Healthcare for All?

MangoTang's picture
Rank: Orangutan | 365

Title of thread is the question. Are your views on healthcare political or morally based?

Considering how contagious the Coronavirus is, what are your thoughts on healthcare for all. It's scary to think that some random guy I could be walking past may not visit a Dr. Of hospital due to the cost.

Comments (87)

Most Helpful
Mar 12, 2020

This debate will split among predictable ideological lines, but I believe in a baseline of universal healthcare known as the "public option" more akin to the German system than the English NHS. People should be able to keep their private health insurance if they like it, or pay extra for "high end healthcare" if they can afford it or prioritize it in their life.

That said, in a first world country, people should not be dying because they can't afford insurance or going bankrupt simply because they got cancer. One of my coworkers got slapped with an absurd bill after his lung collapsed. He went to an in-plan hospital and recovered, only to find out later that while the hospital was in-plan, the specific doctor that treated him wasn't. What kind of bullshit is that? People travel to Mexico or Canada to buy insulin because it's cheaper to buy it there than it is in America. That is a national embarrassment.

Coronovirus tests should be free because it benefits society as a whole, including rich people, for a pandemic to be controlled. Likewise, having a baseline of free medical care benefits society as a whole, including rich people.

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Mar 12, 2020

This ^^^

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  • Intern in IB - Gen
Mar 12, 2020

What's wrong with just keeping medicaid, if you are poor you should receive healthcare treatment, it's only right- but you need to prove you cannot afford it and that is why the taxpayer will help out, otherwise they should just buy insurance. Food is essential too, and taxpayers only support those that prove they cannot afford it on their own which I think is morally correct.

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Mar 12, 2020
Intern in IB - Gen:

What's wrong with just keeping medicaid, if you are poor you should receive healthcare treatment

Adults with an annual income ranging from $13,663 to$57,022 (for a family of eight)** may be eligible for Medicaid coverage.

Lmao, you have to be beyond poor to qualify for medicaid.

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Mar 12, 2020
CRE:

This debate will split among predictable ideological lines, but I believe in a baseline of universal healthcare known as the "public option" more akin to the German system than the English NHS. People should be able to keep their private health insurance if they like it, or pay extra for "high end healthcare" if they can afford it or prioritize it in their life.

That said, in a first world country, people should not be dying because they can't afford insurance or going bankrupt simply because they got cancer. One of my coworkers got slapped with an absurd bill after his lung collapsed. He went to an in-plan hospital and recovered, only to find out later that while the hospital was in-plan, the specific doctor that treated him wasn't. What kind of bullshit is that? People travel to Mexico or Canada to buy insulin because it's cheaper to buy it there than it is in America. That is a national embarrassment.

Coronovirus tests should be free because it benefits society as a whole, including rich people, for a pandemic to be controlled. Likewise, having a baseline of free medical care benefits society as a whole, including rich people.

This will happen soon enough. Republicans can only fight the will of the people for so long. Perfectly put, btw.

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Mar 12, 2020

Also, I agree that the vaccine should be free (much like the polio vaccine). The cost to treat those who are sick will be multiples higher than giving the vaccine out for free

Mar 12, 2020

I support universal health care on moral grounds, There is not much I can say about it.

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Mar 15, 2020
financeabc:

I support universal health care on moral grounds, There is not much I can say about it.

Keep religion out of public policy debates.

Mar 15, 2020

Your are being sarcastic, right?

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Mar 12, 2020

Economics

Mar 12, 2020

Do people really like their insurance? I think people like their doctors. Medicare for all would allow people to go to whoever they want and not be constrained to their insurers network.

  • Intern in IB - Gen
Mar 12, 2020

I like not paying for other people's insurance thank you

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Mar 12, 2020

So when people who have no money go to the ER, who do you think is paying for that?

Mar 12, 2020
Intern in IB - Gen:

I like not paying for other people's insurance thank you

You're an intern. Are you even paid?

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Mar 12, 2020

Do you like sending $400 Million to Ukraine?

I think I would rather have the money help my neighbor or someone I may come in contact with at the grocery store.

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Mar 12, 2020

Funny thing about insurance is, it's already paying for someone else's medical bills. I think an inbetween system of we will provide social benefits only when a need is proven is more complicated than a system of provide social benefits with equity or provide none at all. We've been trying to mix the two contrasting ideologies and it has not been working for decades.

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Mar 13, 2020

That is so correct, either everyone pays insurance except those who cannot afford it and these people will likely not be able to pay treatments either, thus people paying for insurance will pay for the regardless in the end through higher premiums. In some cases people without insurance will not be able to afford healthcare.

Or you have a government run scheme funded by taxes (everyone pays again except those who cannot as above), but in this case healthcare will be provided to anyone so long it is reasonable. We can also expect that given that the government doesn't need the 3-5% profit margin private insurers have, as a whole the society would be better off by 3-5%.

Both basically have the same cost for a good majority of the people, but in one case the society is better off and everyone has healthcare. Which one would you pick?

Mar 15, 2020

Most people who have insurance today certainly won't be better off. Government run health care with the elimination of private insurance means that everyone gets the same shit quality level of health care. See NHS.

Mar 12, 2020

I generally agree with conservative views on most political issues. I'll mention now that I am not American, so no, I don't support Trump. Despite being more on the right than left, there are several issues that I believe the liberals have right, one of the most important IMO being healthcare.

My country has universal healthcare, and although it raises taxes and leads to slightly longer wait times when going to the doctor, I fully support it. Plain and simple, I can't fathom the idea of a family losing a loved one to a disease or situation that was easily preventable because they could not afford it. I'd happily pay the extra taxes each year if it meant that all of my neighbours (figuratively, obviously) got to live healthier and happier lives.

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  • Intern in IB - Gen
Mar 12, 2020

write a donation to the united states every year then man, im sure theyll be happy to collect it from you, you can write in the purpose section "paying for other people's healthcare" hope it makes you happy at night man

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Funniest
Mar 12, 2020

Clearly you don't agree, and thats cool.

I genuinely would love to know how my post upset you this much though. I was just sharing my opinion.

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Mar 13, 2020

Same board as you, just check my post above on why universal healthcare makes sense

Mar 12, 2020

I also feel like 80% of Americans are generally not poor, until they need to live life a little like their not poor. Then the fucked up pricing mechanism in this country makes them poor really quick, really fast. You just get the feeling there is some lopsided power dynamic at play.

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Mar 12, 2020

I think healthcare should be free. Having run companies in Canada and the US...the one huge fucking PITA in the US is dealing with employee health related issues. I'd rather pay a slight premium in tax to avoid it.

Also...it's actually cheaper to offer universal healthcare > private?

On a related note, hold co taxes (canadian co) are lower than my American business partner's.

Mar 17, 2020

I agree with m_1. It's very expensive to hire workers in the US due to having to offer them healthcare. Depending on the employee, healthcare can be more expensive than all other benefits combined (including salary). That definitely depresses hiring and it definitely depresses wages. Many employers would gladly pay into a central pool at a federal level over having to deal with the insurance companies. Most people with company-sponsored insurance have no idea how much the company pays for their care. They only know how much they pay in premiums and deductibles, but the vast majority of costs are covered by their employers--they never see those bills.

I used to hate the idea of socialized medicine because I thought it would lead to shitty care, rationing of care, long wait times, and a host of other problems. But after witnessing what the US health system has become, I think it's pretty clear we have a problem. I think we all know this intuitively when we consider that no other country on the planet adopted our system of care. It's the most expensive care system per capita in the world and we simply don't get the best care. At the very least, we are massively overpaying for the quality of care we receive here.

If the problems in the system were addressed 30-40 years ago when they first cropped up, we wouldn't be in this situation. We could have taken relatively small, directed steps to fix incremental problems. We could have forced the insurance companies to remain not-for-profit organizations as they were all originally created to be. We could have stopped the AMA from creating a quota system for doctors which artificially suppresses the supply of MDs and inflates their wages. We could have pushed back against the pharmaceutical companies from serializing their patents on decades-old technologies and drugs. We could have told the pharma execs to go fuck themselves when they charged us dozens or hundreds of times more for the same drugs you can get everywhere else in existence for a fraction of the price. But every time one of those challenges presented itself, we whiffed. We didn't do anything, and at this point, the system is too much of an amorphous bureaucratic nightmare to fix through legislation. It's like the student loan market--it's a fucking mess.

Given the state of things, I'd say a public option makes sense. At the very least, it should help drive down costs through collective bargaining. But that's only part of the solution. We need to drive down pharmaceutical costs, drive down doctor's wages, decrease the number of medical billing and insurance professionals, and generally eat away at the administrative costs in the system. These all seem pretty obvious to me. Just a couple decades ago, there was no such thing as a medical billing specialist. Now, you can get an associates degree in the subject because it's so convoluted. In 1980, being a doctor wasn't a guaranteed path into the 1%. I'm not sure why it is today. As I said, no other country adopted our system and it's not because our system is so great that no one can copy our brilliance. It's because it isn't very good.

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Mar 12, 2020

I guess my issue is why is it every time something with regards to expanding healthcare comes up, people always ask well how are we going to pay for it? But when we spend trillions of dollars on wars or being the world police....no one bats an eye? So while the other poster doesn't want to pay for others healthcare, I don't want to pay for dumb wars

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Mar 13, 2020

This. I wish we could choose the recipients of some of our taxes so I could divert my cash away from drone bombing, and send it to healthcare initiatives (or rebuilding our roads, or improving our water infrastructure, or getting more low-income housing, or halfway decent public transportation in-and-between cities, or shifting to cleaner energy, or improving public education...)

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Mar 12, 2020

This coronavirus thing is dress rehearsal for when an Ebola severity pathogen hits here

So far we got an F

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Mar 13, 2020

What about the government simply doing its job? For example, the DOJ scrutinizing M&A in the hospital/healthcare management and pharmaceuticals space? Looking into monopolies or duopolies in certain regions, states, counties, etc?

How about Americans taking responsibility for themselves (I know people HATE this)? We have very high obesity rates and people who refuse to exercise even a little yet gorge on food and drink sodas in cups the size of a newborn!

Sure the healthcare system is convoluted but it became this way due to government action (trying to do too much and involving themselves in every aspect) and also inaction (some comments in the beginning of this post).

Mar 13, 2020

These are always weird discussions. I wish we could figure out the question first, and then we might be able to work toward an answer.

Are we asking: "should every US citizen have a right to emergent health care services regardless of ability to pay?" We can argue the role of government in society (either ideally or as currently legislated), but the reality is, we have this currently. Nobody gets turned away at the ER. Replace "US citizen" with "person on US soil" to up the degree of complexity of this particular point.

Are we asking: "should out-of-pocket cost borne by patients be zero for all healthcare products and services?" Note how I avoided the term "free" - anyone in this discussion needs to back away from the idea that healthcare products and services, anywhere in the world, are free. Nothing is free. Things have to get produced and transported and distributed, buildings have to be built and maintained, people have to be trained and paid. The question is if they're paid directly (cash pay, like most of the economy) or through a risk-sharing mechanism where people can choose to opt in (traditional insurance) or where people are opted in automatically (government subsidy) or both.

The emotional debate around this point usually coalesces around heartbreaking situations. Kids with cancer, immigrant single moms with TB, rare disorders with painful outcomes, etc. You'd be hard-pressed to find anyone on the political spectrum that finds joy in watching people suffer and die (yes, even Republicans - and if you don't believe this is true, then you're a victim of the intentional polarization effected by today's mass media).

The truth is that if our national healthcare budget was directed toward lessening suffering of people in emergent situations, although we could debate endlessly about what constitutes "emergent situations," we could pay for all of it - several times over. Those dollars represent a minor fraction of the US's healthcare spending budget.

But what about the rest of situations? Should we collectively pay (because that's what's happening when the government pays for healthcare) for some fat dude's statins for the next 30 years? Should we pay for that guy to get an elective surgery to have his knee replaced once he's demolished his cartilage from being 150 pounds overweight? Should we pay for him to have that knee replacement revised when he ignores the physical therapy guidelines that were also paid for? Should that guy have to bear any of his own costs, or have to make decisions about his care because they affect him and his own wallet?

Should everyone receive the same standard of care? We don't do this in law - our country has established that every person, regardless of ability to pay, has the right to representation in a court of law when accused of a crime. I think this is an excellent decision, even though it costs the government money, because it's the right thing to do. But does everyone get Kirkland & Ellis? Hell no, they get a public defender, who may or may not have graduated from a tier 3 law school, and maybe they took this job because they believe in public service, or maybe it's the best job they could get (those public defender gigs sure don't pay like biglaw).

So should a homeless alcoholic with catastrophic cirrhosis get a new liver at a top-tier OR in a large metropolitan area? Should they get palliative care at an inner-city clinic? Should they see a government-appointed primary care doctor for people who can't afford anything different? Somewhere in between? How do we decide?

Simply waving the flag of "healthcare is a human right!" is an incredibly shallow and uninformed position. In a free society, nobody can claim a right to another person's time or expertise. Healthcare is a group of (admittedly, very important) products and services, but they're still created by and delivered by people investing their time, capital, and capabilities. I don't have a right to a doctor or hospital any more than I have a right to a lawyer's time, or a grocery store's products, or a home builder's products, or someone's land. We can decide as a society that it is good when we can collectively support (i.e. pay for) these products and services on behalf of those in need - and then we can argue about what "in need" means, and the mechanism for payment.

One last scenario: are we asking "should governments subsidize research and development of treatments for diseases that present a major public threat?" Even your most hardline libertarians would argue that this is one of the kinds of things that government is good for. And, to the surprise of many, we do this. We can argue whether or not the coronavirus response has been good enough, but it's a matter of degree, not kind.

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Mar 14, 2020

Really good post, speaks to the key point that all of these issues are significantly more complex than the binary options portrayed to Americans by the media.

Mar 13, 2020

I think there is both a political and moral basis for a baseline of healthcare being provided to all. Yes some services could require a top-up with a privatish insurer but you need a single-payer base if you want to hope to make things affordable.

Mar 13, 2020

Sorry, what is this "moral basis"? I understand the political drivers - people would rather have it and you want to win people's votes.

I am just tired of progressives talking out of both sides of their mouth when it comes to matters of morality.

Let thine own self be true

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Mar 13, 2020

Canada is doing it right

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Mar 13, 2020

The US GOVERNMENT pays far more per person for healthcare than any other country in the world yet it only provides that healthcare to a minority of the population (Medicare/Medicaid). That tells you all you need to know about the quality of the current system.

To start with one major issue that is not frequently discussed, there is both a major shortage of doctors and they make 2-3x more than any other developed country. That's because there are far too few medical schools in the country and the cost of attending them is through the roof. Those in medical school then gravitate towards more lucrative specialties so they can pay back their debts which leads to even worse shortages in areas like primary care. Since there are so few doctors, nurse practitioners and physicians assistants are constantly holding responsibilities that they are not remotely qualified for.

Array

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Mar 17, 2020

I'm glad someone else brought this up. The US system artificially depresses the number of medical school entrances around the country. We compound the problem with some obtuse matching system for graduating doctors that builds in an inherent shortage. That might be good for doctors since it results in them getting higher wages, but it's creating a supply shortage of MDs.

It's one of the many reasons the US medical system has very little 'surge capacity' for, say, a massive infectious disease outbreak. We don't let the market determine how many doctors we need or what to pay them. Wouldn't it be nice if we had 100,000 extra doctors floating around the country at the moment? I wonder what they could be doing right now?

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Mar 14, 2020

Everything related to medical care is double the cost of what it should be in the US. There are a lot of explanations of why that is, but from what I can tell from having worked in the healthcare services industry, the root cause is having a group of payers (insurance companies) who really do not have any incentive to try to negotiate down prices. The payers pass along costs to the employers (who really end up paying for most of the medical costs in the US), and the insurance companies actually make more money if the employers spend more on healthcare.

That leaves providers, hospitals, pharma, and devices companies all trying to negotiate very high prices with limited pushback from the insurers. The patient obviously doesn't care outside of a small copay which is a fraction of the total cost. Employers are stuck with a bill that they can't do much about given the lack of transparency around prices and inability to create their own networks.

A single payer system would cut out insurance companies and employers from the system and takes over all payments of healthcare. In that system, the government can set standard rates and would have way more negotiating leverage against providers, hospitals, pharma, and devices companies. Now, it's questionable how incentivized the government would be to lower rates is questionable, but at least they wouldn't be profiting from increased rates like insurance companies (who do all the price negotiations) are today.

Putting aside any moral or emotional elements of the debate, I mainly want a single payer system to lower healthcare costs. It's ridiculous what's happening right now, and it's only going to get worse until the US is at a competitive disadvantage with the rest of the world for employers.

Also, I find it strange when people say they don't want to pay for other people's healthcare for two reasons: 1) they don't even pay for their own healthcare (their employer does), and at the same time 2) they already do pay for other people's healthcare - 1.5% of our paychecks go to medicare already. If we move to a single payer system, it'll be primarily funded by taxing employers what they would have paid anyway for the sky high healthcare costs of their employees today

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Mar 14, 2020

It's amazing how wrong people can be on this site, while spouting off like experts. There's a reason that if one were to need a life saving surgery or medicine in a short-time then the top country to provide it is America, followed maybe by Japan. Wealthy people in Europe almost all have private plans; why do you think that is??

To your two, among many, (wrong) points at the bottom of your post...

1) people do in fact pay for their own healthcare, even when employer sponsored. It's been empirically shown through multiple studies that the lack of middle class wage gains has been directly attributable to the increasing cost of employer sponsored healthcare. The point here then being that people with employer sponsored healthcare plans OVERWHELMINGLY prefer their private option to a government sponsored alternative. You can't tell the middle class "you have to pay even more, still settle for wage gains that barely match inflation, AND you're gonna hate your healthcare quality to boot."

And before you say something stupid in response, I'm probably the closest this board has to a "business of American healthcare" expert, I took a classes from one of the leading healthcare economists on the planet among many other healthcare focused classes, and I've been in and around the industry for a decade. So I know more than you do.

2) 6.2% is for SS. Medicare is 1.45%.

Get your basic facts correct man.

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Mar 14, 2020

Cool, thanks for pointing out the 6.2% vs. 1.45% - my mistake and appreciate you pointing that out.

Sure, people are "paying" indirectly via lower potential wages, but that only strengthens the argument that a single payer system that lowers healthcare costs overall will save money for the average worker in the form of increased wages that offset any additional taxes to the employee - rather than forcing them to "pay more require them to pay more. So while I don't appreciate your self-righteous attitude (you really think taking a couple of classes makes you an expert?), you've only made my argument stronger.

As for your first point on quality - yes, US has the best quality healthcare. Accessibility is an issue though (how many patients out of the hundreds of millions do you think Mayo Clinic can see every year?). The quality is also a result of the US just having the best universities with the biggest endowments for medical research. Sure, perhaps quality will dip slightly if we cut the cost of healthcare in half, but I'd take that trade off any day

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Mar 14, 2020

You CANT have universal healthcare, extremely high quality healthcare, and unchecked, pseudo open-borders immigration. I don't care about morals, the MATH DOES NOT WORK.

For all you bleeding hearts, pick a side and we can discuss, but you can't get all three. Dumb people don't seem to understand this.

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Mar 14, 2020

Universal healthcare will only work IF we do something about our immigration problem. We need to seriously crack down on illegal immigration.

"Work ethic, work ethic" - Vince Vaughn
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  • Analyst 1 in IB-M&A
Mar 15, 2020

Being a Brit that moved to America I can tell you it's no great shakes. I love the system here. it's not perfect but it's getting better. my aunt died on a chemotherapy waiting list. so I'd rather not hear about how a government healthcare plan will be "perfect".

Mar 15, 2020

Geesh, we've had this debate time and again on WSO. There is nothing left to be said on the topic.

I'm just genuinely blown away by the people advocating for single-payer and/or gov't-run healthcare. In particular, I'm blown away by those who advocate for a complete gov't takeover of the healthcare system. Imagine the complete morons who populate America's administrative state attempting to administer healthcare to 330 million people spanning a continent + numerous outlying territories. It's a complete joke. The same people saying that the Trump administration is composed of a bunch of incompetent clowns will turn around and say that oh by the way, these same people should be allowed to run America's healthcare system. But that's ok, they don't really mean Trump; they mean their party should be running the system. So long as you always elect them the system will run smoothly; elect the other guys every other election and the system will collapse. It's a f*cking joke.

Then you've got a bunch of atheists and/or people who have utter contempt for religion, religious people, or the concept of making morality-based laws making philisophically illiterate moral arguments that it is moral for one man to labor on behalf of another, regardless of consent. The reality is, you don't have a moral right to healthcare--it's a product and service. Nobody has any right to a product or service that he or she doesn't pay for. It's that simple. If we want to argue about what is good for society, then fine, but the idea that a doctor should have to work for below cost (which is what Medicare essentially is today) because it is "moral" is absurd and contemptible.

Finally, this thread continues to perpetuate the lie that America has a broken healthcare system. In fact, the U.S. has good health outcomes, high satisfcation rates, and extremely few people who involuntarily have no access to health insurance (<10M people out of 330M). The reality is, America's lower life expectancy is almost entirely explained through suicide, murder, accidental deaths (vehicular deaths, drug overdoses), conservative infant mortality calculations, and lifestyle choices that cause obesity. It's fine to diagnose America has having a life expectancy problem, but to say the underlying cause is the healthcare system itself is a lie. And that lie will lead to bad public policy decisions. Instead of focusing on crime prevention or drug policy or suicide prevention, we'll end up trying to completely re-make the healthcare system to little benefit.

Mar 15, 2020

My views on public healthcare are selfishly based.
I like a healthcare safety net for my family.

Even though I earn a nice finance salary and my employer provides private health insurance I am aware that my job is at-will and that my insurance does not cover my elderly mom or my kid. I like knowing there's a backstop (we live in Hong Kong).

This week I was in London and met up with a buddy in financial sponsors coverage at a BB. He told me that he loves U.K. public healthcare even though he has private insurance because one day he will retire and he needs to be based somewhere where his health and well-being are covered. A guy getting Uber rich serving KKR and Carlyle still wants to know when shit hits the fan the government will make sure his ass is covered, worst comes to worst.

Somehow there has been a myth foisted on America that public healthcare is awful and expensive. It is neither. Public healthcare as I experienced it in HK and U.K. are amazing in terms of accessibility and quality. My Canadian friends universally loved their healthcare as well. And public healthcare is much more economically sensible than what the USA has (insurance based healthcare) because costs are diffused across Society and the fat is trimmed out (no insurance companies and private healthcare groups getting rich).

So this is not me being ideological or political. I am being 100% selfish, self serving and self interested. I want future retired self, my current infant son, my stay at home wife and my elderly mom covered.

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Mar 16, 2020

As a German with mandatory membership in a public insurance scheme, this thread is beyond laughable. Do I get the Head Physician when I have my appendix removed? Do I get a single room with flatscreen TV and 5-star meals? No and no. But, when staying overnight in a hospital, you pay 20EU, as a working adult. As a low-income adult or a child, you pay fuck all. When I call a doctor because my mother coughs her lungs out, I pay fuck all. When I get any (common) substance prescribed, I pay between 10EU and fuck all. I have to take an ambulance because I broke my leg? That's fuck all for you. You get my point. Is it a perfect system? Hell no. But I believe, paying under 5% of my monthly pre-tax income for a system where no one, really no one, has to go into debt for medical treatment is a pretty good fucking system.
/rant over

Vincet Voluntas - Will shall win

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Mar 17, 2020

100%. Love our public healthcare system in Hong Kong similarly. No frills, but full coverage and peace of mind. Priceless.

Mar 16, 2020
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