Socialize what part of healthcare? Canada generally doesn’t have socialized healthcare providers, only socialized insurance. So providers could still engage in these sorts of billing practices in the Canadian system. Conversely, whatever rules prevent such billing practices in Canada could be applied in the US without socializing anything.

The concept of “socializing the health system” papers over the really important issues. Countries with universal healthcare don’t actually have a uniform system. They all have quite different systems. The Netherlands, for example has private insurance and private providers. The U.K. has no insurance and public providers (doctors work for the government). Other countries have various things in between. Single payer, like Canada has, isn’t even the most common system. Overlooking these distinctions means you may not fix the relevant problems. You can “socialize” insurance, but if you don’t impose controls on billing it’ll just be a different entity being overcharged.

> Socialize what part of healthcare? Canada generally doesn’t have socialized healthcare providers, only socialized insurance. So providers could still engage in these sorts of billing practices in the Canadian system.

The NHS is going to tell them to get bent, that they're paying the agreed upon price for the act and don't care about the rest of their bullshit, and if they're not happy with it they can close their office.

> Conversely, whatever rules prevent such billing practices in Canada could be applied in the US without socializing anything.

It's not "whatever rules". The NHS can negotiate prices and is interested in balancing keeping costs down with having providers.

Not only is this not a thing which can be "ruled", Congress (the GOP) has literally willed away the one lever the US Government has to do this: the Secretary of Health and Human Services is legally forbidden from negotiating prices on Part D prescription drugs.

And even then that'd only be for Medicare itself (though HR3 intends to not only reverse this but makes this negotiation a binding MSRP): the VA can and does negotiate drug prices, but that doesn't benefit people who are not under VA.

In a single payer system, the single payer in question has both incentive and leverage.

> The NHS is going to tell them to get bent, that they're paying the agreed upon price for the act and don't care about the rest of their bullshit, and if they're not happy with it they can close their office.

The Canadian system has socialized insurance plus price controls. But those are two separate things—you can have one without the other. The Swiss system, for example, has price schedules, but not “socialized” medicine.

As to drug pricing: you’re repeating FUD about Medicare. What should clue you in that this is FUD is that, for the most part, Medicare itself doesn’t cover prescription drugs. (Only drugs you get during a hospital visit.) Prescription drugs are covered by an optional program called Medicare Part D, which is provided through private insurance. So yes, the Secretary of DHHS isn’t permitted to negotiate prescription drug prices for Medicare. That’s because that’s the role of the Prescription Drug Plans under Part D. The private insurance plans that are offered under Part D do negotiate drug prices. See: https://fas.org/sgp/crs/misc/IF11318.pdf

> Determination of Drug Prices in Medicare Part D To bolster market competition and limit the federal role, the MMA included a non-interference provision (Social Security Act (SSA) §1860D-11(i)), which states that in carrying out the requirements of the Part D program, “the Secretary: (1) may not interfere with the negotiations between drug manufacturers and pharmacies and PDP sponsors; and (2) may not require a particular formulary or institute a price structure for the reimbursement of covered part D drugs.”

> Part D sponsors, working with pharmacy benefit managers (PBMs), negotiate prices with drug manufacturers and contract with pharmacies to dispense drugs to plan enrollees. Negotiated price concessions mainly take the form of rebates (after-sale reductions) from a manufacturer’s list price for brand-name drugs.

I am in Quebec and here the state sets the rate for every single reimbursed act. Doctors can opt out of the public system, but then they can't take any reimbursement from it at all. It's all or nothing. Needless to say that the overwhelming majority of doctors opt to stay in the public system.

I assume it's similar in other provinces and therefore your premise is mostly wrong.

It's called a Medical Cartel run by Physicians through regulatory capture. There's plenty of leeches upstream (pharmas, hospital admins, PBMs, vendors, you name it), but at the base of the funnels are doctors holding keys to supply through state-level licensing regulations.

Physicians are in an incredibly privileged position.

In no other profession can one murder a quarter million Americans annually(1) via chart reading apathy or gross incompetence at multiplying by 10, and not only keep one's job, but get paid for rendering the botched services, as well.

Imagine being a plumber who gets paid after making your customers' leaks ten times worse. That's the life of every doctor in the US.

1. https://www.ncbi.nlm.nih.gov/pubmed/28186008

Literally this - doctors are gatekeepers and are paid handsomely for it.

Don't know why you're being downvoted... this isn't wrong, just unsavoury.

It’s not irrational. Europe spent decades in economic doldrums before the Thatchers and Merkels and Blairs forced reforms and liberalization. The US largely avoided that. (Though, we’re still stuck with the legacy of FDR, and in many respects Europe is overtaking is on economic liberalization and deregulation.)

As to ACA, it’s a step toward what’s basically the Dutch or Swiss healthcare model. We don’t need to socialize insurance or healthcare services to have a workable system.

The Thatcher years in the UK really weren't anything that special when it came to GDP growth:

https://www.economicshelp.org/blog/2688/economics/data-on-ec...

What they did do was a huge move towards financial services and away from manufacturing - and we all know how well that turned out....

> Europe spent decades in economic doldrums

Is that so? By whose standards? Europe is doing fine across the board. There are fewer billionaires but at the same time we don't have medically induced bankruptcies.

> We don’t need to socialize insurance or healthcare services to have a workable system.

You probably do. Simply because disease is distributed randomly (or actually: worse than randomly), unlike wealth.

I could see the case for Blair being a reformer and pushing an agenda of liberalization, much less so for Merkel and Thatcher left the UK in much worse state than she found it even though somewhere in the middle of her rein things were marginally better.

Whose healthcare did the Republicans decimate? People get worked up any time the system changes (e.g. Obamacare caused some people to lose their health insurance plans and in-network doctors); many Democrats were voted out of office after the passage of the ACA. The Republicans realized that and (narrowly) chose not to repeal Obamacare.

The point is - in case that isn't clear yet - that both Obamacare and whatever is the current flavor of the month are both absolutely terrible for the voters and yet they continue to self-flagellate in spite of there being many examples of properly run healthcare systems.

We have unemployment, Medicaid, social security, workman’s comp, social healthcare won’t be any different.

I’m a doc.

Chronically underfunded with taxes going up repeatedly beyond what was initially promised?

Why is that a good thing?

That sounds similar to indentured servitude.

EDIT: I misread the “here” as “Canada”. The US healthcare system has caused me some personal hardships, so I was surprised Canada had something similar. Luckily it’s more sensible.

the second "here" in the Canada sentence is referring to the USA, so the poster is saying it is a bad thing.

> Why is that a good thing?

It (the US version) is not a good thing, correct.

The U.S., through employer-provided private healthcare, has not just wage slavery, but pseudo medical-slavery. If you quit your job (In the U.S.), you lose health your employer-provided health insurance and could be stuck footing the $28k bill (or at least having to negotiate / deal with it) for a sore throat.

Canada does not have such a system. Canada has taxpayer-funded healthcare. Therefore you have the liberty to quit your job and find more favourable employment without having to deal with the risk of one surprise hospitalization from bankrupting you.

GP is saying Canada did that right. The confusion arises because GP said "here" right after praising Canada, possibly misleading you to think they were referring again to Canada, which they were not.

Why is what a good thing?

I was referring to the non-transferability of health insurance in the USA; e.g. you get fired at Microsoft or anywhere with great healthcare and that is only extendable temporarily via COBRA. Then you either have to find another job or get insurance through one of the Obamacare exchanges. What I am arguing is that this reduces the mobility of labor.

Also as someone who has switched jobs in the last year setting up new insurance/dentist/optometrist multiple times is a absolute waste of my time and would be entirely eliminated if we stopped tying insurance to the employer.

Our current system puts a huge time burden on healthcare "consumers" despite being vastly more expensive than any remotely similarly-effective system. This time burden falls largely, though not entirely, on the sick and their families. It's straight-up inhumane, given it's clearly not necessary.

It sounds to me like you are agreeing with the post you replied to, then ... which was confusing.

He is asking why is it good for the workers. You're basically advocating for price controls on one field. How would you like if you were only allowed to make $30/hr for writing code?

We already have massive shortages of doctors (and nurses, I think). This will only make it worse.

We don't have massive shortages of Doctors, we have shortages in locality. The same places where there is joblessness (think Apalachian Mining towns), you find a lack of doctors.

There's no shortages of doctors, or nurses in major cities.

https://www.google.com/search?q=doctor+shortages+usa+appalac... provides a bunch of links if you want to dive into this topic further.

AFAIK every single other OECD state has explicit or de-facto (via monopsony) price controls for much of the healthcare sector. Hell, even non-OECD free-marketer-beloved Singapore does.

I would, no kidding, love to see any example of a successful, modern healthcare system that doesn't employ price controls to keep costs from getting out of hand. Allowing "successful" and "modern" to describe the system in the US, it's the only one I know of that doesn't.

You didn't answer the question though. You just went with "well, everyone else does that".

... which means you can go look at them to see how it's working out. Again, I am legitimately interested in learning about any healthcare system in a state with an advanced economy that doesn't employ price controls in one form or another, but in the meantime, instead of spitballing about what a disaster it might be, we can just look at, AFAIK, literally any other such state to see how it works out. Dozens of examples.

> You're basically advocating for price controls on one field.

I'm not advocating for anything; it wasn't my comment. I just couldn't be sure what the poster was referring to, as the original comment was convoluted.