this post was submitted on 15 Jun 2024
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Agreed. I've seen examples of that with charter schools (privately run, but funded with tax dollars). With a good mix of charter and public schools, charter schools tend to do a bit better and specialize, but if public schools go away, charter schools become crappy.
I'm a huge fan of public mass transit as a backbone and private transit to fill in the gaps.
So the idea has merit, I just don't know how that mix should work for medicine where competition can be less realistic. Perhaps it should be like transit, public services for emergencies, and private services for scheduled services. Idk, I'm not a policy expert, but there needs to be a middleground between queues for care and massive medical bills for small procedures.
The 1.5% tax stays constant and subsidizes retirees' public insurance (and very poor people, or those with specific conditions).
The rest is just what I approximate based on my income and my employer's selected plan. The plan is kinda crappy (1 free checkup and covered preventative care; deductible for everything else with ~$15k max paid by the individual in a given year). I'm pretty healthy, so I get an extra discount, but the amount is fixed and uncorrelated with income. So for someone making much less, it'll be a higher percentage of income.
Most years we spend near-$0 out of pocket (except maybe $20-30 for medicine), but we've spent ~$10k per kid when they were born. I didn't factor that in, I just counted the premiums, which are about 3% of each paycheck.
Sorry for late response.
Worse than public ones were.
I think small personal transport((e)scooters) better fills in gaps. Big personal transport is overkill in city with proper PT. Private transport, I think, is only needed in rare cases, like you need to transport something big. For example moving server across entire city.
I know that in MHI system polyclinics get funding based on amount of people that registered there. And that people can register in any polyclinic they like, but generally they do in closest to their home.
But with healthcare I think there is no need for competition inside one country. Rather need for competence of doctors. And decent wages. And not have president stealing healthcare money to build palaces for himself.
I think it's very bad idea, because this heavily disincentivises preventative healthcare. Sickness better to prevent than to cure.
For 1.5% of tax USA has too little of healthcare. Even for its own citizens.
This is main problem of private healthcare. No job = no healthcare. Well, one of main. Other is conflict of interests.
I'm sad again. It's terrible. I hope your country will improve. Such things should not happen.
It's needed for medium distance trips that mass transit doesn't serve, like getting from an airport to a specific destination where transit would take far too many transfers.
So:
I disagree. Without competition, you can only manage price through political channels, which just results in lobbying and cronyism. Having paying customers choose one provider over another establishes pricing tiers, and properly rewards better providers and punishes worse providers.
The issue is that many people don't feel comfortable making decisions on medical care (everyone wants "the best"), but I think there needs to be pressure or there's little incentive to stand out and do a better job than everyone else.
The more the government gets involved, the more gov't palace building you'll see.
True. But refusing to serve someone in an emergency because they haven't kept up on preventative care is unethical.
That said, I think people don't get preventative care due to cost, and preventative care is expensive because of a variety of stupid reasons that I think would largely go away if most people paid cash.
People are happy to spend a bunch on supplements in the name of health, so I think people would pay for it.
But that's the thing, it doesn't need to be limited. Doctors don't want competition so they put pressure to discourage new doctors. Insurance companies also make it difficult for new doctors because they demand high certifications.
If medicine is restructured, your regular doctor could be a nurse, and you'd only go to a doctor if you had something the nurse couldn't handle (rare). But because of liability nonsense, they're prevented from actually doing their job, so we have more people chasing fewer resources.
I think people will get creative if they actually see the bill.
That's not true. That tax is for Medicare, which only serves the elderly (65+) and very specific other groups. Medicare is widely well regarded, and politicians want to expand it to everyone as a public option. But if we do that, I'm concerned it'll cost a lot more and they'll stop fighting so hard to keep prices under control (classic monopoly issues).
I think Medicare is best when it's competing with private health insurance. If everything moved to public insurance, we'd have pressure to cut physician salaries (they're a much smaller lobby than pharma), which reduces attractiveness of medicine as a career, which would increase wait times and whatnot.
Maybe we should roll it out to the poor, but I don't it should be universal, at least not in the US.
Eh, $10k for each kid averages out over the long term. I'm relatively well-off (not rich, but solidly middle to upper middle class), so I can handle occasional costs, especially planned costs like having a baby. I then get $2k/year as a credit for each child until they're 17, so that's nice.
Most years I pay nothing outside the premium. So it averages out to being pretty affordable.
Depends on how you define medium distance here. Probably it is not "two bus stops away", but rather "neither inside the city, nor between them". Then suburban tranins like these.
Agreed, but cycling for short distance(depending on definition) in city most of times less convenient that walking or using regular scooter(which in some countries legally same as walking). But this depends on infrastructure, and I can imagine cases where it is more convenient: when you can store bycicle without moving it upstairs. For same reason it is very convenient to use bycicles in rural areas.
Academy of Sciences existed over 4 political systems and over 4 economic systems. Even under Putinism it doesn't look like goverment place as most corporations. What we call goverment place look should better be called along the lines of dictatorship place look. Because this is how power that does not represent interests of society should be called.
True. My point wasn't preventative care instead of emergency, but preventative care should be if not part of UHC, then at least provided to every citizen by state.
Especially if their entire bill is 0.
Nurse that can diagnose is called feldsher. Has secondary special education(between secondary and higher).
That's why I said too little.
Maybe. Maybe not. Medicine is not making chairs or making phones.
This is valid concern. Result here doesn't seem completely predictable to me, because as I understand physician's wage is disconnected from price private hospitals charge. Cutting salaries is likely, but not the only outcome, because a lot of money was spent on communicating with private insurances.
Having healthcare is better than not having it, but if it will be limited to poor and old, then it will be heavily underfunded like public transport.
I mean in certain somecountries it is part of UHC.
Better than nothing.