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this post was submitted on 31 Dec 2024
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politics
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Single payer healthcare is so complex to implement that only 22 of the 23 most developed countries in the world have done it.
The US system is grotesque.
The US system is state sanctioned terrorism of the civilian population by the plutocracy, for profit.
Part of the problem for the US is that such a huge amount of gdp is buried in the masses of beauracracy that makes up the US healthcare system, it's essentially acting (economically) as proxy government spending to prop up a failing economy. The average US citizen is so heavily propaganda'd into hating government run projects that the sensible economic stimulus (government infrastructure projects or public services) are well and truly off the table.
What this ultimately means is fixing healthcare isn't just breaking up the cartels, preventing price fixing and untangling the web of nonsense that makes up the US private system... unless you want to inspire a massive crash (which absolutely has real human cost), it also means redistributing government spending and implementing (unrelated) government run services and/or projects to keep all these people employed (which would also mean re-training and potentially relocating) - all of which needs to be done against the overwhelmingly loud voices screeching "government employee bad".
While I agree with the sentiment (where this should be the case), this isn't actually true for some of these countries.
Australia, for example, though not sure if we're included in this 23, we have a private system also.
For all emergency care, it's single-payer. Private health insurance / private hospitals are not permitted to provide emergency care, nor out of hospital car, but all other hospital care is allowed (I am simplifying, as I'm not super clear on it either). Further, private health insurance is not allowed to cover things that Medicare doesn't at least also partially cover.
Sounds good right? Sounds like private health is kept in check? I mean, sort of, but it's still really profitable, and you even get a tax break.
What it doesn't stop, is prices getting higher and you having to cover the difference because health care employees are not necessarily employed by the stat, and can set their own prices (which is either covered by private insurance in hospital, or out-of-pocket outside hospital as private can't cover that).
If you don't have private health, you often have to wait way longer in the public system for non-emergency (but still medically necessary) care, like hip replacements, eye surgery etc.
It's kinda fucked, everyone ought to be in the same queue, and if things are taking too long well then gee, I dunno, pay more / hire more / train more doctors, this doesn't take a genius to figure out.
Healthcare should be provided by the state, in-full, covered by taxes. We (and the US for that matter) have plenty of tax revenue to cover this. And if you're feeling really frisky, perhaps very slightly increase corporate taxes and tax breaks for the wealthy.
So we now have a two tiered system, where the wealthy get care first, or whoever can afford to pay. And you even get a tax break for it.
The US system is trash, and ours is utopian by comparison, but let's not pretend like all 22 of 23 countries have true, universal healthcare.
We don't, let's aim higher haha