sc94597 said:
Nymeria said:
Sounds like you don't disagree, but differ on the solution. My question is if a compromise between Switzerland and the United States system offered was the Canada system would you take it? Are the draw backs of Canada you see if applied to the US greater than the current US system's issues?
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Very few people disagree that the U.S healthcare system needs reform. The question people disagree on is what it should be reformed into.
As far as I can tell, no U.S legislator wants to incorporate the Canadian system either. The Canadian system works by their central government block-granting provincial governments. In order to earn the block grants, the provincial governments must incorporate "universal healthcare" along certain guidelines. If the U.S government were to block grant the state governments, without any strings attached I'd rather that than merely institute "medicare for all" I would be more willing to accept such legislation. No senator or congressman wants to do this though, because the majority of uninsured are in very red states, and the states probably won't cooperate. So then we have "medicare for all." Well I see some immediate problems with "medicare for all." Let's assume it can be funded through tax increases (which I am skeptical of), I am concerned that consolidating all health-care spending into the hands of the central government gives legislators too much power on what it is spent on. For example, in Britain they are still struggling to approve PrEP/Truvada, because it isn't cost effective. If my insurance company didn't pay for PrEP/Truvada, I can always choose a different insurance company that does. Consequently, most insurance companies cover PrEP/Truvada.
Republicans are already trying to get rid of abortion spending in Medicaid, and a certain segement of Republicans would probably find PrEP/Truvada cost-ineffective for reasons not related to cost. For people at a high risk of HIV this is a problem because the drug is expensive without insurance.
I'd rather have an inneffcient system where I get to decide what healthcare I receive than an efficent one where I don't.
So unfortunately, due to the political effects of having evangelicals and social conservatives in congress, I can't support a national single-payer system.
There is a tradeoff here between what you get and how much you save.
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The choice that plays out over and over in the US these days is "freedom to go bankrupt or freedom to elect to die". The idea of not supporting a change, even an imperfect one, because it doesn't solve everything, makes little sense to me. Conservatives have spent decades making life harder in regards to family planning, they would likely continue doing it to me, but I'd at least get my life saving medication. I'd fight that battle as well, but I wouldn't turn down a massive improvement because it doesn't afford me everything I'd like.
Studying US history many movements are gradual with generational victories. If women wanted full equality in 1910s to be bundled with right to vote they'd win that maybe by the 1980s. In the meantime they'd suffer all sorts of set backs.
If we can at least get people to the table that what we have now is poor and we can do better that is a step forward. What I've seen from congress and the administration is to make it worse. We fight against poorly thought out repeals and for soemthing better. In my mind better means more American citizens getting care regardless of income. Maybe we get the medicare age lowered to 50, see the issues, and try to do better as lower it to 40, then 30, and finally to everyone. I can compromise on elements, but the over arching idea of going back to pre ACA or sticking with ACA seems cruel and I don't understand it.
