A better way to understand our problems is that our medicaid and medicare programs are the most generous in the world - so much so that extending it universally is so friggin expensive.
>so much so that extending it universally is so friggin expensive
I laughed out loud at the idea of the US thinking universal healthcare would be expensive considering all the trillions spent without blinking to pay for two pointless wars, the 1.7 trillions to be spent on a stealth plane that can't fly in the rain, and the trillions printed in the last couple of years and dumped on the stock market.
To be fair, the rampant insane cost of healthcare in the US is due to lack of any regulations on costs and spending, meaning big pharma, doctors and hospitals, etc. will shake down as much as they can get way with from the insurance companies and patients, in borderline fraudulent ways, without any accountability. Plus the expenses of becoming a doctor in the US and the high cost of management and bureaucracy in the US system.
Also, hospitals in the US don't need to be decked out like an oil-sheik's mansion with expensive frivolities. In Europe, they're really spartan on luxuries as they're just places where you go to get treated, not art galleries.
My point is, a lot of the massive costs in US healthcare is just down speculation and waste, both of which could be reduced of desired without sacrificing quality.
Sure, but it's a different conversation about how wasteful American medical expenditures are.
I've been on state Medicaid in the US. I've also been on a single payer in Europe. People really have no point of comparison on how much more luxurious Medicaid is. You are still visiting the oil-sheik mansion, but with no out of pocket and no limitations on how much or often.
Hospital will still shake you down for all your money, but the government has no problem footing the bill.
>I've been on state Medicaid in the US. I've also been on a single payer in Europe. People really have no point of comparison on how much more luxurious Medicaid is.
I don't doubt it. In the US, doctors and hospitals are incentivized to treat you like a cash cow and to do as many tests or procedures as possible, even unnecessary ones, knowing that your insurance company or the government will foot the bill no questions asked.
Whereas in Europe, the doctors and hospitals in the public system are incentivized to do as much cost cutting as they can by doing as little tests and procedures as necessary, to reduce costs and waiting times, and have strict regulations on when they can refer you to specialists or more expensive test, needing to justify it when they do.
This means that sometimes you can end up with some undiagnosed condition going chronic on you because the public doctor didn't want to, or wasn't allowed to refer you to an MRI scan when you first showed some light symptoms, because your light symptoms weren't severe enough to warrant such an expensive test. I sh*t you not, this happens more than I'd like to hear. It's why health tourism is booming in Europe, where people from richer EU countries go to the Eastern states for private tests or treatments since preemptive care in the European public system is failing people big time and they can't afford the private system in their wealthy countries.
Sometimes, having a fully private health system, really does have its benefits.
"treat you like a cash cow and to do as many tests or procedures as possible, even unnecessary ones, knowing that your insurance company or the government will foot the bill no questions asked."
One slight addition. They might be medically unnecessary, but have become legally necessary in some cases. Either because medical protocol has adapted to try to charge more, or because if you don't you might get sued because "Every other doctor would have run that test", etc.
But it is still very much about the money. When I got my wisdom teeth extracted, I had to go in for a 10 minute consult with xray on one day, then go in on a second day (even though it could be done on a single day). Why? Because insurance will not pay for a consultation if it happens on the same day as the extraction.
As for the government footing the bill in the US. Some procedures are deprioritized by hosptials of the patient is on Medicaid. The Medicaid reimbursement rate is generally lower than that of other insurance, so they prioritize the people/insurance that pay more.
"You are still visiting the oil-sheik mansion, but with no out of pocket and no limitations on how much or often."
I generally agree. But I have heard that they will push lower priority (non-life-threatening) operations to the back in order to get other insurance holders to the front of the line. Basically because the reimbursement rate from other insurance tends to be higher than Medicaid.
The part that tends to be left out (maybe unaddressed or I'm uninformed) is, is there a single payer component to it like actual Medicare? In general, you spend several decades of your life working and paying in to collect for maybe a couple decades. And the more you make or pay in, the more coverage you have.
So would we just end up with a government plan that we still need to pay premiums, deductibles, co-pays, etc on? And where are the systemic savings (providers still need to have billing agents to deal with this and private insurance, government overhead peobably isn't that much better than business overhead)? Do the people who can't afford it go on Medicaid to cover the balance like they do if they can't afford current Medicaid? Or are the suggestions really just misnamed and are totally different?
To be fair, all three are expensive, and the returns/merits of each could be argued to varying degrees. If we adjusted the tax structure and spending to arrest or reverse the ever increasing debt, then it could be feasible. Personally, I'd like to see them start responsibly addressing the fiscal situation caused by their past decisions before adding in new programs.
https://twitter.com/BadEconTakes/status/1228143455399858176
A better way to understand our problems is that our medicaid and medicare programs are the most generous in the world - so much so that extending it universally is so friggin expensive.