I believe you've just given me your opinion that competition would be more efficient if given the chance. There has never been any evidence to support it (or refute it for that matter), so it has to be an opinion.
Well there is a ton of evidence that competition is more efficient in markets in general. When it comes to healthcare, there are two paths you can take- your single payer idea is also an opinion. There isn't going to be empirical evidence for any potential solution in this case. But it comes down to statistics and facts and in practice also experimentation. I say we experiment with more competition before being bogged down to single payer.
Medical costs have never gone down. Before healthcare became a "benefit of employment", cost still rose. Before there "was" health insurance, costs continued to rise. In fact, costs have continually risen since doctors "unionized" and the AMA was created in the early 1900's. Before the doctor's union, medicine was a humanitarian occupation (not making a value judgement on quality of care here). My point is, capitalism as applied to healthcare has never shown the propensity to be cost effective.
Actually there is some newer data suggesting at least the rate of growth in medical costs is coming down. I forgot where I saw that, I'll link it if I remember. But that is besides the point. Yes, med costs have gone up a lot, but so has med knowledge and treatment options. With more complex options and more options in general for more diseases, obviously costs will go up. There are some costs we can bring down, but not all costs.
The fact that society WILL always cover the gaps does not change the fact that the burden of cost is on those that do pay to have to make up for those that don't. The difference in single payor is, a) it's not an "option" to not be covered, and you pay your "equitable" share of the costs and nothing more. In a free market approach, there is ALWAYS the option not to buy, which puts the extra burden of cost on those that do pay. You may *think* that because someone doesn't pay the hospital just absorbs it, but that is not true. They write it off their taxes, which amounts to reduced tax revenue, and ultimately higher taxes on others.
First of all, who do you think pays for the poor's healthcare even in single payer? Let me tell you, it is still others
You aren't really going to be able to get around that.
Economically, the argument for single payer is in increasing the pool of cash (and risk). The well-off (both money and healthwise) still subsidize the worse-off (those without money and in bad health). Insurance works this way too, but with several, smaller pools of cash.
I'm not quite sure how you're trying to separate the U.S. from other countries. Seems a bit vague. I realize social morays are different country by country, and lifestyles i suppose as well. I can see this leading to "different" healthcare needs and outcomes. Where I'm confused is, the WHO rankings evaluate every country on the same basis. There are many categories ranked individually, but always equally against other countries. How is this not an accurate appraisal? I believe everyone in the world cares about healthcare in much the same way. I've lived in Europe, Asia, Australia, and the U.S., and I've yet to see anyone fail to seek medical care when they need it.
My point with apples and oranges was more about the costs. My point with the WHO rankings was that it is harder to implement a system for 300 million people vs. 50 million people. It is even harder when the 300 million live in vastly different regions with vastly different risks and come from vastly different gene pools. Risk assessment is a lot easier in a homogeneous population.
I still feel the important point is that, no matter what the culture is, it has it's own unique set of medical "issues". It should not cost more than necessary just to satisfy some ideological predisposition to capitalism. The rankings attempt to compare how each country deals with them. That is all.
I am not making an ideological argument. Are you making one with single payer?
There is one overriding reason costs are high. Greed. That is the domain of capitalism. And it should be. It just shouldn't be applied to healthcare on many levels.
I disagree. Insurance companies make money on investments from the pool, not on premiums. The government operates at a deficit. A large portion of the country's hospitals are non-profits. Doctors are incentivized to order more tests as it reduces their chances of a malpractice suit if they throw a million darts at the board. The US subsidizes the world in drug innovation with its patent policies. And on and on. I don't think the major issue here is greed. I think it is a broken system with perverse incentives. If doctors were all about greed, they probably would have gone into finance- much more money to make there and a lot less stress
Yes, cost is one reason they don't come, but surprisingly the majority of that travel is for highly specialized procedures in which the country excels. For example, Thailand is recognized for certain heart surgeries. Austria and other European and S. Africa for other treatments. Mexico is highly regarded in some bone disorders. One of the primary reasons for this is the very fact that these doctors are doctors more often for humanitarian reasons (over money). Not that they are poor of course....
Lol, I don't think doctors here are the evil, greedy robber barons you make them out to be. It just isn't true.
If you look at the best-of-the-best on the aggregate, I'd say the US easily has the best docs.
One point that we haven't brought up, but is important is rationing. It is a sticky subject, but when you look at things like wait times for certain procedures (especially orthopedic like hip replacements) in a country like the UK- it is horrible. There are plenty of people that can't get hip replacements at all just because the government doesn't want to pay for it. In the US on the other hand, you can walk in and probably get one scheduled within the month. Of course this leads to another question on whether Americans overuse healthcare too. A very complex situation with very complex variables and a lot of noise. Makes it hard to come up with a solution, but certain things standout in the data.
