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Comment by AndrewDucker

8 hours ago

Or you could have universal healthcare. Which everyone else seems to manage and would untie a lot of people from specific jobs.

Abortion is currently too divisive in the US to get a national health care system going. One side will absolutely refuse to include it and the other will absolutely require it. If one side brute forces it there will be immense backlash.

Along similar lines it isn't clear that having the federal government controlling healthcare at a more fundamental level is a good idea. Many (most?) would shudder at the thought of this administration controlling healthcare.

Other places can only afford universal healthcare to begin with because their healthcare sector is not nearly as corrupt or shackled by a huge amount of government regulation that was only put in place here for self-serving reasons. It's not about the model of provision, it's about whether the sector itself is sustainable. U.S. healthcare is doomed by its vast spiraling costs even after controlling for its supposedly higher quality.

  • >Other places can only afford universal healthcare to begin with because their healthcare sector is not nearly as corrupt or shackled by a huge amount of government regulation that was only put in place here for self-serving reasons.

    coughs in Ukrainian

  • > healthcare sector is not nearly as corrupt or shackled by a huge amount of government regulation

    Healthcare is not corrupt. Insurance companies are corrupt.

    And regulation is lacking in Health Insurance and enforcement is lacking in healthcare. (So many doctors that have committed malpractice just switch hospitals.

    > U.S. healthcare is doomed by its vast spiraling costs even after controlling for its supposedly higher quality.

    Healthcare costs are high because of insurance companies and private equity, not doctors and hospitals.

    So please stop with these right wing baby bird food regurgitation.

    • > Healthcare is not corrupt. Insurance companies are corrupt.

      There’s a crazy amount of corruption in the healthcare space. Some of the medical fraud busts that come out every year have staggeringly large sums attached. In some areas there are still schemes that openly recruit poor people to use their information to bill for medical care that is not actually necessary or provided. It’s wild.

      > Healthcare costs are high because of insurance companies and private equity, not doctors and hospitals.

      Sorry, the world isn’t so simple that you can pick your villains (insurance companies and private equity) and declare everyone else to be free from blame. There’s a lot of bad behavior in these systems at every level. Yes, including some doctors.

      If we removed insurance overhead entirely, your healthcare costs wouldn’t change more than a few percent. It’s amazing that everyone united against insurance companies as the cause of high healthcare costs when they barely take a few percent of the overall spend.

    • > Healthcare costs are high because of insurance companies and private equity, not doctors and hospitals.

      It is actually the opposite.

      UnitedHealth, one of the 'worst' insurers in terms of denials, has a profit margin of ~5% [0]. It is mainly the providers that overcharge, under the guise of "the less and lower we bill, the less and lower insurance pays us".

      Insurance only works if there is at least as much going into the pot as is going out. What do you think would happen if insurances weren't denial hawks?

      Get angry at your doctor for overcharging you whilst using insurance companies as the heel.

      [0] https://www.macrotrends.net/stocks/charts/UNH/unitedhealth-g...

      1 reply →

    • > Healthcare is not corrupt. Insurance companies are corrupt.

      ¿Por qué no los dos? Guess what, it's a lot more likely that insurance companies will go corrupt if what they interact with - healthcare - is corrupt.

      > private equity, not doctors and hospitals.

      Guess what is limiting private equity's ability to compete amongst themselves in expanding the effective provision of healthcare and driving costs lower for the ultimate stakeholders i.e. patients? That's right: doctors, hospitals (including those that are nominally not-for-profit, but where the profits just turn into salary for those who can control that flow of money) and government regulation throughout the sector.

I can't think of any credible reason not to have universal healthcare at this point.

Maybe 20 years ago but there is too much empirical data across multiple countries and environments now.

Assuming our cost for care drops commiserate to what's been seen in other countries we could use the saving to increase merit scholarships for the contributing young as a introductory form of UBI.

> Or you could have universal healthcare.

No, they could not have, based on the voting records of the previous 30 years of the federal US Congress. Even what they have passed only by the skin on their teeth.

The only federal wealth redistribution policy in the US in my lifetime of almost 4 decades only had a 6 month window of passing in 2009. And half the population still hates it, and has worked and succeeded at gutting major parts of it.

Even better you can have both like a lot of countries in Europe. The access to public healthcare also keeps the premium down. Extensive cover for a family of four is less than 200 in Spain a month out of pocket.

  • Actually in Spain Social Security is 30 to 40% of what you earn. From the remainder 60% it is up to 50% in IRPF taxes, so you could pay 70% of what you earn.

    The trick is that Franco hid the social security tax in the company side so normal people don't see it, but it is there.

    Over that there is IBI for your house, there is IVA on anything you buy, and there are central bank inflation taxing anything you own in absolute terms.

    • Europe always overcharging and underdelivering.

      I am forever thankful for the Socialism that allowed me to get a degree for $3k, though.

      The downside is of course over-enrollment but at least the bartenders didn't come out $50k into debt. I hear it is different now.