What will it take to get universal healthcare in America?
I grew up under what most Americans call socialized medicine. It worked. It never didn't work. Moving back to America after many years (born in US), I never knew about for-profit medicine. Fast-forward to now and I cannot believe we are the only country in the developed world without it, especially now.
What would it take, realistically, to see this happen, and is it even possible with the people in office now (including incoming POTUS)? I think that the various medical lobbies are simply too strong, which is one reason why I would dearly love to see lobbying made illegal. Term limits would be nice, too. We need fresh blood often enough. I was very much hoping to see Bernie Sanders get the nomination, and I believe he was sabotaged because he represents the working man and woman and hated the corporate elitist system (I could be wrong). Am I naive here in wishing for this? Maybe a starting point could be no-cost healthcare for all children. As a parent, I cannot tell you how expensive children are, and their healthcare, too, and my children have some issues. I dread hospital visits. The bills come for donkey's years, even after a single visit. Something has to give.
Edited for grammar.
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[ 2.7 ms ] story [ 59.7 ms ] threadIf you wait long enough...
* There will be universal healthcare
* The police will not be permitted to use deadly force
* Landlords will not be able to evict tenants for any reason whatsoever
* Colleges will not be able to discriminate based on aptitude or demonstrated performance
In short, if you wait long enough, all the "wants" of the Left will be achieved. It will happen whether Republicans or Democrats are in charge, but voting in Republicans slows down the process just a bit.
https://slatestarcodex.com/2020/04/20/the-amish-health-care-...
https://www.reddit.com/r/PoliticalHumor/comments/glco4u/2040...
https://external-preview.redd.it/soNxegi7UWdcVDUWYf_WcSI8SXe...
And if you really dig into it, modern healthcare, regardless of who pays for it, is a scam. They harm nearly as often as they heal. By many accounts, medical error is the 3rd leading cause of death in developed countries. Prescription opiates in the US were blamed for the recent reduction in our life expectancy. Statisticians (good ones, at least) will verify that the 20th century leap in life expectancy was primarily due to hygiene (distantly followed by antibiotics). All of the other interventions are noise in comparison.
Don't even get me started on oncology. Ivan Illich wrote a book decades ago detailing many of their swindles. Most of it still rings true today.
The only way we can have true progressive/social democratic policies in the US is if that half is no longer a part of the country and no longer able to sabotage attempts to implement those policies when they gain power.
Right now, both "sides" agree that costs are out of control, but generally disagree on what reforms to make. This is the case for many other subjects in politics - the sides might agree with the problem but disagree on the cause or solution.
I think the system has stopped really listening to the people and to the concerns of the other side. It seems both parties try to win full control of the government to ram through whatever their party wants rather than work together. Part of this could be that we have handled most of the common topics and now we are left with the urban vs rural topics/solutions. If you look at the other developed countries you talk of, the urbanization ratios are higher than in the US, so basically one side has won out over the other (in general).
Lobbying itself is not a bad thing that should be outlawed. It shouldn't involve money from corporations in my opinion. You do have groups that lobby on behalf of individual members. I don't see a problem with that, if the money is not from corporations.
No, they don't. They both might agree with that statement, but they don't actually mean the same thing by it, so there is no actual agreement in substance. Which is a primary cause of the disagreement over solutions: there is a disagreement about the problem (behind which is also a disagreement about basic values.)
Both sides may sometimes use the same words to describe the problem, but they don't agree on what the problem is; the words have different meanings when different people use them.
This is also true (and much easier to illustrate) with illegal immigration, where “both sides” agree that “illegal immigration” is a problem, but for one the problem is immigration outside of the current legal rules (or maybe even immigration generally), and for the other the problem is the current legal rules creating illegal status for certain immigrants who are not otherwise viewed by that side as undesirable.
Using the same words for a short description of the problem does not mean agreeing on what the problem is.
On the case of healthcare (the topic at hand), the statement is correct. Claiming it's wrong and then switching the topic is not a valid argument. The fundamentals of the immigration issue are completely different (can both sides say illegal immigration is the problem like they can for healthcare costs? No, Democrats will say immigration law is the problem.). You seem to be missing the difference of what is a shared or agreed upon problem vs conflicting cause and resolution views.
No, it's not.
One side thinks that the total cost to individuals for a broad interpretation of medically necessary care relative to individual income is too high, but isn't primarily concerned about total cost of care except insofar as that limits the solution space for the first problem.
Another side actually does largely agree on that (though has a slightly greater, but still ssecondary, concern about aggregate costs) but disagrees with the first about solutions (in part because of the secondary concern), but those two sides are most commonly viewed as part of the same side (roughly the progressive and centrist wings of the Democratic Party.)
A third side believes that aggregate costs of services are too high, but isn't particularly concerned with how those costs are distributed between the recipient of services and others [1] or relation of cost of consistent baseline level of care to individual income.
There are a few more sides as well, most of which would agree with the “costs are too high” formulation, with even more different interpretations of which specific costs are too high, and what “too high” means.
[1] That understates the case a bit; much of this group actually has a fairly firm ideological preference that actual costs be concentrated on the direct recipient of care.
A lot of talk about the disfunction in the American system misses the point that it is functional. We don't have millions of people dying on the streets because they can't get health care.
We do spend a colossal amount on healthcare here, and there are definitely improvements that could be made. But we also have one of the least healthy populations on the planet.
Realistically to transition the USA to a socialized system you need to make the current system collapse. You won't succeed in major changes to a functional entrenched system like we have now.
https://slatestarcodex.com/2020/04/20/the-amish-health-care-...
Best way to get over this "basic right" business is to be a gainfully employed taxpayer with a sick kid in an american emergency room, and have to wait in line behind a slew of 300lb obesoids (mostly on medicaid) w/ (preventable!) diabetic complications.
And before someone goes, "but Europe!", I repeat that Europe is only a car or two behind us on the entropy train, and I say this with bitter sadness.
It is interesting to me how taking on "the white man's burden" to civilize africa and the orient is a passé and cancellable offense, while undertaking it against the Great American Redneck isn't. If Europe is more civilized, and you want civilization, why not leave Bubba unmolested in his own natural habitat?
Attributing it all to stupid-americans-and-their-prejudice-against-socialism is as much a disservice to yourself as it is to them.
I could illuminate a few of these connections here, but I would be swiftly pig-piled and banned, so you will have to discover them for yourself. Good luck!
edit: Actually, publish and be damned! We had a great many Germans at a chemical plant in the southeast--always telling us how stupid and backward our country was. UNTIL! the waves of refugees came. Now those same Germans fall over themselves apologizing to us. "We didn't know!"
The series is somewhat lengthy, but he takes the important step of enumerating all of the challenges and political/economic/cultural forces that have stymied attempts so far, then proposes a very concrete and incremental path forward that should minimize the aforementioned pitfalls. Given how much we like to argue about what "should" be done in legislative politics on these online fora, I found his breakdown of why these "shoulds" often don't materialize to be very insightful.
- Get rid of insurance companies for EVERY visit to the doc/hospital. Make prices transparent and available OTC for anyone to compare between various practices. It is kinda like car insurance if you think about it. I can bet that if we had to involve insurance companies for things like oil change, premiums would skyrocket and not to mention the overhead of the middleman. Let people pay cash for general stuff. For those who can't pay at all, see below.
- Govt. should insure everyone for catastrophic illnesses to start with. This is where we all pool in a bit from our taxes for the greater good. I however do think that we should limit this to serious illnesses like cancer etc.
- Based on level of income, Govt. should also insure/subsidize poor/low income groups for general visits, procedures etc etc. May be a small CoPay type stuff. But no major bill. High income folks don't get this Govt. Benefit (kinda like Food stamps ?).
- Did I already say get rid of middlemen Insurance Companies for basic stuff ? Ok good.
- Private insurance should still exist but let them compete in a real free market. If someone wants to buy private insurance as additional supplement, no problem. Just don't force me to use an insurance company just because I want to go talk to a doctor for 30 mins.
- Get rid of all the crap like In network, out network, Deductible blah blah. Keep it simple. Get rid of filing an insurance claim for EVEEEERY thing. I got to a doc, I can pay Cash. I am done. Boom. No need for crazy billing systems and figuring out who will send me a bill.
Lets do this ?
https://www.policymed.com/2020/07/district-court-upholds-hos...
"for-profit medicine" is a gross mischaracterization of US insurance. Half of US healthcare expenditures come from the government and a significant portion the other half isn't even "for-profit" e.g. the largest private insurance provider in the US by far is literally a not-for-profit organization.