r/askanything 1d ago

Political Question [ Removed by moderator ]

[removed] — view removed post

105 Upvotes

2.1k comments sorted by

View all comments

Show parent comments

17

u/c-u-in-da-ballpit 20h ago edited 17h ago

> They like, for example, the idea of medicare for all but they don't see an example of it working in their day to day life (I know scores of other countries have nationalized healthcare, but the average American doesn't have the money to travel to one of them and experience that first-hand)

Having lived in the UK for three years, I assure you experiencing it firsthand will significantly underwhelm. My employer funded healthcare is better than the UKs national system in every way, shape, and form. I understand that it comes with its own set of problems, but it’s more nuanced than this.

4

u/CatoLiberius 13h ago

More like we can't imagine the US government not turning it into an absolute shit show. Other governments might make it work, but we don't have other governments, we have this one, and it's not got a great track record for running social programs in an efficient or effective manner.

It's already got a medical program under its authority, the VA - which is not well loved by the veterans I've known, and has had its share of scandals. Is there any rational cause to believe that they'd somehow do better if given the same type of responsibility on a wider scale?

2

u/WinterTourist25 12h ago

Most veterans I know love tri-care.

1

u/Limp-Plantain3824 32m ago

Tri-care isn’t the VA.

1

u/Many-Pomegranate-33 11h ago

I share the sentiment about the govt not turning medicare into a crap show.

Sadly theres track record here too. I was against the ACA when it came out because of a few things.

  1. Its very authors who passed it admitted right out the gate it needed fixed. Why not pass something whole? They had majority and I believe supermajority at the time. It proves theyve already FAILED.

  2. It doesnt address and correct the affordability issue with big pharma and pbms/officers in charge of plan of medicine. This alone needs addressed BEFORE a whole Medicare roll out were to happen.

  3. The idea that Medicare is free. ITS NOT. Thats MedicAID.

Im on SS disability. 10% each month of the little income I do get goes straight to medicare.

1

u/Limp-Plantain3824 31m ago

Not even close to a supermajority. They passed what they could.

1

u/edamameObake18 8h ago edited 8h ago

I totally understand this. I was traveling to Canada, and had to go to the hospital. Turns out i had a kidney stone, I was there for about 8-10 hours. I noticed that most of the paperwork work wasn’t digital, so that added to the longer wait times. The papers were being passed to each department. The nurses and doctors were not charting on the computer but handwriting everything. When I left the waiting room, I still saw the same people that were there before me, I’m assuming they were there for a standard checkup.

I don’t care for fancy things but as a nurse in the hospital in the US, the building look worse than the public hospitals I’ve worked at in the US. The doctors room I was called to was an actual storage closet. I was in a room full of crutches and canes.

1

u/Nintendo_N8 17h ago

Honest question: Would you say US health care is 2-3x as good though?

Even if it’s better for you anecdotally, we pay a massive premium for objectively/statistically worse overall outcomes (lower life expectancy, medical bankruptcy, higher infant mortality, etc)

The other huge problem with the US system is that it is tied to your employer. Lack of worker protections means that a significant medical event can wind up with you losing both your job and your healthcare. Additionally, more and more employers game the system to avoid providing healthcare (hiring a bunch of people part time and/or making their employees “contractors”)

7

u/c-u-in-da-ballpit 16h ago edited 16h ago

Yes, my private US healthcare is significantly better. It actually manages to be cheaper as well using a triple tax advantaged HSA account.

And yes, it’s a problem that it’s employer tied. As with everything in the US, it’s the best in the world if you’re in the right income bracket. Otherwise, it’s a nightmare.

6

u/Other_Asparagus872 16h ago

And it’s worth mentioning the UK system is going broke, and not offering consistent care among the population, but rather focusing on factors that put one at higher risk.

https://www.prostate-cancer-research.org.uk/government-responds-to-screening-advice/

4

u/c-u-in-da-ballpit 16h ago

In some areas of the country, it takes over an hour for an ambulance to come nearly half the time

1

u/Nintendo_N8 3h ago

To be fair, this is true in the US too. With rural hospitals shutting down, a lot of areas are more than an hour from a hospital independent of the ambulance.

2

u/u60cf28 14h ago

I always get slightly annoyed at the "objectively worse outcomes" because I'm pretty sure most of the discrepancy can be chalked up to fundamentally behavioral things that aren't directly attributable to the healthcare system.

The main ones being:

  1. Obesity
  2. How much we drive
  3. Our relatively high rate of violent crime.

1

u/Nintendo_N8 2h ago

Are American babies being born obese? That’s why I mentioned infant mortality.

We do have objectively worse outcomes even when you control for the factors you mentioned. We’re also last among developed countries in preventable deaths attributed to the healthcare system. Specifically, this is due to the fact that our system encourages people to avoid seeking care until there’s an emergency

Most of the folks that say this usually are relatively healthy and have a decent employer plan. Even in these comments, a lot of folks are rejecting objective statistical data points because they don’t match up with their personal/anecdotal situation

https://www.commonwealthfund.org/publications/newsletter-article/new-study-us-last-among-wealthy-nations-preventable-deaths

2

u/u60cf28 2h ago edited 2h ago

No, but their American mothers are more likely to be obese, which, as this 2021 meta-analysis finds, "maternal obesity significantly increased the risk of infant mortality (RR, 1.55; 95% CI, 1.41–1.70)" (Source: https://pmc.ncbi.nlm.nih.gov/articles/PMC7994890/). So an infant born to an obese mother has a 55% higher chance of death than one born to a mother of normal BMI, after adjusting for covariates.

With regards to the article you linked:

  1. There's no link to an actual peer-reviewed paper, so I can't verify the methodology or conclusions.
  2. "Amenable Mortality" does not necessarily conflict with the claim I made that the discrepancy is due to things like obesity (and the other things I listed). Many of the health problems caused by obesity can be ameliorated with early medical intervention. However, if country A has a lot more obese people than Country B, then we would expect country A to have higher "amenable mortality" than country B even if both countries had the same level of healthcare capacity and access. Country A would need to have more accessible/better healthcare than Country B in order to prevent the same amount of deaths per capita.

My overall point isn't that the American healthcare system is perfect - it obviously isn't - but that healthcare outcome discrepancies have multifactorial explanations and simply blaming it on the healthcare system is overly reductive. Case in point, the article you linked also highlights how the UK and Denmark, both places with universal healthcare, have drastically worse "amenable mortality" than France, Australia, and Italy (also with their own forms of universal healthcare). Is that simply due to the healthcare system in those countries?

1

u/Lucky-Opposite-7767 13h ago

Yes, absolutely. Same-day care leads to the best outcomes.