It’s interesting to me how supporting government-run healthcare has become more or less standard for Democratic candidates. I can’t argue that people – all people – should have access to healthcare, but I feel a lot of people don’t understand that what people get with government-run healthcare is not the same as what we get here. I can mainly speak to Ireland and the UK, so that’s what I’ll talk to.
- If you are in the hospital in Ireland, you’ll likely find yourself on a ward. If not, you’ll be sharing a room. As far as I can tell, wards don’t even exist on US hospitals anymore, except maybe in the ICU or whatever. Private rooms are not a standard thing like they are here.
- If you need some kind of treatment for something that’s not life-threatening, you’ll likely have to wait. A long time. Here’s a random example of an article on patients waiting 9 months or more to get shots for macular degeneration. I didn’t KNOW that people had to wait a long time for that treatment, but I guessed they did. My dad has macular degeneration, and it’s terribly time-critical to get treated.
- When my American grandma got cataracts, she made an appointment and got them removed. When my Irish great-aunt got cataracts, she got put on a waiting list, and a year later, she got them removed.
- In Ireland, people unsatisfied with public health care pay for private health insurance. 15% of health care expenditures came from private insurance, and 40% of Irish people have some type of private insurance. My aunt found a lump in her breast. She was unsatisfied with the care she was getting from the public healthcare system, so she sought private treatment and surgery to have it removed.
- Healthcare is like an HMO. I’ve enjoyed being on a PPO for over a decade. As a kid, my parents had an HMO which was super annoying because you couldn’t just go see a doctor if you had a problem. You needed a referral. Not a huge deal, but public healthcare tends to follow the HMO model – your GP is a gatekeeper.
- Education requirements are WAY less to qualify as a doctor in other countries outside the US. It takes five years to qualify as a doctor in Ireland. In five to six years, you can qualify as a surgeon or specialist. That’s out of high school, folks. I actually think this is a good thing, but unless the model is changed, doctors here are going to expect to be paid more.
- GPs in Ireland make $77,000 a year. GPs in the US average between $140,000 and $190,000 a year, depending on the source. And we have trouble finding enough GPs even at that salary level.
- As far as I can tell, Medicare is great in the US. But the rest of us are subsidizing it heavily. Not only that, I’d assert that the US subsidizes healthcare around the world through paying through the nose for pharmaceuticals and advanced operations and equipment not available elsewhere. New treatments are debuted in the US, and after they’ve been shown to work well, they move to the rest of the world. A random example of British kids trying to get to the US for cutting edge cancer treatment. Cancer treatment is very effective in Europe, but many of those effective treatments were developed and paid for here.
- Despite the fact that a full 12% of Americans are uninsured, cancer survival rates are comparable between the US and Europe. 12% of Americans don’t even have healthcare, but survival rates are the same. Why? Shouldn’t they be much higher in Europe? (It varies with type of cancer; for some types, survival rates are higher in the US, others higher in Europe, but comes out roughly even overall.)
I honestly believe healthcare will not be any cheaper whatsoever if we go to governement-run healthcare in the US. I suspect that globally, the rate of advancements in healthcare will declines. I would LOVE to see the US stop subsidizing drugs for the rest of the world, and perhaps government run healthcare would enable that. I do believe it’s a moral obligation of this country to provide healthcare to all its citizens. I’m not sure Medicare for all is the way to do that. Maybe it is. If Medicare for all IS the right answer, I definitely would be in favor of a gradual expansion – gradually reduce the eligibility age and add in children at the same time. So, year one, move eligibility to age 55 and also make all children under 1 eligible. People could still retain private insurance if they wished, but I imagine many or most wouldn’t. Private insurance would experience a slow decline over the next 30 years while it adapted to a role more similar to that which it plays in Europe.