Obamacare, Trumpcare... why not just Firstworldcivilisedcountrycare?

Obamacare was apparently a dysfunctional crapshoot. Whatever Trump's coming up with is likely going to be as bad.

So... why can the United States not simply adopt the model that is standard in literally every other country in the western world?

Here's how it works:

• A healthcare-funding income tax is levied on the entire population. In the UK this is called "national insurance". Other countries might call it some other name, but it's the same thing.
• This funds a central fund from which money is divided up among hospitals and other healthcare facilities.
• Citizens who break their legs or need a gall bladder removed, or whatever, don't have to worry about getting slammed with a medical bill. It's already paid for by the fund above, to which they themselves have contributed in part over the course of their working life.

What's so hard about that?

For starters, it's unconstitutional
We don't need another entitlement program
We don't need more taxes raised on us
What makes you think it will work in a country of 320 million?
We aren't Europe
We aren't a Socialist nation and I personally don't like Socialism

My main problem with your plan MF is that today I don't mind if my neighbor likes to smoke, and eats until obese, and takes drugs or recreates in unhealthy ways. Live and let live.

But tomorrow you tell me I must pay higher premiums for his poor health habits or I should be subsidized by those who live a healthier lifestyle than me? Those I object to.

The only national insurance I would support is some very basic catastrophic (don't think someone should be bankrupted from an accident or some expensive new medicine/procedure than can now save a life).

I don't want to pay more because Joe visits the doctor every month for every ailment. Let Joe pay for the products he consumes, whether tangible goods or services like any other. Look to dental insurance system, since that service is still viewed as a 'luxury' or like any other product.

I may think regular checkups are cost effective, but I don't want the government mandating how much sugar I can have in my drinks or how often I must stick things up my ass.

I don't want to go through the government for my health care. I can buy my own insurance, and I want to be free to pick and choose what I want based on my estimation of my needs.

In any government-controlled health insurance system, I will inevitably wind up paying more and getting less. I'll also have the government levying administrative fines on me without any due process if I don't comply. And I don't want to be "managed" by politicians pulling levers on the health care system.

I'm not a peasant who needs to go begging to the local lord for my needs; I can provide those for myself. And I don't have to be beholden to someone for "giving" me something I paid for.

THAT is civilized to me.

I'm willing to do SOMETHING for those who can't afford insurance, but I don't want to be subsumed into the scheme.

Actually I think the idea has a lot of merit.

Europeans pay a huge chunk of taxes to pay for everybody's medical care.

So why shouldn't we use the same system? My housemate just had her gall bladder removed. Why make her pay for that instead of having the French, Germans, or Brits pay for it? After all, they're paying for health care anyway. What's an extra gall bladder here or there?

I'd like the government to pursue what's causing these outlandish medical prices and work toward a way of resolving that. I'd also like a public option to be available, as in a basic plan that someone with low income could potentially afford in lieu of a private plan.

Gee, what an idea. Rather than having comprehensive reforms, why not tackle each issue individually?

A healthy country is a productive country.

You and I have fundamentally agreed on this for years, but please don’t acknowledge this post. It would be equivalent to the fact that Bill the Cat spoke coherent English this morning for the first time in 35+ years.

(Now, watch how he responds to this.)

I agree. If you don't smoke, drink, use drugs, have a history of dangerous driving (yeah there is going to be a stupid ass comment directed at me on that which of course isn't true), don't engage in high risk hobbies, and don't have significant family histories of various diseases or other risk factor............................then in my opinion you should not be paying remotely as high of taxes to support health care as those who do.

Actually that model is far from standard. Most countries with universal healthcare don't operate it the way the UK does.

In an ideal world, your position holds quite a bit of merit. But in this world, there are a lot of people who cannot afford the care available to you or me. And before you point out your philosophy of winners and losers, I'll remind you that an unhealthy population is a threat to all individuals, whether or not we can afford treatment.

Both good ideas. Actually, there's no need to investigate the first, it's really pretty simple. About half of all medical bills go unpaid. I work in the industry, and you would be shocked by the amount of bad debt written off. The prices are what they are because what billing gets paid has to cover so much that doesn't.

On the second suggestion, I agree completely. How do you make that coverage affordable? Does it work by subsidy? Regulation? I'm curious, because I can get behind such things, but you typically are pretty opposed to them, as they infringe on liberties to a certain extent. What's your way around that?

Holy shit I like your idea! Let me add my two cents - a great compromise! The US (with our huge military that always needs extra training to stay sharp) can defend western Europe. We pretty much do all the heavy lifting anyway, right? Other nations help, but come on - we are the "anchor store" in the military mall. So we build up our forces to in Europe to cold-war strength and in return, they pay for all US medical care. They disband their military - just give us the real estate and we supply the troops & equipment because we are the military combat seasoned experts. They pay the entire US socialized medical care (which apparently they can do much much cheaper) because they are the experienced ones in that field. Each country plays to their strengths and everyone wins.
Okay Trump, you can hire me now!

There's always compromise. If you want free medical care you should have to play ball with the people providing the care (up to a reasonable point). I am not saying the government should manage the care completely - trust me, they will fuck that up. Just have the government pay the bills. The doctors & hospitals & drug companies could then lower their prices because they wouldn't be taking hits on unpaid bills. Yes, taxes would go up - but would they have to if we cut out all the bullshit spending and made free medical a priority? And as bills get paid on time and in full, the hospitals could lower their costs, and taxes could drop. Granted the hospitals would be audited, which is fair. And since the medical treatment would be free, we the citizens would be under scrutiny - and if you smoke or drink to excess (or abuse drugs in general) or are dangerously obese, you pay a huge co-payment. You don't like that? Too fucking bad! Get your shit together because nobody who does play by the rules should have to pay higher taxes for your sickly ass when you live a "high risk" lifestyle. Aren't we always bitching about our tax dollars supporting people who abuse the system? I think so, across the board for all income levels.

Yes, single payer with some payment risk for the patient is probably the best solution. Deductibles and co-pays adjusted for lifestyle choices seems like a good balance against the need to cover all.

This.
Americans likely would receive far more bang for their buck if they weren't paying for profit, insurer/providers. Even over administered systems like Ontario's in the mid 90s are far more cost effective. When we had to cut costs, we cut duplicated administrations far more than actual health care workers.

Ever notice how the most vehement "free market" capitalists are the those who work in some form of management?

Without the profit motive how would medical research be funded?

Yes taking some links out of the admin/beaurocracy section of the chain would be a good idea. It's like college costs - teachers aren't making a lot of money so where is all the higher tuition money going? There are so many things the US can be doing better but we are not.

apples and automobiles.

I'm fairly sure whatever you're paying into your HMO no more supports cancer research than the taxes I pay into OHIP. Probably less as that same tax pool I pay into supports research hospitals...

No reason medical research should be affected at all. I don't think anyone is bitching about paying higher taxes for that.

'zactly... why does a prof make 70 000 while a uni president makes 1.7 million?

Single payer UHC cuts out duplication and is essentially revenue neutral... no stock holders to answer to.

I'm bitching. That's not a government function, and the fedgov hasn't ever been source of any R&D or innovation but instead a hellhole of political maneuverings and internecine one-upsmanships (GOP defund abortions, Democrats handing out contraceptives, but no actual medical innovations of any nature; oh, funding some of the genome project, I'd vote for that funding).
But if/when we go socialized, then ultimately the only R&D will be relegated to that from fedgov for new miracle drugs and medical devices, which, if history is any example, will mean shit like leeches and amputations (instead of statins, stents, and viagra).

One thing to consider though - that university president's "span of control" is much bigger. In other words the more responsibility you have/people you are held accountable for the more you are worth - kind of like the military. But we could cut down on the number of middle-men, that's for sure. Now a fair compromise for that is once an unnecessary position is vacant (somebody currently working in that position retires so nobody is just booted out of a job) it isn't refilled - that position is gone.

But we wouldn't have to run it like that. The people doing the research should be allowed to run their research as they see fit (as long as they aren't milking the system) and the government ponies up the money and just stays out of the way. That said the researchers are monitored and their "progress report" is a matter of public record so the taxpayers see where their money is spent. And we wouldn't have to follow any countries business model to the letter - we could take what would work for the US and discard the rest.

I'd buy that "span of control" if the ratio was 10:1, but nearly 25:1 seems a little like skimming off of the middle at the expense of providing a service.

Maybe that's the disconnect? Do we see post secondary education and health care as necessary public services or as products beholden to market forces?

So you trust government beauracrats to direct
Rezsearch

Absolutely

No, we'd expect them to direct the budgets for research in publicly funded hospitals and universities. That's what bureaucrats do.

So are post secondary education and healthcare necessary public services or products subject to market forces/interests?

Or is it (C), you thinking you're clever?

Because Republicans.