Post by michaelw on Mar 14, 2020 4:26:14 GMT -5
Something I've been thinking about recently:
In general, it seems like people living in developed countries other than the US tend to think the current US healthcare system doesn't make a whole lot of sense. Maybe they have some misconceptions about it here and there, maybe not, but I think that's a fair assessment of the general viewpoint, either way.
Yet, a lot of Americans (especially conservatives) seem to have similar feelings about healthcare in other countries. As someone who doesn't really grok this sentiment, I've tried to highlight what I see as the 3 main concerns for people who feel this way.
1. It costs too much.
This is definitely an argument I've seen a lot over the years. Just recently, PragerU did a video called "The Truth about Canadian Healthcare."
www.prageru.com/video/the-truth-about-canadian-healthcare/?fbclid=IwAR34Ma9-Hr-0J3Uw4NElKb6wnhuhnCJP9hKiMVQyEQi2H9xf9aaXbzo4hp8
(I know I pick on PragerU a lot, but some of my more conservative friends seem to think they're great, and I think a lot of arguments they make are echoed in other right-leaning outlets.) Under their section on facts and sources, they have this quote:
So they have 3 metrics here: total costs, costs per person, and costs as a percentage of GDP. I *think* their point here is that healthcare costs in Canada are awfully expensive. But there's a problem. They don't mention what the equivalent figures are for the US. It turns out, US healthcare costs are even more than this, by all 3 metrics. Complaining that costs in other countries are too expensive just doesn't make any sense to me, when your own costs are even higher.
Am I missing something here?
2. Quality of care is worse in other countries
This one seems a little bit harder to pin down than the issue of costs, but I do see people argue sometimes that quality of care in the US is simply better than what's offered in other countries. But I am not sure I understand what that's based on, exactly. By pretty much any actual metric--whether it's life expectancy, infant mortality rate, maternal mortality rate, etc--there are other countries out there with better health outcomes than the US.
I guess one could argue that maybe the US is only struggling in some of these metrics because some people don't get the care they need, and that people who can afford the best American care that money can buy do, in fact, end up getting excellent care. But that doesn't seem like a very good argument for not reforming the current system. It should be very possible to expand coverage into some form of universal care without sacrificing quality, as evidenced by various other countries who have managed to do it.
Again, am I missing something here?
3. Long waiting times to get treatment
This is probably the argument that seems the least bad to me. Canada is famous (infamous?) for this problem, and although the examples in the PragerU video are anecdotal, there are statistics that back up the notion that Canada has problems with waiting times. Also noted is that some Canadians elect to travel to the US for treatment, because of lower waiting times.
This is hardly a trivial problem, but I have a few reasons why overall I'm not too impressed with these lines of argument.
--A. Not every country w/ universal care has this problem to the same extent as Canada.
--B. You could argue that waiting times can be even longer in the US, if you are someone who's simply not getting treatment at all. (But of course, such people aren't normally included in these types of statistics.)
--C. Yes, Canadians travel to the US for treatment, but it's not clear to me that the number should be taken as all that staggering. According to the Fraser institute, 63,459 Canadians chose this route in 2016. That doesn't really strike me as a huge number, given a total population of around 37 million, where 90 percent (maybe even more than that) live within easy driving distance of the US border.
Now, if the US were to adopt some form of universal care, it would be logical to expect some degree of increase in waiting times, at least for certain things, since more people would be getting treatment. And waiting times that are truly excessive can be a real problem, and certainly you'd want to take steps to improve that rather than just ignoring it. But people who would balk at ANY increase in waiting times just don't make a lot of sense to me. It seems like a version of "Won't somebody please think of the rich people?", because realistically, wealthy people with relatively less serious health issues are the ones who would be most put out by this. (Note, for example, the case cited by Alain Lambert, where his friend paid 20,000 dollars to have faster surgery in Florida. Obviously not everyone has 20,000 dollars to pay out of pocket for fast-tracked surgery.)
So, to sum up:
Lots of Americans seem quick to point out flaws in foreign healthcare systems, but I am not really sure the arguments hold up all that well. And on top of that, there's no requirement that the US fix their healthcare via choosing a single country to emulate. You could pick out some aspects from Singapore, some from Israel, some from Switzerland, some from Japan, and so on, and you could probably end up with something much better than what we have now.
Instead, Americans pay huge amounts of money for private insurance, which in a lot of cases doesn't even provide adequate coverage and still leaves unaffordable co-pays for a lot of people.
Just seems really unfortunate, especially when people insist there isn't anyone else out there doing things more effectively.
Thoughts?
In general, it seems like people living in developed countries other than the US tend to think the current US healthcare system doesn't make a whole lot of sense. Maybe they have some misconceptions about it here and there, maybe not, but I think that's a fair assessment of the general viewpoint, either way.
Yet, a lot of Americans (especially conservatives) seem to have similar feelings about healthcare in other countries. As someone who doesn't really grok this sentiment, I've tried to highlight what I see as the 3 main concerns for people who feel this way.
1. It costs too much.
This is definitely an argument I've seen a lot over the years. Just recently, PragerU did a video called "The Truth about Canadian Healthcare."
www.prageru.com/video/the-truth-about-canadian-healthcare/?fbclid=IwAR34Ma9-Hr-0J3Uw4NElKb6wnhuhnCJP9hKiMVQyEQi2H9xf9aaXbzo4hp8
(I know I pick on PragerU a lot, but some of my more conservative friends seem to think they're great, and I think a lot of arguments they make are echoed in other right-leaning outlets.) Under their section on facts and sources, they have this quote:
The Canadian Institute for Health Information provides the most recent data on Canada’s health expenditures, and how much government-run healthcare costs the average Canadian: “In 2019, total health expenditure in Canada is expected to reach $264 billion, or $7,068 per person. It is anticipated that, overall, health spending will represent 11.6% of Canada’s gross domestic product (GDP)."
Am I missing something here?
2. Quality of care is worse in other countries
This one seems a little bit harder to pin down than the issue of costs, but I do see people argue sometimes that quality of care in the US is simply better than what's offered in other countries. But I am not sure I understand what that's based on, exactly. By pretty much any actual metric--whether it's life expectancy, infant mortality rate, maternal mortality rate, etc--there are other countries out there with better health outcomes than the US.
I guess one could argue that maybe the US is only struggling in some of these metrics because some people don't get the care they need, and that people who can afford the best American care that money can buy do, in fact, end up getting excellent care. But that doesn't seem like a very good argument for not reforming the current system. It should be very possible to expand coverage into some form of universal care without sacrificing quality, as evidenced by various other countries who have managed to do it.
Again, am I missing something here?
3. Long waiting times to get treatment
This is probably the argument that seems the least bad to me. Canada is famous (infamous?) for this problem, and although the examples in the PragerU video are anecdotal, there are statistics that back up the notion that Canada has problems with waiting times. Also noted is that some Canadians elect to travel to the US for treatment, because of lower waiting times.
This is hardly a trivial problem, but I have a few reasons why overall I'm not too impressed with these lines of argument.
--A. Not every country w/ universal care has this problem to the same extent as Canada.
--B. You could argue that waiting times can be even longer in the US, if you are someone who's simply not getting treatment at all. (But of course, such people aren't normally included in these types of statistics.)
--C. Yes, Canadians travel to the US for treatment, but it's not clear to me that the number should be taken as all that staggering. According to the Fraser institute, 63,459 Canadians chose this route in 2016. That doesn't really strike me as a huge number, given a total population of around 37 million, where 90 percent (maybe even more than that) live within easy driving distance of the US border.
Now, if the US were to adopt some form of universal care, it would be logical to expect some degree of increase in waiting times, at least for certain things, since more people would be getting treatment. And waiting times that are truly excessive can be a real problem, and certainly you'd want to take steps to improve that rather than just ignoring it. But people who would balk at ANY increase in waiting times just don't make a lot of sense to me. It seems like a version of "Won't somebody please think of the rich people?", because realistically, wealthy people with relatively less serious health issues are the ones who would be most put out by this. (Note, for example, the case cited by Alain Lambert, where his friend paid 20,000 dollars to have faster surgery in Florida. Obviously not everyone has 20,000 dollars to pay out of pocket for fast-tracked surgery.)
So, to sum up:
Lots of Americans seem quick to point out flaws in foreign healthcare systems, but I am not really sure the arguments hold up all that well. And on top of that, there's no requirement that the US fix their healthcare via choosing a single country to emulate. You could pick out some aspects from Singapore, some from Israel, some from Switzerland, some from Japan, and so on, and you could probably end up with something much better than what we have now.
Instead, Americans pay huge amounts of money for private insurance, which in a lot of cases doesn't even provide adequate coverage and still leaves unaffordable co-pays for a lot of people.
Just seems really unfortunate, especially when people insist there isn't anyone else out there doing things more effectively.
Thoughts?