Only a personal anecdote, but it has swayed my opinion. To be honest with you, living in small town America, I have never found my local government to be anything but inefficient and it barely occupies one building--I have trouble believing that the massive wheels of bureaucracy do anything but turn very slowly when considering paying out.
You might find it illuminating to spend some time looking into what's causing those wheels to turn like they do. And the local government being shit is why we have state and federal oversight -- small town administration and whatnot is pretty notoriously some combination of inept and corrupt. To the extent that state and federal level corruption and ineptitude are
improvements.
I'd suggest popping around the internet for more anecdotes, though, or seeing what the sort of back problem mentioned would have involved cost and effectiveness wise stateside. The first will be illuminating if you're looking in even remotely good faith, and the second probably will be, too. Folks outside this country ain't gaslighting or somethin' when they say what they say about our junk. As for the rest of whatever popped up since I napped...
... man, I'm not awaken enough at the moment to tell if that's satire or not. I'm just going to assume for the moment it's parody so the nap I'm about to take doesn't feel inclined towards thinking about it.
I'm happy to inform you it's not, and if you'd care to defend your point instead of conceding it with a poorly placed jab at my opinion I'd be happy to listen (and most likely rebut) your argument.
We get more than enough people posing ultra-capitalist "burn the state"-level views that the first reaction to most statements like yours, especially from people whose opinions are not already known, is to to ascertain whether they were serious and it's worth debating or whether they're being sarcastic / irritating people for the sake of kt.)
This, yes. I was actually too suddenly!exhausted at that point to parse how serious it was, and bits that I skimmed looked enough like caricature to put a proverbial call back later note. If I had been making actual jab it would have been notably more straightforward, heh. In any case...
That doesn't make any sense. If you think nationalizing healthcare will actually increase the quality of care and speed at which you get it you are mistaken. The more premiums you pay the better care you are afforded and the quicker you get it, though you argue that companies would weasel out of such a deal at first chance that is in fact what the premiums are for, you get the care, they still turn a profit.
... this was half the reason I wasn't sure, I think. Thinking that nationalizing healthcare will actually increase quality and speed of care isn't mistaken, it's experiencing what healthcare in this country is like when you actually have to worry about either with any degree of regularity so far as deciding (or not) to go to the doc, and being even mildly aware of how more or less every other developed nation in the world does their healthcare shtick.
Most of the country, for most medical concerns, would have better care and at least no worse wait times, particularly if you're including folks that functionally have to suck it up or starve for anything not immediately life threatening (and some things that are) in those calculations. So far as I'm aware, at least.
There'd be occasional exceptions (that still would most likely only involve a longer wait for non-vital care), and to what extent it's fair that's mostly because the US healthcare system is and was seriously just kinda' shit for a developed country for more or less everyone that's not in or very near the upper class, six digit year per person per year in household range stuff (which is probably not the official definition, but for all the nap helped I still don't have too much gaf in the tank for meticulously checking every detail that doesn't make much of an actual difference). Which is a super-majority of households and 90+%-ish range for individuals in the US, iirc. And the lower ends of that can still get its finances broke in half by a bad enough medical issue and end up having to wait or avoid the doctor's office for who knows how long.
If you actually think that more premiums == better care, though, you're... naive, I think, would be the best word? And have either never had to pay (or been aware of what your caretakers actually were paying, and for what) for insurance yourself or haven't been alive and/or paying attention to the subject long enough to actually deal with an insurance company for any amount of time or when running into a medical issue that isn't relatively trivial... and sometimes then, too.
Insurance companies will charge you as much as they can, quality be damned, and you only have so much choice by sheer dint of the fact that without it you can be financially ruined at the drop of a hat (and even then, insurance often enough only makes that less
likely, gods help you if they had a way to avoid paying). Premiums can easily be high for shit coverage and
will go up yearly with no change in service (at best, mind you. Sometimes over the last few decades folks have had that happen and service get
worse, ahaha). Deductibles will get worse and be needed for more things. Insurance companies will call you while you're still in the hospital fishing for specifics that will let them drop you or not pay for any or all of the care you receive. And on, and on, and on.
You can talk all you want about the ACA and nationalizing whatever but the state of things was
worse before it came about. The shits in our healthcare and health insurance systems needed collars on them and need tighter ones still so they knock their bullshit off.
Additionally, you are a fool to think the government will act differently--most every branch of government is obsessed with spending as little as possible and as such you can expect them to examine you even more thoroughly to determine whether or not you "really need the care."
Yeeaaaahhh, no. Anything the government will do on that front, the insurance companies are already doing and doing harder than the gov't
could. Even if whichever part of whatever branch pinched pennies until they bled, they don't have the same leeway, mandate, or incentive, to do it with the fervor a for-profit company does. And those do. They're explicitly there to not pay you while you pay them -- that is the vast majority of an insurance company's profit seeking behavior, and they are very, very good at it.
Of course, there's nothing wrong with this system. You're really just normalizing care. Instead of being able to pay more for better care and quicker treatment (which most people already had the ability to do through private healthcare or were otherwise provided for through medicaid or medicare.) You simply make it so that everybody receives essentially the same moderate standard of care at the cost of taking a lot longer time to have access to it due to a shit ton of bureaucracy.
Private insurance would still be there if you're really rich enough to burn that kind of money. So far as I'm aware none of the countries with stuff in the direction of the NHS forbid it, and the things still loiter around despite a notably robust public option. And regardless, most of the bureaucracy isn't something the patient sees, even assuming it
is worse than dealing with private insurance companies (hint: I wouldn't suggest being comfortable making that bet, as ChairP has been ninja-ing).
You can very, very easily find accounts of what a common person's normal interaction with healthcare in canada, australia, the UK, etc., are. Stuff regularly involves less pain in the arse than dealing with getting insurance squared away stateside does, even when the insurance people
aren't trying to make things a kafka-esque parody of bureaucracy in an attempt to avoid paying you.
And, as always, do note that other countries "moderate standard of care" is still an as good or better standard compared to what much of this country has to deal with, and very rarely for anyone not in the upper reaches of our country (who have the money to have other options) would it be appreciably, if at all, worse.
In reality, there was a very small bracket of people who were not actually covered in some way which could have been easily solved by reforming medicaid, but was instead used as a poster child to change the system entirely (which was working quite well frankly), it would have been less of a tax hit that way AND everyone would still have care.
That very small bracket could get up into the 20 to 30% range back in '00 for the lower 2-3/5ths of the country, and didn't exactly improve in the years coming up to the ACA kicking on. Premiums were jacking up yearly (and they still are, for all it's slowed for reasons ACA related or not), coverage seeing either no improvement or outright reduction, etc., etc., etc.
Getting medicaid into better shape would indeed have helped and be great in general, but the US healthcare system for the vast, vast majority of our population looked like something approximating a flaming trainwreck that was heading for a cliff, and that was on private just as much or more as public options. Working, it was not. Providing service, sure, but shit was so poorly functioning the ACA, tangled mess that it is, actually managed to improve things on most fronts. As I've said before, I'm as much serious as joking when I say I'm pretty sure putting every insurance CEO and senior hospital admin in the country to the guillotine would have managed it, too.
ACA's made things better on most fronts but bloody hell there was basically nothing working "quite well" about the US healthcare and health insurance industries, and there's still massive issues with them. And it ain't a problem for the lowest 5th or some junk, basically everyone not in the upper one was having things get worse on one front or another. Some of the stuff the ACA and some other things have done has helped on that front, but it's still not pretty for most folks in this country by a long shot. 80s, 90s, 00s, earlier, the state of healthcare in the US was not good. Still isn't, to a hefty degree, but it's marginally better and any upslope is good when you're tumbling down a hill.
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