Those of you with free healthcare, is private healthcare better in your country?

[Wyrt]

What foreigners don't understand is that Americans have had free health care for decades.

We get our health insurance from our jobs.

That's why health care legislation has such trouble passing a vote in Congress. Why would someone give up their "free" healthcare that has a lot of choice for a huge tax increase?

Other countries pay less than the US does. So, no, there would be no tax increase if we did it right. A universal system in the US should be cheaper than what we have now.

[Edge-]

What foreigners don't understand is that Americans have had free health care for decades.

We get our health insurance from our jobs.

Not all jobs provide health insurance. Not all health insurance plans through jobs are worth a shit, especially prior to the ACA, meaning that you were often fucked anyways.

That's why health care legislation has such trouble passing a vote in Congress.

No, it's not. It's because of constant fearmongering about "socialism" and bullshit, cherry picked horror stories that are paraded as "normal" when they're not.

Why would someone give up their "free" healthcare that has a lot of choice for a huge tax increase?

That employer provided health insurance is often considered a part of your compensation package, and that employer contribution could conceivably be shifted to pay towards single payer rather than private insurance. And I'd happily pay a bit extra if it meant I didn't have to deal with co-pays, deductables, finding in-network providers, hassling with insurance companies to cover appointments/procedures they're supposed to cover, and, prior to the ACA, yearly/lifetime limits, denied applications for insurance or denied requests for appointments/procedures and a huge host of other bullshit.

[Felya]

What foreigners don't understand is that Americans have had free health care for decades.

We get our health insurance from our jobs.

That's why health care legislation has such trouble passing a vote in Congress. Why would someone give up their "free" healthcare that has a lot of choice for a huge tax increase?

You do pay for your job provided healthcare, both through taxes and not seeing that money on your pay check. Your job provided healthcare, is closer to ACA than Medicare. Medicare... which is “free healthcare”...

That's why health care legislation has such trouble passing a vote in Congress.

No, that would be due to lobbying. How much did you pay your legislator to make healthcare better for you? How much did insurance companies pay your legislator? Why should they work for you?

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Not all jobs provide health insurance. Not all health insurance plans through jobs are worth a shit, especially prior to the ACA, meaning that you were often fucked anyways.

Jobs mitigate the cost of insurance, the same way ACA did... through group plan deals. It is then subsidized by the government, but the subsidy is for your employer, instead of you. Then the cost is subtracted from your salary, as part of employee cost that workers don’t see. Oh and then you may also pay for it on your pay check.

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That employer provided health insurance is often considered a part of your compensation package, and that employer contribution could conceivably be shifted to pay towards single payer rather than private insurance. And I'd happily pay a bit extra if it meant I didn't have to deal with co-pays, deductables, finding in-network providers, hassling with insurance companies to cover appointments/procedures they're supposed to cover, and, prior to the ACA, yearly/lifetime limits, denied applications for insurance or denied requests for appointments/procedures and a huge host of other bullshit.

There is also this:

The huge health-care subsidy everyone is ignoring
https://www.washingtonpost.com/news/...e-is-ignoring/

But perhaps the most consequential subsidy is rarely mentioned or even noticed: Government for decades has directly subsidized individuals’ costs of employer-based health care, to the tune of roughly $250 billion every year – sums far greater than the annual costs of the subsidized insurance coverage provisions of the Affordable Care Act.

[Zan15]

What foreigners don't understand is that Americans have had free health care for decades.

We get our health insurance from our jobs.

That's why health care legislation has such trouble passing a vote in Congress. Why would someone give up their "free" healthcare that has a lot of choice for a huge tax increase?

What job do you have where you don't pay a portion of those premiums on a bit weekly basis???

There is also deductible, coinsurance, copays, denials, out of network.....etc etc...cost

The amount of cost sharing by employees has jumped dramatically over the last 20 years.

https://www.kff.org/report-section/2...y-of-findings/

Most covered workers make a contribution toward the cost of the premium for their coverage. On average, covered workers contribute 18% of the premium for single coverage and 29% of the premium for family coverage. Workers in small firms contribute a higher average percentage of the premium for family coverage than workers in large firms (38% vs. 26%).

The average dollar contribution for family coverage has increased 21% since 2013 and 65% since 2008

[Felya]

Other countries pay less than the US does. So, no, there would be no tax increase if we did it right. A universal system in the US should be cheaper than what we have now.

Since we do have socialized healthcare in Medicare and Medicaid... Insurance companies only cover the lowest risk pools of patients. US government is wholly responsible for covering just about every high risk demographic. We end up paying for majority of the expensive patients, while insurance grabs everyone that is supposed to mitigate the cost. It would likely be cheaper, if employer provided healthcare was part of Medicare. Since that would push low risk patients, into Medicare pool to help balance the cost.

It’s Nixon level of stupid... Insurance companies get the majority that are cheap, while we end up paying for majority of the expensive. It’s a really shitty deal for tax payers...

[Slant]

I think we basically agree here - the obvious sticking point is going to be when we bump into what constitutes "basic care". As mentioned upthread, I support universal basic healthcare, but it's not clear to me that my definition of basic is going to match other people's. Some things are easy - if someone breaks a leg, that's surely got to be something that's covered. To take a concrete example that I think is more difficult and non-obvious, should Truvada be free to end users? It's apparently fairly effective at reducing HIV risk from unprotected sex, but costs about $20K/year to provide protection that can more easily be gained through free behavioral changes. Is that the equivalent of a basic wheelchair, or is it gold-plated spinners? There are a lot of examples that are in these sorts of buckets.

Of course, this should not be construed as an endorsement of the current American system - we've managed to pick the absolute worst parts of government and private systems and created an amalgamation that costs about twice as much as it should based on the results.

It's really well defined, if you want it to be. Pathology (as in, the study of illnesses) isn't really as obscure as it was in the middle ages. We know when someone is ill, we generally have a good idea how the body is supposed to work. As long as you can restore the body to its natural working function, that is basic medical care. It doesn't mean, for example, that you cut off a leg if you can save it. Even if saving it is more important. Ethically, I think, we're supposed to "fix" people as well as we can. Doesn't mean we should pimp them and make them better than they were going to be in the first place.

Mind you, this includes psychology as well. And I think the psychological aspect is really the main area where you could have a debate. Assume I don't like my nose. I don't expect any but the most luxurious and idiotic health insurance to cover that. It's a vanity thing, totally pointless as far as nature is concerned. Now, take someone who can't breathe through his nose and is in actual danger of choking on his tongue or something like that, we would expect an insurance to make sure he can actually breathe.

The flip side is that burn victims, even if they survive and you manage to "fix" them to a state where they can survive... sometimes their disfigurement is a burden to their psychology to such an extent that they become suicidal. Plastic surgery can solve that to some extent and absolutely should be covered by insurance.

It's a big sub-debate, but probably the more important one than the idea that generally, in our modern high tech societies we should be beyond letting people die just because they're poor. And there are people on this forum, even if it's not you, that absolutely think poor people deserve to die. Why? Because they're poor. The worst crime of all for some.

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Since we do have socialized healthcare in Medicare and Medicaid... Insurance companies only cover the lowest risk pools of patients. US government is wholly responsible for covering just about every high risk demographic. We end up paying for majority of the expensive patients, while insurance grabs everyone that is supposed to mitigate the cost. It would likely be cheaper, if employer provided healthcare was part of Medicare. Since that would push low risk patients, into Medicare pool to help balance the cost.

It’s Nixon level of stupid... Insurance companies get the majority that are cheap, while we end up paying for majority of the expensive. It’s a really shitty deal for tax payers...

Btw, there is this misunderstanding that other countries run healthcare through taxes. I'm not sure about other countries except the UK, where I know tax money is used for it, in Germany you actually pay for insurance. Half is paid by the employer, though. And the reason why people think it's a tax is because it's paid before you get the money onto your bank, along with other mandatory insurances. The state doesn't touch the money at all.

So no, health insurance doesn't have to be a burden on taxmoney at all.

[Crispin]

It's not better, it's the same doctors working 2 jobs. The waiting time is however shorter.

[Fantomen]

The private healthcare is a bit shady, brag how cheap they are at doing gastric bypass, the goverment healthcare is restrictive on doing gastric bypass (it is only used as a last resort to achieve weight loss becuse of the risk) so peopel turn to the private healthcare, most of the time the operation is successful, but then complications arise, then they do not have the expertise, and "dump" the patient on the goverment healthcare gastric bypass section to "fix" the patient. Hence driving up the cost for the goverment healthcare gastric bypass section.

[lockedout]

"Free" healthcare here in Canada is fucking shit. Our taxes goes towards dumbasses clogging up the waiting lists over simple colds.

Emergency rooms are a mess. Our doctors are too busy trying to keep so many damn old people (that probably wouldve naturally passed away at least 5 years ago) artificially alive. Doctors aren't paid as well so they give less of a fuck.

I'd rather pay.

I don't know man Endus thinks is great to wait 6 months.

[RaoBurning]

I don't know man Endus thinks is great to wait 6 months.

Ignoring the repeated times he's told personal stories (and cited other information) where he only waited a fraction of an hour to see specialists for possible life-threatening diagnoses, and also ignoring that in the US if you don't have insurance you wait until you're dying, go to the ER and hope the issue isn't chronic, and then live life under the constant threat of medical bankruptcy regardless.

Here's our vocabulary word for today: triage

[Machismo]

Free healthcare is of the worst quality in my country, people pay to get their doc diploma

With private there are also risks, but word of mouth can get you a doctor with real qualifications

What country is that?

[Felya]

With private there are also risks, but word of mouth can get you a doctor with real qualifications

Word of mouth is pretty funny in context of healthcare. You do realize that you have to have a volume of negative experience, before the good doctor? How many fuck ups does a doctor have, before word of mouth spreads to you? Why didn’t the people who built up the negative experience, use word of mouth them selfs? A good doctor that doesn’t have infinite time and would result in the same waiting list people bitch about in Canada. My gf couldn’t use ‘word of mouth’ because all the good general practitioners, don’t accept new patients. She went with a new doctor, because even with a 6 months wait, it’s better than nothing. Her previous gp retired...

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Ignoring the repeated times he's told personal stories (and cited other information) where he only waited a fraction of an hour to see specialists for possible life-threatening diagnoses, and also ignoring that in the US if you don't have insurance you wait until you're dying, go to the ER and hope the issue isn't chronic, and then live life under the constant threat of medical bankruptcy regardless.

Here's our vocabulary word for today: triage

Even if you have insurance, if you want a specific doctor, you will be on a waiting list. The idea that there is no waiting lists under private insurance isn’t true.

https://www.forbes.com/sites/bruceja.../#4843f7de2e74

The longest wait to see a doctor was in Boston, where the average wait was 52 days to schedule an appointment with a family physician, dermatologist, cardiologist, orthopedic surgeon or obstetrician/gynecologist.

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Found the problem.

You taking your money to spend it on something else, is now a problem? What?

[Endus]

I don't know man Endus thinks is great to wait 6 months.

Ignoring the repeated times he's told personal stories (and cited other information) where he only waited a fraction of an hour to see specialists for possible life-threatening diagnoses, and also ignoring that in the US if you don't have insurance you wait until you're dying, go to the ER and hope the issue isn't chronic, and then live life under the constant threat of medical bankruptcy regardless.

Here's our vocabulary word for today: triage

The relevant point of my "I waited 6 months to see a gastroenterologist" story was the bit where there were two likely diagnoses (celiac disease, or severe gluten intolerance), the treatment for both was the same (don't eat gluten), and I was already doing that. The gastroenterologist and colonoscopy and such were to confirm which was the case, since celiac is an auto-immune and there are long-term issues that can arise. There was no rush, and faster treatment wouldn't have done anything to improve my quality of life.

And like you noted, the atypical migraine I got an MRI within 90 minutes of entering the ER. When I crushed my finger nearly off with a big-ass rock, I had to wait an hour and a half to get stitched back up by the best hand surgeon in the province, but only because there was a major three-car accident that came in RIGHT after me, and they had at least one guy with a sucking chest wound, so yeah, save the guy that's dying, my finger can wait an hour.

And I'll repeat, again, for the cheap seats; I paid precisely $0 out of pocket for any of that. $0 for the monthly visits for injections, before I paid the $0 for the nurse to teach me to deliver them myself safely. Not a $250 deductible and then insurance covered it, literally did not pay a dime.

[Xarkan]

It's not better, it's the same doctors working 2 jobs. The waiting time is however shorter.

In some cases a few years ago it was shorter because the doctor took money for the same time from both the region run hospital and the private hospital and did the procedure for the private hospital.

[Bodonius]

I dont know, only really rich people use it and i guess sports people (if not they just cut the line anyway).
Free healthcare is nice in Sweden, the problem is that it takes forever... if you need a operation that isnt life threatening it might take years before you actually is well. Atleast 6 months before they do the 10 minute check up, when they say we should do bla we will send you a time later and thats atleast 6 months more

[Pterodactylus]

I don't know man Endus thinks is great to wait 6 months.

I waited 4 months for my gastro. In the USA, the country with the "greatest" healthcare in the world. I likely paid a hell of a lot more than Endus did. Was all the cost I paid what was responsible for my 2 month faster visit? Fucking laughable.

[Gaidax]

Free healthcare is not really free, it's a tax, just that if you are a deadbeat you pay next to none of it, so it's "free" there.

Private healthcare is better, both because of the availability and because private physicians are more skilled. Availability is the bigger factor - appointment for next month(s) for something bigger than your usual family doctor and shit like that can turn into appointment in next week or even few days when you let money do the talking.

[Draco-Onis]

Free healthcare is not really free, it's a tax, just that if you are a deadbeat you pay next to none of it, so it's "free" there.

Private healthcare is better, both because of the availability and because private physicians are more skilled. Availability is the bigger factor - appointment for next month(s) for something bigger than your usual family doctor and shit like that can turn into appointment in next week or even few days when you let money do the talking.

Yea except private health care isn't free either and the caveat to this is private health care is great for those who have money which most people don't. The wait line is pretty freaking long when you are broke it starts at the grave.

[Endus]

Free healthcare is not really free, it's a tax, just that if you are a deadbeat you pay next to none of it, so it's "free" there.

Private healthcare is better, both because of the availability and because private physicians are more skilled. Availability is the bigger factor - appointment for next month(s) for something bigger than your usual family doctor and shit like that can turn into appointment in next week or even few days when you let money do the talking.

There are basically two ways you get shorter wait times, in a private health care system.

Either you're paying to cut in line, meaning you're bumping others into even longer waits.
Or you're cutting people out of the line entirely, and telling them they're not getting the care they need.

The first doesn't make the line shorter, it just means some people are being allowed to cut in line. The latter does make the line shorter, but only by outright denying service to people, which isn't an improvement.

[Aenigma84]

In countries with free healthcare, the rich don't use it. Instead they use "private" paid for healthcare which everyone thinks is a lot better. Better doctors, better patient care, better facilities, equipment and so on.

There is often private medical insurance that companies buy for their high level employees so that these employees don't have to go to free healthcare.

At least, this is what I've heard. Is it true?

Should private health care be outlawed and the money generated by private healthcare be given to free healthcare to make it better?

private healthcare is always better then public i think thats the point of paying extra
then again public healthcare in belgium is one of the few things they actually did well so can't complain

but public never includes everything, and even then private here is alot cheaper then in the US
in general i think the point of public healthcare is to give people reasonable healthcare for the things they actually need
but if you want crap like liposuction, skin removal or plastic surgery and other shit you dont need then you should pay for it yourself

even then those are way cheaper here then in the US, i once had a abdominoplastie after loosing weight and cost me 2800 euro total,
if you read what you pay for some stuppid shit in the US wel there is something very wrong there