder. That makes for a very loud voice.
At this point socialized medicine could literally save US taxpayers money while also removing the need for health insurance.
It's not even that. "Sticker price" is simply the opening of negotations, sam as with any big-ticket purchase like real estate and vehicles and school tuition, and to a lesser extent airfare and hotel rates.
As with any high-overhead business with room for high-marginal-profit on units, they simply seek to maximize total revenue or at least cover costs. They don't care which customers pay how much.
My routine healthcare is not a big-ticket purchase and should not be the kind of thing I need to negotiate over. The total package between hospitals and insurers is, but my transaction is not.
What numbers are published can be haggled over in future laws.
But the requirement for some numbers to be published is a big win.
FWIW, the move to digital health records was basically realized through Medicare demanding it. Providers can't afford to go without Medicare payments; like Texas and California, so goes Medicare, so goes the market.
It would be refreshing to have a conversation with someone who holds such a position that was willing to say that hospitals should turn uninsured and poor people away at ERs and let them die in the streets. Its at least more honest.
You won't ever hear them suggest people should die in the streets - why that'd be just unhospitable!
They'll instead say - "why don't they have insurance? Why don't they get a job so they have health insurance? Why should I have to pay for people that don't feel like working when I go to work every day without complaint?"
If you suggest all the myriad of reasons the trapped impoverished don't have a job, they'll counter with "those are obstacles to getting a job, sure, but it's not impossible."
If you point out that many people have jobs that don't offer health insurance, you'll either get a sarcastic reply about Obamacare, or the question "why don't they just get a better job? Why don't they go to night school and get a degree?"
Empathy has been replaced by the desire to be infallible in debate.
Take a non-strawman like Paul Ryan, who is in every way a typical Republican, and his proposal is not to abandon Medicaid, but to make it into an Obamacare-like system whereby people are provided subsidized insurance.
Ah, Paul Ryan.
>There’s nothing inherently wrong with high-risk pools, but they have to be adequately funded in order to work properly because the people in them are so expensive to care for. Many states had high-risk pools before Obamacare was enacted, but they charged much higher premiums than normal and excluded coverage for certain services. The federal government also had a high-risk pool temporarily, but it grew too expensive and had to cap enrollment. According to some estimates, the $10 billion a year allocated in the AHCA would still not be enough.
https://www.theatlantic.com/health/archive/2017/03/the-bigge...
> Unless the amount of the credit is linked to the cost of coverage comparable with what people received under the Affordable Care Act (and subject to indexing), it will represent a reduction in coverage (or higher costs if people want to "buy up"). If people will be reduced to buying catastrophic coverage, their deductibles may be larger, not smaller than they were under Obamacare policies. That's a step backward for many Americans, who complain that the deductibles are too high already. Moreover, depending on the differential between the credit for older and younger Americans, older people (who use more health care) may wind up paying more.
>Equally problematic is the use of health-care saving accounts in lieu of the subsidies available on the Obamacare exchanges. If working-class people do not have the extra income to contribute (albeit on a pre-tax basis), once again they will be worse off than they were previously.
> Without massive new taxes to pay for it, it's hard to deliver more coverage for less. In other words, Republicans promised more and are delivering arguably less than Obamacare does.
http://www.chicagotribune.com/news/opinion/commentary/ct-pau...
Then again this goes against my theory that socialized aid should come directly in the form of the thing needed - voucher for healthcare, food (or very specific food vouchers), rent free housing or vouchers for housing, rather than cash which is a bit silly to give to someone the government failed to give good financial education to (speaking from experience here...)
There's a reason theres a huge market for under the table financial management among the trapped impoverished.
It's a bit like assuming grocery stores must give away food to anyone or people will starve in the streets. In fact, there's other ways to get food to those in need.
The difference is that healthcare costs are so outrageous, that the "people who can't afford healthcare" bucket includes families solidly in the middle and even upper-middle classes. Which includes most of the nation.
But there is an issue in certain areas of people using ERs like a GP because the ER can't legally turn people away due to EMTALA
A lot of people seem to think ERs are simply required to treat everyone, which is not even close to true.
2. Charities. You can start your own: give 5% of your income to underinsured. For example:
http://www.philanthropyroundtable.org/almanac/hall_of_fame/j...
At the urging of Frederick T. Gates, perhaps his most trusted philanthropic adviser, Rockefeller became increasingly devoted to medical research. In 1901, he funded the Rockefeller Medical Research Institute in New York City. Modeled on the Institut Pasteur in France and the Robert Koch Institute in Germany, it was the country’s first biomedical institute, soon on a par with its European models. The results were dramatic. Within a decade, it created a vaccine for cerebrospinal meningitis and had supported the work of America’s first winner of a Nobel Prize in medicine. Today, known as the Rockefeller University, it is one of the leading biomedical research centers in the world. Twenty-four Nobel Prize winners have served on its faculty.
But don't force charity on others who may be struggling.
Having worked in non-profits extensively, it's also disingenuous to claim that non-profits answer to anyone other than their primary donors, whose priorities are frequently not aligned with regular people.
That's a shockingly high amount, especially if you don't get healthcare out of that.
16% of my taxes go to pay for my health care system, which covers the whole country. For someone on a median income that's 3% of their income. For someone on a top 10% income that's 4.15% of their income.
To spend 5% of your Gross Income on the NHS in the UK, you have to pay 31% in total taxes, that's an income of £75k, that's circa top 5% income.
2. Charity has had thousands of years to solve societal problems, yet it didn't. What you're describing is a pipe dream.
Within the span of a less than a century, countries around the world have addressed healthcare effectively such that care is available to most, if not all.
[1] https://en.wikipedia.org/wiki/Martin_Shkreli#Daraprim_price_...
I do believe that making hospitals publish their prices would be a good start. The first thing I think that would do is bring to light the difference in price between paying in cash versus using insurance. From there we could make arguments why the same service has a 10x to 100x difference in price depending on how or who pays for it.
Not everyone gets cancer, the medical insurance profit model is predicated on a bet that most people won't. The more people in the coverage pool, the less likely you will be paying out for every single person.
Socialized care is just the expansion of that model to encompass the entire country's citizen population. What would have been privately-captured profit from people that were healthy members of the pool can instead be used to reduce the premiums paid by all members of the pool.
Another example is eye surgery. Originally the procedure was expensive but now it is more affordable because it is not covered by insurance. Comparatively, plastic surgery is relatively affordable because it is not normally covered by insurance.
Reducing or eliminating health insurance would also eliminate a lot of the medical administrators that provide zero care but due incur a cost due to their salaries.
As far as getting rid of the profit motivation but capturing the profits and giving it to those without health insurance I believe that you would also eliminate any reason to innovate and create new drugs.
I will admit that if you got rid of health insurance tomorrow that there would be a lot of short term pain. But I also believe that in the long run people would be better off because they would be able to afford there healthcare.
Using a different example look at the cost of college. I believe that we could fix that problem one of two ways. The first way would be to get rid of government loans and grants. The other way would be to allow people to file bankrupcy for student loans. The first way would attack the problem by getting rid of easy money. Because easy money makes things expensive. The second way could work by shifting the risks of the loans from the student to the banks. The problem with this solution would probably make it harder to pay for degrees that don't pay well.
To summarize my arguments, cheap money makes things expensive and is destroying almost everything is this country.
Edit: added the college example.
- Compulsory basic insurance (private or public) (Switzerland)
- Private insurance + equalization pool (Netherlands)
- Compulsory HSA + government price fixing (Singapore)
- Socialized general coverage + private supplementary coverage (France)
I will admit that I have not read up on those countries healthcare plan but I think it is a lot more complicated than saying lets copy X countries plan. If you made a big change there would be a lot of second and third order effects that we would have to deal with and we may not like those out comes.
I could see California residents arguing why they should pay for the medical expenses of tourist.
We could point finger all day long about who is responsible but at the end of the day nothing changes. I think politics at this point is more about entertainment then anything.
I don't think anyone in the discussion thread is advocating carbon copying another country's healthcare.
I think that both we and everyone in this discussion can agree that what we are doing now is not working and is unsustainable. We are just arguing over the best way to fix it. I personally believe that easy (cheap) money makes things unaffordable where is seems everyone else wants to spend or devote more tax dollars to an already broken system. I would just like to fix the root problem and not the symptoms.
Are you suggesting that healthcare legislation should be drawn up in a vacuum? It's important to compare and contrast the benefits and pitfalls of other countries' systems. It's really all we have to go off of evidence-wise. It's also good to look at them for inspiration. There are a lot of different ways the public and private sector are being combined to make far more cost-effective healthcare systems than in the US. You are correct that some might not work in the US; that sort of reasoning needs to be weighed into whatever overhaul happens.
> I would just like to fix the root problem and not the symptoms
What are you suggesting as the root issue?
The main point to my arguments is that cheap money makes things expensive. Meaning is the government or somebody else subsides healthcare it will get more expensive. Because why not. Hospitals are trying to compete with other hospitals so they want the biggest budgets for paying the best doctors and newest equipment and technology. So why not charge just a little more then you need to get that. Then the next year comes around and the hospitals need more money so they charge just a little be more this year and it goes on and on.
You could probably start to fix things by making everyone publish their prices and charging the same price for cash as they would to insurance. From there things would start to unwind.
I would argue that rights are things that we declare by agreement as a group, not physical objects or measurable qualities. Of course healthcare is not currently a right; we haven't made it one. The question is: "Should healthcare be a right?"
Too much could be written about this argument but to me a right can't be provided by someone else's labor.
Now that I think about it, a right is also something that can't be taken away. No one should be able to prevent your free speech (1st Amendment), defend yourself (2nd Amendment), or violate your privacy (4th Amendment) without due process.
In this case no one is preventing someone from being able to care for themselves. We are just arguing over who pays for it. It is probably a bad example but everyone has the right to use the roads for transportation. We just don't have the right to the car, insurance, and gas.
Edit: Added more comments
https://en.wikipedia.org/wiki/Negative_and_positive_rights
You're also touching on the difference between Natural and Legal Rights.
You can't have rights without guaranteeing action. My right not to be tortured requires all sorts of individual and societal interventions in order to fulfill. There's no classification of rights into positive/negative and certainly no difference in validity between the two.
Even the Singapore model (which looks capitalistic on the consumer end) relies on huge amounts of government price-fixing on the hospital side of things.
(I guess more so in areas where freestanding urgent care is a less interesting investment)
There's even hospitals that provide urgent care style care (and billing!) in their ERs, undermining the argument that this isn't viable.
In fact it's really the opposite; it takes extra money from those who can't pay (the uninsured) and gives it to those who can (the insured), because it's the insurance companies that negotiate the lower rates.
If you're uninsured and rich, well, you're paying sticker price and making the hospital very happy.
If you're uninsured and somewhere in the middle, you could be helped by the hospital, you could be screwed, really depends on the hospital.
Private insurance companies pay more than Medicare/Medicaid on basically all procedures. The price they negotiate is lower than the list price of a procedure, but remember, these sticker prices are hugely inflated. Hospitals will often raise the list price to renegotiate higher prices with insurers. In the end, I would suspect it is largely private insurance providing extra income for the hospitals (more common than cash patients, and they pay a greater % of the list price than Medicare).
Here's more info: https://www.nbcnews.com/health/health-care/hospitals-highest...
edit: forgot to add the link.
I don't know where you get this. In my experience nobody who advocates for socialized healthcare is under this impression. They know how the system works, just don't think it's an efficient way to run it (it isn't).
The way the incentives are structured on the American healthcare system now are beyond ridiculous and having public published prices is a way to start a much needed debate about the underlying issues, with data and facts instead of political viewpoints.
It's absurd that having a baby in an average facility in the US "costs" five times more than a private hospital in Switzerland. I put quote marks on cost because that's usually billed price and insurance tend to negotiate down, so in reality is more like twice the cost, but still absurd at any level.
Did you misread? I said that many that are against socialized healthcare don't realize that wealth redistribution is already happening in the American system.
Exactly this. The numbers that hospitals bill are largely fictitious compared to cost of care. What a lot of people don't realize is that hospitals use inflated billing from paying patients to cover the costs of uninsured patients that the hospital is required by law to treat in the ER.
A lot of people against socialized healthcare don't realize that the system still takes extra money from those that pay and gives it to those that can't--just through hospital billing.