I think the global problem is that medicine has improved so much that, unlike a hundred years ago, it's impossible to provide the full extent of modern medicine (which is huge!) to everyone, so some form of rationing/filtering is inevitable and necessary.
You can do the rationing through market forces, where people who can't afford it get less care; you can do the rationing through some other allocation system (e.g. priority systems, or long queues, or lottery, or committee allocation) which in effect still mean that not all people get everything.
If you want to say "In our society, everyone gets healthcare" then you have do define "healthcare" narrowly, which includes some services but not everything technically possible - I mean, if we have services that take more than a man-month of labor for each month of prolonged life (and there are some) then that's not possible to provide for everyone always even from a purely mathematical standpoint.
This is the crux of the matter, and the solution at some point is to either have people deny themselves "extraordinary care" or have someone else do so.
There's a "motte and bailey" that goes on with healthcare - emergency services like handling broken legs and illness and such is actually relatively cheap; it's the prolonged costs of all the various things we die of that really puts a burden on things.
Sure we spend $5 million now and then to save premie infants, etc, but that's such a small portion of total healthcare spending as to be a rounding error.
In the name of profit and efficiency, all slack as been wrung out of our healthcare systems. Systems with no slack are brittle and prone to failure under stressors.
Profit? Aren’t all of your provincial healthcare systems publicly run and publicly funded? I feel that there are two issues.
One is taxes. Canada already has high taxes, which does not pair well with low salaries and a high cost of living that isn’t too far from either the SF Bay Area or even NYC.
The second is your confederation’s central government is weak. Your provinces have too much power, and they’re the ones controlling the healthcare systems which seem to be managed completely differently from one province to another rifht?
> Profit? Aren’t all of your provincial healthcare systems publicly run and publicly funded? I feel that there are two issues.
The directly publicly run parts are only subject to the "efficiency" part. But more and more gets contracted out where it's also subject to profit pressure.
> The second is your confederation’s central government is weak. Your provinces have too much power, and they’re the ones controlling the healthcare systems which seem to be managed completely differently from one province to another rifht?
That's pretty backwards. Locally managed healthcare tends to beat centrally managed. It also helps inject a bit of competition in, gaining many of the benefits of for-profit healthcare without so many of the downsides.
> Locally managed healthcare tends to beat centrally managed
I tend to agree, but the downside to having each province having their own special healthcare system is that it’s hard for them to collaborate like with something as simple as sharing medical records. Also, the central government can’t do things like mandate minimum spending for healthcare and a more consistent floor on salaries for healthcare workers. Overall though I agree with you.
> It also helps inject a bit of competition in, gaining many of the benefits of for-profit healthcare without so many of the downsides.
People would have to be able to easily move between provinces for that to be true. Unfortunately, it’s hard due to the housing crisis and low salaries. Having a private option would increase competition. It might even offload some strain from the public system assuming that everyone still gets taxed for the public option.
Btw since we’re on the subject, how do Canadians mitigate the long wait for everything healthcare related? Is it common to cross the border for healthcare?
> People would have to be able to easily move between provinces for that to be true.
Not really. If a few people can move at the margin, that's enough to keep things in equilibrium. Even if no-one's moving, it still creates political pressure if one province is clearly offering better healthcare than another.
> Btw since we’re on the subject, how do Canadians mitigate the long wait for everything healthcare related? Is it common to cross the border for healthcare?
Again just assuming it works like the UK: a few people pay to go private and get treated quicker, some travel to a cheap place for the same, most people deal with it. While you hear about a handful of dramatic failures (partly since, unlike in a private system, there are many people with an incentive to publicise them), by and large the system is actually very good at prioritising the things that are actually urgent.
Yes, its a global issue since last 40 years - im reposting what i posted to the GP:
> Wait times for medical care seem surreal.
Its due to the governments defunding public healthcare in order to 'strangle it then save it'. You defund it, make people say 'it doesnt work', then say that "We need to privatize it."
Its de facto privatization method used since Reagan/Thatcher. Same method is being used in any country that ends up with a 'privatizing' government.
Using monopsonic position to keep costs as low as possible is a primary advantage of single payer healthcare. And raising healthcare payroll taxes is politically unpopular like raising any other taxes. No need to spread conspiracy theories about preparation for privatizations.
I feel that the bigger problem is that the demographic bomb has finally hit more developed countries beyond Canada. Unlike either the US or Canada, Europe just isn’t very used to immigration yet. The EU is nearly as good at assimilation compare to the US because they’re still relatively new to the game, which exacerbates the problems associated with immigration. Of course countries in Asia, like Japan and South Korea, are even worse than the EU when it comes to assimilation
Any proof for this? Because in the Netherlands wait times are increasing because, get this, more (old) people are using health care.
This increases pressure on the people who work in health care so they burn out, leaving fewer people to pick up the work, who then burn out, lather, rinse, repeat.
Salaries in health care are not fantastic, true, but the people burning out do so because they have to work too hard, not because the government is defunding them.
Another problem is that there simply is more treatment options available because of scientific progress. Afflictions that used to kill people can now be treated or at least managed, but this takes up a lot of time and money. Great for you if you end up living longer and in better health, not so great for the system as a whole.
Its amazing how people are still unaware of this after so many documentaries, reports, advocacy on the matter.
Just google. "Neoliberal privatization tactics", "Economic hitmen" (that was a pretty popular take), neoliberalism etc.
> more (old) people are using health care.
Irrelevant. The number of older people in any country is not enough to bankrupt healthcare systems Healthcare is a function of the percentage of national GDP spent on it. If there are more people, you have more GDP, you can spend more. If you have less people, you cant spend more but you also have less people.
Blaming the problems on irrelevant 'reasons' is one of the ways in which privatization is hidden from sight - just check how many cuts have been made to the healthcare spending in your own country in the past 40 years, and how much. There you will have your answer.
I appreciate that you’re angry and I agree that for the most part there’s entirely too much privatization going on (railways? really?). As far as healthcare is concerned, however, in the Netherlands (it might very well be different elsewhere), it is mostly not being privatized and the government is spending ever increasing amounts of money on it which take up an ever increasing cut of the budget and the reason for this is more people are growing older and sicker and are therefore requiring more complex care.
We’re currently at €7000 per person per year spent on health care, with average salaries being €36.000 annually. This is unsustainable.
Same for Germany, same for the UK, same for Canada, same in any Western European country - im reposting what i posted to the GP:
> Wait times for medical care seem surreal.
Its due to the governments defunding public healthcare in order to 'strangle it then save it'. You defund it, make people say 'it doesnt work', then say that "We need to privatize it."
Its de facto privatization method used since Reagan/Thatcher. Same method is being used in any country that ends up with a 'privatizing' government.
Only in countries where there are people in power who stand to benefit from privatizating healthcare so as to turn it into the dystopian hellscape like the American healthcare system.
We don't have this issue in Taiwan for example. I'm sure other countries can pipe up.
Actually now that I think about it the devs could relatively easily get a gold card visa and emigrate here... From what I remember of their documentary they basically love to just code all day and go on walks, a lifestyle easily supported here. We also got FAT internet pipes.
People keep telling us this but we feel it's overblown. When you listen to western media they make it seem like an invasion is just around the corner, whereas over here the relationship with the PRC is little changed.
Nobody can know for sure but you can never know if a huge earthquake will hit San Francisco, better not live there. Or if the subway will flood in new York city, better not live there. Or if Berlin will be hit with a terrorist bomb, better not live there...
And so on. At least here we are very unlikely to be shot, and, our public transit means we don't have to risk death from drunk driving. I believe a rational analysis of actual likelihood to random death in Taiwan vs the usa, the outcomes are much better in Taiwan, and that's before considering better access to healthcare and other reasons our quality of life is higher here.
I think I'm going to take the Taiwanese person's opinion on the matter over yours, no offense haha. Frankly being a Japanese native in Japan, I can only confirm his opinion. Endless political posturing does not make a war, except in the case of the classic gung-ho American cowboyism.
> I’ve been watching news in Asia, including from Taiwan, Japan, Singapore, and the Philippines.
It should be obvious, but so have I. What are you seeing in your news that makes you think you know more than I that there's not only a higher risk of PLA invasion, but that said risk is at all measurable in any meaningful way?
> The further China’s social order degrades, the higher the chances of an invasion.
By what basis? Try my logic: the further the PRC's social order degrades, the less support Xi will have for a foreign war. What happened back in Russia when they invaded Ukraine? Protests. Does the CPC want more protests right now?
It's moot. Think about it: if you are so certain that there will be an invasion, then you likely would acknowledge that our intelligence services are even more certain. If your certainty is so high, their certainty would be, well, probably at 100% in the next year, right? If they knew that, would they not completely mobilize our army, activate our standing militia? The PLA would know that we know, and wouldn't the invasion simply happen tomorrow?
I say this because I ask you to recognize the inherent uncertainty at all, and that the statistical probability of a PLA invasion is dependent upon human whim and global politics. If you can't tell me which way a stock is going to go confidently enough to bet your entire savings on it, there's no way you can reasonably guess whether Taiwan is livable based on risk of invasion.
I mean, if you're telling me you wouldn't live in Taiwan because you'd be afraid of an invasion, I definitely don't want to hear that you've been in a car any time in the last year, because if you're that concerned about the PLA invading Taiwan, there's no WAY you would risk the objectively, measurably higher likelihood of getting in a car accident from a drunk driver.
But don't take my word for it: in the words of a huge portion of the staff of the US state department stationed here in Taiwan (we had a dinner party recently (I have no authority to quote them on this so you know, don't run to the press)): the US State Department is skittish to a fault. If they haven't pulled staff, they don't consider invasion a realistic probability.
TSMC wouldn’t be making foundries in multiple countries if the danger of a Chinese invasion wasn’t both real and imminent.
There’s also a lot of troop deployments in both Fujian and Hainan.
Focusing your country’s rage outward towards a foreign enemy is also a strategy so old that even the Romans mention it.
I get it. You don’t want to leave like the Cantonese in Hong Kong. You can keep your head in the ground all you want, but it’s not going to make the danger go away
> the EU’s healthcare system was working well compared to North America
I think it's "working well" in the sense that "sudden illness won't bankrupt you" but not "working well" in the sense that "you might have to wait two years to get a new hip" (which I believe is the current waiting time in the UK.)
The capitalist European governments that are being elected are privatizing healthcare. The first step for doing that is defunding public healthcare to make people say that 'it doesnt work - its better in private hospitals'. Then you say you have to privatize the entire system. It also funnels people to private hospitals early - when you defund public healthcare and force people into long wait times, they have no option but to go to private hospitals.
Most affluent European nations have seen net negative economic growth for the past 15-20 years, and in some cases for a generation (France and Britain).
Now they're commonly seeing population contraction or flattening.
They already have high taxes.
They're in deep shit and it has little to do with Capitalists taking over their healthcare systems. The math was always going to take them here. Only per capita economic growth to offset the aging and population shrinkage can save them, short of epic scale high income immigration.
30 years ago Germany's GDP per capita was ~$26,500. That's $57,000 inflation adjusted. The projected GDP per capita for Germany in 2022 is $48,000.
30 years ago France's GDP per capita was ~$23,800. That's $51,300 inflation adjusted. The projected GDP per capita for France in 2022 is $42,330.
30 years ago the UK's GDP per capita was ~$20,500. That's $44,200 inflation adjusted. The projected GDP per capita for the UK in 2022 is $47,300.
30 years to end up with a net contraction or otherwise close to flat. And these are supposedly the economic giants of Europe. In some cases it's even worse than it seems per capita, as eg France has added nine million people in that time; the UK has added ten million people.
The same scenario is playing out for nearly all the affluent European nations.
As the World Bank dataset shows, Germany has in fact had GDP per capita growth - the 26500 figure you cite is in 2015 dollars, so it is already adjusted for inflation. GDP growth is never reported in nominal terms, but always in real terms, which is adjusted for inflation.
This is the best summary of what’s happening with the demographic bomb that is occurring in every developed country. It’s even starting to hit developing countries.
> Most affluent European nations have seen net negative economic growth for the past 15-20 years, and in some cases for a generation (France and Britain).
Economic growth is a meaningless term in itself. There was so much growth in the US, and what did it do for the majority? A tiny ~1% or less got extremely rich. But the majority are not able to feed themselves.
> They're in deep shit and it has little to do with Capitalists taking over their healthcare systems.
The capitalists took over the economy of entire Europe starting with Thatcher/Reagan.
> The math was always going to take them here
This sounds like religious sermon. There is a magical 'math', which makes everyone happy when there is 'growth'. Like how it obviously did in the US.
...
That has nothing to do with it. Growth, or contraction, has nothing to do with people having public healthcare since public healthcare is run over the fraction of the GDP that people generate. If there are less people, there is less GDP, but less need for healthcare. If there are more people, you need more healthcare spending but there are more people that generate GDP.
Its capitalism. Unequal distribution of wealth can never be sustained even with gigantic growth. Like the US demonstrated since Reagan.
Two things are at play, the capitalists, and the nationalists that make everything for what would be new European citzens to be shoved away, people that could be paying for those taxes instead of caged in some camps waiting years for their future.
Finite resources don’t disappear when you change economic systems, and neither does corruption. To me, what changes with different economic systems is the currency. With capitalist systems, currency is obvious. However in socialist systems, the currency tends to be political power and connections. Otherwise, you’ll have to wait in lines just like everyone else.
Neither system is perfect and they both have pros and cons
> However in socialist systems, the currency tends to be political power and connections.
That's objectively false and its a perception that is based on the Angloamerican cold war propaganda.
With all the 'power and influence', the 'elites' of Eastern Bloc did not live so much more in luxury compared to their own people.
If an ordinary person got his house at the age of ~35, a party official got it a few years earlier. If an ordinary person drived an X years old car, the official drove a 4-5 year newer car.
The catch is, all the citizens in the Eastern Bloc systems got their houses, cars, guaranteed jobs, education, healthcare, childcare, paid vacations, paid maternity leave, retirement and all that stuff.
They were very surprised when they changed to capitalism and learned that none of those were guaranteed under capitalism. Now they have so much freedom.
> With all the 'power and influence', the 'elites' of Eastern Bloc did not live so much more in luxury compared to their own people. If an ordinary person got his house at the age of ~35, a party official got it a few years earlier. If an ordinary person drived an X years old car, the official drove a 4-5 year newer car.
You’ve contradicted yourself in the same comment.
Besides what you wrote doesn’t fully reflect reality
Power is much more centralized in socialist systems. Consequently, corruption spreads much faster compared to more decentralized systems like capitalism. The end results is everyone is equally poor except for high level government officials.
> Power is much more centralized in socialist systems. Consequently, corruption spreads much faster compared to more decentralized systems like capitalism
Those are religious statements without any sound basis. In a capitalist system corruption is normalized in the form of the 'freedom of the property owner to do whatever he wants with his property' and 'election funding'.
> The end results is everyone is equally poor except for high level government officials.
Which contradicts the reality. The US is not at war. Nobody is sanctioning the US. Nobody is conducting economic warfare against the US. The US sat at the top of the world's economic system uncontested for the last 30 years. And that is the result.
> There is absolutely no practical difference in between driving a car that came out last year and driving a 5 year old car.
Newer cars weren’t the only thing socialist kleptocrats were found to be hoarding. They had all sorts of luxury goods from the West ranging from fashion, jewelry, and even food.
I don’t deny that late stage capitalism will happen or is happening as we speak, but socialism isn’t immune to corruption either. Late stage socialism also happens much sooner than late stage capitalism because power is so much more concentrated in socialist systems. We know this because we’ve had plenty of failed socialism experiments in the 20th century
> Those are religious statements without any sound basis
It’s ironic that you’d write this when you never offer solid facts yourself despite other commenters requesting that you provide data. My data is more valid than your little anecdotes
