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

Photo above - would this guy have shot the head of the Veterans Administration if he blamed his chronic back pain on THEIR policies?

Americans (as a nation) spend the most on healthcare, die sooner, and are sicker when we die (see link below). Yeah . . . been hearing that for more than a decade now. Since before Obamacare, actually. A program which was supposed to increase lifespans, cut costs, and insure everyone for everything. (insert sound of crickets chirping).

And now the US spends $5 trillion annually ($13,000 per man, woman, child, and non-binary). Double the amount spent by countries like Australia, Canada, and the UK.

So, we MIGHT be able to save money on healthcare by putting 200,000 federal bureaucrats in charge. That’s about how many collectively work at the FDA (Food and Drug Administration); HHS (Health and Human Services; Medicare, Medicaid, and the VA healthcare programs. And the ARHQ, ATSDR, CFSAN, CNPP, CDC, CMS, DHA, FNS, FSIS . .

Yeah, there are dozens and dozens of agencies. No, I’m not going to spell out all the acronyms here. Use Google if you’re skeptical.

But still, it MIGHT (theoretically) be possible for Americans to live longer, healthier, and less expensive lives, if we put politicians and bureaucrats in charge. And if those brainiacs might do not repeat any of the awful policies in effect at the VA, Medicare, Medicaid, Pentagon, Public Schools, and whoever is in charge of fixing our 41,000 unsafe/collapsing bridges.

This might possibly work. But I’m still skeptical.

I know how Britain and Canada make it work (I’ve been to both countries, but not Australia). They pay doctors and nurses a pittance – which is why so many of their medical professionals aspire to migrate to the USA.

Also, if you live in Britain, you can’t have elective surgery whenever you want. You can get on a waiting list and then cross your fingers. Things like hernia repair. Bunion surgery. Joint replacement. Chronic back pain. Tonsillectomies. Kidney stones. The NHS WILL do something about your appendicitis, but only after watching it fester for weeks and hoping for the best until it takes a turn for the worse.

This is, in fact, how America’s own veterans' administration health care operates. And a contributing factor for why so many vets have untreated PSTD, substance abuse, mental health issues, etc. They’re on some waiting list.

I do want the extra 19 months of life expectancy Brits enjoy. But to achieve that we’d probably have to allow the government to take charge of even MORE (non-healthcare) stuff. Transition us to fewer cars and shorter trips. Re-criminalize narcotics. Use Britain’s weird method of defining live birth or not. Criminalize gun possession (full disclosure – I believe guns should be licensed and insured like automobiles). Restrict the use of ski-doos and personal watercraft. Stop alcohol consumption on college campuses. Arrest and jail all those streetcorner Fentanyl impresarios.

Simply paying American doctors less, and pivoting to Veterans Administration style treatment policies probably won’t get us there. And creating a panic about vaccinations won’t either, Mr. Kennedy. Your dad is probably rolling over in his grave.

I’m just sayin’ . . .

‘The US is failing’: Shocking study of 10 wealthy nations reveals Americans die the youngest, ‘live the sickest lives’ — despite the US spending the most on health care. Here’s the problem

List of countries by total health expenditure per capita - Wikipedia

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LeopoldBloom · M

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.

Adeptlinguist · M

@LeopoldBloom I doubt as many people would be needed to administer a universal system. In the US system, vast numbers are employed in order to find reasons to deny care. Those roles simply do not exist in a European-style system.

SusanInFlorida · 31-35, F

@LeopoldBloom this is the silliest reply of this thread. there is absolutely no plan to "transition" private sector doctors, nurses, claims analysis, benefits adminstrators, etc to become government employees.

that's called "nationalizing" an industry. Nations repeatedly try this with airlines, farms, mines, oil companies, electric companies.

it's always a disaster, and leads to inflation and plummetting standards of living.

LeopoldBloom · M

@SusanInFlorida I didn't say there was. But when you mentioned the VA, that's what it is - the doctors work for the government. It wasn't clear that you understood the difference between that and single-payer, which only nationalizes insurance. If you have Medicare, the government becomes your insurer, but you still see a private doctor. Are you under the impression that single-payer adds a new level of bureaucracy, where the government pays your private insurance premium?

Nationalization isn't always a bad thing. Some functions are better performed by government, such as national defense, law enforcement, and infrastructure - anything where the "free market" can't promote competition between providers, or where the service needs to be provided to everyone, regardless of their ability to pay for it.

Health care would fall into this category. Several countries have a two-tiered system - basic care available to everyone, and private care for those that can afford it. That's the system we have in the US, where anyone can show up at the ER and get care for an emergency, even if they can't pay for it (this is because of the Emergency Medical and Active Labor Act, signed into law by that socialist pinko Ronald Reagan). The problem is that emergency care is a profoundly wasteful and expensive way to provide primary care, but if it's the only option people have, they're going to use it. Ensuring that everyone can access basic medical care by being able to see a doctor regularly would free up ERs to handle actual emergencies.

SusanInFlorida · 31-35, F

@LeopoldBloom from the perspective of hospitals, single payer and nationalized health insurance are an existential threat. they set reimbursement rates below the cost of treatment.

from the perspective of patients, doctors as government employees are a problem. mostly the least qualified, with the worst patient survival rates.

pick your poison.

Adeptlinguist · M

@SusanInFlorida I fear you are oversimplifying matters.

All developed countries except the US manage just fine with universal healthcare - and there is a huge variety of different models (eg French vs British vs Swedish). Don’t generalise.

If your patient survival rates include only those who can afford to pay luxury prices, then maybe. If you include the untreated who are just left to die, less so.

Compare OECD figures on population life expectancy or infant mortality (cited elsewhere) for a more realistic assessment.

SusanInFlorida · 31-35, F

@Adeptlinguist most of the life expectancy difference in the USA vs Britain can be summed up as:

1 - fewer cars, fewer miles driven
2 - gun control
3 - less fentanyl and crack

Britain basically gets a free ride (or low cost one) on medicines and devices developed in the USA. They still don't have a UK produced covid 19 shot.

Adeptlinguist · M

@SusanInFlorida I’m not just talking about Britain. Every OECD country does better than the US.

There’s no escaping it: US healthcare is expensive, inefficient and highly inequitable.

Adeptlinguist · M

@SusanInFlorida Actually the first Covid vaccine came from Oxford University and was manufactured by AstraZeneca. The mRNA vaccines subsequently proved safer and more effective so were adopted most broadly. The pharma industry is global, so who cares who invented what? I received both BioNTech and Moderna vaccines free of charge in Sweden.

Why are you focusing on the UK? As stated, basically every developed country does better than the US, for far less money.

Adeptlinguist · M

@SusanInFlorida Doesn’t look like road fatality rates are a significant factor:

https://ourworldindata.org/grapher/road-accident-deaths-per-passenger-kilometers?country=GBR~USA~DEU~POL~SWE~AUT~BEL~BGR~HRV~CZE~DNK~FIN~FRA~GRC~HUN~ISL~NLD

As for gun deaths, that is a choice that the US makes. It wants its kids to die. All sane countries essentially ban guns for the general public.

SusanInFlorida · 31-35, F

@Adeptlinguist

traffic fatalities are not the problem. injuries are. hundreds of thousands of people who need long term care after a collision.

Adeptlinguist · M

@SusanInFlorida So lacking proper universal healthcare impacts life expectancies, just as I said.

SusanInFlorida · 31-35, F

@Adeptlinguist the top post actually discusses America overpaying for healthcare. $5 trillion annually. if you go back and read it from the beginning you are certain to agree.

It's not about traffic fatalities.