Well yes, and "free over-the-air TV" isn't free either; it costs quite a bit of money to produce and broadcast. It's free in the sense of no payment at the point of receipt. Same with, say, a "free" library card or county park.
Here (Australia) we have one broadcast channel paid for by the government (ie, by taxes). In this case TV is exactly the same as the free healthcare we get (also paid for by taxes).
Yep. And the !#!$ers are promising to increase funding to healthcare by 30% in 5 years. Doctors already got a 100% raise last decade in some provinces and one of the biggest cost is physicians.
Meanwhile, the doctor lobby lobbies its ass off to prevent cheaper alternatives like nurse practitioners or the reduction of importance of hospitals for anything but emergencies or weird shit.
I'm probably only slightly more informed than you since I live here.
However, that's not indicative of a well functioning system. I can't find a nice pie chart for you, but it's about 20% of costs. It is the largest single cost.
And it is kept high by absurd education requirements in many cases. If you read a few healthcare books about the American system, you will probably find similar criticisms. There are so many government sanctioned monopolies in the healthcare system that it's impossible to change it.
In Canada, the healthcare system is basically a non-competitive rationed care system. If you know someone who personally knows the surgeon you need, you will get the care you need. However, if you do not good luck to you. I've had personal experience with this in my family (on the good side, prognosis was a minimum of x months to live without surgery, surgery was scheduled for x + y months(!) and we had to use our considerable network to get the surgery faster.)
But it was free, right?
Trust me when I tell you that the reason people are living longer is not because of the Canadian government's healthcare. In fact, the quality of life of many people is severely diminished because of the cost spiral.
But in general, it works very well for I-impaled-myself-in-my-crotch emergency care.
Edit: I should add that I have physicians in my family and they are very happy with the current system. In particular, compensation. I completely agree with their viewpoint: it's fair pay for the level of education they've had to receive. However, 90% of the work is routine and could be carried out by people who have less education. From my discussions with people in the healthcare system, this would reduce costs dramatically and potentially improve outcomes as well.
semantics everyone knows what they mean. Call it public health system if you want. The idea is you are not charged per visit or per service rendered.
And a vast amount of people in countries with public health systems aren't paying a cent considering they don't pay taxes for various reasons. You can't get healthcare like this in the US you pay or get nothing.
Things certainly aren't perfect, but it irks me when everyone thinks they are an expert in US affairs. It may not be universal but there absolutely is free (or very cheap) health care available in the US. There are all kinds of programs for the old, young and poor. Otherwise, just about any job will offer health care. Sure, there are people that fall through the cracks and that's a huge problem.
> Otherwise, just about any job will offer health care.
Many do, but it's no longer the case that "just about any job" does. 59% of Americans have some sort of employer-based coverage, and that includes people who get it through their spouses or parents. Small businesses in particular are rapidly dropping coverage (according to this random article, only 1/3 of small businesses in Wisconsin offer any, down from 50% a decade ago: http://www.jsonline.com/business/124753109.html).
Self-employed individuals also qualify as "small businesses", so I'm not sure if that statistic reflects existing businesses dropping health coverage or new, often 1-person businesses popping into existence without setting up health coverage.
Interestingly enough, the US government spends about the same per capita on providing free healthcare as the UK government does - but to only something like only 2/5 of the US population.
You are right there are options that are free. Community health clinics and such. But those things are such basic health services it doesn't cover nearly enough to compare to what a public health system covers.
Walk into a hospital and demonstrate that you have no money, free clinics, teaching hospitals, Medicaid, finding a kind-hearted doctor that will work for free or for whatever you can afford.
Maybe of more concern for people on HN is starting a business and having some minor medical history that is deemed a pre-existing condition and thus being rejected for insurance. In that case, go to http://www.healthcare.gov/ [1] and you'll find a very reasonably priced plan. Depending on the state, you can find premiums well under $200/month, $20 doctor visits, $10 prescriptions with the deductible waived for most services. That's nothing for most people with the earning-power of the average HN visitor.
EDIT:
[1]: Just looked for Michigan and aged 25-29, with a pre-existing condition, premiums are $127.44/month.
Thanks for the link--I hadn't seen that before. The last time I looked around for health care for myself (many years ago) I don't recall seeing plan prices that low.
That's fine, but I'm worried what would happen when the health care industry realizes they can charge whatever they want, and the government will tax people to pay the bill.
Unfortunatley we already have enough price control to be feeling the bite of price control problems. For instance, the ratio of what a general practitioner can charge in fees to what a surgical specialist can charge is set by the government. Its also set by a formula cooked up by a sociologist using the labor theory of value, for heaven's sake.
And we do have production quotas for prescription drugs, issued by the FDA. Drug companies can set whatever prices they want but they can't change their production in response to market prices - producing more of drugs that have shown an unexpected demands.
In many ways the current US healthcare system is the worst of both worlds.
Exactly, which means that market forces are pretty much destroyed. When the government decides by fiat how much things should cost, there's no incentive to make a better product. It's just a race to the bottom. Not to mention regulatory capture etc.
Market forces can't be /destroyed/. Market forces just /are/. These forces don't always lead to market efficiency (which is called market failure), which I think is what you're thinking of.
Most often, market intervention leads to unexpected consequences, as people have a great deal of trouble predicting the effects of market forces.
The government deciding by fiat how much something should cost is more likely to lead to removal of consumer surplus, rather than a race to the bottom, if the government maintains competition amongst its suppliers. If you know you're competing on product quality at a certain price point - rather than on price - you'll likely be motivated to produce the best product possible at a price point that maintains normal profit. That's what I think anyway, but as I've already said, it's remarkably difficult to predict how market forces will play out.
I do note, however, that most of the developed world gets significantly better health outcomes for significantly less outlay than the US. This suggests massive market failure in the US health market.
This may be because while the US market is in theory a free market, in practice, it's anything but - it's an oligopoly with absolutely massive barriers to entry and no end of government interference.
Universal healthcare is a safety-net, to make sure everyone gets a basic standard of care.
It doesn't preclude premium offering which include "a better product".
Here (Australia) we have a public health system, but you can also buy private health insurance which gets you into things like private hospitals (nicer rooms, etc).
I didn't really say that. The hard problem with price controls is difficulty producing the right amounts of goods to meet demands because of regulation needed to mandate supply of less profitable goods. It becomes very complex when so many different products are involved, and because of insufficient resources it's not possible mandate overproduction of every good.
Yes, there are problems with socialized medicine. But there's problems with US style medicine too. Theorists can argue forever about this, but it's pretty empirically clear that the US system sucks, and costs a lot of money. The other systems suck less, and cost less. Which would you prefer?
I didn't say anything about US medicine, especially whether it has price problems and whether it could or does have price control problems. I only gave a specific answer to what happens when there is inelastic demand because of a government that can also regulate the suppliers. I see how "this is known" might be taken the wrong way, but all I meant by it was that the OP didn't need to wonder...it's found in any standard microecon textbook.
I would like to think we could talk about cause and effect in isolation here without making everything a grand political statement.
