America spends too much on healthcare ($5 trillion annually). So the solution is . . . to put the government in charge of everything???

It seems you have fallen into one of the common manipulation traps used by the medical, hospital, and pharmaceutical industry intended to sway American public opinion away from universal health care as a right...

1. "Medicare for all" is socialism.
2. Do you really want the government to control your healthcare?
3. If we let the government control our healthcare, then that will open up control of everything.

These are all fear tactics originating from a formidable lobbying effort to keep medical care a high-cost specialty. The traps were originally designed and intended to keep healthcare segregated. After the Medicare program was successfully implemented after many decades of failed starts, those traps were retooled into keeping healthcare obscenely profitable (when segregation became unsustainable).

The socialism argument is as old as the USA and has no real merit. Sadly though, it remains as effective of a tool of manipulation of the masses as it was when George Washington, Thomas Jefferson, John Adams and their peers suggested some form of baseline healthcare for all. An educated person should ask why non-socialized healthcare is superiour?

Fearing a government take-over becomes a weak argument if you do the research to compare it against insurance companies running the programme. While it's fun to think competitive industry is inherently efficient, the reality is industry bureaucracy is designed to extract as much profit regardless of healthcare outcomes. It should raise the question if that kind of efficiency is favourable.

The exaggeration of, if healthcare then what is next is a common favourite refrain taken up by the gun lobby to prevent any regulation or restrictions on its products and one often used by school children to dramatize how a given punishment will negatively impact them if carried out. It's strictly dramatic for the sake of drama. Why not, if you get a morning rest break from work, then you will want a lunch hour, then an afternoon rest break, and then you will want to be treated with respect, and then washroom breaks, and then...

Fear of bureaucracy is valid and reasonable, but it doesn't matter if that bureaucracy is run by the government, industry, or AI. So, it needs to be managed rather than feared. Forms of socialism already exist, so that tired argument is just tiresome. And, the exaggeration tactic is literally grasping at grass clippings. If it does open the floodgates for other things to be controlled, maybe that's because that is what people want OR get off your fat, lazy arse and vote against those who want to extend government control beyond what the majority want OR fix what isn't working. Of course, you can just decide to sit back and continue, generation after generation to be manipulated and enjoy it. That could be genetic... I suppose.

It is. It's not a theoretical model, pretty much all the first-world has tax-funded single-payer healthcare without middlemen (practically compulsory for-profit insurance companies) and indeed it's far less expensive to maintain, and universally accessible too.


But America is hellbent on remaining in the third-world on this particular issue, in spite of all the real world data supporting the transition.

What you're missing is that under a single payer system, we won't just hire new federal workers on top of everyone else working in the medical profession. The people currently working for for-profit insurance companies will be transitioned to government employment. We already have people working for Medicare; single-payer will simply expand that. It will also do it more efficiently as not as many people will be needed, and there won't be highly-compensated industry executives. The problem with our current system is the astonishing waste due to every hospital and doctor's office needing people who do nothing but deal with insurance companies.

This isn't socialized medicine, like the VA. Under socialized medicine, doctors and other medical personnel work for the government. Under single-payer, the government handles insurance, but the medical workers are still in private industry. You can't confuse the two. There's no reason doctors would have to be paid less. Instead of paying for private insurance (or your employer covering the cost through payroll deductions plus their own contribution), you (or your employer) would pay a premium to the government. This would save most people several thousand dollars per year.

The reason people oppose this is because they think there will be what amounts to an additional tax on top of their premiums, when in fact, a lower tax would replace their insurance premiums. If there was a way to get this concept across to people (while explaining that the government would only take over the insurance industry and not the entire medical profession), there would be more support for single-payer.

Of course, this doesn't mean every conceivable treatment is covered. It's still possible that we'd have the same issues we have now with coverage; the main difference is that we'd get the same care for less money. Don't assume that government would be less efficient than private industry in this area. Health care isn't subject to market forces the way other services are. I don't hear conservatives complaining that police forces are wasteful and should be turned over to private industry, where citizens would pay a fee for police protection instead of paying for it through their taxes. There are certain areas (like law enforcement and the military) that are more efficient and effective under the government.

Health care is one of these. If you need heart surgery, you don't want the guy who will do it for a bargain, you want someone who knows what they're doing and charges accordingly.

Single-payer isn't as big a change as socialized medicine. While you're correct that the UK, Canada, and other countries have issues with timely service, Israel's medical system is socialized and from what people who live there tell me, it's pretty good. We don't have Israeli doctors clamoring to emigrate to the US, so clearly they're paid enough. Whether their system could be duplicated here is a different story. But single-payer would only require that the qualifying age for Medicare be lowered to birth.

This critique touches on several important and contentious issues about healthcare in the United States, including cost, efficiency, and the role of government. Here's an analytical breakdown of the key points raised:

1. The Cost of Healthcare in the U.S.

Observation: The U.S. spends $5 trillion annually, approximately $13,000 per person, which is significantly higher than other developed nations.

Reality Check: The high cost stems from a mix of administrative expenses, high salaries for healthcare professionals, pharmaceutical prices, and a for-profit system that prioritizes revenue over patient outcomes.

Counterpoint: Simply putting the government "in charge" doesn't necessarily cut costs without systemic reforms. However, other nations with government-involved healthcare spend less while achieving comparable or better health outcomes.

2. The Bureaucracy Argument

Observation: The U.S. already has sprawling healthcare-related bureaucracies across federal agencies.

Reality Check: Consolidation and smarter administration could reduce redundancy, but the scale of bureaucracy isn't necessarily the problem—it’s inefficiency, mismanagement, and conflicting interests that create waste.

3. Comparisons to Other Countries

Observation: Countries like the UK and Canada spend less per capita but have longer life expectancies and broader coverage.

Reality Check: These systems come with trade-offs, like longer wait times for elective procedures and lower pay for healthcare workers, which can deter some professionals. Yet, their citizens largely support these systems for their fairness and accessibility.

Counterpoint: Adopting a hybrid model (e.g., public coverage for basic healthcare with private options for elective procedures) could address some concerns while reducing costs.

4. The VA and Public Health Systems as a Warning

Observation: Your critique highlights inefficiencies and long wait times in the Veterans Administration and other public systems as examples of potential pitfalls.

Reality Check: The VA serves a complex, high-need population, which amplifies its challenges.
However, VA healthcare outcomes are often better than those in private systems for equivalent conditions when timely access is achieved. The issue lies more in resource allocation and management than the public system itself.

5. Cultural and Behavioral Factors

Observation: You link lifestyle differences, gun violence, narcotics, and other societal factors to the U.S.'s lower life expectancy.

Reality Check: These factors undeniably impact health outcomes. However, healthcare reform and public health initiatives (e.g., addressing chronic diseases, obesity, and addiction) can mitigate these issues without requiring a wholesale cultural shift.

6. Economic Implications

Observation: You suggest that lowering doctor salaries and implementing stricter healthcare rationing could negatively affect quality.

Reality Check: While high salaries are part of the cost issue, physicians in other countries still achieve good outcomes despite earning less. The focus should be on aligning incentives with patient health rather than maximizing income.

7. Skepticism Toward Change

Observation: You express doubt about whether government-led reforms can succeed, given existing inefficiencies.

Reality Check: Skepticism is warranted, but successful models exist worldwide. Reform requires learning from these models, tailoring them to American needs, and avoiding ideological rigidity.
Potential Solutions

Administrative Streamlining: Reduce waste by consolidating insurance plans and simplifying billing systems.

Value-Based Care: Shift from fee-for-service to models that reward outcomes rather than procedures.

Public-Private Hybrid System: Guarantee basic coverage through public funding while allowing private options for those who want them.

Drug Price Regulation: Allow negotiation of drug prices to reduce pharmaceutical costs.

Preventative Care Investment: Focus on preventing chronic conditions to reduce long-term costs.
The debate over healthcare reform is complex, but dismissing potential solutions without considering evidence-based approaches and nuanced trade-offs risks perpetuating the status quo—an unsustainable, inequitable system.

“The government” does not typically run healthcare in countries with universal healthcare - but healthcare is funded largely from taxation.

All systems I have experienced (UK, France, Sweden) use different approaches.

UK is split into a large number of regional “NHS Trusts” which run hospitals etc.

France is a hybrid public/private system with most doctors being private practitioners under contract to the public system and major hospitals being publicly owned. Smaller clinics are private.

Sweden has regional health authorities.

None is “the government”.

Yes, certainly allow the state to have a guiding hand. In the USA it already does the difficult bits that the market will not touch (ie. ensuring that everyone has at least minimal access to healthcare irrespective of ability to pay).

The wastefulness in the US system is due to layers of intermediate bureaucracy in the private sector. Armies of professional administrators who draw salaries and make profit even though they are not directly providing health services.

And the UK does not underpay doctors and nurses as a business strategy. Salaries are grossly inflated in our private sector also, because they are allowed to cherrypick the services they choose to supply in order to maintain profitability. In the knowledge that the taxpayer will effectively undewrite their profits by doing all the difficult and expensive parts.

Private healthcare is parasitical and inefficient and should be consigned to the dustbin of history.

How could government mandated healthcare possibly ever work here? I mean sure 32 out of 33 developed countries in the world have had it for YEARS and it works fine.....but according to the GOP that don't mean we could do it. smh

Comparisons with other nations (who DO have gov't managed health care) say there is plenty of room for improvement here in the USA.

Note the graph goes 1970-2018.
Source: https://ourworldindata.org/grapher/life-expectancy-vs-health-expenditure

---

---

---

---

Infant mortality in 2020
Source: https://ourworldindata.org/us-life-expectancy-low

I'd much rather live in Europe

I wonder if the people complaining about how bad the governement is doing stuff, complain about the broken windows at the capitol building on januari the 7th 2021 too?

Thats what a privatised healthcare system leads to medicare for all cut away CEO pay and profits from the system,

End "FOR PROFIT" Healthcare.

Insurance companies telling doctors and their patients what they will cover and what they refuse to cover....life and health have nothing to do with it.

Notice the number of providers who are eliminating many of their advantage care plans...doctors and hospitals who no longer accept certain plans....or some who have ended providing any health care plans.

Profit over people in the good old USA.

Some things just dont respond well to the short term focus and the profit motive..😷

The govt should not be in charge of hc.

🇨🇦 If I may add my two loonie$-worth of insight to this brilliant discussion, since Canada no longer uses pennies as a legal form of currency, my hand is now forced to actually contribute $2.00 if I want to contribute two of anything.

As a qualified end-user of the Canadian healthcare system, the Canadian model works well if you're not in a hurry, it's not free, it's administered by the government and it's not a money-making, get-rich-quick scheme for aspiring young Med students fresh out of Med School who want in on the action.

What it costs each Canadian on average for their annual healthcare premium is about $500 dollars per year/per person and that healthcare premium is automatically charged to each citizen when they file their annual income tax return on April 30th each year, which of course is for the previous year's income filing. This is where we pay for our annual healthcare premium. We are not billed separately for it in Canada.

That healthcare premium is based on each person's annual gross income, not net income. If you earn $30,000 per year, your annual healthcare premium will cost you about $200.00 max.

If you earn $300,000+ per year, that healthcare premium will cost you about $900 whether you use the healthcare system or not, regardless of how many millions of dollars you earn in gross income.

Now, just think about that for a minute... if I earned $300k per year and my healthcare premium was $900, that is exactly HALF of what I would normally pay for my car insurance premium each year which includes full auto coverage, but which means I pay $1,800 per year for eff'ing car insurance but only $900 for government health insurance!

I live in the Province of Ontario where cage for the Toronto Blue Jays is hanging from a ceiling. Because I'm domiciled in the Province of Ontario, my healthcare coverage is ONLY valid in the Province of Ontario! That means that if I get in my car and drive to the west or east coast of Canada and I get sick out there and end up in the hospital out there, my Ontario Health insurance does NOT follow me outside the Province of my residence!

What this means is, that if I travel to another Province in Canada, I must first purchase 'Emergency Medical Travel Insurance', no different than what most people would do when they fly to the Caribbean for a 1 week vacation and purchase Emergency Travel Insurance from their Travel Agent before they leave home.

So then, how much does Emergency Medical Travel Insurance cost then?

It would cost me about $20 per day for every day I was intending on being out of the Province of Ontario for a maximum out-of-Province excursion of 30 days. If I stay away for longer than 30 days, I must purchase another bunch of travel insurance over the phone and have my credit card handy.

If I do not buy travel insurance when I travel to other parts of Canada on vacation or on business and I end up in the hospital while away, I am handed a hospital bill just like they do in the USA, which must be paid by credit card or cash before I'll be discharged from that Canadian hospital which is outside my Province of residency.

If however, I end up in a hospital while I'm still in my Province of residence in Ontario, I simply hand the hospital Triage Nurse my Ontario Hospitalization card which we Canadians all carry in our pockets, or in my case in my bra next to my discretely-stowed Derringer, then I can have a heart transplant while I'm in there and walk out after I'm discharged with NO cost to me at all. All that heart transplant would have cost me was my annual $900 premium which I would have to pay anyway, even if I never used it!

The problem with the Canadian healthcare system is that it is grossly under-funded, which means Canadians don't pay near enough for their annual healthcare premiums!

We may complain about the high cost of car insurance here, but we pay it regardless if we want to drive our car. The problem with the government running the show is that they don't know enough to raise the healthcare premiums to actually make the healthcare system work much better in Canada.

Instead, they dither and dick around, trying to be nice to everyone while trying to make it 'affordable' to people who have just spent $1800 on car insurance because they own a car. If people are that poor, then sell the car and cancel the car insurance, ffs's!

From what I've understood about the American system of healthcare, Americans spend a lot of money on healthcare premiums but they also have to sell their house to pay their hospital bills on top of that, which works out to be about $1000 per day for just the bed and 3 hospital meals per day, assuming the doctors do nothing with you while you're in there!

So, in the USA then, it costs a thousand bucks a day just to get in the door before you even pull your pants down or stick your tongue out before some high-priced doctor does anything whatsoever with you, but who then charges for his professional services by the minute because American healthcare is a high-stakes game of roulette where you pay-to-play, not a Constitutional right!

It's a Constitutional Right to own and perhaps even carry a loaded firearm in the USA, but healthcare in America is not a Constitutional Right and can potentially cost you everything you own if you step one foot inside an American hospital. How did that happen, Doctor Kevorkian? 🤕