# The realities of socialized health care: share your experiences



## russmuller (May 24, 2016)

As an American, I've lived all my life with private health care and insurance (and very little interaction with public hospitals or health services). I truly believe that our current health care system and legislation in the states is a scam that serves to enrich insurance and pharmaceutical companies at the expense of patients and medical professionals.

There are a lot of people in the states (like myself) who believe that universal, socialized health care is the right thing to do, but our exposure to it comes almost exclusively through media outlets. As a result, people succumb to all kinds of propaganda and misunderstandings as to the reality of socialized medicine and how best to execute it.

I just got back from my first trip to Europe where I stayed in Ireland for a week. They have socialized health care, but our tour guide talked at length about how they have a shortage of nurses because of poor pay, hospitals and emergency rooms closing at 8PM, and hundreds of patients on gurneys (or trolleys, as they call them) for their stay instead of getting a proper bed.

While that doesn't necessarily convince me that socialized medicine is an inherently bad idea, it highlights the fact that there are probably better and worse ways to implement it. I was hoping that perhaps some of our forum members who live with socialized health care could share some of their experiences and perceptions of what it's really like. I think this would at least help me to form a more educated opinion about the issue. So please, do share!


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## MoshJosh (May 24, 2016)

To my understanding there is a nursing shortage in the US as well but I don't think it's related to low wages as I know of many establishments that pay very well. At least in the US I think it has more to do with an increasing population with longer life spans(ie people are living to be much older than they once did) leading to more people in need of care. Also certain other things like the rise in obesity and related health issues probably contributes to the number of people in need of health care and therefore nursing care.


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## Randy (May 24, 2016)

> I just got back from my first trip to Europe where I stayed in Ireland for a week. They have socialized health care, but our tour guide talked at length about how they have a shortage of nurses because of poor pay, hospitals and emergency rooms closing at 8PM, and hundreds of patients on gurneys (or trolleys, as they call them) for their stay instead of getting a proper bed.



My mother's been an ER nurse for 40+ years and I can tell you all (besides the 8pm thing) are issues here as well. She left two different hospitals because patients were being left in hallways for DAYS and people were showing up to the ER and sitting in the waiting room for 5 - 8 hours without being seen. And that's pre-ACA.


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## ferret (May 24, 2016)

I have this feeling that a tour guide's statements might need to be taken, at least partially, with a grain of salt. I mean, to a degree, they are meant to cater to the customer, right? I'd tell the customer things they want to hear, and they're well aware "we" Americans think they have death panels and decade long waits for organ transplants.

My family has dealt with a ton with healthcare due to illnesses, so no one is going to convince me that our healthcare doesn't have these same issues. When my son has trouble (I'm not going to go into the full details, other than to say we have a lot to deal with and worry about) and the TICU has been full for over a week so they put him on floors not capable of dealing with things....

For myself, I'd still take a gurney over a life time of debt though.


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## zappatton2 (May 24, 2016)

Certainly every system has its flaws, but as someone who has had a myriad of health issues since the moment I was born, including several surgeries, I can't fathom the idea that were I to live somewhere where health care was viewed as a purchased product rather than a right of citizenship, I would either be broke or dead.

One complaint a socialized system often gets is with regards to long waiting lists for common procedures, and that can certainly be true, but it's also a triage system; if your life is in imminent danger, you will be tended to right off that bat. I know a couple of friends diagnosed with cancer who are slated for surgery, though they were only diagnosed recently.

Keep in mind, I am no expert, this is all me talking from personal experiences, so all of it is anecdotal.


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## VBCheeseGrater (May 24, 2016)

I'm an american citizen these days. Born in England. If you want to get me angry, bring up private health insurance in the US.

My experience aside from birth in england, etc - went back to england around 2004 and my 3 year old at the time daughter got chicken pox on the ride over to England. So we ended up having to go to the equivalent of the emergency room. 

First of all, we did not wait. We were seen pretty much promptly. We got great service, and instead of handing us a prescription for some pricey meds to go pick up and fight with the insurace over whether we actually needed them, they gave us the medication we needed before we left.

So in short, my experience with socialized healthcare makes me that more angry when over here in the U.S. I show up to the pharmacy, wallet ready to be drained, only to be told "Your insurance needs pre-authorization and won't cover their portion until you jump through 10 hoops.....dance boy, dance!!!"

Bastards.


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## tedtan (May 24, 2016)

I have a few not necessarily linear thoughts on this subject, so here they are in somewhat random order.

I'm in the US, but have family members that have lived in Canada for a few years due to their company transferring them there briefly. They mentioned that the health care was as good as they expect in the US, but non emergency procedures would take longer. Not decades as ferret joked, but a month or three to have the procedure as opposed to a week or two in the US.

The company I work for has employees around the world, and when we hire someone in a country with social health care, we have to buy private insurance for them in order to bring their overall standard of care in line with what our US based employees have. I don't know if that is because our insurance is better than most or if the social healthcare provides less "coverage" than typical US based private insurance, but it's an interesting data point.

The US health care system is a bit different than other countries' systems. 

First, our society as a whole is much more sue-happy than are other countries' which leads to the insurance companies writing professional liability/malpractice insurance to charge the doctors, clinics, hospitals, etc. more in premiums to offset their much higher payouts. These doctors and institutions have to pass these higher insurance costs on the patients which results in higher healthcare costs.

Second, the US healthcare system is very research focused (new procedures at hospitals and clinics, new drug development and testing by pharmaceutical companies, new equipment development and testing by various health care product manufacturers, etc.). These research costs are not necessarily paid for through taxes, so much of the costs we pay for healthcare here in the US go to offset research and development costs incurred in developing these new products and procedures.

Q: What do you call the guy who graduates at the bottom of his class in medical school? A: Doctor.

So it stands to reason that hospitals, clinics and doctors are not all created equal. If you are in need of treatment beyond the typical every day procedures, it makes sense to seek out the best doctor and hospital you can, and this applies to the US, too. For example, if you have breast or prostate cancer, those are common cancers that are easily treatable if caught early, so you will likely recover just as well if treated in a regional hospital as you would if you went to a major cancer treatment facility like MD Anderson on Houston (the world's leading cancer treatment facility). But if you have Leukemia or Lymphoma, you probably need to come to Houston so you can work with the best doctors and nurses and have access to the latest and greatest research, techniques, equipment, etc.

Last, the US has experienced a shortage of nurses primarily because the largest generation in our history, the baby boomers, are at the point of retirement and death. With that comes an increased demand for nurses and doctors to help care for them. However, after the baby boomers pass away, there will be an oversupply of health care workers so I would expect their pay levels to decrease across the board after 2030 or 2035 or so.


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## CapnForsaggio (May 24, 2016)

Free markets will always develop the best products. Not everyone's service is equal (ability to pay, skill of doctor etc.) but the end result is a continuous "ratcheting" up of quality of product and lower of price (increased value). These are due to economic forces CREATED by competition and choice.

Socialized anything is a race to the bottom in terms of quality (more money for administration if they have ....ty docs or offer limited procedures).

Have any of you been to a DMV, post office, VA hospital, or other govt run business lately?

Socialized medicine is a great IDEA. Socialism is a great IDEA. There are troves of real-world evidence that it does not function in the ways we anticipate. Quite simply, it lacks COMPETITION and CHOICE, the only mechanisms with which we improve our lot. It might work for awhile before grinding to a halt. 

I would like humans in 100 years to have better medicine than we have today. Socialism will not provide this. Mark my words.


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## UnderTheSign (May 24, 2016)

The worst thing our government has done to healthcare in the past 10 years is partially privatise it and made it possible for insurance companies and health care providers to cut deals. Costs went up and service went down.

Every company that went out of government hands so far (our railway - which has since been plagued by delays, defects, endless maintenance and excuses, postal services which though improving were absolute bogus for a few years, etc) have turned out worse.


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## mnemonic (May 24, 2016)

I lived in the US until shortly after I graduated university, then moved to the UK and have been here several years now. 

In the US I was always on my dad's insurance (teamsters, which apparently was pretty good cover). Never had a problem with that, always easy to deal with from my end, quick to be seen, etc. Though there were costs involved. I can't remember the benefit in kind my dad was taxed on, but it was a lot. 

Here in the UK I've never directly paid for any kind of healthcare (taxes sure are a lot higher here though). Wait times for things kinda suck but I imagine it depends where you live. I dont like any General Practitioner I've seen here, I really get the feeling they don't know what they're doing. Again, probably depends on who you see. in the 6ish years I've been here, I've been to the GP maybe three or four times, and seen a different person each time. 

Wait times are long though, took 9 months to get an appointment with the dermatologist for a moderate/severe skin condition I had. That was not super fun. 

On the up-side, I injured my elbow at one point and I couldn't straighten my arm fully without stabbing pain, got an appointment the next day at the hospital where they X-rayed it to see if I broke anything (I didn't, luckily). 

I'm currently waiting on an appointment to get a possible tendon injury in my hand checked, and I'm sure I'll get a 'just take it easy' as usual. 



There has been some stuff in the news about junior doctors strikes, NHS funding, etc. I get the feeling that the government wants to privatize, so they're pushing for ....ty contracts with doctors, too-long hours, cutting funding, etc. so when complaints go up and waiting times increase, they can point and say, "See? It isn't working, we need to privatize!" I really hope this doesn't happen though, since I'm certain taxes wouldn't go down if I suddenly needed to pay out of pocket for healthcare. 

Also, regarding wait times here, I think you can pay to go private and be seen by a specialist right away, though I'm not sure what is involved with that or what the costs are.


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## coffeeflush (May 24, 2016)

This might not seem about health care but bear with me. 

I was in a job (entirely different industry but same working conditions) where I had to work insane hours for low pay. The experience was enriching and I had to deal with lot of emergencies all the time , after 2 years I got burnt out and left the job. 

Doctors and Nurses in public sector have it worse , lot of good ones either start private practice or move onto other fields. Nurses as well. 

In India , while healthcare is somewhat affordable, it is affordable at the cost of making life for medical staff tougher then it is in 1st world countries. Currently I am in Germany and though healthcare I have heard is much better here, I am happy I have not yet had to experience it. 

But the cost of even basic medicines/procedures is staggering.


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## bostjan (May 24, 2016)

The USA is on a continual decline. Health care here got awful before the ACA, and the ACA didn't change much, from what I can tell.

When I was younger, things were great. I had great insurance through my parents, then through my 20th century employers. If I was sick, I would call the family doctor, make an appointment to see the doctor within 48 hours, be seen by said doctor, talk to the doctor, usually receive my diagnosis and something to help, but sometimes be sent directly somewhere else for immediate testing or treatment ... whatever. It wasn't cheap, but compared to now, it was affordable.

Then the economy started crumbling in my area, so I moved away. Long after, I had an accident and broke my arm. My employer fired me and cancelled my insurance _immediately_ when they heard. I was left with no insurance and a broken arm, requiring surgery. The family doctor referred me, and this other guy I didn't know didn't give a ..... I ended up getting, in writing, a quote from the doctor and the hospital that ended up being a complete farce when the bill was over 2000% higher than the quote. The payment options the hospital offered were reneged when the cost soared, which was the hospital's fault and had nothing to do with me (aside from being allergic to one kind of medication, which I was given, despite telling several nurses and having in writing that I was allergic to it), nor anything unforeseen. I ended up being completely ruined, financially. I went from being days from putting a down payment on a house in a nice neighbourhood to being tens of thousands of dollars in debt. I went from working two full time jobs with good benefits to working just as much at one salaried job with no benefits. And that was beside going from healthy to crippled.

Now, when I get sick, I have nowhere to go. No family doctors in this area are even accepting people to go on waiting lists. I took my wife to the ER, and had a doctor tell her she was being a wimp, and she needed to toughen up, even though she clearly was injured and has an infection and needed antibiotics.

So, health care in the USA is a pile of dog...., but not because of the ACA, and not because of capitalism, but because of scammers and shady business practices.


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## CapnForsaggio (May 24, 2016)

'But the cost of even basic medicines/procedures is staggering.'

This. This right here. They shouldn't be.

The ACA benefited ONE group: Pharmaceuticals. It was suppose to work for insurance companies too, but that isn't going so well. Double digit annual price increases for all paying customers. My employer has moved health plans twice since the passage, TRYING to keep our costs manageable.

If you think that our current government works in YOUR best interests, on ANY level.... You are a lost cause at this point.


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## asher (May 24, 2016)

So the multiple millions of previously uninsured people who now have health care didn't get anything?


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## flint757 (May 24, 2016)

IME with my healthcare I rarely see the same GP (usually end up seeing the on staff nurse practitioner), appointments can take up to 45 days or more for me to get with specialists, major surgeries get pushed in favor of triage cases (even when your surgery seems significant), the doctors I have seen seem sometimes incompetent or can't be bothered, if something is wrong with your bill it takes months to fix and you have to jump through hoops, if your doctor fills your script wrong it could cost you 2-3x as much, and so on. 

I needed a bone density scan and MRI and it cost $2800 with my deductible being $2500. I've waited over 4 hours at an urgent clinic and everyone I've ever known who goes to the ER with something not immediately life threatening sits there for at least 5 hours. 

They also consider a great deal of things to be superfluous and/or cosmetic. Example: I'll need IOL's implanted in my eyes because I have rather severe cataracts. Not only will I have to likely pay at least 20% of that bill, but they base their coverage for the procedure on the bare minimum necessary to get me walking out of the door. So if I want implants that don't absolutely suck balls I'll have to pay any additional costs completely out of pocket, including the fees I already have to pay, the deductible, and the cost of holding insurance to begin with.

We have a nurse shortage, doctors are being told to see more patients (thus less personal and way shorter visits), and wait times are only increasing (leading me to presume that how healthcare is paid for has nothing to do with any of these issues like it is usually presented when single payer is being brought up).

This is US PRIVATIZED healthcare. 

On that topic, didn't a high court also just rule that the government can't appropriate funds without full congressional approval to pay the backdoor payment to the insurance companies for theoretically lowering their costs? I never agreed with that portion of the ACA at all. The idea of congress subsidizing healthcare (an extremely bloated industry) disgusts me, but the idea that they now can't even make those payments leaves me wondering what will happen next (unless something more recent has occurred).


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## bostjan (May 24, 2016)

^ If someone is robbing you blind, whether you are in a democracy, or a monarchy, you still got robbed blind.



asher said:


> So the multiple millions of previously uninsured people who now have health care didn't get anything?



I guess that's why this thread exists. If they are insured, but not getting proper medical treatment, then probably not.


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## flint757 (May 24, 2016)

Being insured isn't enough either because most people in poverty go for either high deductible plans or minimal benefits to lower the monthly costs. So when they really need to use their insurance often the insurance isn't even paying for it, you are.

I had a conversation with someone who worked in HR and they said most young folk don't even ask what is covered or how much the deductible is when a company offers insurance. They just hear company paid for insurance and typically that's enough. Her boss was making a half serious comment that they could raise the deductible to $4000 and likely no one would care because no one would even look into it until they actually needed to use it.


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## Hywel (May 24, 2016)

I think the NHS is one of the best things about the UK. 

I love the fact that I can see a doctor for any reason and I don't have to worry about how much it's going to cost or if I can afford it. Sure, there are some waiting times for less urgent problems but anything serious or urgent will generally get seen very quickly.

I also love the fact that doctors can see patients and not have to worry about whether their insurance will cover tests they want to run or procedures. NHS doctors have no incentive to try and push expensive tests or procedures since they aren't trying to make a profit. I can't imagine anything worse for a doctor than telling a patient they can't help them because they can't afford it.

Private healthcare still exists in the UK but is entirely optional and it's the same doctors as the NHS. All it does is skip some queues and it's generally still quite reasonably priced. Experimental treatments and non cost-effective treatments (such as some new cancer drugs) are not covered by the NHS except in special circumstances and they are assessed on an individual basis.

There are some problems with the NHS. The changes to the junior doctor contract has tanked morale amongst existing doctors in training and medical students (and the BMA has somehow managed to negotiate it to be worse than before), there are long wait times for many non-emergency things, there's not enough staff and everyone clinical is overworked to name a few but I still think it's a far better system than what's found elsewhere.

TL;DR - NHS is amazing. 10/10, would pay for though taxes again.


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## CapnForsaggio (May 24, 2016)

asher said:


> So the multiple millions of previously uninsured people who now have health care didn't get anything?



They didn't GET anything. They were legally required to BUY something. Its cost is subsidized by government funds (tax revenue), but no one GOT anything. They bought it, under threat of penalties from the IRS.


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## CapnForsaggio (May 24, 2016)

Further more, why not end homelessness with threat of penalty from the IRS?

Because we can't afford to tax/house everyone, and it wouldn't be fair to try.


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## UnderTheSign (May 24, 2016)

Hywel said:


> I love the fact that I can see a doctor for any reason and I don't have to worry about how much it's going to cost or if I can afford it. Sure, there are some waiting times for less urgent problems but anything serious or urgent will generally get seen very quickly.
> 
> I also love the fact that doctors can see patients and not have to worry about whether their insurance will cover tests they want to run or procedures. NHS doctors have no incentive to try and push expensive tests or procedures since they aren't trying to make a profit. I can't imagine anything worse for a doctor than telling a patient they can't help them because they can't afford it.


This. So much. Same in the Netherlands. Deductions and regulations included I pay 15-20 per month on health insurance. That covers most doctors visits, a select number of appointments with a physical therapist, multiple dentist visits a year and a ton of other stuff. 

When I got my wisdom teeth pulled, I think the only reason I had to pay out of my own pocket was because I required extra anesthetic and my budget insurance (I was a student back then) didn't cover for that. Whole thing cost me 25 and my insurance still covered the rest.


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## mongey (May 24, 2016)

I have lived with public healthcare all my life and I am a huge fan of it. 

I have broken multiple bones badly needing serious operations and it has never cost me a cent.

I don't understand why anyone wouldn't want a free public system for everyone b


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## Winspear (May 24, 2016)

Said it better than I can. Had nothing but good experiences. People will moan about the wait times but it's a small price to pay. How many hours do you work to pay off medical bills?



Hywel said:


> I think the NHS is one of the best things about the UK.
> 
> I love the fact that I can see a doctor for any reason and I don't have to worry about how much it's going to cost or if I can afford it. Sure, there are some waiting times for less urgent problems but anything serious or urgent will generally get seen very quickly.
> 
> ...


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## CapnForsaggio (May 24, 2016)

mongey said:


> I have lived with public healthcare all my life and I am a huge fan of it.
> 
> I have broken multiple bones badly needing serious operations and it has never cost me a cent.
> 
> I don't understand why anyone wouldn't want a free public system for everyone b



Because you have never really needed it, its all good.

When YOU do need it, and can AFFORD it, but can't have it because there are a bunch of people who CAN'T AFFORD it waiting in front, your tune will change. I assure you.

We were created equally, I whole heartedly believe that. We won't die that way. And fudge anyone who thinks I need to die an equal death to some fat lazy welfare pot head porker.


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## estabon37 (May 24, 2016)

CapnForsaggio said:


> Socialized anything is a race to the bottom in terms of quality (more money for administration if they have ....ty docs or offer limited procedures).
> 
> Have any of you been to a DMV, post office, VA hospital, or other govt run business lately?



The quality of care in Australian public systems is pretty top-notch. The last time I went to our equivalent of the DMV, I was there for a total of ten minutes. The longest I've spent in the last fifteen years is an hour; on average, thirty minutes.

I've showed up at the emergency room several times throughout my life (never by ambulance, for which I pay $60 a year coverage for both myself and my partner). The only time I had to hand the hospital money was when they gave me a pack of anti-inflammatories, and six months later they sent me a letter asking if I could pay $10 for it (the receptionist was super surprised when I showed up with the money). The longest time I've spent in an emergency room is three hours.

A close friend of mine had a nasty fall and wound up decimating her elbow. She now has an arm full of pins and staples. The procedure took ages, and was fairly intricate. It cost $0. It is our right as Australian citizens to be provided with health care, which we pay for in taxes. Our system is imperfect, but it is not suffering.



CapnForsaggio said:


> Socialized medicine is a great IDEA. Socialism is a great IDEA. There are troves of real-world evidence that it does not function in the ways we anticipate. Quite simply, it lacks COMPETITION and CHOICE, the only mechanisms with which we improve our lot. It might work for awhile before grinding to a halt.
> 
> I would like humans in 100 years to have better medicine than we have today. Socialism will not provide this. Mark my words.



This is stated from a position of ignorance. Public health care is not socialism. Competition and choice has led America's health care system down an expensive and poorly serviced path; there's really no denying it. Australia has also contributed significantly to developing many areas of medicine (cancer research, hearing and vision, rehabilitation, etc) largely on the public bill. Instead of competing, we work together to achieve shared goals. 

What you seem to think of as socialism, the rest of the world thinks of as community. Why wouldn't we work in the interests of our neighbours?


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## mongey (May 24, 2016)

CapnForsaggio said:


> Because you have never really needed it, its all good.
> 
> When YOU do need it, and can AFFORD it, but can't have it because there are a bunch of people who CAN'T AFFORD it waiting in front, your tune will change. I assure you.
> 
> We were created equally, I whole heartedly believe that. We won't die that way. And fudge anyone who thinks I need to die an equal death to some fat lazy welfare pot head porker.



It really doesn't work that way in my 42 years of living in the system. Yeah if you need a less serious procedure you will need to wait inline. 

Again I don't understand how a system that cares for everyone is so scary to you but it's all good man. I don't have to live with your system.


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## jeremyb (May 24, 2016)

In New Zealand we have a public health system and I choose to have private medical insurance as well as I can afford to, best of both worlds!

So if I need non-urgent surgery I can get it done quickly in the private system, rather than be on a waiting list for a long time.

But if I have a serious accident or emergency health issue the public system will do a damn fine job of looking after me, and I won't be faced with a 6 figure bill at the end of it.

Any country that cares about it's people should have a public health system, you're kidding yourselves if you think a country in which only the rich deserve access to first world health care is an ok situation.


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## jeremyb (May 24, 2016)

CapnForsaggio said:


> Because you have never really needed it, its all good.
> 
> When YOU do need it, and can AFFORD it, but can't have it because there are a bunch of people who CAN'T AFFORD it waiting in front, your tune will change. I assure you.
> 
> We were created equally, I whole heartedly believe that. We won't die that way. And fudge anyone who thinks I need to die an equal death to some fat lazy welfare pot head porker.



Wow, great empathy for your fellow man.... you won't find that "fat lazy welfare pot head porker" are the majority of people in a hospital....


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## aesthyrian (May 24, 2016)

CapnForsaggio said:


> And fudge anyone who thinks I need to die an equal death to some fat lazy welfare pot head porker.


 
LMAO this is too good. Do you live your whole life simply seeing people and issues as various stereotypes. You do know you fit a certain stereotype yourself, having spewed such obvious talking points. 

I mean, if you want to share your viewpoint and actually convince others, there are more tactful ways. But, if you want your argument to lose most, if not all of it's credibility, then carry on.

None the less, thanks for humor!



jeremyb said:


> Wow, great empathy for your fellow man.... you won't find that "fat lazy welfare pot head porker" are the majority of people in a hospital....



Lack of empathy is simply the "American way"... 

It's ok, we're all going to heaven anyway! Country full of "Christians" sure don't act very Christ like. I mean, I'm an American and I know my fellow citizens can and will do more harm to this Country and it's people than ISIS or whoever will. 'Cause we're #1! Keep saying it...


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## Hywel (May 24, 2016)

CapnForsaggio said:


> When YOU do need it, and can AFFORD it, but can't have it because there are a bunch of people who CAN'T AFFORD it waiting in front, your tune will change. I assure you.



A nationalised healthcare system doesn't need to wipe out private healthcare. Both can exist in the same country at the sane time and in many places they do. If you can afford it you are welcome to pay to skip the queues using the concurrent private system. If you can't afford it then anyone is welcome to join the queue.

---------------

I tried to find some numbers to compare and found this. There's a US group called the Commonwealth Fund that publish data comparing international healthcare systems every year. Below is a link to the 2015 report (with some 2013 data) if anyone would like to read it.

International Profiles of Health Care Systems, 2015 - The Commonwealth Fund

Some interesting bits below if you don't fancy reading the whole thing.

Comparing the US to the UK (there are man others in the report but I'm unfamiliar with their systems)...The US spends 17.1% of its GDP on healthcare compared to the UKs 8.8%

The US spends $9086 per capita on healthcare compared to the UKs $3364
The US spends $1074 per capita on healthcare compared to the UKs $321 (Out of pocket expenditure is any direct outlay by households, including gratuities and in-kind payments, to health practitioners and suppliers of pharmaceuticals, therapeutic appliances, and other goods and services whose primary intent is to contribute to the restoration or enhancement of the health status of individuals or population groups.)
The US has 2.56 physicians per 1000 population compared to the UKs 2.77
48% of patients could get a same/next day appointment in the US compared to 52% in the UK. 39% could get out of hours care in the US compared to 69% in the UK
The US has 115 avoidable deaths per 100,000 compared to the UKs 86
The healthcare system in the US is viewed less favourably by its population in comparison to the system in the UK with 25% thinking it works well compared to the UKs 63%
The NHS isn't perfect however.


The US has a shorter length of hospital stay until cure at 5.4 days compared to 5.9 days for the UK. Israel and Australia were best with 4.3 and 4.8 days respectively
The US has 35.5 MRI machines per million population compared to the UKs 6.1. Japan has the most with 46.9
The US found it easier to get a healthcare professional to talk to between visits at 86% compared to the UK at 71%
The US has a higher breast cancer 5 year survival at 88.9% vs 81.1% in the UK. Norway has the best rate with 89.8%
 a lower 30 day mortality post heart attack with 5.5/100,000 vs. 7.6/100,000 in the UK. Australia wins at 4.1/100,000
[E. Mossialos, M. Wenzl, R. Osborn, and D. Sarnak (eds.), _International Profiles of Health Care Systems, 2015,_ The Commonwealth Fund, January 2016. P 6-8, Table 1]

Summary/TL;DR - The nationalised healthcare system in the UK costs less, has more doctors, provides faster appointments, has fewer avoidable deaths and is viewed more favourably by its population than the system in the US. The US system does have shorter average hospital stays, more MRIs, easier to talk to HCPs, better breast cancer survival rates and mortality post heart attack than the UK but is still beaten by other countries with nationalised and/or universal healthcare systems.

This is all from one source however so if anyone finds anything else please comment


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## Demiurge (May 24, 2016)

flint757 said:


> Being insured isn't enough either because most people in poverty go for either high deductible plans or minimal benefits to lower the monthly costs. So when they really need to use their insurance often the insurance isn't even paying for it, you are.



Hell, I work for a Fortune 100 company and the only choice of plan we have (entry level or executive) is the super high deductible, the-bare-minimum-that-can-be-called-insurance plan. When I tell people, they always remark, "but you work for an insurance company- that's crazy!" "Exactly." 

It says a lot about the healthcare industry and health insurance when the insured and the uninsured can both be one medical emergency away from being broke.


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## Altar (May 24, 2016)

CapnForsaggio said:


> Free markets will always develop the best products. Not everyone's service is equal (ability to pay, skill of doctor etc.) but the end result is a continuous "ratcheting" up of quality of product and lower of price (increased value). These are due to economic forces CREATED by competition and choice.



This is a really two dimensional, simplistic way of analyzing these issues. We've tried free market and it was sh/t for almost everyone involved.


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## Altar (May 24, 2016)

I think it comes down to whether we view healthcare as a human right or a commodity. And I think the world is moving in the right direction by regarding it as a right.


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## QuantumCybin (May 24, 2016)

My girlfriend is an RN, and I worked in a hospital in Florida for five years as a patient transporter. Now, Florida might not be the best example because, well, Florida is where old people go to die  however, I can absolutely tell you that the hospital I worked at (and all others in the area) were severely over-loaded with patients and understaffed with clinical personnel. The ER at the hospital I worked at (a stroke center, the trauma center was downtown), ESPECIALLY from the months of October to April (season time for all those godforsaken snowbirds. So glad I don't deal with them here in TN) was typically two to three times over maximum capacity. The ER has 32 rooms, sometimes we would have 85-90 patients in the ER. Patients on stretchers in the hallways with little privacy screens, others would sit in chairs if they weren't completely fvked up.

HIPAA violations EVERYWHERE lol. Literally being able to hear a doctor diagnosing and going over a patients entire medical history in the hallway is such a huge no no, and it happens all the time. I don't work in health care anymore but my girlfriend tells me its fairly similar here in Chattanooga. In regards to the lack of nurses, part of it is definitely that the biggest generation of humanity's existence, the baby boomers, are dying off, and also, nursing school is no joke. That sh!t is not like it used to be. Couple that with a lazier generation of people, and you end up with big problems. My girlfriend works on the trauma floor downtown. 18 patients, only 3 nurses. Six patients per nurse is NOT okay. I saw that at the hospital I worked at in Florida too. Same issue applies to physicians. Medical school is absolute hell. In all the years I worked at the hospital, I never saw a doctor spend more than 5-10 minutes with a patient, simply because they just don't have the time.

Bigger, more reputable hospitals, known as Magnet hospitals, typically don't have the staffing issue (4 patients per nurse, with the exception of critical care areas where you only have two), but that's because they have a tighter requirement (usually a BSN or an ASN with two years of experience) and/or they're attached to a university and are a teaching hospital.

Kinda got off track but what I'm really saying is, I've seen how sh!tty the conditions can be in a system where we pay for it. It's not pretty.


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## Dog Boy (May 24, 2016)

So sad that people can't talk about this without the political BS and us v them mentality.

FWIW my Dad (a WW2 vet) died about ten years ago. The pros...the VA hospital in Houston was amazing. He never waited more than 2-3 weeks to see a doctor and the building itself was like a palace with the latest procedures and equipment. No need to go anywhere else. The cons were...the paperwork...OMG it was time consuming and tedious to say the least. I also realize not every VA hospital is so well funded. All in all the Govt. run VA did us proud. It CAN work.


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## will_shred (May 24, 2016)

VBCheeseGrater said:


> I'm an american citizen these days. Born in England. If you want to get me angry, bring up private health insurance in the US.
> 
> My experience aside from birth in england, etc - went back to england around 2004 and my 3 year old at the time daughter got chicken pox on the ride over to England. So we ended up having to go to the equivalent of the emergency room.
> 
> ...



"I'm sorry, your pharmacy isn't in the network"


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## flint757 (May 24, 2016)

Something similar happened at a clinic to me. They took my insurance card when I paid, the name of the hospital (a chain) was on my insurances website, but their particular facility was not. The bill for a sinus infection, after waiting 3-4 hrs to see a doctor, was about $1000 give or take.

$1000 dollars to check if I had Strep and to check my breathing (the actual appt. was only like 10 minutes, not including the wait on the culture).


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## will_shred (May 24, 2016)

tedtan said:


> I have a few not necessarily linear thoughts on this subject, so here they are in somewhat random order.
> 
> I'm in the US, but have family members that have lived in Canada for a few years due to their company transferring them there briefly. They mentioned that the health care was as good as they expect in the US, but non emergency procedures would take longer. Not decades as ferret joked, but a month or three to have the procedure as opposed to a week or two in the US.
> 
> ...



John Green did a really good video that basically expands on this. We also spend more tax money per capita on healthcare, then the countries with socialized healthcare, and we don't get socialized healthcare. More taxes, less healthcare. 

https://www.youtube.com/watch?v=qSjGouBmo0M

#2 

https://www.youtube.com/watch?v=wMuXcuudvCc


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## Xaios (May 25, 2016)

After having experienced a significant amount of socialized healthcare firsthand, I would never want to do without.


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## thraxil (May 25, 2016)

I'm American, but I've lived in China, the Netherlands, and now the UK. Thankfully, I never had cause to deal with the health care system in China, so I can't say anything about that. I'd take the NL or UK health care system over the US any day. I've seen too many friends and family in the US have accidents or medical issues either during periods where they were uninsured or that their insurance for whatever reason refused to cover end up tens of thousands of dollars in debt or fighting legal battles against the insurance company. Obamacare, while far from perfect, was a huge step forward for quite a few of my friends with pre-existing conditions who just couldn't even get insurance before that.

Meanwhile, in NL and UK, it's just not something you worry about on the same level. If you quit/lose your job and take your time finding a new one, you don't do that with the same dread hanging over you that one spill on your bike could leave you financially ruined. You don't delay going to the doctor to have something weird checked out because you currently don't have coverage or you're afraid that it will give insurance companies a reason to refuse you later on.

FWIW, I haven't experienced any exceptional waiting times or bad experiences with NL or UK health care (at least, nothing that I'd consider atypical compared to the US). When we first moved to NL, my partner had to go to the doctor and it was a bit of a pain, but that was because our immigration paperwork was still processing and we weren't entirely in the system yet. I've heard some horror stories here and there, but nothing as tragic as what I've seen in the US. And my English friend who was living in Brooklyn for eight years would avoid going to the doctor in the US (even though she had full insurance), preferring to wait and go during her visits back to London instead. My dentist in NL is so cheap, even if you're not covered and paying entirely out of pocket, that he has patients who fly back from abroad to see him, because the cost of the plane tickets is less than what many procedures cost in the US.


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## chopeth (May 25, 2016)

Altar said:


> I think it comes down to whether we view healthcare as a human right or a commodity. And I think the world is moving in the right direction by regarding it as a right.



Sadly it is going the other way round for some countries too thanks to ignorant narrowminded ultraliberals as capnforsaggio. My country was the envy of most national healthcare systems in the world until the conservative liberals took the place of the socialist a few years ago. Not saying the socialist are better, but they don't want to make (such) a big bussiness of education, health care and justice system, what every democrat should consider sacred, but nobody can blame them, they are the heirs of a dictator, so they never believe in democracy.


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## bostjan (May 25, 2016)

A lot of people from other countries chiming in. I'm curious as to how health care worked in those countries prior to nationalized health care.

I reiterate that in the USA, it seemed like private healthcare worked, then it got greedy and stopped working, and the government stepped in to fix it, and there might have been improvements, but it is not what it used to be.

A lot of people will make anything and everything political, when, in fact, sometimes people are ....ty and it has nothing to do with government.

I think this is an insurance corruption issue. Insurance companies are in the business of making money, like any other business. The only way they make money is by collecting more than they pay out. 10/10 times, the world would be better off if everyone kept a nest egg in case of getting sick rather than employing a bunch of people to collect money. In the USA, the government does not collect the money and insure the people, but rather, requires people to be insured by an insurance company.

We saw the same thing with hurricane Katrina. People's homes were washed away. These people had flood insurance. The flood insurance did not pay these people, as a rule. When the government (FEMA) stepped in, it sided with insurance companies on 80% of denied claims. (According to NPR) The insurance companies might not have even been able to pay everything they had covered, but therein lies the basic problem with insurance of this sort.

I'm not saying privatized insurance is necessarily a bad idea, but, mandated privatized insurance coverage is almost never a good idea.


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## celticelk (May 25, 2016)

bostjan said:


> A lot of people from other countries chiming in. I'm curious as to how health care worked in those countries prior to nationalized health care.



And *when*. My understanding has been that most of the rest of the industrialized world went to nationalized health care in the wake of WWII, before they had ever built what we would regard as a "modern" health care system. That's a substantially different process than trying to nationalize a modern, privatized system, especially when that system accounts for a sixth of your yearly national GDP.


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## celticelk (May 25, 2016)

chopeth said:


> Sadly it is going the other way round for some countries too thanks to ignorant narrowminded ultraliberals as capnforsaggio.



Just to clarify terminology: in American politics, CapnForsaggio would never be referred to as "liberal," which is a term reserved for people on the political left, and often used as an insult by people on the political right. Americans generally refer to people like CapnForsaggio as "conservatives," unless they're using less charitable language.


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## Edika (May 25, 2016)

I live in the UK for the past three years but my previous experience was a somewhat intermediate situation with public healthcare and private co existing.

I have to first say that I agree with the concept of NHS and support it but the way the system works sucks donkey balls. Of course this has nothing to do with the NHS workers but the fact that they are understaffed and the government is trying to shrink it even more. 
Why I think it sucks donkey balls? Because there is not enough staff and specialists to handle the cases and you have to rely on whether the GP is adequate enough to recognize the if you might have something more serious. If you do get referred to a specialist it takes at least two months to be seen by the specialist. Unless you're actually showing symptoms of a specific disease of a specific disease then tough luck seeing a specialist or getting treatment. So the system is mostly focused on firefighting instead of prevention that would cost them less. Again it's not an issue of the NHS staff and I assume if you're leaving in a region which will have more hospitals and specialists it might be easier to get seen.
I don't mind paying more into taxes if it gets the system working better or better yet if funding of taxes was diverted a bit more in healthcare in education instead of defense let's say. But the slash on my salary for social security payments are certainly not worth what I'm getting as a service.

In France there is a 25% you pay of the costs on public healthcare but at least it doesn't take as long to see a specialist, even though you go through the GP's. They also don't have a stick up their butt when you want to do blood tests, especially if you have a family history of certain diseases, like they do in the UK.


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## chopeth (May 25, 2016)

celticelk said:


> Just to clarify terminology: in American politics, CapnForsaggio would never be referred to as "liberal," which is a term reserved for people on the political left, and often used as an insult by people on the political right. Americans generally refer to people like CapnForsaggio as "conservatives," unless they're using less charitable language.



No need to clarify, I assumed you americans knew something about labels in politics in other countries as well as we know about'em in yours. Just in case it weren't, I added the prefix "ultra-" or the epithet "conservative" to make a bigger contrast. I'm also perfectly aware a bare "conservative" in your country isn't even exactly the same as a "conservative" in mine, although the term is the same. Anyway, back on topic.


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## Altar (May 25, 2016)

chopeth said:


> No need to clarify, I assumed you americans knew something about labels in politics in other countries as well as we know about'em in yours.



Can't say I'm all that familiar with Spain's political terminology, no. :-/ The clarification was certainly helpful.


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## chopeth (May 25, 2016)

Altar said:


> Can't say I'm all that familiar with Spain's political terminology, no. :-/ The clarification was certainly helpful.



The clarification was mostly directed towards those living outside the states about the USA politics. 

In case you want to know about Spain's politics, we also have a Trump, well, actually a lot of them


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## Altar (May 25, 2016)

Ah I see now - sorry!


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## CapnForsaggio (May 25, 2016)

celticelk said:


> Just to clarify terminology: in American politics, CapnForsaggio would never be referred to as "liberal," which is a term reserved for people on the political left, and often used as an insult by people on the political right. Americans generally refer to people like CapnForsaggio as "conservatives," unless they're using less charitable language.



Thank you. I self identify as a libertarian, who advocates for free markets.

Nothing is PERFECT, but free markets are FAIR.

I am guilty of black/white thinking (no grey areas). Take it for what it is.

IMHO, grey areas are fertile grounds for lying, mistruths, and doublespeak. I see them exploited by the gov everyday....


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## russmuller (May 25, 2016)

CapnForsaggio said:


> Free markets will always develop the best products. Not everyone's service is equal (ability to pay, skill of doctor etc.) but the end result is a continuous "ratcheting" up of quality of product and lower of price (increased value). These are due to economic forces CREATED by competition and choice.



This is valid when you're talking about voluntary spending. Cars, guitars, computers, etc... It's totally invalid for healthcare though.

No healthy individual sees an ad for Cancer Centers of America and says "you know, I think that's where I'm gonna go to spend my money!" People are forced by reality to treat their medical conditions or suffer and die from them. The development of a product for sale in the free market and the development of a medical treatment are almost nothing alike.


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## russmuller (May 25, 2016)

I'm delighted to see that my post has spawned such a lively discussion. I appreciate all of your input.


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## bostjan (May 25, 2016)

russmuller said:


> This is valid when you're talking about voluntary spending. Cars, guitars, computers, etc... It's totally invalid for healthcare though.
> 
> No healthy individual sees an ad for Cancer Centers of America and says "you know, I think that's where I'm gonna go to spend my money!" People are forced by reality to treat their medical conditions or suffer and die from them. The development of a product for sale in the free market and the development of a medical treatment are almost nothing alike.



Well, yes and no. Just like food, you need it, but government does not buy your food for you. Also, there are options. You can go to Cancer Centers of America, or you can go to Johns Hopkins Medical Center, or to the university medical center, or to the local hospital, or whatever. If you need cancer treatment, you need cancer treatment, but that doesn't mean that there is one supplier of one kind of cancer treatment and then that's it.

If the medical industry is making billions in profits on a certain medical treatment, then they will want to keep doing that.

The trouble is this: you take Joe Schmo. He works 40 hours a week at a gas station, making $8/hour. Many people in the USA are in this situation. He's divorced and pays $200 a week in child support, and $80 a week in taxes, leaving him with $40 a week to live on. Joe gets sick and has to go to the hospital. Living off of $40 a week, he has no savings and quite a bit of debt, so how is Joe Schmo going to deal with getting sick? Is socialized medicine going to help him or not?

Case I: Privatized health care - Joe gets treated, but cannot afford to pay his $500 medical bill. He dives further into debt because of this. Joe is ....ed.
Case II: Socialized mandate on health insurance in a privatized health care system - Joe never got health coverage, because, frankly $40/week is not enough to afford it. Now Joe is already deeper in debt, because the IRS penalized him and between debt collectors and his job and all of the other crap Joe deals with on a daily basis, he didn't have time to hire H&R Block's lawyers to get him out of it for not making enough money. Joe is ....ed.
Case III: Socialized medicine - Joe gets treated and pays nothing out of pocket, however, Joe also doesn't make $40/week, because his taxes are now $100 instead of $80, in order to fund socialized medicine. Joe starves.

Bonus case, where Joe gets free education: Joe has a Ph. D. in humakinetics. Joe is still ....ed, becuaseJ oe still works at the gas station, however, because people are better educated in general, the GDP is higher, so wages are better, so Joe makes $9/hour instead. Joe is slightly less ....ed.

Point is, resources are limited. It's nice to think that we can save everyone from getting sick. I certainly don't want anyone to get sick. I don't want anyone to die. But, regardless of what I want, people will die. People will get sick, and people will be poor. It's not within any one person nor any one government's control to stop that from happening.


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## tedtan (May 25, 2016)

CapnForsaggio said:


> Thank you. I self identify as a libertarian, who advocates for free markets.
> 
> Nothing is PERFECT, but free markets are FAIR.



Free markets are great for certain things, but the sciences don't benefit from the type of economic competition you mention. And with healthcare so fundamentally rooted in the sciences, a laissez faire free market approach is not the most apropos means of achieving the best results.




CapnForsaggio said:


> I am guilty of black/white thinking (no grey areas). Take it for what it is.
> 
> IMHO, grey areas are fertile grounds for lying, mistruths, and doublespeak. I see them exploited by the gov everyday....



The world is almost always some shade of gray in between to two simplistic extremes, so you are missing out on much of what is going on around you.

Plus, the government is exploiting the extremes as well, so you're not really missing out on that.


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## bostjan (May 25, 2016)

tedtan said:


> Free markets are great for certain things, but the sciences don't benefit from the type of economic competition you mention. And with healthcare so fundamentally rooted in the sciences, a laissez faire free market approach is not the most apropos means of achieving the best results.



Do you have evidence of this? I'd say most of the greatest inventions and scientific discoveries happened in places and times when and where there was a free market, and some of the most bogus science has come from the USSR and China. I mean, your statement is a pretty sweeping one, contrary to my general observation, and I'm not claiming I've done a study or anything, but have you?


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## Randy (May 25, 2016)

I don't mean to say this to imply I'm pro-Communism or Socialism (because I'm not and I think the world is more complex than being able to do any one things exclusively), but 'free markets' implies Capitalism, with the "capital" part essentially meaning "money is the primary incentive structure". That means the corporation (since that's the body that manages an operation in a capitalistic model) will be administering it's care based on what's most profitable. You might image that it's two-dimensional, so the desire to make "more money" will drive them to be "better" or even less expensive than the competition, thus driving more business their way and making them more successful. If all markets worked that way it would be fantastic but corporations can fulfill the desire to be financially successful without necessarily offering a superior service. You'll see all over the place (especially in a "Walmart Economy") the fundamental method used to boost profit margins is exclusively by CUTTING costs, ie: cheaper or inferior materials or cutting out some services all together and politicking or using your size to shutter any competition. 

The typical free-marketeer might say "well then word will get around and that means they'll lose business!". Monopolies and collusion go a long way in making sure there's little to no alternatives. Free market capitalism might work for something like a landscaping business or hamburger restaurant but the overhead in opening your own competing hospital, or drug company, or healthcare/insurance provider is VERY high and it's a guarantee the marketplace would ultimately be filled with very few options (see: cable and cell phone carries). It'seasy to end up in a situation where your service is garbage but you've got no choice because that's the only provider in your area and always will be.

That's not a very desireable situation in ANY market but is orders of magnitude worse in something like healthcare where you don't make the choice to have cancer or to have a piano fall on your head where you're rushed to a hospital and they do bunch of stuff to save your life before you've got a chance to even tell them what you want done (as if you should have to ). You can't exactly pick the cheaper ambulance or choose to have the less expensive fluid pumped into your body to save your life. And even if you could, it's pretty inhumane to think that's the how healthcare should work.


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## russmuller (May 25, 2016)

bostjan said:


> Point is, resources are limited. It's nice to think that we can save everyone from getting sick. I certainly don't want anyone to get sick. I don't want anyone to die. But, regardless of what I want, people will die. People will get sick, and people will be poor. It's not within any one person nor any one government's control to stop that from happening.



I think we're addressing the issue from different angles. My point of contention was that free markets create economic incentives to meet a demand, but medical treatments and cures are not developed because research scientists project huge profits from them.

While there are economic benefits that stem directly from having a workforce and markets populated by healthy and able-bodied individuals, that's not filtered back as monetary reward for the people who made the scientific breakthroughs to enable that. The dynamic is entirely different from that perspective, and that's really what I was talking about.


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## mongey (May 25, 2016)

bostjan said:


> Well, yes and no. Just like food, you need it, but government does not buy your food for you. Also, there are options. You can go to Cancer Centers of America, or you can go to Johns Hopkins Medical Center, or to the university medical center, or to the local hospital, or whatever. If you need cancer treatment, you need cancer treatment, but that doesn't mean that there is one supplier of one kind of cancer treatment and then that's it.
> 
> If the medical industry is making billions in profits on a certain medical treatment, then they will want to keep doing that.
> 
> ...




that one thing that surprises me about the anti medicare vibe in the USA . the wages are so low and you still arent getting these services for free that many countries consider the rights of its people . minimum wage is just under $18 a hour here . automatic 25% on top if you are a casual employee who doesnt get paid sick leave or holidays 


If I was earning $10 an hour I'd want all the free services the govt could provide


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## CapnForsaggio (May 25, 2016)

russmuller said:


> I'm delighted to see that my post has spawned such a lively discussion. I appreciate all of your input.



Thank you, sir. 

These topics usually flame out quickly due to rabble rousing from both sides. The discourse here is refreshing. I am certainly guilty of being the 'worst party' involved, but in my defense, social darwinism is part of my platform 

I'm not trying to put any one or group down, I really do want the best OPPORTUNITY for people in the USA. Sometimes, in my view, this is in direct conflict with what the liberal platform (socialized medicine, high corporate taxes, etc.).


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## bostjan (May 25, 2016)

russmuller said:


> I think we're addressing the issue from different angles. My point of contention was that free markets create economic incentives to meet a demand, but medical treatments and cures are not developed because research scientists project huge profits from them.
> 
> While there are economic benefits that stem directly from having a workforce and markets populated by healthy and able-bodied individuals, that's not filtered back as monetary reward for the people who made the scientific breakthroughs to enable that. The dynamic is entirely different from that perspective, and that's really what I was talking about.



I contend that people will be driven to make scientific breakthroughs, not to become millionaires (lol autocorrect thought this was suppose to be milkionaires!), but to actually improve the state of being of humanity. Most (perhaps all) inventors never make it into the upper echelon of wealth.

If you put a pile of bureaucracy and red tape in the way of such a person, be it capitalistic, socialistic, or whatever, the person is going to be exhausted long before discovery is made.

Right now, if you had a chemical formula for a drug that cured any disease, you would not be able to get it to market in the USA for decades, if ever, because of all of the lawyers, insurance companies, and government agencies in place.

So, again, not that socialized medicine is bad, but the more the US government gets into something, the less effective, more expensive, and slower it will function, with very very few exceptions.

In my example with Joe Schmo, he is clearly ....ed by greedy capitalists. Question, though, is Ivan Schmokinsky in USSR better off under Soviet socialism? Or Jose Schmovera in Bolivia better off? No, no one has it easier because the government flies a red flag or a blue flag. They have it worse if somebody in power (maybe government, maybe insurance company, maybe rich CEOs, ...) wants to bleed them dry.


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## CapnForsaggio (May 25, 2016)

russmuller said:


> This is valid when you're talking about voluntary spending. Cars, guitars, computers, etc... It's totally invalid for healthcare though.
> 
> No healthy individual sees an ad for Cancer Centers of America and says "you know, I think that's where I'm gonna go to spend my money!" People are forced by reality to treat their medical conditions or suffer and die from them. The development of a product for sale in the free market and the development of a medical treatment are almost nothing alike.



Nowhere did I or anyone else say that being a good capitalist is easy. It does take research, personal choice, and risk. 

When things are not available to you easily in a capitalist system, this represents OPPORTUNITY. That's the whole point:

'Cancer treatment sucks in my city, but many people have cancer.... Maybe it would be profitable for me to open one....' 

Not everyone person in the city has the CAPITAL to open the treatment center, but the OPPORTUNITY exists for anyone. That person creates wealth (but suffers risk) AND actually improves the cancer treatment options for the community.

The decision gets made to build/not build the treatment in the EXACT same way as socialized medicine: If enough people would use it (pay) to justify its existence, it gets built. Socialism = government gets bigger/richer, Capitalism = some person/people get richer.

Socialism = government inertia and mismanagement
Private = we better do a good job, or someone ELSE will see OPPORTUNITY and take our business....


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## mongey (May 25, 2016)

CapnForsaggio said:


> Socialism = government inertia and mismanagement
> Private = we better do a good job, or someone ELSE will see OPPORTUNITY and take our business....



do you really trust you and your families health to large corporations more than you trust governments ?I'm no lover of most governments but at least they are accountable to the people not shareholders 

the problem is someone has sold the idea that socialized healthcare is socialism. and you know who sold it. the corporations


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## flint757 (May 25, 2016)

CapnForsaggio said:


> Private = we better do a good job, or someone ELSE will see OPPORTUNITY and take our business....



That's not how it works in practice. That's the problem with capitalism; ideally that would be the case, but the way industry is setup in the US it doesn't tend to allow for such things to occur. Ideally it would require a 100% free market, good will, and money spread more evenly across a bell curve for it to work that way. What we see in practice is that the more 'free' the market is the more large companies take advantage and screw people over to save/make a buck. We have become a society of profit through cutting corners and cornering markets entirely, creating oligopolies/monopolies. This well intentioned 'free' market would also have to completely ignore the barrier of entry most large scale businesses have. Starting an ER, setting up a wireless tower, laying cables, etc. costs more money than your average person is ever going to have. Once someone enters a market in an area with high barrier of entries it is often not worth it to competitors to invest the money to compete. That happens quite often. What you end up with is a market with very few competitors which brings prices up and quality down [hello Comcast].

Governments don't have to be wasteful and bloated when running services. They're only like that because of the jackasses we have running congress currently.

---

To bring socialism around to a separate topic, how would you feel if the fire department or police force and various other protection agencies were all for-profit and private. A system such as that means your neighborhood goes to .... if you don't have the money to pay for these services, because most neighborhoods are divided by class. So if your house is on fire pretty soon so will the whole neighborhood because no one can afford to pay for the service. I look at healthcare in a similar sense, at least as it applies to highly contagious illnesses. I'm less likely to need medical care if everyone around me is healthier because they can more freely access healthcare. If I can't afford my meds and the doctors visit I might be going into work Monday still sick and contagious, getting everyone else in the office sick as well. If they don't want me there because I'm sick I'm also now sick longer and unable to contribute effectively at my job. 

It's a lot bigger than just markets. Our society is the clock and we're all the little cogs keeping it running. The better off we are individually the better we are as a whole.


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## bostjan (May 25, 2016)

With all due respect, if your neighbourhood doesn't have money to maintain police and fire departments, it makes not a damn bit of difference if the local government is socialist or not, nothing gets taken care of.


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## flint757 (May 25, 2016)

bostjan said:


> With all due respect, if your neighbourhood doesn't have money to maintain police and fire departments, it makes not a damn bit of difference if the local government is socialist or not, nothing gets taken care of.



Except those services are socialist in our country already and do a fair job, or at least the fire department does, of taking care of communities paid for by taxes.

Your stance on all this is incredibly ambiguous. 

It's not a stretch to say that if fire departments were private they'd expect a payment before servicing you. Not so long ago medical care in our country functioned that exact way. Luckily the law changed. If the market were 100% free, like cap was saying he'd prefer, then we'd likely return to an era where people are dying in hospital lobbies just because they don't have insurance and fire departments let houses burn down because they can't pay. This is all incredibly hypothetical anyhow. It was just an extreme example of what unreined free capitalism tends to do: cut costs and risk while providing minimal services for maximum profit.


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## A-Branger (May 25, 2016)

bostjan said:


> I think this is an insurance corruption issue. Insurance companies are in the business of making money, like any other business. The only way they make money is by collecting more than they pay out. 10/10 times, the world would be better off if everyone kept a nest egg in case of getting sick rather than employing a bunch of people to collect money. In the USA, the government does not collect the money and insure the people, but rather, requires people to be insured by an insurance company.



this so much this. When they treat the health of a person as a money profitable business, thats when the problems come. As any other business of any kind, if you want to keep running you need to make a profit, you need to get more customers and you need to get mroe of those customers to come back for more. And as sad it sounds the people on top of this dont give any crap about the average Joe health, they only see the $$$ potential on it. This same goes to the pharmaceutics companies as the insurance ones. They are there for the money not for you and your health, they are there to make profit, big profit. And everyone who works for them are encourage to get more and more, like a car dealers, when you sell more you get a bigger bonus. Exactly the same, difference is you arent selling cars here. Sadly, but its the true of the system

I work for a video and photo company, mostly weddings but we do corporate gigs. Any gigs, including corporate retirements. You know, those one week get away deals with conferences, team building, and parties, lots of it. So we are there to take photos of the event and make a highlight video of everything that is happening. Im not going to say any names, money or the things they did. But, you would be jaw drop on the floor amazed and the serious amount of $$,$$$,$$$ this big US Insurance company trow away on one week for the "top sellers" of their US base companies. So the more money you did for your branch, the better the chances for you to come. From accomodation, speakers, traveling expenses, destination, companies hired, guest, food, activities, bands, decorations, ect ect ect. Lets just say that for the "big guys" its on a different country every couple of years, and for the next level down is every year on a luxury destination that most of you wont be able to afford

Although it was an amazing event, for the whole week I couldnt stop thinking on the how many people got their claims denied, or are drowning in debt to pay for these guys to come to this place and chill on luxury


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## chopeth (May 26, 2016)

CapnForsaggio said:


> Thank you. I self identify as a libertarian, who advocates for free markets.
> 
> Nothing is PERFECT, but free markets are FAIR.
> 
> ...



If you had endured a methastased cancer and been almost on the other side, taking almost a year in a hospital to recover with every kind of treatment... you wouldn't profess that love for exclusively black or white thinking as you put it.

How does that apllies to it? you pay a ridiculous amount or you die if you can't?


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## cwhitey2 (May 26, 2016)

Demiurge said:


> It says a lot about the healthcare industry and health insurance when the insured and the uninsured can both be one medical emergency away from being broke.



This. Right here.


I only use the US healthcare system when I'm physically broken. MY mom is a nurse so I just go to her free of charge.




Do you love the concept of always paying for something and never using except that 1 time, and when you do use it it cost you money out of pocket?


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## celticelk (May 26, 2016)

CapnForsaggio said:


> Socialism = government gets bigger/richer, Capitalism = some person/people get richer.



Remember that socialism and capitalism are economic systems, not political systems. If you pair socialism with a democratic form of government (see: Western Europe), then "government" is the people of the country. The choice is then between *a few people* getting richer and *the country as a whole* getting more well off. If you believe in the inherent moral superiority of capitalism because people should only have what they "earn," then this probably won't convince you. I don't subscribe to that particular view.


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## Edika (May 26, 2016)

CapnForsaggio said:


> Nothing is PERFECT, but free markets are FAIR.



Unless you have trusts, price fixing, tax free heavens, banks too big to fail, wall street bailouts etc etc etc. Now if you have tightly legislated and regulated markets globally they might be fair.


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## cwhitey2 (May 26, 2016)

celticelk said:


> Remember that socialism and capitalism are economic systems, not political systems. If you pair socialism with a democratic form of government (see: Western Europe), then "government" is the people of the country. The choice is then between *a few people* getting richer and *the country as a whole* getting more well off. If you believe in the inherent moral superiority of capitalism because people should only have what they "earn," then this probably won't convince you. I don't subscribe to that particular view.





Americans hear the word Social and just loose their sh!t. 

They don't have to know what it means or understand it to give an opinion on it


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## bostjan (May 26, 2016)

flint757 said:


> Except those services are socialist in our country already and do a fair job, or at least the fire department does, of taking care of communities paid for by taxes.
> 
> Your stance on all this is incredibly ambiguous.
> 
> It's not a stretch to say that if fire departments were private they'd expect a payment before servicing you. Not so long ago medical care in our country functioned that exact way. Luckily the law changed. If the market were 100% free, like cap was saying he'd prefer, then we'd likely return to an era where people are dying in hospital lobbies just because they don't have insurance and fire departments let houses burn down because they can't pay. This is all incredibly hypothetical anyhow. It was just an extreme example of what unreined free capitalism tends to do: cut costs and risk while providing minimal services for maximum profit.



How is my stance ambiguous? I'm saying that the economic system does not directly affect the health care situation. That should be clear. I think the evidence of this is clear. The USA had one system, which worked for some people and then, as time passed, and the economic situation of the general workforce deteriorated, that system no longer worked, so we tried a new system, designed to fix the problem, and that system clearly does not work. What I am saying is the obvious thing - the insurance companies who are raking in huge piles of cash and continue raking in huge piles of cash, are driving the cost of medical treatment in the USA through the roof.

Look, when you get sick, and go to the hospital, you still have to pay. What your insurance covers goes to the doctors, who have to pay their licensing insurance and malpractice insurance and the insurance for all of their crap, and the part that you pay that goes to the hospital ends up getting paid by the hospital for their malpractice insurance, their liability insurance, and their employee's insurance. A great deal of the money from you being sick goes directly to insurance companies, who, when they pay for you being sick, which is their job, are mostly paying each other.

When you pay money, there is a conservation of flow. Every dollar you pay ends up somewhere. The basic idea of insurance is that you store money somewhere, like a bank, and that place is only accessible when necessary. In reality, there isn't a need for different kinds of insurance, you could, just the same, have financial insurance where money is set aside somewhere in case of a dire emergency. The rest is smoke and mirrors.

Anyway, if insurance companies are paying executives seven figure salaries, and spending tens of millions of dollars on advertising, hundreds of millions of dollars on business expansion, etc., all of that money is paid for by people paying insurance. That money does not suddenly appear magically.

With this sort of corrupted system, there is no government you can put on top of it that can solve the issue without cracking down on insurance.

But the government is paid a lot of money by lobbyists, by donations, etc., by guess who?


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## celticelk (May 26, 2016)

bostjan said:


> The basic idea of insurance is that you store money somewhere, like a bank, and that place is only accessible when necessary.



Except that neither banks nor insurance companies actually work that way. Neither does Social Security. Nobody's keeping Scrooge McDuck-like piles of cash sitting around to disburse when needed, and the money you put in is not the money you get out.


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## cwhitey2 (May 26, 2016)

bostjan said:


> Look, when you get sick, and go to the hospital, you still have to pay. What your insurance covers goes to the doctors, who have to pay their licensing insurance and malpractice insurance and the insurance for all of their crap, and the part that you pay that goes to the hospital ends up getting paid by the hospital for their malpractice insurance, their liability insurance, and their employee's insurance. A great deal of the money from you being sick goes directly to insurance companies, who, when they pay for you being sick, which is their job, are mostly paying each other.





The fact that people can sue doctors and/or hospitals is one of the major issues we have here. The fact that people are people and will make a mistake is life.

If doctors and hospitals didn't have to pay for all that insurance, I bet you would see the costs drop in a socialized medical system.


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## bostjan (May 26, 2016)

cwhitey2 said:


> The fact that people can sue doctors and/or hospitals is one of the major issues we have here. The fact that people are people and will make a mistake is life.
> 
> If doctors and hospitals didn't have to pay for all that insurance, I bet you would see the costs drop in a socialized medical system.



I agree 100%.

The people who sue, again, don't realize that their legal winnings will mostly go to grease the cogs in the legal machine, which runs with rubegolbergian inefficiency.

The US legal system should have gone to reform in the early 1990's when it became most painfully clear that it was a sham. Now that the health care system has adapted to best survive in that legal system, we all have to likewise adapt to survive by not getting sued and not getting sick, in an environment where anyone can sue anyone for any reason without negative consequences, and anyone can get sick at any time.


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## 7 Strings of Hate (May 26, 2016)

My wife an I have been on obamacare for 2 years now. In that time I had a vasectomy, my daughter had a minor hip surgery and a minor hernia surgery, and my wife has been seeing a doctor for anxiety regularly.

It that time, we haven't had a single issue with it, and in fact, its been pretty much perfect. Price is very very fair. 

The hate seems to come from privliaged people that don't want the less fortunate to have privileges because it will cost them a few extra bucks from their fat wallets.


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## CapnForsaggio (May 26, 2016)

flint757 said:


> That's not how it works in practice. That's the problem with capitalism; ideally that would be the case, but the way industry is setup in the US it doesn't tend to allow for such things to occur. Ideally it would require a 100% free market, good will, and money spread more evenly across a bell curve for it to work that way. What we see in practice is that the more 'free' the market is the more large companies take advantage and screw people over to save/make a buck. We have become a society of profit through cutting corners and cornering markets entirely, creating oligopolies/monopolies. This well intentioned 'free' market would also have to completely ignore the barrier of entry most large scale businesses have. Starting an ER, setting up a wireless tower, laying cables, etc. costs more money than your average person is ever going to have. Once someone enters a market in an area with high barrier of entries it is often not worth it to competitors to invest the money to compete. That happens quite often. What you end up with is a market with very few competitors which brings prices up and quality down [hello Comcast].
> 
> Governments don't have to be wasteful and bloated when running services. They're only like that because of the jackasses we have running congress currently.
> 
> ...



I have just one thing to leave you with, an example, from similar industries in the US, with vastly different amounts of government interference:

1) How much do you pay for your cell service every month? $80?

Think about what you are buying.... 2GB of data from the internet, and crappy audio of your friends talking to you (worthless info to anyone but you, and the NSA). All in all, maybe 4GB of data every month. Delivered slowly.

This industry is HEAVILY regulated by the fed. Many of those taxes are used to provide free phones to the poor, fund govt oversight, etc.


2) How much do you pay for Netflix every month? $15? (yes I know you are already buying internet but just hold on...)

Think about what you are buying here. Netflix is BUYING the use of the ISP infrastructure. As much as 40% of all ISP traffic can be Netflix at times. Netflix does pay to rent this bandwidth from the ISP, and passes that cost to you. They are delivering upwards of 100 GB a month of high-speed streamed copyright protected brand new HD video programming. For $15.

This industry is barely regulated by the fed (although they would LOVE to).


What is the non-statist explanation for the difference in value for this scenario? ____________ One vendor sends a little (worthless) data to you for a lot of money. One vendor sends a lot of expensive new data to you, quickly, for very little money.

Really, I want to know how you think this happens....


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## CapnForsaggio (May 26, 2016)

7 Strings of Hate said:


> My wife an I have been on obamacare for 2 years now. In that time I had a vasectomy, my daughter had a minor hip surgery and a minor hernia surgery, and my wife has been seeing a doctor for anxiety regularly.
> 
> It that time, we haven't had a single issue with it, and in fact, its been pretty much perfect. Price is very very fair.
> 
> The hate seems to come from privliaged people that don't want the less fortunate to have privileges because it will cost them a few extra bucks from their fat wallets.



Not the case. I want everyone to eventually have more value from their transactions. I do not want to exclude anyone from services.


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## tedtan (May 26, 2016)

bostjan said:


> Do you have evidence of this? I'd say most of the greatest inventions and scientific discoveries happened in places and times when and where there was a free market, and some of the most bogus science has come from the USSR and China. I mean, your statement is a pretty sweeping one, contrary to my general observation, and I'm not claiming I've done a study or anything, but have you?



I think we're looking at this from different angles. The fact that the discoveries occurred in countries with free markets is coincidental because the breakthrough discoveries do not always occur within that free market.

For example, we didn't get to the moon because several corporations were competing against one another in the free marketplace and the winner got us to the moon. We got there because the US government set a goal and funded the various companies as necessary in order to achieve that goal.

Likewise, we didn't end up with nuclear power as a result of free market competition; the research and development was funded by the US government for use as a weapon.

When the human DNA sequence was cracked, it was largely funded by various government agencies with the research itself being conducted at numerous universities, many of which were publicly funded.

The fact that these innovations were ultimately commercialized for profit, sometimes within a free market and sometimes not (e.g., power plants tend to be monopolies or oligopolies with little actual competition) is separate from the actual scientific breakthroughs themselves. And I don't mean to imply that scientific breakthroughs can't occur within a competitive free marketplace, only that sometimes cooperation yields a better or faster result.

Hopefully that helps explain the point I was making earlier that science does not always benefit from free market competition. 




bostjan said:


> Right now, if you had a chemical formula for a drug that cured any disease, you would not be able to get it to market in the USA for decades, if ever, because of all of the lawyers, insurance companies, and government agencies in place.
> 
> So, again, not that socialized medicine is bad, but the more the US government gets into something, the less effective, more expensive, and slower it will function, with very very few exceptions.



Yet those same drugs come to market much faster in European countries with nationalized healthcare. Which is probably due to the bloated, incompetent nature of US bureaucracy, our lawsuit happy culture, etc. vs. a more streamlined approach employed in other countries.


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## tedtan (May 26, 2016)

bostjan said:


> Then the economy started crumbling in my area, so I moved away. Long after, I had an accident and broke my arm. My employer fired me and cancelled my insurance _immediately_ when they heard. I was left with no insurance and a broken arm, requiring surgery. The family doctor referred me, and this other guy I didn't know didn't give a ..... I ended up getting, in writing, a quote from the doctor and the hospital that ended up being a complete farce when the bill was over 2000% higher than the quote. The payment options the hospital offered were reneged when the cost soared, which was the hospital's fault and had nothing to do with me (aside from being allergic to one kind of medication, which I was given, despite telling several nurses and having in writing that I was allergic to it), nor anything unforeseen. I ended up being completely ruined, financially. I went from being days from putting a down payment on a house in a nice neighbourhood to being tens of thousands of dollars in debt. I went from working two full time jobs with good benefits to working just as much at one salaried job with no benefits. And that was beside going from healthy to crippled.



I've seen a lot my coworkers go to the hospital and have had a lot of experience with hospitals with my ex-wife, so I hope I can pass on some of what I've learned so that others can avoid the experience you describe here.

First, if you have insurance through an employer and you leave that job for some reason, you can continue on the insurance through COBRA. You will most likely pay more because the employer is not covering part of the cost any longer, but it's worth having the insurance.

Second, if you can't afford insurance or healthcare, you can still be treated at regional indigent hospitals and clinics. You'll wait quite a while longer than if you had insurance in non-emergency situations, but you'll still be treated. In emergency situations, you'll be treated at the closest emergency room until you are stable and then transferred to the regional indigent center.

Third, don't expect a doctor to give you the total price for a surgery. He will typically only be able to give you his costs. The costs of the operating room, the hospital room for recovery, the anesthesiologist, the radiologist, the physical therapist, etc. etc. will each be extra. Expect that you will receive bills from people you never even saw because you will, even if you have insurance.

Last, almost no one pays their hospital bills in the US. The hospital gets what they can from the insurance companies and more or less expects that they won't see any money from the individual unless they collect it up front as a deductible payment (note that this often holds true for doctors as well). What this means is that you can negotiate with the hospital to lower your bill just like the insurance companies do. And if that doesn't work, you can simply not pay the bill. I know that sounds odd to most people, but medical charge offs on your credit report won't affect your ability to buy a house, car, etc. and won't affect you in the same way that not paying your mortgage would, for example. It's still best to pay the bill, but if you truly can't, it won't follow you around forever like student loans.

Fortunately, I've only been in a position to negotiate the hospital charges myself, but I've seen all of these approaches work for others more than once.


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## tedtan (May 26, 2016)

CapnForsaggio said:


> I have just one thing to leave you with, an example, from similar industries in the US, with vastly different amounts of government interference:
> 
> 1) How much do you pay for your cell service every month? $80?
> 
> ...



While I agree that cell phone plans cost too much (in part due to too little competition) you're neglecting the fact that cell phone carriers must build and maintain cell tower networks and other physical infrastructure whereas Netflix does not, which directly affects their fixed cost structure (which you omitted entirely in your example).


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## celticelk (May 26, 2016)

CapnForsaggio said:


> One vendor sends a little (worthless) data to you for a lot of money. One vendor sends a lot of expensive new data to you, quickly, for very little money.



"Worthless" is a value judgement. That cell data is probably pretty valuable to you if what you're receiving are maps and driving directions, as opposed to cat videos.


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## ferret (May 26, 2016)

tedtan said:


> While I agree that cell phone plans cost too much (in part due to too little competition) you're neglecting the fact that cell phone carriers must build and maintain cell tower networks and other physical infrastructure whereas Netflix does not, which directly affects their fixed cost structure (which you omitted entirely in your example).



And also ignores one of the reasons some of the regulation exists, to avoid conflicts and over-congestion of various radio frequencies. Something physical hardwire networks don't have to worry about.

Plus I don't pay that much anyways, and the taxes and fees are on top of the carrier's price, not rolled in.


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## bostjan (May 26, 2016)

tedtan said:


> Likewise, we didn't end up with nuclear power as a result of free market competition; the research and development was funded by the US government for use as a weapon.



I disagree. You are confusing nuclear power, which was spearheaded by Enrico Fermi's work with Chicago electric companies, with nuclear weapons, developed by the Manhattan Project, some time later. Neither of them have anything to do with socialism.

The most active time in the history of modern scientific discovery was during the turn of the 19th to 20th century and early 20th century. This was the time when most of the inventions we associate with "modern" appliance-oriented suburban living developed, the time when the natures of electricity, magnetism, light, and aerodynamics were developed into workable theories by science. This was also the time associated with the most free-market activity since the industrial revolution. This time culminated with the works of scientists, such as Fermi, Einstein, Curie, Dirac, Pauli, Schrödinger, et. al., in the fields of nuclear physics (that brings the atom bomb as well as MRI and many other medical scans), quantum mechanics (that brought about solid state electronics upon which all modern electronics are built), and our understanding of the interactions between different kinds of matter and different kinds of electromagnetic radiation (principles that led to cellular phones). So not only did this time foster the birth of the inventions of the age of suburban American life, but also the scientific foundations for post-modern technologies.



tedtan said:


> I've seen a lot my coworkers go to the hospital and have had a lot of experience with hospitals with my ex-wife, so I hope I can pass on some of what I've learned so that others can avoid the experience you describe here.
> 
> First, if you have insurance through an employer and you leave that job for some reason, you can continue on the insurance through COBRA. You will most likely pay more because the employer is not covering part of the cost any longer, but it's worth having the insurance.



I was fired from my job, specifically so that they wouldn't have to deal with their premiums going up. Since they managed to cancel out my medical insurance effective the day I was fired, which was the day of my accident, I was not eligible for any insurance coverage for my injury. I spoke with a couple lawyers about this and, according to both of them (who had no affiliation with each other, as far as I was aware), I had no legal recourse in that situation, since it was perfectly legal for my employer to fire me with or without any reason, perfectly legal for them to cancel my insurance under the explanation that I was immediately terminated, and perfectly legal for no insurance company to agree to cover my injuries, since it would have nothing to do with them.



tedtan said:


> Second, if you can't afford insurance or healthcare, you can still be treated at regional indigent hospitals and clinics. You'll wait quite a while longer than if you had insurance in non-emergency situations, but you'll still be treated. In emergency situations, you'll be treated at the closest emergency room until you are stable and then transferred to the regional indigent center.



Well, this is where things get stickier still. I was not aware that my coverage had ended immediately, so I went to a hospital that was covered under my old insurance, used my old insurance card, and then my insurance _claim_ was denied because of the reasons I listed above.



> Third, don't expect a doctor to give you the total price for a surgery. He will typically only be able to give you his costs. The costs of the operating room, the hospital room for recovery, the anesthesiologist, the radiologist, the physical therapist, etc. etc. will each be extra. Expect that you will receive bills from people you never even saw because you will, even if you have insurance.



Which is exactly why I got a quote from the hospital, and the radiologist, separate from the surgeon's quote. The surgeon's quote included anesthesia, so I took that to mean that the sum total of the three would be, roughly, my cost for everything the day of surgery. I actually did my due diligence here to be as financially responsible as possible. The surgeon said that there were "unexpected complications," even though the surgery took no longer than expected and no tangible surprises were found, other than that the anesthesia wore off ten minutes in, not that anyone did anything to put me back out. My issue with the experience was that, despite having quotes from the hospital and the surgeon (separately, as I've pointed out) and the radiologist, the only one who charged me any fees on the actual same order of magnitude as the quoted cost was the radiologist. The surgeon charged me many times what he quoted, the hospital charged me even more more, and then I started receiving bills from other people, some of whom I had already paid via surgeon's and hospital's bills.



tedtan said:


> Last, almost no one pays their hospital bills in the US. The hospital gets what they can from the insurance companies and more or less expects that they won't see any money from the individual unless they collect it up front as a deductible payment (note that this often holds true for doctors as well). What this means is that you can negotiate with the hospital to lower your bill just like the insurance companies do. And if that doesn't work, you can simply not pay the bill. I know that sounds odd to most people, but medical charge offs on your credit report won't affect your ability to buy a house, car, etc. and won't affect you in the same way that not paying your mortgage would, for example. It's still best to pay the bill, but if you truly can't, it won't follow you around forever like student loans.



This is flat out not true, based on my experience. I defaulted on my hospital bills, because of my situation at the time. I even paid back every penny I owed, but it took me years. After that was all said and done, I was denied a mortgage, simply based off of that. Aside from the hospital and surgeon and everything that orbited around that incident, I never missed so much as a movie rental bill. I had even developed great credit with my student loans, car payments, and credit cards, simply by paying everything on time, before this happened.

I'm sorry if I sound cranky. It's not you, but I did live through all of this first hand. It was years ago, but all still feels extremely unfair to me.

If I had to go through something similar to my accident today, I really have no hope whatsoever that I'd be treated any better. It's not the government, it's the damn greedy bastards who nickel and dime and quarter and dollar and gold bar you to financial death when you are down on your luck. Those folks will never go away so long as they are enabled.



tedtan said:


> Yet those same drugs come to market much faster in European countries with nationalized healthcare. Which is probably due to the bloated, incompetent nature of US bureaucracy, our lawsuit happy culture, etc. vs. a more streamlined approach employed in other countries.



This is exactly my point. These drugs go to market quicker in Europe, quicker in India, quicker in Nigeria, etc. Why? Because of all the BS in the USA. If you didn't get that such was my point from my insanity-laced ranting thus far, then perhaps my posts were too longwinded for you to read, which I don't blame you. Suffice it to say that I am neither a fan of continuing the ACA as it is, nor repealing the ACA and replacing it with nothing, which seems to be the democratic and republican platforms, respectively. Democrats and republicans just want to bleed us all dry, they don't give a flying leap about solving the nation's crises, otherwise they would have acted to improve things about 15-20 years ago. It's time for a change. But I digress. The topic is healthcare in the USA and it sucks, almost the worst it's ever sucked since it was ever identified as something that could stop sucking. I firmly believe the ACA was as bandaid is on a severed limb stump. It wasn't aggressive enough, it didn't address the main issue, and it came too late.


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## CapnForsaggio (May 26, 2016)

tedtan said:


> While I agree that cell phone plans cost too much (in part due to too little competition) you're neglecting the fact that cell phone carriers must build and maintain cell tower networks and other physical infrastructure whereas Netflix does not, which directly affects their fixed cost structure (which you omitted entirely in your example).



Netflix literally RENTS infrastructure from ISPs and then bills you for it! It is included in the $15 you pay. So are the royalties to the content makers. Your argument doesn't hold up.


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## CapnForsaggio (May 26, 2016)

celticelk said:


> "Worthless" is a value judgement. That cell data is probably pretty valuable to you if what you're receiving are maps and driving directions, as opposed to cat videos.



Relative to the newest season of 'House of Cards' your friends' words to you are "worthless" - We are not discussing personal valuation, we are discussing things with real market value. 

I am certainly not going to convince a blind man to see here.....


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## cwhitey2 (May 26, 2016)

celticelk said:


> "Worthless" is a value judgement. That cell data is probably pretty valuable to you if what you're receiving are maps and driving directions, as opposed to cat videos.





Now you crossed the freaking line buddy!!!!!!!


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## ferret (May 26, 2016)

CapnForsaggio said:


> Netflix literally RENTS infrastructure from ISPs and then bills you for it! It is included in the $15 you pay. So are the royalties to the content makers. Your argument doesn't hold up.



Renting infrastructure is considerably cheaper than building and maintaining infrastructure. Netflix is just one customer out of thousands, who's paying rental fees. You can't compare a bandwidth customer to a bandwidth network and say they have any sort of industry equivalence. Content delivery network is to mobile carrier, as Netflix is to mobile customer.


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## celticelk (May 26, 2016)

CapnForsaggio said:


> Relative to the newest season of 'House of Cards' your friends' words to you are "worthless" - We are not discussing personal valuation, we are discussing things with real market value.
> 
> I am certainly not going to convince a blind man to see here.....



You're being deliberately disingenuous here, I think. The price of a good in an open market is determined by a number of factors, including what it costs the seller to produce it and what buyers are willing to pay for it. That latter portion is simply an aggregate function of "personal valuation" over the entire market. (You're also apparently reducing cell data access to "your friends' words," presumably meaning phone calls and texts, which is a ridiculously small part of your actual smartphone plan.)


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## tedtan (May 26, 2016)

bostjan said:


> Neither of them have anything to do with socialism.



We're still not communicating.

Capitalism, socialism, communism, etc. are economic models upon which a state builds it's economy differing primary in the ownership and degree of control of the enterprises. Science, however, is not directly tied to the economic conditions or environment or even those enterprises. Sure, many businesses use science or scientific discoveries in competition with their competitors, but the scientific process (and the discoveries resulting therefrom) holds up regardless of the economic environment. And while some scientific discoveries result from direct competition between businesses competing with one another, many come about in environments largely removed from economic constraints. Sometimes science is "pure", so to speak.




bostjan said:


> I was fired from my job, specifically so that they wouldn't have to deal with their premiums going up. Since they managed to cancel out my medical insurance effective the day I was fired, which was the day of my accident, I was not eligible for any insurance coverage for my injury. I spoke with a couple lawyers about this and, according to both of them (who had no affiliation with each other, as far as I was aware), I had no legal recourse in that situation, since it was perfectly legal for my employer to fire me with or without any reason, perfectly legal for them to cancel my insurance under the explanation that I was immediately terminated, and perfectly legal for no insurance company to agree to cover my injuries, since it would have nothing to do with them.



Employers with less than 20 employees are not required to have health insurance in compliance with COBRA (this may have changed since the ACA came into effect; I haven't looked as it is not applicable to me). But for the past 30 years, people working for employers with 20 or more employees are eligible to continue their health insurance coverage (at their expense) after voluntary or involuntary termination. There may be a few exceptions here and there, but this generally holds true.




bostjan said:


> Which is exactly why I got a quote from the hospital, and the radiologist, separate from the surgeon's quote. The surgeon's quote included anesthesia, so I took that to mean that the sum total of the three would be, roughly, my cost for everything the day of surgery. I actually did my due diligence here to be as financially responsible as possible. The surgeon said that there were "unexpected complications," even though the surgery took no longer than expected and no tangible surprises were found, other than that the anesthesia wore off ten minutes in, not that anyone did anything to put me back out. My issue with the experience was that, despite having quotes from the hospital and the surgeon (separately, as I've pointed out) and the radiologist, the only one who charged me any fees on the actual same order of magnitude as the quoted cost was the radiologist. The surgeon charged me many times what he quoted, the hospital charged me even more more, and then I started receiving bills from other people, some of whom I had already paid via surgeon's and hospital's bills.



I was trying to help others avoid having the same experience you did, not knocking how you handled things as I didn't have any info on your particular situation beyond what you originally posted. 




bostjan said:


> This is flat out not true, based on my experience. I defaulted on my hospital bills, because of my situation at the time. I even paid back every penny I owed, but it took me years. After that was all said and done, I was denied a mortgage, simply based off of that. Aside from the hospital and surgeon and everything that orbited around that incident, I never missed so much as a movie rental bill. I had even developed great credit with my student loans, car payments, and credit cards, simply by paying everything on time, before this happened.



I have not been through this first hand, but I know several people who work in the mortgage industry and a couple that sell cars. They've told me that once charged off, these medical charge offs won't hurt you. I could see it being an issue if they haven't yet been charged off, though, as it would look like you owe money and would hurt your debt to income ratio, debt to net worth ratio, etc.




bostjan said:


> This is exactly my point. These drugs go to market quicker in Europe, quicker in India, quicker in Nigeria, etc. Why? Because of all the BS in the USA. If you didn't get that such was my point from my insanity-laced ranting thus far, then perhaps my posts were too longwinded for you to read, which I don't blame you.



I read the post, your point was just obscured by the vitriol you hold for the healthcare industry. 




bostjan said:


> Suffice it to say that I am neither a fan of continuing the ACA as it is, nor repealing the ACA and replacing it with nothing, which seems to be the democratic and republican platforms, respectively.



Agreed. It opened the door to something better, but now we need to effect that something better.


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## tedtan (May 26, 2016)

CapnForsaggio said:


> Netflix literally RENTS infrastructure from ISPs and then bills you for it! It is included in the $15 you pay. So are the royalties to the content makers. Your argument doesn't hold up.



I was about to respond to this, but ferret beat me, so I'll just quote him.




ferret said:


> Renting infrastructure is considerably cheaper than building and maintaining infrastructure. Netflix is just one customer out of thousands, who's paying rental fees. You can't compare a bandwidth customer to a bandwidth network and say they have any sort of industry equivalence. Content delivery network is to mobile carrier, as Netflix is to mobile customer.


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## celticelk (May 26, 2016)

CapnForsaggio said:


> Socialism = government inertia and mismanagement



I finally found an easy visual reference for corruption in Europe:







(Source: https://jakubmarian.com/corruption-perceptions-index-of-european-countries/)

Higher numbers = less corrupt; the US rating in this data set is 76. Given that most of Western Europe rates as well or better than the US, and highly-socialist Scandinavian countries rate *much* better than the US, I think it's safe to say that your hypothesis lacks supporting evidence.


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## asher (May 26, 2016)

My reaction to Russia's rating:


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## bostjan (May 26, 2016)

tedtan said:


> Capitalism, socialism, communism, etc. are economic models upon which a state builds it's economy differing primary in the ownership and degree of control of the enterprises. Science, however, is not directly tied to the economic conditions or environment or even those enterprises. Sure, many businesses use science or scientific discoveries in competition with their competitors, but the scientific process (and the discoveries resulting therefrom) holds up regardless of the economic environment. And while some scientific discoveries result from direct competition between businesses competing with one another, many come about in environments largely removed from economic constraints. Sometimes science is "pure", so to speak.



I think we will just continue to disagree on that point. Necessity is the mother of invention. Putting food on the table is a pretty strong necessity.

I have worked my entire career post-university either in education or in the science industry. All of these places do the work they do to make money. The universities have to apply for grants if they want government money, which the government issues based upon how the grant proposal is written, but mainly based on zeitgeist. For example, apply for a grant with the word "green energy" in it, or something to do with wind power, and you are far more likely to get the grant. And grants do support a lot of the university studies. But, to be frank, a lot of the studies from government grants are tripe. The real stuff that turns into real products and services are done in the private sector nowadays. All of the data I have on wind transformers and how the grid responds to wind farms is from private industry. Wind turbine technologies were developed in the private sector long ago. The real motivating factor is economics for industry. Even with all of the government grants available, if fuel oil was $0.79 / gallon there would be nothing actually moving forward with wind power.



tedtan said:


> Employers with less than 20 employees are not required to have health insurance in compliance with COBRA (this may have changed since the ACA came into effect; I haven't looked as it is not applicable to me). But for the past 30 years, people working for employers with 20 or more employees are eligible to continue their health insurance coverage (at their expense) after voluntary or involuntary termination. There may be a few exceptions here and there, but this generally holds true.



Except when someone fires you for your injury, and pulls what I see as shenanigans. I did file with COBRA, and my application was denied with no explanation given. The whole ordeal was very frustrating. I don't know how my employer pulled it off, but, as I said, there was no lawyer who would take my case, and only two who bothered to return my calls, if only to explain to me that they would not take my case. I never sued anyone before, and I would not have taken any legal action in that case, had I not been totally ruined financially by the mess.



tedtan said:


> I was trying to help others avoid having the same experience you did, not knocking how you handled things as I didn't have any info on your particular situation beyond what you originally posted.



Cool. It really doesn't matter though. You can get quotes from everyone involved down to the janitor who will mop the blood off the hospital floor in the event that you bleed out, and the quotes won't necessarily be the least bit accurate.



tedtan said:


> I have not been through this first hand, but I know several people who work in the mortgage industry and a couple that sell cars. They've told me that once charged off, these medical charge offs won't hurt you. I could see it being an issue if they haven't yet been charged off, though, as it would look like you owe money and would hurt your debt to income ratio, debt to net worth ratio, etc.



That's great. Thanks for telling me that I didn't go through what I went through, even though you've never gone through similar yourself. To be clear, I got a mortgage anyway, but it was a ....ty mortgage instead of the low APR mortgage I sought after.



tedtan said:


> I read the post, your point was just obscured by the vitriol you hold for the healthcare industry.



So my point stands, at least.



tedtan said:


> Agreed. It opened the door to something better, but now we need to effect that something better.



Except no one in the government is going to do anything about it, the consumers have no say, and the industry itself has no motivation to correct itself. So nothing happens, except if Trump is elected and republicans take over the house and the senate (which I don't think likely), and the ACA goes away entirely, then, who knows, but it won't be an improvement in any case.


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## Sumsar (May 26, 2016)

celticelk said:


> (Source: https://jakubmarian.com/corruption-perceptions-index-of-european-countries/)



As someone living in Denmark which apparently is the least corrupt country in the world (or one of them):
It's not like corruption does not exist here, it certainly does, I guess it is just at a lower level than anyone else.
Ministers lying to the parliament is pretty common practice these days, to the point where they don't even leave office once it is found out. And generally getting elected and ruling though propaganda, fear and lies seems to be the way to go if you want votes.

I guess it depends on how you view corruption, but from my point of view we got plenty of it here.


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## CapnForsaggio (May 26, 2016)

ferret said:


> Renting infrastructure is considerably cheaper than building and maintaining infrastructure. Netflix is just one customer out of thousands, who's paying rental fees. You can't compare a bandwidth customer to a bandwidth network and say they have any sort of industry equivalence. Content delivery network is to mobile carrier, as Netflix is to mobile customer.



1 customer out of thousands, who happens to consume a VAST majority of actual bandwidth. Netflix is to ISPs what Amazon is to UPS... essentially the entirety of the business at this point in MBs delivered to your home.

Whatever guys, the state/fed WILL eventually screw you over, I just ask that you resolve the cognitive dissonance in a productive way when it happens.

Good luck to you all. Remember to vote at the polls and vote with your wallets. They are both important.

Thank you for the reasonable opinions.


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## russmuller (May 26, 2016)

CapnForsaggio said:


> 1 customer out of thousands, who happens to consume a VAST majority of actual bandwidth. Netflix is to ISPs what Amazon is to UPS... essentially the entirety of the business at this point in MBs delivered to your home.
> 
> Whatever guys, the state/fed WILL eventually screw you over, I just ask that you resolve the cognitive dissonance in a productive way when it happens.
> 
> ...



Does that mean we can get back to the original topic of people sharing their personal experiences with socialized medicine, rather than a largely American audience debating the philosophy of such systems?


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## CapnForsaggio (May 26, 2016)

Yes, I suppose so.


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## SD83 (May 26, 2016)

CapnForsaggio said:


> Free markets will always develop the best products. Not everyone's service is equal (ability to pay, skill of doctor etc.) but the end result is a continuous "ratcheting" up of quality of product and lower of price (increased value). These are due to economic forces CREATED by competition and choice.
> 
> Socialized anything is a race to the bottom in terms of quality (more money for administration if they have ....ty docs or offer limited procedures).
> 
> ...



Having a working society does not equal socialism. 
Socialism is a pile of .... that can not and must not work because as long as there is more than one man, all men are not equal. Equality is rubbish, but fairness isn't. Your personal health is not fair. Some lazy asshole, smoking, driving drunk, 160 kg, might drop down dead at 64 without ever having to see a doctor. Others work 50, 60, 70 hours a week as lawyers or doctors or whatever, eat healthy, never smoke, work out, bamm!, cancer. Our influence on our own health is, at best, limited.
You wouldn't want law enforcement to be privatized, would you? So if a poor mans daughter gets raped, no one gets punished because no one can pay for it? Well, most people do not chose to be victim to a crime, and most people don't chose to need healthcare. 
And even with "socialized healthcare", at least the way it is here, you are free to go find an additional insurance on the free market. It can get you shiny implants in the exact same color as your own teeth instead of rather random colored dental fillings. It can get you a room all for yourself in the hospital, so you don't have to bother with a bunch of "fat lazy welfare pot head porker". It's not like the money you don't have to pay for treatment is lost to the economy, on the contrary. You spent it on other stuff. What if you never get ill, never have an accident? Well, lucky you. But that is not your accomplishment, it is luck. A capitalist society, I think, should reward competence, determination, commitment, work. Not luck. Otherwise we could as well throw a dice to determine our wage. 
We don't have to directly pay the police to help us if we need them, we don't have to directly pay the teachers to teach our children how to read, why should we have to pay our doctors to remain able to work and contribute to the society & the economy? The way I see things, the only positive thing the US health care system has done was set the background for Breaking Bad...
/rant


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## Ebart (May 27, 2016)

Dude. I just got back from Berlin. Similar situation. All healthcare workers are underpaid. You sometimes have to wait WEEKS if you are sick and need to see a general care doctor. The care you receive is inferior if you use their public healthcare system, however if you purchase your own private insurance, of course you get better care, and whenever you need it. Socialism doesn't work guys...it's nice to think things like that could be free...but they can't...and they're not truly free anyway. Germans lost SEVENTY PERCENT of their paychecks to taxes to fund their socialist system. No thanks, I'll pass.


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## asher (May 27, 2016)

Ebart said:


> Germans lost SEVENTY PERCENT of their paychecks to taxes to fund their socialist system.



Citation?

Seventy percent of the entire thing? _Not_ top marginal rate?


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## UnderTheSign (May 27, 2016)

According to Wikipedia it's 15,5% of their salaried income in Germany of which 7,3% is covered by their employer. 

Seventy and seven is quite the difference, bud.


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## Edika (May 27, 2016)

^ Hey it's just a zero. Zero means nothing .


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## SD83 (May 27, 2016)

All taxes etc. combined, it's said to be 226 days that we work for the goverment before we work for ourselfs, so it's not that far of. Yes, there is those 7,3%, but then we pay a certain mandatory percentage for health care, for future pension, as insurance against unemployment etc. We pay 19% taxes on everything we buy in the stores, and additional taxes on fuel or even coffee. 
What do we get for that? Rather good roads, rather competent police, rather free health care, rather free education including university, a lifelong pension, state support if our employer bankrupts, lifelong state support if we are unable to work, support if you are unable to find a new job within any margin of time (although that is hardly enough to survive and they will offer you whatever jobs are around and if you decline they cut your money, question is if they cut it enough...), support if you find a job but still are unable to feed yourself (you think socialised health care is socialism? What about minimum wage? We only have it for a handful of years, and people were raging about how that would ruin the economy etc. Until then, 4$ an hour wasn't unusual in some areas for some jobs) etc. I do agree though that the state got a bit overprotective over the decades. But: In many fields you can completly avoid those mandatory insurances for health care, pension etc. You can work as a freelancer, as a construction worker or as a lawyer or whatever, you lose some of the safety and gain some more freedom...
@Ebart, it highly depends where you are in Germany. I usually get an appointment with the GP within the same day of calling. It's worse with more specialised doctors, and I had to wait 2-3 weeks sometimes to get an appointment with an orthopedist, but when I wake up sick in the morning and call the doctor, I usually have a diagnosis and medication by noon. I'm not the most healthy person (several allergies, asthma, chronic back pain), but as far as I can remember, the only thing I could ever complain about was that I had to pay extra for longer lasting fillings at the dentist (where I got the appointment within days).


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## synrgy (May 27, 2016)

I'm on the outside looking in, but I'm married to a Canadian, and have had exposure to the Canadian system through her and her family. I've told stories before, so I'll keep this super short, focusing on one incident from one family-member:


Heart attack -> Ambulance -> Helicopter transfer -> Emergency Bypass Surgery -> Post-Op/In-Patient Care, Etc
Cost = $12.00 CAN. For parking. (No, that decimal isn't in the wrong place.)
Fallout = None: Full recovery, no scary moments in the (5-ish) years since the incident.
That's just one in a laundry-list of events that have happened since we've been together.

As a side, I'm _fully_ aware of US media's propensity toward complaints that the Canadian system's wait times are out of control, but in my (admittedly limited) experience, they've been comparable-to and/or better-than what I've experienced in our US system.


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## tedtan (May 27, 2016)

I don't want to continue derailing this thread, but want to clarify a couple of points and then we can get back on topic.



bostjan said:


> I think we will just continue to disagree on that point. Necessity is the mother of invention. Putting food on the table is a pretty strong necessity.



I'm not saying the private sector does not innovate (I've certainly benefited from the innovations my company has made over the years), just that attaining some goals requires a bit more outside influence in order to get competitors working together rather than against one another, and that a properly functioning healthcare system may well be one of those goals.




bostjan said:


> Thanks for telling me that I didn't go through what I went through, even though you've never gone through similar yourself.



Nice attempt at appeal to emotion, but if you read what I wrote I was discussing charge offs (e.g., the amount owed has already been written off as a loss). If you were still paying the hospital bill, they would not have charged it off at that point, so your situation is not the same as what I mentioned.


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## bostjan (May 27, 2016)

tedtan said:


> I'm not saying the private sector does not innovate (I've certainly benefited from the innovations my company has made over the years), just that attaining some goals requires a bit more outside influence in order to get competitors working together rather than against one another, and that a properly functioning healthcare system may well be one of those goals.



I suppose that's a general and mild enough statement that it'd be difficult to disagree with it. All I've been saying all along was that going after people to get insurance and requiring insurance companies to insure sick people is not the definitive answer to the crisis it was intended to solve.



tedtan said:


> Nice attempt at appeal to emotion, but if you read what I wrote I was discussing charge offs (e.g., the amount owed has already been written off as a loss). If you were still paying the hospital bill, they would not have charged it off at that point, so your situation is not the same as what I mentioned.



Appeal to emotion? Come on.

How would someone who had lost their job as a result of their injury, defaulted on their bill and declared bankruptcy not be a charge-off?!


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## flint757 (May 27, 2016)

Both my parents had medical bills they couldn't pay and it didn't affect their credit at all. All it did was get a creditor calling until the debt completely disappeared from the record.

If you declared bankruptcy that is likely what caused your bad score, no? Pretty sure filing for bankruptcy destroys your credit even if you choose to pay it back. It certainly did for my Aunt 20 years ago. 

The fact that you filed for bankruptcy and then chose to also pay it off would be why it screwed your credit up. If you had completely ignored the bill it would not have likely negatively effected your credit at all, as tedtan stated. By trying to do the right thing you inadvertently screwed yourself.


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## bostjan (May 27, 2016)

flint757 said:


> Both my parents had medical bills they couldn't pay and it didn't affect their credit at all. All it did was get a creditor calling until the debt completely disappeared from the record.
> 
> If you declared bankruptcy that is likely what caused your bad score, no? Pretty sure filing for bankruptcy destroys your credit even if you choose to pay it back. It certainly did for my Aunt 20 years ago.
> 
> The fact that you filed for bankruptcy and then chose to also pay it off would be why it screwed your credit up. If you had completely ignored the bill it would not have likely negatively effected your credit at all, as tedtan stated. By trying to do the right thing you inadvertently screwed yourself.



Probably. I would not have had to do that if I had not had so many issues with the medical bill collections agencies in the first place, though.


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## wankerness (May 27, 2016)

Ebart said:


> Dude. I just got back from Berlin. Similar situation. All healthcare workers are underpaid. You sometimes have to wait WEEKS if you are sick and need to see a general care doctor. The care you receive is inferior if you use their public healthcare system, however if you purchase your own private insurance, of course you get better care, and whenever you need it. Socialism doesn't work guys...it's nice to think things like that could be free...but they can't...and they're not truly free anyway. Germans lost SEVENTY PERCENT of their paychecks to taxes to fund their socialist system. No thanks, I'll pass.



Did you copy this post from some GOP member's filibuster, or what?


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## CapnForsaggio (May 27, 2016)

wankerness said:


> Did you copy this post from some GOP member's filibuster, or what?



He is totally off the mark at 70%, but come on....

There is literally zero people here who identify with the classic GOP. You are thinking inside the same box as the GOP'ers you so despise. Open those eyes up bud..... Nancy Pelosi isn't your buddy.


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## wankerness (May 27, 2016)

CapnForsaggio said:


> He is totally off the mark at 70%, but come on....
> 
> There is literally zero people here who identify with the classic GOP. You are thinking inside the same box as the GOP'ers you so despise. Open those eyes up bud..... Nancy Pelosi isn't your buddy.



I have no idea what you are talking about. His insane "facts" are the exact same kind of crap they threw around. I am not saying "Obamacare is awesome," I'm saying "this post lacks any facts and is hilariously alarmist to a point I haven't seen in a while."


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## CapnForsaggio (May 27, 2016)

wankerness said:


> I have no idea what you are talking about. His insane "facts" are the exact same kind of crap they threw around. I am not saying "Obamacare is awesome," I'm saying "this post lacks any facts and is hilariously alarmist to a point I haven't seen in a while."



Agreed, the post sucks, but what does that have to do with your boogeyman, the GOP...?


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## CapnForsaggio (May 27, 2016)

Here's a DNC "fact" thrown around today: Hillary doesn't know how to use a computer or make passwords (this link is to the actual deposition).

https://www.scribd.com/doc/313937693/Lukens-Lewis-051816

Does that mean that all Dems can't use computers? Your being really small about this. It was a bad post, not incriminating evidence against a political party. All I'm saying.


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## vilk (May 31, 2016)

I used to live in Japan, a country with arguably some of the most social health care that there is.

And it. was. super. dope.

Then again, they aren't a country of junkies and trigger-happy 'necks. I wonder how much that factors in.


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## 1b4n3z (Jun 1, 2016)

Socialized health care makes sense both ethically and economically, it's not a good you can shop like food is (and how insightful are people when it comes to right kind of food?). I mean, do you leave your stove on or doors open if you have socialized police or firefighters?

Opposing those are like private unemployment insurance - designed to keep certain people out.


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## bostjan (Jun 1, 2016)

US health care under the ACA is nothing like socialized police, BTW.

If the police were run like health care, then:

1. You would have to pay a private company out of your paycheck to subsidize the police department, and your employer chooses which company to use. If you are unemployed, you have to find such a company on your own or else pay extra taxes to the government.
2. If you needed police rescue from an intruder, you would have to call the police dispatch and ask them if their police department was covered in your network. If no local police were in your network, no one would rescue you from the intruder.
3. If the police are within your network, you would file a help ticket, to which the patrol information technology department would have to create a profile for you, which could take up to 24 hours, or as little as 2 hours. Once your profile was complete, the police would send a trooper to your home.
4. Once the trooper arrives at your home, he will intervene. If the intruder already left on his own, he proceeds anyway.
5. The trooper will bill you. If the intruder killed you, your family will be billed.


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## celticelk (Jun 1, 2016)

bostjan said:


> 2. If you needed police rescue from an intruder, you would have to call the police dispatch and ask them if their police department was covered in your network. If no local police were in your network, no one would rescue you from the intruder.



Oh, come on. This wasn't true of healthcare even pre-ACA. If you were gunshot or having a heart attack, emergency services would save your life and worry about the billing issues later.


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## russmuller (Jun 1, 2016)

bostjan said:


> US health care under the ACA is nothing like socialized police, BTW.



Nice job tearing up that straw man.


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## bostjan (Jun 1, 2016)

celticelk said:


> Oh, come on. This wasn't true of healthcare even pre-ACA. If you were gunshot or having a heart attack, emergency services would save your life and worry about the billing issues later.



From one native Detroiter to another Detroit area resident, you and I both know the truth about this, anyway. How many people died in waiting rooms? How many people put off seriously needed treatments, because of billing shenanigans?



nb4n3z said:


> I mean, do you leave your stove on or doors open if you have socialized police or firefighters?





bostjan said:


> US health care under the ACA is nothing like socialized police, BTW.





russmuller said:


> Nice job tearing up that straw man.


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## celticelk (Jun 1, 2016)

bostjan said:


> How many people died in waiting rooms?



Was that due to lack of insurance, or because the emergency rooms didn't have the staffing and infrastructure to deal with the volume of patients? A Google search for "emergency waiting room deaths statistics" turns up a bunch of stories that all seem to suggest that the latter is the actual culprit.



bostjan said:


> How many people put off seriously needed treatments, because of billing shenanigans?



We're talking about emergency care here - the healthcare equivalent of calling the cops because someone's breaking into your house. Don't move the goalposts.


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## SD83 (Jun 1, 2016)

bostjan said:


> US health care under the ACA is nothing like socialized police, BTW.
> 
> If the police were run like health care, then:
> 
> ...



Judging only from what I read about it: That might be because politicians took a system that wasn't exactly working perfectly and then tried to "fix" it instead of replacing it with another to avoid pissing off too many people. It's like trying to turn a broken steam engine into a diesel engine without changing too many parts, it probably won't result in anything good. Seems to be something politicians are particularily good at all around the world...


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## bostjan (Jun 1, 2016)

celticelk said:


> Was that due to lack of insurance, or because the emergency rooms didn't have the staffing and infrastructure to deal with the volume of patients? A Google search for "emergency waiting room deaths statistics" turns up a bunch of stories that all seem to suggest that the latter is the actual culprit.
> 
> We're talking about emergency care here - the healthcare equivalent of calling the cops because someone's breaking into your house. Don't move the goalposts.



What kind of staffing issues? Nurses or HIT personnel? 

How are we moving the goalposts here?

This argument is stupid, anyway. No one is going to say that the US health care system is perfect. I don't think anyone is even saying it is good. My point was that it doesn't compare to socialized police and fire departments. Are you arguing that it does, or are you just trying to be a nitpicking contrarian? If not, then we don't really disagree on the point.

I'm not saying things are not better under the ACA than they were before. I'm merely saying that the ACA did sadly little to improve a healthcare system that was arguably the worst in the developed world. If you want to get into the reason why, I understand that, but I haven't made any statement as to why.

You guys are mistaking me for a Republican. I am not. I am merely making an observation that s...ty health care is s...ty, and making the judgement (that some consider a leap, whatever, that's something maybe we can discuss) that it is a symptom of bloated greedy health insurance providers and too much paperwork requiring too many pencil pushers to complete. There's too much red tape. If you disagree and think that everything is totally hunky-dory under the ACA, I'm simply impressed with your commitment to how bad you want to me to be wrong so you can have someone with whom to argue.



SD83 said:


> Judging only from what I read about it: That might be because politicians took a system that wasn't exactly working perfectly and then tried to "fix" it instead of replacing it with another to avoid pissing off too many people. It's like trying to turn a broken steam engine into a diesel engine without changing too many parts, it probably won't result in anything good. Seems to be something politicians are particularily good at all around the world...


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## celticelk (Jun 1, 2016)

SD83 said:


> Judging only from what I read about it: That might be because politicians took a system that wasn't exactly working perfectly and then tried to "fix" it instead of replacing it with another to avoid pissing off too many people. It's like trying to turn a broken steam engine into a diesel engine without changing too many parts, it probably won't result in anything good. Seems to be something politicians are particularily good at all around the world...



Given the difficulty of getting the ACA passed, I'd say that this was the best we were going to get. The votes simply were not there for a more radical overhaul of the American healthcare system, and one could argue that a more radical overhaul could have profoundly negative effects on our economy if done too quickly (those paying attention will note that this has been one of my criticisms of the Sanders platform for months).


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## celticelk (Jun 1, 2016)

bostjan said:


> This argument is stupid, anyway. No one is going to say that the US health care system is perfect. I don't think anyone is even saying it is good. My point was that it doesn't compare to socialized police and fire departments. Are you arguing that it does, or are you just trying to be a nitpicking contrarian? If not, then we don't really disagree on the point.



I'm arguing that a specific point of your comparison of the ACA to socialized police services is flawed, in a way that makes the ACA seem worse than it actually is. That's it. If you don't want to argue about that any more, we can let it drop.

I wouldn't argue that the ACA is perfect by any means, but I think that it's an improvement over pre-ACA healthcare, and given the economic and political reality in America, we were and are unlikely to get anything substantially better.


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## cwhitey2 (Jun 1, 2016)

As far as the ER waiting room stuff, they care about 3 things...heart attacks, strokes or you punctured a major artery...they are life threatening...otherwise you will wait. Hell, when I snapped my foot (literally) off, I went to the hospital where my mom works and still had wait 5 hours before the doc would look at me.


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## bostjan (Jun 1, 2016)

That's democracy for you. You could have something pretty cool, or not have anything at all. As a compromise, we get most of the drawbacks of having the cool thing without most of the benefits.

And then people like me complaining about it...


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## 1b4n3z (Jun 1, 2016)

bostjan said:


> US health care under the ACA is nothing like socialized police, BTW.



I thought this thread was about socialized health care? ACA is nothing like that - it's a unique compromise stemming from rather irrational fear of anything 'social'


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## Drew (Jun 1, 2016)

russmuller said:


> I just got back from my first trip to Europe where I stayed in Ireland for a week. They have socialized health care, but our tour guide talked at length about how they have a shortage of nurses because of poor pay, hospitals and emergency rooms closing at 8PM, and hundreds of patients on gurneys (or trolleys, as they call them) for their stay instead of getting a proper bed.



You know, when push comes to shove, it's just a different form of rationing. In the UK, they tend to ration based on need. In the US, they tend to ration based on whether or not you can afford insurance. 

Neither is a magic bullet to give everyone as much health care as they want at the price they want, but let's not pretend that there isn't rationing in America either, and while we're at it, maybe we can drop this illusion that anything about American health care is somehow "free market."


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## russmuller (Jun 5, 2016)

bostjan said:


>


I was referring to this exchange:


1b4n3z said:


> I mean, do you leave your stove on or doors open if you have socialized police or firefighters?





bostjan said:


> US health care under the ACA is nothing like socialized police, BTW.
> 
> If the police were run like health care, then:
> 
> ...


1b4n3z made a comment which made an analogy to police and firefighters, then you tore apart 5 points about "if the police were run like health care." I accused you of making a straw man fallacy in that nobody was making the points you addressed.

I think what 1b4n3z was driving at is that people don't act irresponsibly with fire hazards simply because there are socialized firefighters who will come to put out the blaze, and by analogy people are not likely to do terrible things to their body purely on the basis that the state will provide medical care.


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## Andromalia (Jun 27, 2016)

I'm french.
In 2005 I had a motorbike accident going to work. Going to work over here is covered as a "working accident" provided you go straight from your home to your workplace (and back).

Broke 12 bones in my left hand (yeah, my guitar playing had issues with it:  ) and various other minor bruises and injuries. 
Cost: 0 and I got 100% of my salary during the recovery time.

Conclusion: don't complain about taxes, boys.


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## canuck brian (Jul 12, 2016)

If you look all the way back to my oldest posts on here, you'd see me talking about severe nerve problems in my arms and neck - the tests, procedures and all the visits to the doc over the course of 2 years set me back $0. I saw a US doctors bill once with a couple of similar procedures that I had costing well into the $100,000 mark.

My father had a heart attack almost 20 years ago - bypass surgery and a lot of hosptial time. Sees an award winning cardiologist once a month. $0

My ex had her mouth and teeth obliterated by a softball when she was pitching. Jaw set, teeth splinting, painkillers, ambulance.... $0 She had to spend upwards of 8g's on cosmetic fixing of her teeth but she would have been out well into the 50g's mark from a lot of the bills that i've seen posted.

There was a U.S. guy on reddit who posted a picture of his arm because he wasn't sure if he could really afford to go to the doctor so he was asking if he should. He had compartment syndrome and it's pretty damn obvious it's a problem that needs a doctor. NSFL warning on looking that up.

I used to work with a guy from our remote office in the States when i was working for another company here in Toronto. He couldnt' leave his position for something far more closer to home and financially lucrative because his health care plan would change and screw up his son's cancer treatments. I'm not sure how that's changed in the last 8 years with Obamacare but when he told me that, I was pretty floored.

That's really just off the top off my head. I might have to deal with wait times and go "oh no, i have to wait 4 hours", but at no point am i going "oh god, i'm going to have my life ruined with a 100k hospital bill on top of cancer." Chuck probably said that.


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## CapnForsaggio (Jul 12, 2016)

canuck brian said:


> If you look all the way back to my oldest posts on here, you'd see me talking about severe nerve problems in my arms and neck - the tests, procedures and all the visits to the doc over the course of 2 years set me back $0. I saw a US doctors bill once with a couple of similar procedures that I had costing well into the $100,000 mark.
> 
> My father had a heart attack almost 20 years ago - bypass surgery and a lot of hosptial time. Sees an award winning cardiologist once a month. $0
> 
> ...



In your mind, where did the funds come from that paid for those procedures?

Answer: all taxpayers, with 80% of the funds scraped off for "administration."

You ALL paid so much more for those procedures than you will ever realize.

In the short term, governments like the US just print more money. Longterm, many people believe we are all fracked. 



Couple that with the fact that EVERYONE will eventually need life-saving medicine... and there is NO WAY this ponzi scheme will work out.

You either need to reduce care cost overhead, or reduce doctor compensation in the long run for it to pan out.

Just shifting huge costs to the taxpayer saves NOTHING. You will see.


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## bostjan (Jul 12, 2016)

russmuller said:


> I was referring to this exchange:
> 
> 
> 1b4n3z made a comment which made an analogy to police and firefighters, then you tore apart 5 points about "if the police were run like health care." I accused you of making a straw man fallacy in that nobody was making the points you addressed.
> ...



As you pointed out, the other guy was arguing against a point no one made, and I addressed his argument. Not sure how you classify that as me making a straw man fallacy.


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## SD83 (Jul 12, 2016)

CapnForsaggio said:


> Answer: all taxpayers, with 80% of the funds scraped off for "administration."



I have no idea where you get those numbers from, but that is just ridiculous...

As for governments just printing more money... to my understanding, that's just how economy works these days. Banks lend money to everyone, ruin themselves in the progress, claim to be important, get hundreds of billions from the government, circle begins again. No one has any intention on paying all those bills. Worst case scenario, they declare bankruptcy and more or less get a fresh start. 
"Socialised" healthcare has worked in Europe and Canada for decades, not perfectly, but in my eyes a lot "fairer" than the US system as your personal health is not something you have total control over at any given point. 
Sure, it needs to be reformed (and from what I hear, the US version of it/Obamacare has to be redone, sounds like it works almost as bad as, I don't know, putting new wheels on a burned down car), as people grow much older these days, and their health is much more a matter of their own decisions. But is it a broken system, and will it break the country? Not even remotely. (and as for "socialism" being mentioned to describe any country in Western Europe... the most "socialist" thing we have here in my eyes is minimum wage, and the USA had that way earlier...) If you insure your car, it matters what car you want to insure. With current day technology, in some cases it also matters how you drive it. Why not use that for health insurance as well? I don't see why I should pay as much as someone who lives of a diet of hamburgers, pizza, beer and cigarrettes.


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## bostjan (Jul 12, 2016)

I'd also like to see a source. It wouldn't be completely shocking to me, though, since 25% of a hospital bill in the USA goes to hospital administration. ( source ) Insurance companies have high overhead, since they ideally would not provide any services at all, and on average, pay 80 cents to the dollar ( source ) to hospitals, out of their premiums. Also, some argue ( same source as above ) that there may be as much as eleven percent of the premium wasted in the transaction on top of that.

So, if we assume those sources are correct (which, if you read them, they mostly are, but there are some issues), 70% of your insurance money makes it to hospitals, of which 75% of that makes it to your procedure. That's about 47% total admin cost. Not nearly 80%, but still eyeroll worthy, IMO. The actual figure, which I'd like to see, is ostensibly a little lower, but ballpark, should be pretty close.


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## celticelk (Jul 12, 2016)

CapnForsaggio said:


> In your mind, where did the funds come from that paid for those procedures?
> 
> Answer: all taxpayers, with 80% of the funds scraped off for "administration."



Citation needed. Medicare administrative costs are substantially less than American private insurers, as are overhead costs in non-US countries:

Medicare Is More Efficient Than Private Insurance
Health Costs: How the U.S. Compares With Other Countries | PBS NewsHour


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## flint757 (Jul 12, 2016)

Yeah, to say that socialized healthcare has bloated overhead is to completely ignore the profit margins private insurers get and the ridiculous number of employees they have to pay, as well as their own 'administrative' charges. That doesn't even take into account that private insurance is one of the causes of our expensive price tag for many treatments.


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## SD83 (Jul 13, 2016)

celticelk said:


> Citation needed. Medicare administrative costs are substantially less than American private insurers, as are overhead costs in non-US countries:
> 
> Medicare Is More Efficient Than Private Insurance
> Health Costs: How the U.S. Compares With Other Countries | PBS NewsHour



Was about to post this... the difference in cost is just insane. But reading that and other sources, if you subtract those 47% bostjan mentioned (which, sadly, I find believable given the amount of bureaucracy we have), you're suddenly suprisingly close to "socialist countries" like France or the UK. 

And here are some more numbers that make me question the paradigm that a free market will result in lower prices at equal or better quality. It might do in other cases, I still see myself as a supporter of capitalism. In this case, something seems beyond broken... (cost per day in hospital over 4000$? Most people here will never earn nearly as much per month  )
https://www.washingtonpost.com/news...ow-americas-health-care-prices-are-ludicrous/


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## canuck brian (Jul 15, 2016)

CapnForsaggio said:


> In your mind, where did the funds come from that paid for those procedures?
> 
> Answer: all taxpayers, with 80% of the funds scraped off for "administration."
> 
> ...



Actually i'm acutely aware of taxes, how much I pay in taxes and how my medical care is paid for by taxes. I do not require some someone to explain it to me. We have schools here in Canada and I'm quite capable researching my statements ahead of time. 

I'm not paying $4000 a month in medical bills for the rest of my life while living off Ramen and wondering how i'm going to live next month, while praying I don't break my toe and incur another 20g's in bills while freezing to death because they shut off the electricity becuase i couldn't afford it and the medical bills. Other Canadians are not doing this either, much unlike a lot of highly unfortunate American citizens. But screw them, they're poor, right? Maybe if they put a few more hours at their jobs they'd be worthy enough to live.

If you're more than willing to chance economic devastation that's your call. I'll continue to be 100% supportive of Canada's health care system. You can continue to blather on calling it a ponzi scheme, but unfortunately for you, it's proven to work in a very large amount of other countries that dont' have people dying because they can't afford a surgery. Go look at other countries and their socialized health care systems. Our system, while is full of flaws, really does work. A majority of Canadian's hold this view. 


Your system sucks. People die because they cannot afford a life saving treatment. The insanity of that statement cannot be ignored.


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## shredfreak (Jul 15, 2016)

reading about healthcare in the usa is just sad.

Last trip to the hospital i payed about 700$ total (give or take with the conversion rate),
Wich was tendonitis in the left shoulder (as a bonus i got artrose in the right joint for free...):
2 appointments with a specialst
2 examinations (mri scan & ct scan + contrast injection)
1 month of fysiotherapy treatment 2 days a week.

I should get that back at some point in the future since legally it's still listed as assault, although it's taking them painfully slow to be honest.

As for healthcare ensurance its a yearly fee of 50&#8364;. A large part is already getting deducted from my paycheck however & my employer pays a part aswell for that (wich is why employmentcost is hotly debated over here). 

Im pretty safe to say that i pay around 800$ a month to taxes that get deducted already from my paycheck. Wich is the not so pretty side of the coin.

The pretty side is:
lots cheaper healthcare & some procedures are stupidly cheap (but only if they are deemed needed). My girlfriends breast reduction only cost her 50$ for example (yes they were that big...), cancer treatment is also a world apart from usa standards.

Education. Bachelor degree = 3 years = 3 * 550 = 1650&#8364;. for a master that would be 2200&#8364;.

Most people don't realize how money gets sourced from that but the darker side of the coin here is quite desastrous in some cases making it that bigger companies simply move to the lower wage countries. 

The system we got does lead to a whole other set of problems though wich most people don't consider.


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## MrWulf (Jul 15, 2016)

Reading this thread reminded me of an experience while i was in California with my brother. He had pain in his eyes due to dirty lens in the middle of the night, so I called up ambulance for him. I wasnt aware how absolutely .... the US health care system was until we were hit with 2k worth of bills for what essentially a 10 minute drive to the nearest hospital. And thats not to mention all the trips to an eye specialist afterward either. The worst part? The international student insurance we bought earlier in the year for him was a waste of money because the insurer did not want to pay for it. 

When Americans complains about taxes and big government but then moans about falling infrastructure and expensice healthcare, I can only shake my head. You guys' idea of freedom is basically having your cake and eat it all at the same time.


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## bostjan (Jul 15, 2016)

As I said before, I believe the crux of the problem in the USA is corruption in the insurance industry. As your anecdote pointed out, insurance companies deny valid claims. I do not believe that they do this to avoid fraud as much as they do it to make more money. This goes for health insurance, car insurance, flood insurance, etc. There are still hundreds of appeals in the works from claims that were denied after hurricane katrina, as if insurance companies are saying that there is some interpretation going on regarding where the hurricane caused damage and did not cause damage, on a large scale, even a decade after it occurred. I don't think that's right.


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## Andromalia (Jul 26, 2016)

> You guys' idea of freedom is basically having your cake and eat it all at the same time.



I'd add to this that this is usually someone else's cake too.


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## vilk (Jul 26, 2016)

My idea of freedom is we all bake a massive cake so enormous that none of us could ever possibly finish it and then we all can eat as much as we want but try to help each other understand that there's no value in stuffing yourself.


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## bostjan (Jul 26, 2016)

I like that analogy, so I'll roll with it:

Republican: We use our military to take the cake, then the richest people get to eat it.
Democrat: Let's borrow some cake and eat it now, then bake a cake later to pay it back.
Socialist: What's my cake is my cake and what's your cake is my cake, too.
Tea Party: The tax on cake is too high!!!!one!!!
Libertarian: Don't tell me how to eat my cake!
Green Party: Cake is too fattening and bad for consumers! We should grow kale instead.
Pirate Party: Arrr, take yer own cake if ye dare!
Communist Party: All cake is created equal. Except fearless leader's cake, less equal, therefore, fearless leader may eat much more cake.
Progressive Party: Poor people don't get enough cake.
Silly Party: Kake! F'tang f'tang f'tang!


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## HeavyMetal4Ever (Aug 3, 2016)

My last significant medical procedure was having two wisdom teeth removed. It ended up costing me about $150AUD and the dentist was excellent.


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## estabon37 (Aug 3, 2016)

CapnForsaggio said:


> In your mind, where did the funds come from that paid for those procedures?
> 
> Answer: all taxpayers, with 80% of the funds scraped off for "administration."
> 
> ...



It's really as if you're not reading what people are writing about their knowledge and experiences. Sticking insulting names on social services and constantly muttering "wait and see" lends no credibility to an argument that is already disturbingly low on credibility.

Check out the numbers according to the World Health Organisation: http://www.who.int/mediacentre/factsheets/fs319/en/. For those that don't ever click links, here are the first five figures:

Total global expenditure for health per person per year (US$ 948)
Country with highest total spending per person per year on health United States (US$ 8362) 
Country with lowest total spending per person per year on health Eritrea (US$ 12) 
Country with highest government spending per person per year on health Luxembourg (US$ 6906) 
Country with lowest government spending per person per year on health Myanmar (US$ 2)

 The country with the highest government spending per person per year pays over $1000 less than the US. Furthermore, Fig 2 shows that the impact on health outcomes by amount of money spent stops increasing drastically at around the $1500 mark, so spending over $8000 is insanity. 

Go to the OECD's 'Better Life Index' page, prioritise 'health' on the sliders, and then sort by ranking. US citizens aren't concerned about their health by a long shot, they're just paying an abnormal price to stay as healthy as some of the most 'socialist' countries on earth. So, what gives? Bring the 'health' slider down and push the 'income' slider up, and you'll see that US citizens, unlike almost every over member of the OECD, prioritises income over health, and prioritises income over every other standard of living.

In other countries we are essentially happy to pay more in taxes to secure the health and wellbeing of our fellow citizens without judging them. This philosophy has not ruined civilisation for us, and is somehow more cost effective than US's system by, on average, a factor of 8:1. When the damage caused by corruption in the *private* insurance industry in the US far outstrips the corruption in the *public* health industries in other nations, it's either ignorance or belligerence to claim that ...



CapnForsaggio said:


> Just shifting huge costs to the taxpayer saves NOTHING. You will see.



... without making even a half-arsed attempt at supporting the claim, particularly when the whole world's evidence points in the opposite direction.

So, which is it? Ignorance, belligerence, or both?


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## vilk (Aug 4, 2016)

fckn pwned


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## celticelk (Aug 4, 2016)

@estabon37: Well said. All the likes for you.


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## bostjan (Aug 4, 2016)

estabon37 said:


> It's really as if you're not reading what people are writing about their knowledge and experiences. Sticking insulting names on social services and constantly muttering "wait and see" lends no credibility to an argument that is already disturbingly low on credibility.
> 
> Check out the numbers according to the World Health Organisation: http://www.who.int/mediacentre/factsheets/fs319/en/. For those that don't ever click links, here are the first five figures:
> 
> ...



I think it'd be the argument of least resistance to retort to this by pointing out that most countries without socialized medicine (ignoring the fact that these are 3rd world countries) have the lowest per capita health cost. So, I would merely warn that correlation implying causation could be a weak argument in this case.

I am firmly of the belief that the US healthcare system could benefit from just about any kind of reform other than allowing it to descend into anarchy, as the Republican party seems to want to do. Maybe it's not fair to assume that's what they want, but, other than repealing Obama's reforms, I haven't heard a single detail on how they'd handle it.

In the USA, we have gotten stupid, as a mass. I don't mean to offend anyone individually by stating this, but it's true that we tend to vote for really stupid things and allow congress to vote for stupid things without repercussions. For example: the Iraq war was a stupid thing, but the majority here supported it. Bush even got "re-"elected because of it (Bush's first term was a result of being appointed PotUS by the SCotUS; his second term was by election). Repealing Obamacare, at this point in time, is a really stupid thing, yet, I fear a majority of Americans are for it. Hilary vs Trump presidential election..., well, you get the point. That's democracy, though, when the majority of people vote stupidly, everyone suffers...

Back to the corruption in US healthcare - why is healthcare here more expensive than in other countries? Is it better healthcare? I think that maybe one could argue that our top tier healthcare _is_ the best in the world, but in reality, it's probably not, let alone, I don't think anyone would argue that the USA's average level healthcare is better than any other country on Earth. Our cost of living in the USA is certainly not the highest, nor is our quality of living. Ahh, but what about our medical innovation? It is very high by global standards, but it is also very highly subsidized by the government already, so that does not explain, rightly, why healthcare costs here are so damn high. I boil it down to corruption, by process of elimination, reinforced by my personal experiences with both healthcare workers in daily life and experiences dealing with the US healthcare system. A bureaucracy is an inefficient way to function, yet healthcare systems here seem extremely efficient when it comes to generating revenue, which is counter to the idea that simply bureaucracy in and of itself is to blame.

TL;DR - I agree with your conclusions, but not with your argument.


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## celticelk (Aug 4, 2016)

bostjan said:


> I think it'd be the argument of least resistance to retort to this by pointing out that most countries without socialized medicine (ignoring the fact that these are 3rd world countries) have the lowest per capita health cost. So, I would merely warn that correlation implying causation could be a weak argument in this case.



A better comparison comes from further down the table: the average per-capita yearly health expenditure in the combined OECD member nations (http://www.oecd.org/about/membersandpartners/list-oecd-member-countries.htm) is $4380. Given that there are $30 member nations, and the annual US expenditure is $8362 per capita, you can back-calculate that the OECD average without including the US is about $4243 per capita per year. That's a pretty stark difference.


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## vansinn (Aug 4, 2016)

We used to have very well working public health care here in Denmark.
We still per-definition have it this way; however, it has become halfways useless.

There are pros and cons to both mechanisms.
In general, I'd say any country should have a fully functional public health care system.
However, this is only possible as long as the country's state avoids too much privatization.
As soon as this dreadful mechanism starts rolling in, banks and, in this case, Big Pharma, will pervert the health care system based on desired revenues from drugs.
Doctors will get additional revenues based on selling pills.
I find it scary looking at how many are on prescribed morphines in the US, and it's being slowly rolled out here too.

An example of how our system has become much less useful than it used to be:
I had severe pain in my back. Doc send me to X-ray (which I knew wouldn't reveal anything). X pics looked ok'ish to the doc, that is, he said "you have a fine back for a man in your age (58 at the time). There is a little bending here, but that's no problem".
No problem? This is what I paid loads of money for in private chiropractics to fix (such damages never sully goes away); and what prevented me from entering military back then.
The doc ended up writing down address and phone for a shrink..

What I might see as ideal would be a well functioning public system, combined with the ability to have private treatment - but tax deductable.
I do realize that some/many may say that this will only benefit the ones who can afford the private mechanism.
But this I, at least partially, disagrees with. simply because those that do go private won't take up space in the public queue, and those who cannot afford private as such ought to get in faster.

There's of course a problem with this: The private sector tends to pay better salaries than the public system, so guess which sector gets the best doctors and such..?

There's another problem with privatization: Accountability and proper, unbiased research and documentation.
But hell, in some places, even the university research is biased due to Big Pharma lobbying and fundings..

Then there's the so-called alternative medicine and treatment sector.
I have some 25-30 years of experience with using this, incl having taken several training courses in various disciplines.
If I hadn't used alternative, I have no idea in which state I'd be in today..

This sector used to be laughed at here in Denmark, but over the years, despite resistance against it from the public old-school doctors, it has grown a lot, and is now largely covered by minimal requirement to how these educations are arranged.
I find this really good, as it adds some recognizable common standards to such treatments, and serves to de-mystify what it's really about.


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## flint757 (Aug 4, 2016)

The biggest medical problem in the US IMO is pharmaceuticals for sure. They find loop holes to keep generics from entering the marketplace, and no innovation has really occurred for this exact reason in quite some time. Many companies have slashed their R&D departments. Couple that with the bloat from insurance and you have really expensive healthcare. It doesn't help that lobbyist keep getting our politicians to right ....ty bills that pad their bottom line.

Frankly, the insurance game is ridiculous. My current insurance plan is pretty good, but a few people on the plan have had serious health issues which has made our particular portfolio for our insurance company more expensive. Mind you, insurance companies have tons of clients so realistically they could offset each other in a larger pool. So anyhow, now the company is either going to increase our monthly payment by over $500 or increase the deductible from $1000 per person and $2000 for family to $3000 per person and $9000 per family (for my family; the more people on your plan it just keeps adding up instead of stopping at 2). I can't afford either of those option, especially if I needed medical care, which means I likely just won't go to the doctor or get treatments done when I need them. I need a $6000 eye surgery done at some point and with the new plan I'll have to pay almost all of it myself (insurance won't cover part of it to begin with). I don't have that kind of cash lying around and I already have a mountain of debt from student loans. 

The biggest failure of the ACA is how it went about making sure everyone is insured. Being insured isn't enough if people can't afford the services offered due to high prices and high deductibles. This may have changed, but getting on a different plan was pretty much impossible if your company offered one even if it sucked. Obama's optimistic speeches about the number of people insured and number of people off unemployment are about as meaningless as when Clinton talked about the number of people he got off welfare. People with insurance still can't afford medical care, people are working lower paid jobs and in some cases less hours or not looking anymore, and the people Clinton kicked off welfare were still in fact poor once he removed them from the program.

[EDIT]

To bring it back to my original point, because a few people actually needed to use their medical care they're essentially increasing the prices so high that fewer people will use it moving forward (essentially what the meeting sounded like). This is how insurance works in the US and it is why insurance IMO is not the answer to our problems. It's like when you get in a car accident and then your plan goes up. They don't want you to use your insurance, but they want you to pay your monthly premiums nonetheless. It's a joke. /rant


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## estabon37 (Aug 4, 2016)

bostjan said:


> TL;DR - I agree with your conclusions, but not with your argument.



My argument (at least in my head) was more about people dismissing the systems of a couple of dozen countries without attempting to support the dismissal with evidence or logic. I'll admit upfront that the figures I found were brought together inside of 10 minutes; but that's kind of my point again. I at least spent 10 minutes looking around to see whether or not what I was planning to say could be supported. 

It's exactly what you did when you wrote this:



bostjan said:


> Back to the corruption in US healthcare - why is healthcare here more expensive than in other countries? Is it better healthcare? I think that maybe one could argue that our top tier healthcare _is_ the best in the world, but in reality, it's probably not, let alone, I don't think anyone would argue that the USA's average level healthcare is better than any other country on Earth. Our cost of living in the USA is certainly not the highest, nor is our quality of living. Ahh, but what about our medical innovation? It is very high by global standards, but it is also very highly subsidized by the government already, so that does not explain, rightly, why healthcare costs here are so damn high. I boil it down to corruption, by process of elimination, reinforced by my personal experiences with both healthcare workers in daily life and experiences dealing with the US healthcare system. A bureaucracy is an inefficient way to function, yet healthcare systems here seem extremely efficient when it comes to generating revenue, which is counter to the idea that simply bureaucracy in and of itself is to blame.



That's the kind of thing I'm trying to draw out of people that insist on using catchphrases and insults instead of their brains. You've made a better argument than I did (in my opinion), using different premises and a different method to draw your own conclusion. Awesome!

Celticelk also used my sources better than I did, to make my argument better than I did:



celticelk said:


> A better comparison comes from further down the table: the average per-capita yearly health expenditure in the combined OECD member nations (http://www.oecd.org/about/membersandpartners/list-oecd-member-countries.htm) is $4380. Given that there are $30 member nations, and the annual US expenditure is $8362 per capita, you can back-calculate that the OECD average without including the US is about $4243 per capita per year. That's a pretty stark difference.



Awesome again!

If we don't support our claims, the conversation goes nowhere, and the opportunity to take action to support real solutions evaporates entirely. I feel a little bad for picking on Forsaggio in particular, but if you really do believe in a certain stance on an issue, you only harm it by spewing unsupported nonsense. I'm more than happy to have people tell me I'm wrong, but they at least need to tell me WHY, and back up the details of their argument. What I posted might have been inflammatory, but it at least progresses the conversation.

EDIT: The lack of a 'like' button really forces us to go to more trouble than necessary to say to someone "I like what you got!" (as opposed to "Show me what you got!"). Shit's fucked, yo.


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## narad (Aug 6, 2016)

As an American who has lived the past many years in Australia and England, I have mixed thoughts on this. When I think of my US healthcare experience, the memories that come to mind are mostly of sitting in waiting lines. I never had any medical conditions that were too serious, but it was pretty apparent that most of the medical clinics I visited in upstate New York were way overbooked -- waiting rooms with like 35 patients sitting around to see 2 doctors. Awful.

In London things have been much better. When I've been sick enough to need to visit a hospital, the wait times have been reasonable (45 mins?) and the service very comprehensive: doctor + x-rays + antibiotics + follow-up. When they suggested x-ray some involuntary twinge in the core American part of me shuddered, ".... - does my insurer cover that? what will the co-pay be?" before snapping back into reality. It's great to not think about these things, and to just be handed antibiotics on my way out as casually as possible - no pharmacy stop or prescription involved.

However, when .... really hits the fan, when you need emergency life-saving surgery or cancer treatment, I'd much rather be in the US. The specialists in the US and the equipment they have access to just seem to be a notch above. This is quite anecdotal but I work in research wings of universities and what's going on at Johns Hopkins and Stanford just seems to blow the water out of what's going on at Cambridge/Oxford/Imperial.

Obvious we can have both though -- universal healthcare and more research funding to top university hospitals.


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## flint757 (Aug 6, 2016)

narad said:


> However, when .... really hits the fan, when you need emergency life-saving surgery or cancer treatment, I'd much rather be in the US. The specialists in the US and the equipment they have access to just seem to be a notch above. This is quite anecdotal but I work in research wings of universities and what's going on at Johns Hopkins and Stanford just seems to blow the water out of what's going on at Cambridge/Oxford/Imperial.



You won't be feeling that way when you get the bill. 

I'd personally rather get just below amazing service for next to nothing than to get potentially better service, because medical care quality varies widely across the US, that saves my life, but I'll be paying it off until the day I die (or your family will).


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## FEcorvus (Aug 6, 2016)

I'm not going to get in on this argument, but I would like to put up this article from Forbes
http://www.forbes.com/sites/rickung...-costs-are-so-artificially-high/#3f0d36605cc4

basically for those who don't want to read it, this source points to the prices of American Healthcare being due to hospitals overcharging insurance companies to make up the losses from people who can't pay for treatment and then the insurances propogating this as it leads to higher premiums and thus more profit for them and then the whole process snowballing until it got where it is now


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## narad (Aug 6, 2016)

flint757 said:


> You won't be feeling that way when you get the bill.
> 
> I'd personally rather get just below amazing service for next to nothing than to get potentially better service, because medical care quality varies widely across the US, that saves my life, but I'll be paying it off until the day I die (or your family will).



I think they're pretty good with that kind of stuff? I never thought of my father as having particularly good insurance -- it was always a pain for me personally to do anything under his coverage -- but his heart bypass operation was covered all but a couple thousand. Similarly my friend's mom had a rather serious cancer and about a year's worth of treatment and IIRC that was about $8k out of pocket for almost $200k "worth" of treatment.

To continue with the anecdotes though, there was a kid in my high school whose parents didn't have insurance or didn't have a good plan for high cost treatment, and the family was forced to do these fundraiser dinners to cover the treatments. Pretty sure he died. And I can understand how it happens when you're a young dad, and your kids or teenagers and still quite healthy, maybe it seems safe to take on a more practical insurance policy.

Too many details unknown but I don't like the thought of considering a country "first world", let alone "the greatest country in the world", but young guys can still wind up not getting first rate treatment for fatal diseases. You have to give props to St. Jude and similar hospitals that won't turn away children with cancer, regardless of the insurance situation, but really the entire country should have similar values.


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## flint757 (Aug 6, 2016)

Agreed, but even if you end up only paying 3-10k for treatment that is a huge chunk of many Americans annual salary. More importantly, people who can't afford to pay their premiums or deductibles end up forgoing tests that could catch things like cancer because it's the difference between being able to pay rent and put food on the table. Sometimes that gamble works out and sometimes people end up dying.

I've had a wide array of tests done over the years and the cheapest one, aside from blood work, was about $600 (mostly CAT scans and MRI's which fell between $1000-$2000). When I needed a bone density scan and DEXA scan done last year it cost me $2800. It took care of my deductible, but I had to pay for it all entirely out of pocket and if I was having to choose between rent and those tests I wouldn't have gotten the tests done. 

We shouldn't have to make decisions like that in regards to our health is all I'm saying and insurance offers no real solution to solve it.


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## narad (Aug 6, 2016)

Agreed. I injured my knee lifting while in the US for a couple months, and while I technically had insurance I knew it'd be such a hassle to work it out in that brief period while I was there. So I just took some time off, hoping it wasn't anything serious. 2 years later my knee still clicks and grinds up stairs even after 6 months of free UK physio :-/

Preventable if I had convenient coverage and saw someone immediately? I'll always wonder.

I think that also goes to this point I hear occasionally: because the US plan seems rigged against early detection and prevention, we pay great premiums for the costly treatment that attempt to undo that damage. Seems like a sensible criticism.


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## coreysMonster (Sep 16, 2016)

Lived in Germany nearly all my life. Gotta say it was a very uneasy feeling to come to the USA and have to worry about not being able to go to the doctor. It's just another thing on top of every thing else to worry about. "I can't afford to go to the doctor" is a thought that never even crossed my mind before coming here, and it's IMO one of the biggest flaws of this country. Having to decide to not get vital treatment because of the cost is such a foreign concept it seems like it's from a century ago.

Also, the idea of chronically ill people having to pay even MORE money just to stay alive because of their medication. So many people just fighting to have the bare minimum needed to survive, it's obscene.


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## flint757 (Sep 16, 2016)

Yup, it sucks. My insurance is changing for the worse and my pay is dropping. Technically if I get a surgery I need done before October my old deductible will be applied, but I can't even sort of afford it right now. After October I'll have to pay it almost entirely out of pocket, which I also cannot afford. Rock meet hard place. So I'll likely have to put off a surgery I desperately need until a year or two from now when my financial situation is hopefully a bit better.


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## chopeth (Sep 16, 2016)

flint757 said:


> Yup, it sucks. My insurance is changing for the worse and my pay is dropping. Technically if I get a surgery I need done before October my old deductible will be applied, but I can't even sort of afford it right now. After October I'll have to pay it almost entirely out of pocket, which I also cannot afford. Rock meet hard place. So I'll likely have to put off a surgery I desperately need until a year or two from now when my financial situation is hopefully a bit better.



Hold on, mate. I know by experience it's terrible enough to endure a health condition, let alone not being able to economically handle it. That health care system is utterly absurd in the "first world" to me.


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## anunnaki (Sep 21, 2016)

I enjoy not ever having to pay for medicine or seeing a doctor, and I take some kinda expensive medicine so it works out well for me.

One thing I'm not happy about is wait times. I've been waiting 6 months to get an appointment to arrange some tests to be done to find out if I can get a surgery I want, and I'm on a waiting list, but apparently the responsible doctor is on leave as well, so who knows when I'll get seen.

On the other hand, the surgery I want would cost about £10k on private healthcare so financially it's worth the wait I guess


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## Jzbass25 (Sep 21, 2016)

coreysMonster said:


> Lived in Germany nearly all my life. Gotta say it was a very uneasy feeling to come to the USA and have to worry about not being able to go to the doctor. It's just another thing on top of every thing else to worry about. "I can't afford to go to the doctor" is a thought that never even crossed my mind before coming here, and it's IMO one of the biggest flaws of this country. Having to decide to not get vital treatment because of the cost is such a foreign concept it seems like it's from a century ago.
> 
> Also, the idea of chronically ill people having to pay even MORE money just to stay alive because of their medication. So many people just fighting to have the bare minimum needed to survive, it's obscene.



My dad died because he didn't have the money to go to the doctor to get his checkups especially when he was feeling "off." When he was having his heart attack (we weren't sure what was happening) he didn't even want to go to the hospital because of the bill. 

I have a chronic condition and it costs me more than I afford and absolutely nothing is helping me, there are a few medicines and treatments that I haven't tried though but it is because my insurance (which I can barely afford, I'm literally selling off anything I can nowadays) won't pay for it. 

In HS I was going for top schools but my disability just destroyed my ability to do that, I had A's but I would have failed out of places like MIT and I had no extra curricular activities. Nowadays my professors were saying I should be looking at great jobs at Microsoft and Google but after they realized how bad my disability actually is they're like oh maybe look at these other small places that aren't as stressful (I worry I can't work at all). I have no safety nets for anything, I just have to keep doing my best in basically constant pain or a constant disabled state or I guess become a bum? 

I wish I had at least a hope that I would get healthcare that might help me. Just getting medicaid in my state would possibly get me a treatment that could change my life but that won't happen probably.


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## angus (Oct 13, 2016)

Jzbass25 said:


> I wish I had at least a hope that I would get healthcare that might help me. Just getting medicaid in my state would possibly get me a treatment that could change my life but that won't happen probably.



What is it you want that you aren't getting? I'm not seeing anything in your story that suggests you can't get access (I work in medicine). You might just need to figure out who to go to and how to navigate your insurance.


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## KnightBrolaire (Oct 14, 2016)

narad said:


> Agreed. I injured my knee lifting while in the US for a couple months, and while I technically had insurance I knew it'd be such a hassle to work it out in that brief period while I was there. So I just took some time off, hoping it wasn't anything serious. 2 years later my knee still clicks and grinds up stairs even after 6 months of free UK physio :-/
> 
> Preventable if I had convenient coverage and saw someone immediately? I'll always wonder.
> 
> I think that also goes to this point I hear occasionally: because the US plan seems rigged against early detection and prevention, we pay great premiums for the costly treatment that attempt to undo that damage. Seems like a sensible criticism.



knee injuries are horrible just due to the minimal blood flow to the tissues. The ligaments and tendons of the knee are pretty avascular. The clicking and grinding is called crepitus fyi. I was doing a muay thai fight and my opponent kicked me in the side of the knee repeatedly, I could barely walk for 3 months, still felt pain after 6 months. The doctor told me that knee injuries can take over a year to heal up :/


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## fps (Oct 15, 2016)

Lol, *socialised*, terrible term for it.

Here in the UK, it's a wonderful service, it makes total sense and once you have it, the idea of it not being there seems cruel and stupid. The quality of care is generally very high, although there are still issues, and what can be done for the most vulnerable, as a basic right, is something that makes me very, very proud to be British.

The negatives are, as with anything, that people want a piece of the pie, so there are currently too many middle managers who do nothing and the service has become bloated. A very determined government is currently, slightly too brutally, cutting away at this, in a way that is affecting frontline services but not getting rid of enough of those cushy pen pusher jobs that are the problem.


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## buffa d (Oct 19, 2016)

I see social benefits as a great system. If you are sick you have to go see a doctor and it would be wrong to take that away from someone. Of course there are also private hospitals, which offer the same services in a faster and nicer package. 

However, this kind of a system always brings a metric f-ton of bureaucracy which is ridiculous. 

I know that socialized healthcare is not for everybody since it would be a huge structural change for any society. It would require a lot more money from the government itself, which basically means raising taxes.
Here's the fun part: I actually don't mind paying taxes because I can personally see what I get out of it - Health care, free education (I know it's not free due to high taxes but we actually get paid to study) unemployment benefits etc. 

This means: No homeless people, high education rate, free health care.
This also means: Lot of paper work, more power to the government since they own more than the average nation, dumb rules.

My wife moved to Finland from the US and I can tell for sure that we wouldn't have been financially stable without the benefits she gets (even as an American citizen). So with this in mind 

I think one of the main reasons why this system is overlooked is that it's considered socialism, which especially for Americans is a big no-no. I've had my fare share of anger from my wife's family's side for living in a socialist country  I guess I might have to remind them about the benefits she is getting haha. 

I feel the wealthiest should help the ones who don't have the same income. People don't choose to be poor. Otherwise the population gets more and more polarized between two socioeconomic groups which can lead to severe tensions in the long run.


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## tedtan (Oct 19, 2016)

buffa d said:


> I think one of the main reasons why this system is overlooked is that it's considered socialism, which especially for Americans is a big no-no. I've had my fare share of anger from my wife's family's side for living in a socialist country  I guess I might have to remind them about the benefits she is getting haha.



In the US, when people hear the word socialism, most immediately jump to thinking of Marxist socialism and USSR style communism. If you can make the distinction between that and European style socialism, and the person you're speaking with is still listening, you might have a better discussion. But good luck with that - hatred of communism runs pretty deep, so most people here won't bother listening if they can make the mental jump to communism.


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## StevenC (Oct 19, 2016)

This morning I went in for an X Ray and consultation. I left with an MRI appointment and the option of surgery. All for free.

I'm quite happy with the healthcare I receive.


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## CapnForsaggio (Oct 19, 2016)

Nothing is FREE.

Don't be a rube.

Everyone ELSE is paying for it, at far above market value. AND, they don't have a choice.


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## StevenC (Oct 19, 2016)

Not really. The UK government spends far less per capita on healthcare than the US government, for example, so I wouldn't say far above market value. And while it's paid for by my and everyone else's taxes, I don't have any bills to pay or take out a loan to stay alive. I'd say that's on the money saved end of free.


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## mongey (Oct 19, 2016)

There is also the argument that access to free , or cheap , healthcare means people use it more often and are healthier overall ass problems get caught earlier . costing less on hospital costs in the long run


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## buffa d (Oct 20, 2016)

tedtan said:


> In the US, when people hear the word socialism, most immediately jump to thinking of Marxist socialism and USSR style communism. If you can make the distinction between that and European style socialism, and the person you're speaking with is still listening, you might have a better discussion. But good luck with that - hatred of communism runs pretty deep, so most people here won't bother listening if they can make the mental jump to communism.



Yes this is exactly what I mean. 
It is so deeply rooted in the culture that people associate it with communism without even knowing what it actually means. 
Funny enough, this could also be solved with a proper level of education, which is ridiculously expensive in some countries.


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## AxeHappy (Oct 20, 2016)

CapnForsaggio said:


> Nothing is FREE.
> 
> Don't be a rube.
> 
> Everyone ELSE is paying for it, at far above market value. AND, they don't have a choice.



If we determine Market Value based off what the US is paying then they're paying way below market value. Also, since the cost is spread across everyone each person is paying less then they otherwise would. 


I'm glad I live in a society where most people think everyone chipping in to provide access to basic quality of life is a good thing. It's almost like, that is the entire point of cilivisation.


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## UnderTheSign (Oct 20, 2016)

CapnForsaggio said:


> Nothing is FREE.
> 
> Don't be a rube.
> 
> Everyone ELSE is paying for it, at far above market value. AND, they don't have a choice.


A thread full of good posts in support of socialised healthcare, and you had to return to PC&E with this? 

Like I've said before, my health insurance is less than 100 a month and I even get part of that back so it's below 50 realistically. My income tax is 36% and I'm sure some of that goes to healthcare as well. I'll happily pay that if that means everyone gets to to to the doctor without worrying about the costs. If that makes me a commie, get me one of those fancy warm hats because I'll take it and wear it with pride.


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## bostjan (Oct 20, 2016)

Hmm, I work full time. I live and work in the USA. I have an issue, where I live, that even though I am in a town full of doctors, it's the only town with doctors in the greater area, so everyone else comes here for medical care.

First issue is that I cannot find a doctor who will even make an appointment to see me. And I'm not joking, I've tried several doctors, each several times, over the past nearly seven years I've lived here. The standard answer is "We are not taking new patients." When I broke down and asked what I was supposed to do, the standard answer is "Go to the emergency room." Every time I have been sick enough to need antibiotics or hurt enough to need stitches or to check a bone for a break, I've had to go to the ER.

Every time I go to the ER, the waiting room is mostly full, and I have to wait over an hour. And then I get a bill for several hundred dollars, and that's after insurance covers a majority of it.

So this model is not feasible.

Is socialized healthcare to blame for me not getting primary care doctor? No. But my experience with paying the bill is no better than what I would have to deal with before. Where things differ is that my past employers, who did not offer healthcare benefits, now have to do so, but I already wised up and quit those jobs to get one with better benefits, so I'm largely unaffected.

I still say that we've approached reforming the industry from the wrong angle. Maybe it's not a bad angle to approach, but it's a bad angle for the initial approach, because it does not address the root of the problem.

In any problem solving situation, you need to first define the problem, and, rather than defining the problem as healthcare is too expensive, we approached it as people without jobs cannot afford healthcare. I think that was too narrow, and it took us in a direction that was less effective than it should have been.

In the EU, healthcare costs are not great, but they are hands down better than they are in the USA. Is it because the government pays more or is it because the healthcare industry bills less, or a combination of those and other factors?


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## Pablo (Nov 7, 2016)

bostjan said:


> In the EU, healthcare costs are not great, but they are hands down better than they are in the USA. Is it because the government pays more or is it because the healthcare industry bills less, or a combination of those and other factors?


I think the answer to this question is fairly obvious: over here, you buy health care at cost (through taxes), wheras in the US you buy that same service from a provider, that adds a profit margin, which is usually paid through an insurance company, that also adds a profit margin...


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## bostjan (Nov 7, 2016)

Pablo said:


> I think the answer to this question is fairly obvious: over here, you buy health care at cost (through taxes), wheras in the US you buy that same service from a provider, that adds a profit margin, which is usually paid through an insurance company, that also adds a profit margin...



When I was in an accident and needed surgery, prior to Obama's presidency, I was financially ruined by the cost, and it wasn't even a special procedure in any shape or form. My employer dropped my insurance anyway, and the insurance company refused to pay, so the insurance company was not the problem, either. What was the problem, was that, for about an hour of his time, I had to pay the surgeon $3500, and he was the cheapest surgeon around. $3500 is a lot of money, but that's just the tip of the iceberg, as I had to pay an anesthetist $2000 to not even properly anesthetize me, I had to pay the hospital $4500 for the room, $1500 for needles and IV bags, $800 for drugs, etc. etc. When it all added up, it was nearly $30kUS. But that wasn't even the end of it, as tons of weird bills kept popping up, even years after the surgery. Everyone was demanding money from me, even the company who disposed of the medical waste, despite the fact that I paid the hospital a medical waste disposal fee. And there was no accountability for any of it, meaning that I had no way to challenge this bill from a medical waste disposal company that came to me nearly three years after the surgery.

The Affordable Care Act was like a bandaid on a severed limb. The issue is that, in the USA, at least in the 2000's, not only is there a health care industry, but there are all of these little industries that don't rightly need to exist as highly lucrative industries - Health Information Technology, Healthcare Billing and Collections, etc.


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