I know quite a few Canukes that lives in the US. Their basic care is fine, but “elective” surgery can be on the waitlist for a while.
A good case study is Taiwan which done a huge switch-over to single payer system from a pay-as-you-go system. Because of the lack of employer paid insurance, their health care cost was low. The cost has now raised quite a bit.
There are a number of demographic differences between countries that make direct comparison of health outcomes difficult.
Also, that commonwealth fund report really downplays health outcomes in their ranking criteria, in favor of nebulous stuff like affordability and equity. You can die for free with no healthcare but if you get treated for various things like strokes or cancer in the UK your odds of a successful outcome are much worse than the US. That’s what I would care about but these commonwealth people have a different agenda.
Even the Commonwealth Fund study in question concedes that, while they ranked the NHS as the number one health system overall, its competence in the small matter of actually keeping its patients alive was the second-worst of any country under consideration.
This is just sophistry and semantics. If your “business” has and can only have one customer–the government, you are a government employee.
“The National Health Service is the closest thing the English have to a religion,” Margaret Thatcher’s Chancellor Nigel Lawson famously once observed.
How true. Remember the absolutely bizarre opening ceremony at the 2012 London Olympics where they had women wearing nurses outfits swooping around on guy wires and other actors dressed in hospital gowns jumping up and down on trampolines decorated as hospital beds. The announcer intoned how “we love our NHS.”
By that definition all Lockheed, Northrop, and Raytheon employees are government employees.
Heard an informative discussion on future of California medical system on radio. The interviewee is Craig Gotwas, a lawyer who makes his living advising companies on how to cope with government regulations for their employees’ medical insurance. Scroll forward to about the one minute mark to get over the show opening stuff.
Comments:
Taxpayers in California now fund 70% of all healthcare (UCLA Study: Taxpayers Foot 70 Percent Of California’s Health Care Tab | California Healthline) via Medicare, Medicaid, CHIP, the VA, Tricare, County/Local Health Programs, PPACA Exchanges and state, local and fed gov’t employees. Other states are generally 60% to 65%. So we already have a mostly socialized system
Gotwas estimates that if the Democrats’ plan is implemented it will add about 2 million people to the government paid medical system in California
His prediction is that this will lead to even longer wait times for services and reduction in quality of the service.
Craig’s website is well worth reading for fact based information on the state of medical system
Interesting. My first reaction is that 70% sounds really really high but then I realized that majority of the people I see at the local HMO are older folks. People over 65 are already covered by Medicare and that older people use the healthcare system way more than younger folks so with that in mind, the 70% number starts to sound possible.
Medicare is ~20% of total healthcare spending. About 13% of the population is on Medicare. So yeah per capita.
Medicaid is almost 20% too. A bit over 20% of the population is on medicaid.
VA, Obamacare subsidies, etc all add up too.
The broad umbrella of ‘government spending’ may also include government employees which is around 12% of the workforce. That might be 12% of it too.
They cited a report that is here :
http://healthpolicy.ucla.edu/publications/Documents/PDF/2016/PublicSharePB_FINAL_8-31-16.pdf
Government employee health insurance spending is included but its only 3.5% of the total
12 % of the “government spending” are tax subsidies for employer sponsored insurance.
That is a surprise to me. 1 in 5 people in CA or in the USA? Either way, that’s a very high #.
1 in 5 in the USA
1 in 4 Californians
Within hours of assuming office on Monday, CA Gov. Gavin Newsom issued a defiant challenge to the Trump administration with sweeping plans to expand health coverage to more Californians, pushing for a single-payer system and insurance for undocumented young adult immigrants.
U.S. Rep. Ro Khanna, D-Calif., who is working with Newsom, said Congress needs to pass a bill that gives states permission to create their own healthcare programs and still receive federal funding.
The last part won’t happen under the current Congress but very well could if the Democrats take complete control in 2021. It’s scary since it calls for the Feds to give Medicare funding directly to the states and to take it away from individuals.
It should be a Republican ideal right? Letting states decide what they want to do instead of the federal government.
While I, as a Republican, support federalism I also support individual freedom. I think Medicare and Social Security are unconstitutional but if the law exists it should be followed. Medicare and Social Security law creates individual accounts with benefits to each individual taxpayer forced to participate.
If the Democrats want to rewrite the law saying that benefits go the the taxpayer’s state of residence they should do so. But people like me who paid into individual accounts should, under the last clause of the Fifth amendment, be able to get the benefits for our accounts as when we paid into them.
You didn’t pay into any account, you paid a tax that is used to operate a welfare program.
When social security constitutionality was being challenged, the Federal Government took the position that social security was not an insurance program, that it is simply a tax, and that it has no relationship to any benefits being paid. The government does not have the authority to run insurance programs or hold accounts for individuals. The 1960 Flemming v. Nestor decision reaffirmed that paying the tax creates no entitlement to benefits.
A republican ideal would be getting the federal government out of healthcare and let states compete. If they want to tax their citizens and run socialist medicine then let them do so. It doesn’t make any sense for the federal government to forcibly tax everyone and then hand the money over to states, essentially forcing their hand to intervene.
Lest you fall for that line that everything’s cheaper and affordable in Europe because of socialized medicine, here’s an update and they’re have the same issues with rising healthcare costs that we are.
https://www.reuters.com/article/us-finland-government-idUSKCN1QP0R6
Healthcare systems across much of the developed world have come under increasing stress in recent years as treatment costs soar and people live longer, meaning fewer workers are supporting more pensioners. Nordic countries, where comprehensive welfare is the cornerstone of the social model, have been among the most affected
Sweden is to gradually raise its retirement age and has opened up parts of the healthcare system to the private sector in a bid to boost efficiency. Denmark will gradually increase the retirement age to 73 - the highest in the world - while cutting taxes and unemployment benefits to encourage people to work more.
The article doesn’t go into specifics of how much healthcare is increasing in Finland or other European countries.
The rate of increase is indeed similar in Europe as in the USA.
Of course since we’re spending over 2x what they are that increase hurts us a LOT more than them…
In 15 years the costs in Europe went up ~$1700/capita and ours went up ~$5000
source:
Vermont is arguably the most liberal American state. Word is the last conservative Vermonter passed away about ten years ago. The old guy was living in the mountains hard alongside the Canadian border, as far from Massachusetts as he could get while still remaining in his beloved Vermont. There were no mourners at the funeral. 
If Vermont Governor Peter Shumlin and his legislature could not make this work, it cannot be made to work. That is my view, anyway.
Democrats don’t have any more knowledge on how to fix health care than Republicans do. I think it’s generally accepted by both parties that there’s a problem with our current system.
Democrats are willing to try new ideas, try to fix problems, etc., while risking that things end up worse. Republicans want to keep things the way that they are until they are fixed naturally, or just maybe they come up with an idea they are confident will work, because they don’t want to do something actively that might not work.
Neither approach is necessarily right or wrong, either, both, or neither could end up in the system crumbling.
