What is the most promising pathway to reach universal healthcare?
Let’s assume we want all people to have health care. What are the steps / methods most likely to get us there?
In the U.S. seems like we’re a long way from that goal. I’m curious about chunking down the big goal into smaller steps. Interested to hear perspectives from other countries too.
First step would probably be to decouple healthcare from being company, so people realize how expensive their health plans are and how much they pay for stuff most people don't end up needing. Pretty sure for most people it's more expensive than their single yearly checkup would be out of pocket.
Then, make state-wide and state-owned insurance plans that are capped in profits, so the rates have to match the true cost of things.
Let it simmer for a bit, get people to get used to the idea that the government provided service is actually good and cheaper for once.
Then make it mandatory for every state resident to be covered by it.
The big problem with universal healthcare in the US is the strong individualistic mindset, those that go "but I don't want to pay for other people's hospital bills". Ease all those people that think they'll suddenly be paying way more to subsidize other people's health care into realizing it ends up cheaper because the costs are amortized over way more people. It needs to be spun up as a benefit to them, they're getting a better deal on their health insurance. Because they simply don't care about other people's problems.
One thing that struck me living in the US is just how much distrust there is for anything government operated, even though it's usually the companies they love so much that nickel and dime them. Although seeing how the politics are going right now, I kind of understand that sentiment. And pretty much every company does try to squeeze you out of your money, which makes people want to screw the companies over. Land of the fees.
Some sort of strike. Either a general labor strike, or a debt strike. A general strike of laborers will be hard to organize, and there will always be scabs.
But a debt strike ia easier. Although I should probably say “Bill strike”. It goes like this: don’t pay four or five figure medical bills. Just put them in the shredder. If a significant portion of the population does this, it will force change. Just like the courts getting backed up because there were too many evictions, they will get backed up by all the wage garnishment cases that I’m sure someone is typing a reply about. If nobody pays, there isn’t much of a way to enforce it.
American here. I dont have the answer but these are my thoughts.
a 4th wing of the government gets created, appointed by popular vote - it has oversight over everything beneath this paragraph. funded by legislative branch, veto powers over it held by the electoral branch, and life/death/malpractice issues decided by the judicial branch. the 4th branch controls nation-wide medial staffing, coverage/who is allowed to get what treatment, R&D, and building new/repairing existing medical infrastructure.
first of all I’d wipe the slate clean - immediately and permanently scrap all current healthcare and insurance systems. get rid of all private medical/drug companies. they all get broken up and assimilated by the government. no choices, it’s what gets to happen. no golden parachutes, no buyouts, no backroom deals. elimination.
the current system isnt going to provide the same level of healthcare that we have now to everyone, its just impossible - but R&D is now run by the government,… so gene therapy for diseases that only affect a few thousands of people dont get funded. perhaps they get treated internationally, or die. doesnt really matter - the goal is to treat as many people as possible with as few resources as possible, as cheaply as possible, for as long as possible. no one is allowed to stay on life preserving machines when they’re too old or ill - we pull the plug. machines are useful if you’re in surgery and only then. you can choose not to get medical aid but if your wages arent getting garnished to pay your fair share, and you get hurt, well, too bad. opting into the national health plan = opting into organ harvesting if your brainbox goes flatline and the organs can be better used by someone else. no more burial at death, it’s incineration only. religious exemptions are not permitted.
structure the system so that medical personnel are paid according to position - not by experience/seniority, or how much education is needed. flat rates. no unions, no organizations, no private practices - the system is run by the 4th branch of the government, and they set the rates. pay rates would be linked to national inflation rates. the number of specialists would be tied to population of a given area - that includes plastic/cosmetic surgeons as well as sex change specialists. traveling across the country to see a specialist is not permitted - they come to you, within a limited geographic area or you dont get the treatment you want. best cosmetic surgeon not available? go travel internationally if you dont like it, we dont care. need an emergency dental procedure? visit the hospital, a generalist will see to you - private practices are no longer permitted (it’d be filed under malpractice).
automate as much as possible - many if not most administrative positions cease to be a thing anymore - medical billing? lol we have software for that. insurance? a thing of the past, your wages will be garnished to fund the program. hospital administration will likewise be cut by 90%, automated away by software.
this would fix a lot of the issues that people in America have with the medical/insurance system - but it would introduce a lot of the issues that socialized medicine has in countries like Canada or England. might be worth a try anyway, our current system is untenable, unwieldly, and prone to error.
I don’t think you’re being serious, but the idea isn’t to give everyone worse care. If you talk to people from the UK, France, Spain, Germany, Australia, Canada, or any other country that has universal healthcare (all the green ones on this map) they would have plenty to say about things that could improve. You also wouldn’t find too many who would be willing to trade with the U.S.
You need to fix your political landscape first, for example have > 2 parties, and have other than these two ultra conservative parties. Only then will you be able to make significant changes in your country.
You're 100% correct on principle. The problem is that given our electoral system, third parties end up taking votes from viable candidates, and we end up with terrifying people running things.
We can't change the electoral system, because we've never actually had an Article V convention (Constitutional Convention) so we don't know what would happen there. We'd get an entirely new constitution, and it would not be a better one. You've probably seen how dysfunctional our republicans are, I'm not about to let them tear up e.g., my right to free speech or a fair trial.
Given the current makeup of the Supreme Court, what would come out of that convention would be provide zero protections for anything.
But yes, we need third parties. I just don't see a plausible way to get them without taking on an amount of risk that most people aren't willing to take.
Gotta convince the voters around you. Talk to your coworkers, friends, etc. Be prepared to receive pushback, and a lot of ignorance, but occasionally, people that are trying to zoom out on the problems they’re seeing. I used to lean pretty right, but it wasn’t the Michael Moore types that brought me around; it was the Bertrand Russell types. People are plenty smart, but often need help connecting the dots. If you are condescending, you’ll get resistance. If you show them the right direction, they’ll find their own path, naturally.
Get all the people you want to have universal health care, to want universal health care. If you want it for them, sell it to them.
The only thing ever stopping any policy from existing is vote counts. Convince others that universal healthcare is in their best interests. If you’ve tried that and failed, take steps to improve your communication skill and try again.
A 57% majority of Americans say the government should ensure health coverage. Of course then 53% say the system should be based on private insurance, which is contradictory.
Another factor to consider here is people don’t vote directly for policies. They vote for legislators who then decide which policies are a priority, and can interpret for themselves, right or wrong, what it is their constituents voted them in to do.
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