Comment by nickpp
2 days ago
Any system needs a resource allocation algorithm.
In capitalism it is easy and transparent: price, with the side effect of aligning society interests with those of the selfish individual.
Of course the strange and heavily regulated US health-care system is obviously far far away from a free market.
In socialism it's much more random: black markets, lists, lotteries, friends and network of connections. The side effect is that the most productive individuals are discouraged and punished, with the whole society lagging in effect.
Case in point: the EU that started lagging the USA so much in growth that ended up having to beg for basic defense when a blood-thirsty neighbor came hungry for land.
When I'm unconscious in an ambulance, I'm definitely in a position to appreciate all that price transparency the free market has provided, so I can rationally weigh up all my options calmly and objectively while my organs are shutting down.
The great majority of health care is not emergency health care. Actually, the fact that emergency health is so expensive is quite the incentive for preventive medicine. And for the rest, insurance is necessary. Like for house fires or floods: I get the insurance but I also check my wires and pipes regularly.
Calling the american healthcare system easy and transparent is insane.
Theory:
> In socialism it's much more random: black markets, lists, lotteries, friends and network of connections. The side effect is that the most productive individuals are discouraged and punished, with the whole society lagging in effect.
Evidence: the vast majority of European countries who have socialized medicine and seem to be doing fine.
> the vast majority of European countries who have socialized medicine and seem to be doing fine
You do realize that the "vast majority" of European countries doesn't mean highly developed Western Europe, right?
Here in Central and Eastern Europe (where I live) socialized medicine is not "fine". You should visit some hospitals in Bulgaria or Romanian to get a more complete picture. We pay the state outrageous insurance costs every month then go and pay out-of-pocket in private hospitals when we actually need them.
My point remains that there are plenty of thriving countries with socialized medicine, so socialized medicine _per se_ is not the problem.
>>In socialism it's much more random: black markets, lists, lotteries
>Evidence: the vast majority of European countries who have socialized medicine and seem to be doing fine.
That evidence of socialism working well, only works as long as there are enough resources to cover the needs of most people, basically some of the wealthier European countries.
But when those resources become scarce due to poor economic conditions and/or mismanagement, then you'll see the endless queues, black margets and nepotism running the system.
Evidence: former European communist countries who experienced both systems and where in some, nepotism to bypass lists still work to this day.
I think the 2024 Economics Nobel disproves this. It showed that nations with strong institutions create wealth - and it was a causative link they proved, not simply correlation.
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Can't think of a socialist country, but invite you to visit the German system. Significantly less costly for society and objectively better for the people falling ill (or just having a baby born).
And no, no lists, no lotteries or any of that other lies the conservative US media is spewing out to keep the masses pacified.
I strongly believe, that if US citizens were to experience German healthcare for a year and having to go back to the US system, that there would be riots. Because I don’t think anyone with first hand experience of both systems would ever want to return to the US system.
Yep, loving my gesetzliche Krankenkasse (public health insurance, which is more like "highly regulated insurance"), even more than I liked the Privatkrankenversicherung (less highly regulated, but still with better guardrails than a lot of things I've seen in the States) I was on my first decade in the system here. Sure, there are some specialists who won't accept it, or who will give you a sooner appointment if you're private pay, but in that situation, you have the option of declaring that you're a self-payer that quarter, and your public insurance will reimburse in the amount they normally would have for that procedure or exam. For things like an MRI, the full retail cost in Germany is still much lower than in the US (it was about 600 EUR for my back a few years ago, while I was still privately insured, and I still had to wait for reimbursment).
Even once I do hit the income threshold to switch back to private (switching back to fulltime work), I'm pretty sure I won't.
As far as doctor choice goes, I feel like I have more on the public insurance here (like 90% of the population) than I did with UHC in the early 2000's back in the US. I certainly have fewer financial surprises.
No lists? Have you ever actually lived in Germany and had to interact with its’ healthcare system?
Healthcare in the US seems to cost about double per capita what it does in other developed countries with universial/social healthcare. Public spending in US is on-par with others, and then private spending is that much again. Standard of healthcare I've heard (and would hope) is world class if you can pay, but still something seems broken there to be sure.
But you have lists, queues, lotteries, whatever you call it. That's not a lie. The fact you think lists are a vast right wing conspiracy demonstrates your government is not really forthcoming about your healthcare system. There are lists everywhere. There are ambulance wait times, hospital emergency wait times, various levels of urgent and elective treatment wait times. There are procedures and medicines and tests that are simply not covered at all.
Now, obviously USA has queues and lists too. And I could be wrong but I'm sure I've heard that US private insurance companies are notorious for not covering certain treatments and drugs as well. I don't know what it is exactly these right wing people are saying about healthcare, I thought they did not like the American "Obamacare" though.
>And no, no lists
There definitely are lists. You don't just get the surgery or therapy you need the next day. You get the next free slot in the list of people queuing at the hospital/practice that still has free slots.
For example the first appointment you can get at my state funded therapist if you call today, will be in june. How is that "not a list"?
Or like, if you call most public GPs in my neighbourhood, they'll all tell you they're full and don't have slots to take on any new patients and you should "try somewhere else". How is that "not a list"?
There are multiple lists here in the NL. I called for a surgery and got put on the fast list (she said that if it weren’t urgent, it would be over a year wait). Your doc has a lot of influence on how urgent things are and how far you are willing to travel. I got in to see a therapist in a matter of weeks, because I was willing to travel out of the city; otherwise it will be months. The doc can see the lines and give you recommendations; all you have to do is ask to be seen sooner.
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That's the difference between a corrupt and non-corrupt system rather than a capitalist vs socialist one. Nearly all European countries have an at least somewhat socialist healthcare system but in most you don't have to resort to those tactics.
Humans have tendency to become corrupt
the market / capitalism won’t correct itself, much people want to call it God/ perfect
Regulation, anti-trust laws try to correct somethings but many politicians are against those things because they limit the profit that can be made, profit first, that’s the corruption