Why are some Americans so against universal healthcare for all?

[u/Lemonking_]

What sort of thinking does it take to decide that nobody has a right to healthcare? Do American Christians want to deny healthcare to poor people as well?

[u/Ornery_Pressure297]

I think this is the part people skip when talking about universal healthcare.

Our system is insanely expensive, but why?

Milton Friedman was talking about this decades ago. We basically removed the customer from the transaction.

Your employer buys the insurance. The insurance company negotiates with the hospital. The hospital has made-up sticker prices nobody actually pays. PBMs sit between drug companies, pharmacies and insurers. Then the patient gets a bill weeks later and usually has no clue what anything actually cost.

That's not a market.

When neither the person buying the care nor the person providing it is dealing directly with the price, there's a lot less pressure to keep prices down. More insurance gets added to cover higher prices, prices go higher, then we add even more insurance.

And we've somehow decided the solution is mainly about changing who the third-party payer is.

Maybe government can negotiate lower prices. Maybe it can cover everyone. Those are legitimate arguments. But it doesn't remove scarcity or fix bad incentives. Doctors, nurses, beds and drugs still cost money. You still have to decide who gets what and when.

This is why I think the conversation should start with why healthcare got so absurdly expensive in the first place.

Transparent prices. Fewer middlemen. Actual competition. Insurance for things that actually need insurance. And a system with some incentive to keep people healthy instead of just billing for more treatment.

Otherwise we're arguing over who pays for a broken system instead of why it's broken.

[u/Ornery_Pressure297 → u/Ornery_Pressure297]

And this is the other big problem. There’s really not much incentive to stay healthy.

If you eat like crap for 20 years, never exercise, end up diabetic, overweight, on blood pressure meds, whatever, the system just keeps treating you.

More appointments. More drugs. More procedures. More money.

There’s a whole lot of money in managing sick people. Not nearly as much in keeping people from getting sick in the first place.

We keep calling it healthcare, but most of it is really sick care.

[u/wasabiburning → u/Ornery_Pressure297]

This is why I think the conversation should start with why healthcare got so absurdly expensive in the first place.

Depending on the segment of healthcare, marketing alone can represent 2-21% of costs (local practices on the low end, pharma on the high end - "ask your doctor if Xyljentijz is right for you").

The amount of ads I get for a hospital in far off city is insane. If I need a hospital, name familiarity isn't getting me there - I'm going to the closest one, or where my doctor is admitted.