Healthcare reform isn’t actually hard. Every advanced country has done it bar the United States.

In every case costs have gone down and outcomes have improved.

You always build on what you have because you can’t pause healthcare for very obvious reasons.

Hence a lot of different systems all with the same aim. Controlled costs and universal coverage.

The idea the US is somehow different and cannot make the change is the result of propaganda and a mistaken belief that the current Us system is the worlds best despite its costs.

Healthcare reform is easy and there is an ocean of prior art.

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tptacek 3 hours ago | parent | next [-]

Yeah, and they all generally get there by paying practitioners much less than the US does (by integer multiples). Single-payer, which this working paper equates with "universal coverage", is in fact not the norm among universal systems; besides using Medicare to ration the supply of practitioners, the original sin of our system is employer-based coverage, not payer structure.

Health care is an absolutely massive industry (everywhere, not just in the United States), and slashing compensation in a massive industry by top-down fiat is in fact not an especially easy thing to do.

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bigmadshoe an hour ago | parent | next [-]

Why do doctors need to be paid integer multiples more in the US than every other country on earth? This is not rhetorical, I mean it sincerely.

And I’m aware that medical debt is a big issue, but it seems like a chicken-or-the-egg type problem. Of course you can charge $500k for a medical degree when the doctor can make it back and then some in 5-10 years.

	▲	26 minutes ago \| parent \| next [-]
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	▲	tptacek 40 minutes ago \| parent \| prev [-]
		They don't! It's a huge problem! It's probably the problem in US health care, which, despite my own belief that single-payer is bad policy, is in fact a total shitshow.

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moregrist 2 hours ago | parent | prev [-]

Funny how one of the arguments against Medicare in the 60s was that providers wouldn’t accept it.

Turns out when you have the choice of accepting lower payment per patient for Medicare or having a lot fewer patients, you choose the lower payment per patient.

I would expect the same situation here. Doctors would grumble, but no one would force them to accept patients on whatever “Medicare for all” would be called. Nothing other than market forces.

A number of things would probably have to change, including the cost of medical school. But the system right now is expensive and essentially unsustainable. So change is inevitable.

	▲	nradov an hour ago \| parent [-]
		Nope. More and more providers are dropping out of Medicare, or imposing limits on the number of Medicare patients that they're willing to see. It's tough to sustain a financially viable medical practice on Medicare rates, especially for primary care in HCOL areas. Medicaid is even worse. There are a lot of patients who nominally have coverage but in practice are functionally uninsured because they can't find a local doctor to take them on.

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VirusNewbie 2 hours ago | parent | prev [-]

>In every case costs have gone down and outcomes have improved.

this isn't really true though, if you look at survival rates of many diseases.