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.
It’s cheaper to have free health care than it is to have our current system and more productive for our country, so it’s really just a matter of following through on any of the public health care referendums.
The Medicare for All act has been introduced multiple times since 2003 and is a great intermediary step to true comprehensive health care for all. Another comment linked to that above.
Ah, so a referendum is a direct vote by the population on a given issue - for example a lot of states have passed recreational marijuana referendums, in my opinion at least because a lot of lawmakers didn’t want to to be seen as supporting it, but you can’t get blamed if the public approved it directly.
I’m not aware of any state level referendums on universal healthcare (which doesn’t mean that there haven’t been any) and there isn’t a national level referendum. (Although in googling this to confirm that I found an interesting article about implementing a national referendum)
With the Medicare for All Act it’s been introduced as a bill, but as I understand the process it first needs to be reviewed by a committee and voted out of that committee before the senate or house can consider it to possibly hold a vote. Then it needs to do the same thing in the other chamber of congress. So you can imagine that’s a lot more convoluted process than a referendum, and while voters may ask their representative to pass it, plenty of opportunities for legislators to say, “oops, some technicality or person who’s not me has stalled the process.”
Yeah, I was gonna say “guillotines” but basically the same idea. At the very least, we’d have to make bribery illegal, but that’s not going to happen while bribery is legal.
What are you talking about? All the first world countries have public health care and it works better than private health care.
Even in the states, public health care would be far cheaper than private healthcare. Anybody who wants private healthcare instead of public health care is brainwashed.
That is not the problem in this country keeping us from public health care. With the money we saved transitioning to public health care away from private health care, we could fund the tuition of as many doctors as we wanted.
It’s not tuition, but rather openings for students and residents. If you want more people to receive more health care, you need more doctor hours. Which means more doctors. Which means there need to be more spots in medical schools and residencies. These are currently scarce.
In the same way other public services are funded, fund the education of your medical professionals like they do in other countries, and you will have plenty of doctors.
Put the money saved by transitioning to public health care to good use.
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.
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.
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