netcrusher88 wrote:A problem suspiciously unique to the US.
It's because the US system is fancy.
Seriously, that's it. Quality of care delivered is higher in the US, but we pay out the nose for those tiny improvements.* We already routinely get ranked for best preventative care in the world- but that increases costs overall. We tend to have the widest adoption of new gadgets (once the FDA approves them), and those tend to be expensive.
Say what you will about whether or not there should be the few percentage points that go to profit, but it should be repeated that it's only a few percentage points. Eliminating the profit from the system will not make our system as cheap as European systems: that's only possible with a decline in quality.**
*Actually, it seems to be the case that health outcomes are roughly independent of the amount of money thrown at them- for most things, modifying the patient's lifestyle is more effective than treatment. But the system doesn't get paid when you exercise, and does get paid when you take pills or get your fat cut out of you. A system forced to work on the cheap could come up with clever, effective solutions that a system with the wrong incentives doesn't.
**This isn't strictly true: you could have a technological improvement that only affects the US system, or there might be enough policy and procedural changes you can do to make the US system cheaper. Consider a half example: we could get rid of or severely limit malpractice liability, which would both get rid of the payouts to the sufferers of accidents and negligence (paid for by everyone thanks to insurance instead of just the sued doctors***) and the massive costs of defensive medicine. I call this a half example because 'quality' would go down- people would probably be just as healthy, but wouldn't have the peace of mind / payouts to compensate for their suffering.
***Fun stories from studies: quantity of accidents is pretty much unrelated to number of malpractice lawsuits; the tone the doctor uses is enough to predict their malpractice cases with good accuracy. People only sue doctors they don't like, even if that wasn't the doctor that made the mistake.
elasto wrote:Healthcare, like road building, the military etc is too important to be paid for by the private sector. It can't possibly be done equitably. It needs to be done through taxation to pool the risk and share the cost fairly.
Emphasis mine: that word is a sticking point. Wanting something isn't deserving it.
Lazar wrote:I have yet to see a safety net provided by the market. Some people don't have money for education, work low-paying jobs, get laid off from those jobs, and are left to die of treatable illnesses.
The market provides both insurance and charity. But you are right that the fundamental activity of a market is trade
, which requires each person have something of value to add (noting that beggars provide a service that has a supply and demand like other services).
Lazar wrote:In my mind, one which provides people with the equivalent of a living wage (i.e. enough to maintain them at the poverty line, including such necessities as health insurance) when they're unable to receive that from the market.
Living wage and poverty line are both very ill-defined amounts, and if you include health insurance then we're got unlimited
exposure. If we say "ok, normal people should be able to live on $12,000 uncomfortably, let's give everyone $12,000 a year paid out of taxes on income" that will only take care of normal people. People's medical costs can go into the millions- and so we have to answer the tough question of "should only the people who put aside money use to treat expensive conditions get their expensive condition treated?" For most of history, the answer has been yes. If we try to make the answer "yes" in America now, we have to give up other things to do that- and it's not clear to me those other things are worse than this. If you had to choose between universal health care and fighting climate change, for example, which would you rather have? And that's a real choice, since the money is coming from the same place.