Hepatitis C & Universal (Socialist) vs. Private Healthcare

[Jastall]

Strictly speaking, it's never been nothing. Hospitals for example have to take you for emergency care (they bill you later, but cannot refuse you). There's always been charity. And with go-fund-me campaigns, it would probably be easier than ever to give the free market+charity system a proper try.

But that aside I'll tell you why this is a bad idea.

First, who pays for it? If it's anything like Europe, then expect your taxes to go up by 5-10% of your gross income. You make 50k a year? You'll pay 5k.

Now the problem is due to government being crappier at everything it does (we already know for example many veterans avoid the VA if they can afford something else), there will be lots of frustrated people opting out only they can't opt out, they still have to pay the tax whether they use those medical services or not. So they just end up paying for two different insurances.

Bernie's a moron, this will never work as intended.

I love how you use the expense argument when, if you combine public and private spendings, the American system is by far the most expensive in the world per capita. You already pay almost as much as a person in Canada or the UK for healthcare on a public level to patch up the holes in the system, and that's before you factor in private costs. That is mostly due to the fact your healthcare is so decentralized that pharma companies (among others) can price gouge the ever loving fuck out of your doctors and hospitals, while a centralized system is far more able to negotiate prices.

And medical research doesn't have much to do with the insurance paradigm in the United States (which is really the main difference between its healthcare system and that of other Western nations). The US is the pinnacle of medical research due to a variety of factors, but most of which boil down to your government putting tons of money in it and being amazingly anal retentive when it comes to intellectual property. Which are good things, mind you, But this absolutely isn't the magical hand of the free market at work.

Then again, you've been told this upthread a couple times and happily ignored it, picking on low hanging fruits instead so you can thump your chest at achievement that aren't yours. So I hardly expect you to understand the fifth time around.

[Deleted]

https://en.wikipedia.org/wiki/Miles_D._White
"While CEO of Abbott Laboratories in 2008, he earned a total compensation of $25,104,085, which included a base salary of $1,795,471, a cash bonus of $4,200,000, stocks granted of $7,499,925, and options granted of $10,757,796.[7] He has been listed in Forbes' list of America's Most Powerful People and recognized as one of the world's 30 Best CEO's by Barron's for nine consecutive years and Executive of the Year by Scrip."

https://en.wikipedia.org/wiki/Kenneth_Frazier
"Frazier received a total compensation of $21,387,205 in 2014; $17,023,820 in 2015; and $21,781,200 in 2016"

If drugs are so expensive to research and manufacture then how do these companies have the money to give their CEO's such high compensation?

Looks to me like that the drugs aren't as expensive to produce as claimed and what we actually have are a bunch of leeches of making money off the pain and suffering of others.

I would be for CEOs getting so much money if there would be a law that makes them public sexual property if they get a high enough compensation.

[Deleted]

It is more to do with the fact that drug companies receive MASSIVE amounts of subsidy from the US government, which rather obviously has more money to spend than almost any other country, but which is also a government which is quite content to then allow those same companies to charge vast sums of money in order to make obscene profits. The USA is also the biggest first word country, you wouldn;t expect a place like Germany to compete in a numbers game, because the USA is as rich as Germany but it's four times bigger.

It's kind of ironic that the US health system actually costs every US citizen far more per head than the terrible "socialist" health system do their citizens. The one and only difference is that in America, you pay a tax called health insurance to a private company, whilst I in the Uk pay a tax to the government which operates the NHS. Only you probably pay a lot more than I do - and you certainly will if you're unlucky enough to be born with some inherited condition, or suffer come disability as a child (let's hope your parents can afford those payments).

The only freedom this gives you in the USA is the freedom to be uninsured - but you'd be absolutely crazy to do so. That's probably why only poor people aren't insured, which probably also explains why the USA rates poorly when it comes to life expectancy, infant mortality rates and so on. It offers some of the finest healthcare in the world - but only to people who can afford it.

The USA spends far more of it's national wealth on healthcare than a country like the UK does, but in many cases the outcome for the whole population is better in the UK; in short we spend less and get more back.

My mom was just diagnosed with macular degeneration. As I'm in the UK I don't have to dig out her insurance plan to see if it's covered by her health plan or worry about finding the cash to pay if it's not. When I took her to the eye hospital the first person I saw was a doctor, not an administrator grilling me about how I was going to pay for the treatment. No health system in the world is unrestricted, even in the USA there are plenty of treatments that are denied standard health plans and of course, the majority of treatments are denied to uninsured poor people unless it;s covered by Medicaid or Medicare.

And of course, it also has to be kept in mind that those terrible socialist health systems pay drug companies too. The only real difference between the USA and those terrible commie countries is this: you eithe rpay your health insurance to a private company, or you pay it as a tax. It's kind of ironic that Americans will gloat about how they pay less tax, but the smile drops off their faces when you say "but how much a month do you pay for health insurance?"

A fully private health system means that a basic human right is determined by how much money you've got, it incentivises perverse behavior by the health system (for example, a chronically sick patient who needs constant treatment is more profitable than a cured one, hospitals compete with each other for customers so they tend to invest in expensive stuff that attracts a wealthy minority, but not so much in basic , less profitable, less visible healthcare)

And as I said, it is cripplingly expensive, as an American you probably pay far more for healthcare than I do or ever will as a Brit.

The finest healthcare systems in the world with the best outcomes for life expectancy, disease prevention, cancer, infant mortality - they are all "socialised"

It's a funny old thing, Americans have a horror of "socialised" medical care. But they are quite happy to have law and order, defense and all that stuff "socialised". Imagine if someone in the US suggested that the cops would only come if you paid a private company crime insurance, or the fire engine would only come to your burning house if you paid fire insurance....

Or that the US Army, Air Force and Navy were taken over by a private company and only peopel who paid defense insurance benefitted, everyone else would be left to fend for themselves.

[Deleted]

It is more to do with the fact that drug companies receive MASSIVE amounts of subsidy from the US government, which rather obviously has more money to spend than almost any other country, but which is also a government which is quite content to then allow those same companies to charge vast sums of money in order to make obscene profits. The USA is also the biggest first word country, you wouldn;t expect a place like Germany to compete in a numbers game, because the USA is as rich as Germany but it's four times bigger.

It's kind of ironic that the US health system actually costs every US citizen far more per head than the terrible "socialist" health system do their citizens. The one and only difference is that in America, you pay a tax called health insurance to a private company, whilst I in the Uk pay a tax to the government which operates the NHS. Only you probably pay a lot more than I do - and you certainly will if you're unlucky enough to be born with some inherited condition, or suffer come disability as a child (let's hope your parents can afford those payments).

The only freedom this gives you in the USA is the freedom to be uninsured - but you'd be absolutely crazy to do so. That's probably why only poor people aren't insured, which probably also explains why the USA rates poorly when it comes to life expectancy, infant mortality rates and so on. It offers some of the finest healthcare in the world - but only to people who can afford it.

The USA spends far more of it's national wealth on healthcare than a country like the UK does, but in many cases the outcome for the whole population is better in the UK; in short we spend less and get more back.

My mom was just diagnosed with macular degeneration. As I'm in the UK I don't have to dig out her insurance plan to see if it's covered by her health plan or worry about finding the cash to pay if it's not. When I took her to the eye hospital the first person I saw was a doctor, not an administrator grilling me about how I was going to pay for the treatment. No health system in the world is unrestricted, even in the USA there are plenty of treatments that are denied standard health plans and of course, the majority of treatments are denied to uninsured poor people unless it;s covered by Medicaid or Medicare.

And of course, it also has to be kept in mind that those terrible socialist health systems pay drug companies too. The only real difference between the USA and those terrible commie countries is this: you eithe rpay your health insurance to a private company, or you pay it as a tax. It's kind of ironic that Americans will gloat about how they pay less tax, but the smile drops off their faces when you say "but how much a month do you pay for health insurance?"

A fully private health system means that a basic human right is determined by how much money you've got, it incentivises perverse behavior by the health system (for example, a chronically sick patient who needs constant treatment is more profitable than a cured one, hospitals compete with each other for customers so they tend to invest in expensive stuff that attracts a wealthy minority, but not so much in basic , less profitable, less visible healthcare)

And as I said, it is cripplingly expensive, as an American you probably pay far more for healthcare than I do or ever will as a Brit.

The finest healthcare systems in the world with the best outcomes for life expectancy, disease prevention, cancer, infant mortality - they are all "socialised"

It's a funny old thing, Americans have a horror of "socialised" medical care. But they are quite happy to have law and order, defense and all that stuff "socialised". Imagine if someone in the US suggested that the cops would only come if you paid a private company crime insurance, or the fire engine would only come to your burning house if you paid fire insurance....

Or that the US Army, Air Force and Navy were taken over by a private company and only peopel who paid defense insurance benefitted, everyone else would be left to fend for themselves.

There is absolute no comparison between private healthcare and private police/army.

A private police wouldn't work. Not because "socialism is better" but due to inherent conflicts of interest.

You cannot serve both the law impartially and your shareholders AND your customers. If I hire a private cop they do what I say, not what the law says. Do you honestly think they're going to ever arrest the guy paying them the money? It is categorically impossible to make a private police force work. Their monopoly on the use of force as a private company would also be incompatible with the free market itself. They would be little more than mafia goons.

[Louisa Bannon]

Their monopoly on the use of force as a private company would also be incompatible with the free market itself.

So, a little bit straw man and a lot just missing the point? A new low...

[Deleted]

So, a little bit straw man and a lot just missing the point? A new low...

Nope.

Private healthcare works, you trade your resources for the services of a doctor or for medication. You get better, the doctors/pharma companies get wealthier. All voluntary.

Private police doesn't work, it's that simple.

[XDurionX]

Nope.

Private healthcare works, you trade your resources for the services of a doctor or for medication. You get better, the doctors/pharma companies get wealthier. All voluntary.

Private police doesn't work, it's that simple.

Private healthcare doesn't work either. 600000 people go bankrupt from medical bills in the US EVERY YEAR, many millions more are denied treatment they need because they can't afford it. It's basically modern highwaymen: Pay us or die. That's not acceptable in every civilised country.

[Deleted]

Private healthcare doesn't work either. 600000 people go bankrupt from medical bills in the US EVERY YEAR, many millions more are denied treatment they need because they can't afford it. It's basically modern highwaymen: Pay us or die. That's not acceptable in every civilised country.

1. It's not modern highwaymen. Those doctors didn't make you sick and as such don't bear any responsibility for curing you.

The left once again refuses to make a moral distinction between bad action and simply not getting involved in something, letting things run their course as if you had never been there in the first place.

Your argument would only make sense if doctors spread diseases in order to sell you a cure. That's not something that happens and if it did it would be one hell of an outlier.

2. Many millions are denied treatment despite universal healthcare. Universal, single-payer, whatever you want to call it only ensures equal access to healthcare, it doesn't guarantee quality at all and in practice governments around the world ration it based on their ability to pay.

If universal healthcare is so great, why do 0 Americans travel to Zimbabwe for treatment? They have universal healthcare. And sure you wouldn't get it free cause you're not a citizen, but even just paying for it would be cheaper since everything in Zimbabwe is cheaper. Is it good quality to warrant the trip? No.

3. When I said it works I never claimed it was a utopia. I merely said it works. There are no inherent conflicts of interest in paying for healthcare. You get better, the doctor/pharma company gets wealthier. It's a win-win and it's voluntary.

Private police doesn't work because a private cop will never enforce the law against his employer or customers. It's as nonsensical as claiming two sides in a trial can have the same lawyer.

[Flarelaine]

Are these drugs cheap? Far from it, they go up to 5 figures, but that's because it's hard to research them in the first place, NOT because evil billionaires are conspiring to keep people down. When patents expire, cheaper and cheaper generic drugs will become available until a hepatitis C infection becomes more or less a minor nuisance.

So how do you explain charging hundreds of dollars for a single fucking bag of intravenous saline solution, which costs around a dollar to manufacture? It has been researched ages ago. Face it, US healthcare is just plain overpriced. They charge as much as they can because they can.

Just the first search result for saline solution:

An older woman and her young grandson were charged $787 and $393, respectively, for "IV therapy." The patients were covered by an HMO under Medicaid and spent just a few hours at the hospital, but the HMO did not reimburse most of the cost of the IV.
One patient privately insured through Aetna at another hospital was charged $91 for a unit of saline solution that cost the hospital 86 cents, according to a hospital spokesperson who told Bernstein that the markup is "consistent with industry standards" and includes "related services and processes." The patient was also charged $127 for administering the IV and $893 for ED services. She ended up paying $100 out of pocket for her visit.
One patient at the same hospital—who spent three days recovering from food poisoning—was charged only $8 through her United HealthCare coverage. Her insurer was billed $546 for six liters of saline.

Link

[XDurionX]

1. It's not modern highwaymen. Those doctors didn't make you sick and as such don't bear any responsibility for curing you.

The left once again refuses to make a moral distinction between bad action and simply not getting involved in something, letting things run their course as if you had never been there in the first place.

Your argument would only make sense if doctors spread diseases in order to sell you a cure. That's not something that happens and if it did it would be one hell of an outlier.

2. Many millions are denied treatment despite universal healthcare. Universal, single-payer, whatever you want to call it only ensures equal access to healthcare, it doesn't guarantee quality at all and in practice governments around the world ration it based on their ability to pay.

If universal healthcare is so great, why do 0 Americans travel to Zimbabwe for treatment? They have universal healthcare. And sure you wouldn't get it free cause you're not a citizen, but even just paying for it would be cheaper since everything in Zimbabwe is cheaper. Is it good quality to warrant the trip? No.

3. When I said it works I never claimed it was a utopia. I merely said it works. There are no inherent conflicts of interest in paying for healthcare. You get better, the doctor/pharma company gets wealthier. It's a win-win and it's voluntary.

Private police doesn't work because a private cop will never enforce the law against his employer or customers.

1. Failure to render assistance IS a crime.

2. Universal healthcare doesn't pay for everything every time, yet access is a lot more widespread than in the failed privatised system the US has. US citizens are not covered by other countries' insurances for obvious reasons, if they had the access there would be A LOT of medical tourism.

3. No matter the metric, single payer healthcare works better in every country it is employed by. Heck, you even pay 3-4 times the amount for the SAME procedures. I don't get how anybody can defend this. When you're health and well being is on the line, it is not a free market. Never was, never will be. You basically want corporations to be able to hold people at ransom.

[Deleted]

So how do you explain charging hundreds of dollars for a single fucking bag of intravenous saline solution, which costs around a dollar to manufacture? It has been researched ages ago. Face it, US healthcare is just plain overpriced. They charge as much as they can because they can.

Just the first search result for saline solution:

An older woman and her young grandson were charged $787 and $393, respectively, for "IV therapy." The patients were covered by an HMO under Medicaid and spent just a few hours at the hospital, but the HMO did not reimburse most of the cost of the IV.
One patient privately insured through Aetna at another hospital was charged $91 for a unit of saline solution that cost the hospital 86 cents, according to a hospital spokesperson who told Bernstein that the markup is "consistent with industry standards" and includes "related services and processes." The patient was also charged $127 for administering the IV and $893 for ED services. She ended up paying $100 out of pocket for her visit.
One patient at the same hospital—who spent three days recovering from food poisoning—was charged only $8 through her United HealthCare coverage. Her insurer was billed $546 for six liters of saline.

Link

This only displays your ignorance, the high prices you list are typical of emergency rooms, NOT ALL HEALTHCARE RELATED COSTS IN GENERAL.

See, the ER isn't just a bunch of expensive meds lying around, it's a whole service that operates 24/7 with a lot of challenges.

Add the fact that they are obligated to treat everyone despite the fact many don't pay or can't pay. So they just raise the costs on the ones that do pay so they stay operational.

https://health.howstuffworks.com/med...-expensive.htm
https://www.foxbusiness.com/features...ges-what-to-do

That’s why a single aspirin can cost $30 per pill in the E.R., which is more than six times the price for a bottle of them at the drug store.

Disingenuous leftist claiming that because something costs more in the ER then it also costs the same everywhere in the US.

[Machismo]

This only displays your ignorance, the high prices you list are typical of emergency rooms, NOT ALL HEALTHCARE RELATED COSTS IN GENERAL.

See, the ER isn't just a bunch of expensive meds lying around, it's a whole service that operates 24/7 with a lot of challenges.

Add the fact that they are obligated to treat everyone despite the fact many don't pay or can't pay. So they just raise the costs on the ones that do pay so they stay operational.

https://health.howstuffworks.com/med...-expensive.htm
https://www.foxbusiness.com/features...ges-what-to-do



Disingenuous leftist claiming that because something costs more in the ER then it also costs the same everywhere in the US.

If you like America so much, maybe you should move here, and pay more for health care.

[Najnaj]

Lots of private companies make drugs in countries with socialized healthcare and a lot of state run research sells stuff for huge profit to private healthcare so there goes your entire argument OP....

[Deleted]

1. Failure to render assistance IS a crime.

Okay buddy, sell your house, buy a crappy box and never pay for anything other than food/bare necessities and just send any extra money to Africa.

If you don't you're a criminal. Do you like that standard? Probably not.

Assistance isn't given freely. At best I have an obligation to call emergency services if I see people in danger. I don't have an obligation to save you personally or put my money on the line to save you.

2. Universal healthcare doesn't pay for everything every time, yet access is a lot more widespread than in the failed privatised system the US has. US citizens are not covered by other countries' insurances for obvious reasons, if they had the access there would be A LOT of medical tourism.

You could just pay out of pocket even if you lack insurance, in Africa it would be cheaper since everything in Africa is cheaper. Different living costs. You could even go to a 2nd world country like Bulgaria.

Not many are rushing to try it though. I wonder why? Might it have something to do with the quality?

3. No matter the metric, single payer healthcare works better in every country it is employed by. Heck, you even pay 3-4 times the amount for the SAME procedures. I don't get how anybody can defend this. When you're health and well being is on the line, it is not a free market. Never was, never will be. You basically want corporations to be able to hold people at ransom.

Do you want to compare average American earnings vs. average international earnings?

And that doesn't fly in most cases since people have the option to prepare for these events by getting insured or saving money for a rainy day.

You're not held for ransom. You're given an option that otherwise wouldn't have existed anyway.

[Flarelaine]

This only displays your ignorance, the high prices you list are typical of emergency rooms, NOT ALL HEALTHCARE RELATED COSTS IN GENERAL.

See, the ER isn't just a bunch of expensive meds lying around, it's a whole service that operates 24/7 with a lot of challenges.

I suppose that could be an argument for a high fee on the time of qualified personnel. In one example, though, those are cited separately from the saline, which is still priced at $91.

[Deleted]

If you like America so much, maybe you should move here, and pay more for health care.

So should you. Maybe then you would learn American culture and stop denying its existence.

[Deleted]

it's all fun and games until you or your loved ones need that 100k procedure.

[Machismo]

So should you. Maybe then you would learn American culture and stop denying its existence.

I am An American, born and raised.

What is "American culture?" You keep saying it, yet cannot seem to explain what it actually means. So sad for you.

[Deleted]

There is absolute no comparison between private healthcare and private police/army.

A private police wouldn't work. Not because "socialism is better" but due to inherent conflicts of interest.

You cannot serve both the law impartially and your shareholders AND your customers. If I hire a private cop they do what I say, not what the law says. Do you honestly think they're going to ever arrest the guy paying them the money? It is categorically impossible to make a private police force work. Their monopoly on the use of force as a private company would also be incompatible with the free market itself. They would be little more than mafia goons.

That's correct. And you cannot practise medicine impartially in a healthcare system that depends on profit. Which is why in the US rich people get the best care and poor people don't get any. Doctors in the USA do not only serve their patients, they operate in a system where they have to make a profit. A hospital in the USA either makes a profit or it closes. Unlike in the UK, American doctors not only have to serve their patients, they have to satisfy the demands of private insurance companies and they also have to satisfy their practise or hospital administrators that they aren't incurring a loss

Even if a doctor wants to treat their patient, and they know the best procedure, they will often have to say no can do unless you can get the money to pay for it.

So we're agreed, law and order have to be socialised, because only in that way can everyone be equal in the scales of justice, and it would be totally wrong for victims of crime who happened to be poor to have no access to justice.

In short , it's a bad idea to have anything that provides so basic a human right as healthcare, law and order or defense to a private company.

- - - Updated - - -

If universal healthcare is so great, why do 0 Americans travel to Zimbabwe for treatment? They have universal healthcare. And sure you wouldn't get it free cause you're not a citizen, but even just paying for it would be cheaper since everything in Zimbabwe is cheaper. Is it good quality to warrant the trip? No..

Because Zimbabwe is a much poorer and far less developed country than the USA? You're not comparing like with like. If you want to make comparisons, why not look at countries of comparable wealth and development but who otherwise differ on the model or healthcare provision?

Why not compare the health outcomes and costs of, say, France with that of the USA?

Sad to say, all you are doing is "America is the best in the world and everyone else is wrong".

The vast majority of developed, wealthy, advanced countries in the world - have a socialised medical system. And most of them score better on healthcare whilst spending less of their national wealth.

If fully privatised healthcare is so great a thing, why is it that it costs so much for a worse outcome?

And before you jump in with your ridiculous argument about why aren't Americans jumping into planes to go to France, the reason is simple: they are not covered by the French health system, and therefore, they would have to pay the full upfront costs of treatment PLUS the travel costs, even assuming they were fit enough to travel.

Socialised medical procedures are not necessarily cheaper to do, they are simply much cheaper to the individual, since the risk is shared across an entire population. Also you don;t have a whole heap of insurance companies wanting to take their cut before you even get started.

But as I said, if you look at the actual numbers, Americans actually spend up to double the amount of national wealth on healthcare, and yet despite spending all that money....America performs quite poorly on the international performance tables. A lot of that is because a huge numbers of Americans simply cannot afford proper healthcare at all, and end up on relying going to emergency departments who have to treat people on a "treat now and maybe pay later" basis

And the irony of that is that by that time, conditions that started out as quite simple and cheap to treat have turned into expensive and difficult to treat. if not fatal. And even mor eironically it pushes up the cost of emergency treatment hugely for those who can eventually pay. But it is literally emergency treatment, not ongoing care, a stickign plaster over a wound.

[Delekii]

1. It's not modern highwaymen. Those doctors didn't make you sick and as such don't bear any responsibility for curing you.

The left once again refuses to make a moral distinction between bad action and simply not getting involved in something, letting things run their course as if you had never been there in the first place.

Your argument would only make sense if doctors spread diseases in order to sell you a cure. That's not something that happens and if it did it would be one hell of an outlier.

Sorry?

How is that different from a private police force with a conflict of interest not arresting their employer? Is that police force responsible somehow for the crimes committed by their employer? The analogue stands up just fine. An argument that you have made ad nauseum in this thread is that you cannot force people to work (or more specifically, to work selectively on the basis of personally detrimental criteria), so why do you think it's ok in the case of police?

2. Many millions are denied treatment despite universal healthcare. Universal, single-payer, whatever you want to call it only ensures equal access to healthcare, it doesn't guarantee quality at all and in practice governments around the world ration it based on their ability to pay.

If universal healthcare is so great, why do 0 Americans travel to Zimbabwe for treatment? They have universal healthcare. And sure you wouldn't get it free cause you're not a citizen, but even just paying for it would be cheaper since everything in Zimbabwe is cheaper. Is it good quality to warrant the trip? No.

You're right; the universal healthcare offered in an essentially non-functioning country doesn't work well. On the other hand, in all other actual comparable scenarios, it works just fine or better, and leaves far less people in life-crippling debt.

3. When I said it works I never claimed it was a utopia. I merely said it works. There are no inherent conflicts of interest in paying for healthcare. You get better, the doctor/pharma company gets wealthier. It's a win-win and it's voluntary.

Private police doesn't work because a private cop will never enforce the law against his employer or customers. It's as nonsensical as claiming two sides in a trial can have the same lawyer.

The conflict of interest inherent in for-profit medical care are so obviously apparent you have to be acting to stupid to ignore them. Here are the most important ones:

a. The person you pay to make you better benefits financially from you staying sick, or receiving treatments that are either unnecessary or questionable.
b. If you are allowed to pay more to receive better healthcare, those who provide healthcare benefit from selectively choosing who they treat, thanks to (a). The financial incentive for treating the right patients exists, and thus can outrank the medical necessity of treatment between two potential clients.

You approach the discussion of healthcare from the point of view of the system you currently exist in, which makes you unable to see how it would work with a different paradigm. Your inability to see the parallel to a police force highlights this perfectly. You assume that by virtue of being police and upholding the law, that they are somehow able to be compelled to uphold the law in their employment, which is perfectly reasonable. However, logic dictates that there is no reason that the same expectation and/or law cannot compel the same out of the medical profession, when it can (and does).

You are right that this means that those systems are then forced to ration those resources as they can, which is precisely the point. You can't pay to acquire a higher portion of the resource pie in a market where everybody is a captive consumer who cannot choose not to engage without catastrophic self consequences. These systems still work, they still allow (mostly) timely access as widely as possible to medical care that is needed. Top end access is definitionally lower, while average access is either the same or better, and most importantly, extremely few people go bankrupt and lose their entire capacity to engage in society at all.

In reality, though, most of the systems we are talking about are two-tier systems where private health insurance still exists and provides access to faster healthcare if you are privately paying or insured. They are set up in such a way that the government run systems still functionally operate, with varying degrees of speed of access. Australia, for example, strongly incentivises private healthcare for people who can afford it (by levying for the public system on those who don't have it above a threshold of income). The outcome of this system is that private payers are able to pay to increase their level of healthcare to a controlled degree (private health funds are still heavily regulated), and indirectly fund the public system to provide a functional baseline for the public system that, while not perfect, works, and doesn't leave people with a choice between debilitating ill health or destitution. Recently there has been a spate of specialists grossly overcharging the "gap" (which is the amount on top of documented price in medicare and thus covered by health insurance providers charged by the specialist in question) which was met with severe backlash from within the medical profession itself (that is; the governing medical body, which is run by active doctors and surgeons, actively fought AGAINST inflated costs for private healthcare).