If you think our current system doesn't have rationing, I'm not sure what to tell you. "Long wait times" are one way to ration care -- but equally effective is just denying 30 million people the ability to get any care at all due to unaffordable insurance and ruinous costs for any 'touch' with the system. Another effective way to ration care is to make routine things so expensive that people self-select out of receiving care or filling prescriptions even when they are insured.

Literally the entire point of copays and other forms of cost sharing is to 'ration' healthcare by reducing demand. There might be health insurance out there without cost sharing, but I've never seen it and it's certainly not the norm in the US.

Is having 41% of adults in America in debt really worth "innovation" for the rest of the world?

And what exactly is "rationing" - I bet almost every adult in America knows someone (or is that someone) who has delayed going to the doctor/for a procedure (or just never got it entirely) because of how much it is going to cost? Doesn't the inability to even get the required care due to the cost really count as "rationing" in the system we already have?

We already have rationing. My (expensive FAANG-funded) health insurance said no MRI without 4 weeks of PT.

Yes, technically I could pay the couple thousand dollars out of pocket, but in most socialized health care systems you can do that as well.

Is this just sarcasm? Rage bait? Are you out of touch? Poor people already ration care. I experienced it first hand working in a grocery store. God forbid you got hurt or sick because you'd be losing work days aka income. Then you'd be eating less or borrowing money or skipping a few medications. But, sure, socialism in healthcare * like every other developed economy* will stifle innovation.

U.S. healthcare underperforms in most verticals. High cost is the primary reason that prevents Americans from accessing health care services. Americans with below-average incomes are much more affected, since visiting a physician when sick, getting a recommended test, or follow-up care has become unaffordable. https://www.commonwealthfund.org/publications/issue-briefs/2...

It’s already rationing with a different mechanism that you personally prefer

I don't think "The Atrocious American Way of Doing Healthcare" and "Rationing" are the only two options available.

Also, note that 63% of the people in debt are already literally rationing.

"Cut spending on food, clothing, and other basics" - 63%

idk. Most innovation in the field of medicine comes from research in universities, which are pretty socialized for the most part. The workers that are doing the innovation are also educated in a mostly socialized learning system. And there are plenty of economies with mostly socialized medicine that do plenty of innovation (including the USA). So I think your fears of collective funding of important institutions are unfounded.

The commonly accepted definition of innovation is the practical implementation of ideas that result in the introduction of new goods and services. So while the ideas may come from research in universities, I struggle to think of examples of practical implementations resulting in new goods and services. Do you have any examples?

I'm no socialist, but you can actually have a system of government health insurance but keep private healthcare. Or basic free healthcare (government run hospitals/clinics) and if you want better, pay out of pocket for private.

For example, in my wife's home country, she give birth in an awesome private maternity hospital for about $2k out of pocket for everything. I mean everything. But if we wanted, she could have done it in the government run hospital for $0.

> you can actually have a system of government health insurance but keep private healthcare.

This is what we currently have in the US. In fact, the US government is the largest healthcare insurer in the US (through Medicare and Medicaid) [1].

Interestingly, economists have found the US government becoming a healthcare insurer substantially increased US healthcare prices. For example: "Finkelstein estimates that the introduction of Medicare was associated with a 23 percent increase in total hospital expenditures (for all ages) between 1965 and 1970" [2].

It turns out making healthcare "free" to certain people caused them to demand more healthcare. Higher demand caused higher prices. Congress "didn't consider the effect of the increased demand that Medicare set off." [3] Now healthcare prices are high AND Medicare/Medicaid is being paid through deficit spending.

If we want to solve the problem of unreasonably high prices for healthcare, and the debt that causes, we can't keep doing the same thing and expecting different results. We need to fix what we've broken with the healthcare market so it can operate like markets do and find a fair price.

[1] https://www.trillianthealth.com/insights/the-compass/the-gov... [2] https://www.nber.org/digest/apr06/medicare-and-its-impact [3] https://reason.com/1993/01/01/the-medicare-monster/

can you elaborate on the "rationing" part? I'm guessing you tied "socialist" and "rationing" together, but did you do it in the context of other developed economies (i.e most of Europe?)

He prefers healthcare to be rationed according to the amount of money they have instead of the amount of need.

For all the downvoters - this was also on the front page: https://news.ycombinator.com/item?id=31767347

Downvote away though :p

Go ask any law enforcement officer, fire fighter, or EMT how many times a week they hear "please don't call an ambulance, I can't afford it" and the answer will be so depressing that you may change your tone about this.

Fun fact about the US's system too - even when ambulances are called for things like heart attacks -- they take much longer to show up in poor areas compared to wealthier ones;

https://jamanetwork.com/journals/jamanetworkopen/fullarticle...

There are some common agreed upon thresholds that strongly correlate with positive outcomes, e.g. 15 minute response time after a heart attack. In wealthy areas, this outcome was achieved 97% of the time vs. only 93% of the time in poorer ones. That doesn't sound too bad, but that means you were something like 230% more likely to miss that cutoff if you were in a poor neighborhood. But at least it's not "socialist".

No point arguing with people about this, they believe those who can’t afford it are in that situation because of personal moral failings

My friend who lives in the USA had to deliver her own baby in a hospital hallway because all the rooms were full and the doctors were too busy to tend to her.

The hospital still sent her a $30k bill for the delivery.

Yes, I will always vote down comments talking about down votes, and the comments they reference, regardless of what they are talking about.

Comments talking about voting (including this one) are worthless, and deserve every down vote they get.

So I guess we need to down vote you? And you need to down vote me?