In my book, the fact that the US healthcare system excludes people who can't afford it automatically drops it to bottom of the list, regardless of how amazing it might be for the rich.
Excludes is an extreme view. Anybody with the wit to stand in line can get free healthcare at an emergency room or local hospital.
I value living in a place where I can work harder to get better things for my family. Or work less hard and coast, my choice.
Making money is not a sport or game in America. Its real, its important, its meaningful and it motivates millions of us to work hard and smart.
I can pull out my gold card and get to the head of the line for a heart transplant, sure. That's not a failure, thats one of the strengths of a capitalist/free market country. It can be cruel, but life is cruel and honestly there is no 'fair' way to ration such healthcare. If you tried, the 'black market' (read: free market) would and does compensate anyway.
The free market motivates me. Some hunky-dory view of the world as full of free services for everybody does not.
Excluding people from good health causes others to have poorer health. And compared to other countries, the USA does exclude people from proper health care.
> Anybody with the wit to stand in line can get free healthcare at an emergency room or local hospital.
There is so much wrong with this sentence.
To paraphrase someone else, you sound like someone who has not been kicked out of the emergency room for having the wrong kind of insurance. I found out later that it is illegal to do so, but since hospitals don't get compensated for nonpaying people(varying state by state), emergency rooms do anything not to provide it.
Emergency room care is not health care, it is patching you up until you can get health care. Last time I was in the emergency room, they put on a temporary cast, with a proper one to be put on Monday.
And lastly, emergency room care is the most expensive care available. Suggesting that taxpayers foot the bill of emergency rooms as an alternative to having taxpayers foot the bill of health care is one of the most insane ideas I've ever heard of.
> Some hunky-dory view of the world as full of free services for everybody does not.
Some hunky-dory view of the world making everything available via the free market would be nice if it actually worked that way.
Countries with free health care for everybody can still offer plenty of incentives for making money, I don't think anyone would argue the UK isn't a capitalist country, and if you came to live here I'm confident that the NHS wouldn't be enough to make you stop caring about wealth.
I'm not in favour of communism, but as far as I'm concerned, medical care should be considered a right not a priviledge - there's really no benefit to denying it for the poor.
(For the record, I fit into the group of people who could easily affordto go private with Bupa here in the UK, and I'm far happier paying more in taxes to subsidise the NHS.)
The UK is not a capitalist country in the proper sense of the term, it's a mixed economy.
I believe keeping what you earn is a right. You believe free medical care is a right. Not mutually compatible. Glad I don't live in the same country as you.
And I do have to pay taxes. I live in a country where there are a lot of people that do agree with you (the US), so my remark was a bit facetious.
Actually, it's a double punishment to live here, because not only is the government taking lots of money to pay for the medical system, but Americans are too incompetent, broadly speaking, to run a centralized medical system. So the more the government spends, the more it sucks. At least you Europeans can make socialized medicine "work" in some sense of the term.
I would urge caution when using the terms "free" when discussing the NHS in a context like HN - I know you mean "free at the point of delivery" when you say "free" but many people won't! :-)
Obviously it has to be paid for, and I did end with the words "paying more in taxes to subsidise the NHS", but it's not as simple as paying for in advance, because people who don't make enough money to pay taxes, the unemployed, or people who need healthcare that costs more than the taxes they have paid do get it free.
Sure its a hassle. A doctor who doesn't know you, no followup, hours in a waiting room.
But is your HMO really any better? Any healthcare run on a budget gets pretty dismal. Any healthcare run by the govt will be run on a budget.
I maintain that if I pay more, I should be able to find the quality of health care I want/can affort. If not, then what's all this working and striving for? Just a game?
I still don't get why you think making money is pointless if you can't spend it on healthcare. There's plenty of things you either use while paying for them in taxes (e.g. roads) or things you wouldn't be able to buy even if you wanted them (a private spacecraft, too expensive, or a child prostitute, too illegal) yet they haven't made you stop wanting to earn money.
I'm covered by the NHS, I still find plenty of reasons to cash my paycheques.
A hassle? Again, I seriously doubt you've been to an ambulatory for anything worse than the flu.
Having to wait until things become serious has long term negative effects on your health. (e.g. delaying getting checked out for a persistent cough until you have pneumonia)
Further hospitals are not ignorant of the issue of people without money or insurance. Unless you were delivered by an ambulance, they will run through your entire financial situation and demand up-front payment. They will bill you and they will send bill collectors. And they will happily bill you far more than what any healthcare provider on the planet pays for those services, let alone what they'll see after giving bill collectors their cut.
And they will happily provide inscrutable bills, separated between each legally-distinct part of their operation. (A bill from the ER, a bill from the doctor, a bill from the lab, a bill from the x-ray service). These bills will show up months apart and months after you were seen. And you'll have absolutely no clue how many to expect.
Unless you spend hours with their payment departments trying to get estimates. (Good luck if you were seen after normal business hours.) And even after you spend hours getting these estimates and negotiating fees and payment schedules, these have absolutely no bearing on what you'll ultimately be billed. Nor will the various legally-distinct parts of the ER necessarily be clued in or included in your discussions.
And ERs and ambulatory care centers will turn you away if you can't pay, up until you are delivered by an ambulance (or in that kind of state).
And, yes, HMOs and the like are a wild improvement over that. You may have crappy care with piles of restrictions, but the starting point for your fees will be far lower than if you were on your own. And the plans' coverage will spare you from hospitals pushing expensive services when cheaper ones will do. And it will spare you from other hospital shenanigans, like the $40 over-the-counter aspirin. The $200 saline when a gatorade will do, the procedures that were never performed, the ambulance rides you never took, etc.
And you will receive 1 bill. And have 1 company to deal with to pay it. And whatever you work out with that company will be binding on the entire event. There will be no surprise follow-up bills from parts of the hospital that you didn't even know you received a service from. (And you legitimately may not have)
My parents were self-employed when I was growing up. I've had health coverage on and off over the years. I know of what I speak. Not from a one-off event in a relatively healthy youth. But from 30 years of experience seeing an entire family having to deal with health care. And let me assure you, that the billing shenanigans are the rule. Fee-for-service has warped the practice of medicine and the uninsured feel the pain disproportionately.
Also: what do you think insurance company healthcare is, if not run on a budget? It all is. Even your hypothetical 'the best i can afford' care. Up until you reach a budget of tens of millions of dollars.
And you'll always be able to get better care if you pay more. That's true if you're uninsured, if you bought your own care, if your employer pays your coverage, or if you get coverage from your government. The UK has higher levels of care available. As does Canada. As does Australia.
Why do you assume that correcting the problems in our healthcare system and providing everyone with a sane base level of care remove any incentive to get better care? Are you suggesting that for-profit healthcare will evaporate in a single payer system in America, despite that having never happened in any other country with a single-payer system?
