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> why is there even a hospital bill for being hospitalized?

Because hospitalization takes a lot of expensive resources. The bill has to go somewhere.

> Keeping your people healthy should just be a given.

For the entirety of human history, up to and including this point, it hasn't been.

> How many hundreds of years will it take before universal healthcare is finally accepted as the basic standard of a humane civilization?

Realistically? When they have AI doctors that can treat the plebs for very little cost.

Until then, we're talking about at least 10-15% of GDP of a rich country, which is a massive amount of money. Even places with "universal healthcare" make tradeoffs (e.g. IIRC, healthcare waiting lists for many things are absurdly long in Canada compared to the US).



The figure 10-15% of GDP of a rich country seems to be concealing something important: in the US, it's nearly 20%. In Western Europe, it's generally around 10%, for the same, slightly better, or in some cases much better health outcomes.

The UK has a famously stingy system which costs 7.5% of GDP, however the UK has better infant mortality than the state with the best infant mortality, Massachusetts. The worst states have infant mortality 2-3 times that of the UK. (Note that the poorest states in the US, LA and AL, still have GDP higher than the UK. So the 7.5% is of a much lower per capita GDP.)

The average EU country spends a little more than the UK, as a % of GDP. But has health outcomes well ahead of the UK, and considerably far ahead of the best-performing US states.

It seems kind of distorted not to point out that around half of the US spend goes either on luxury healthcare for the rich, or emergency healthcare to those who can't afford proper healthcare, or simple rent-seeking by entrenched players (pharma, doctors, insurance companies) and that none of these improves health outcomes by very much.


> the UK has better infant mortality than the state with the best infant mortality, Massachusetts

The US uses a different definition for infant mortality than the UK or any other European country. (One major difference is whether a borderline-nonviable birth gets counted in the infant mortality or stillbirth column.) The raw numbers are not directly comparable. Correcting for the expected effect of difference in definitions, the UK still has lower infant mortality than the US overall, but by a far smaller factor.


You are talking about a difference which would reduce recorded US infant mortality by around 15%, when it's nearly double that of Western European countries, and infant mortality in poor regions and for ethnic minorities is far more than that.


For the majority of human history, health care was done by village shamans etc (that did actually treat most ailments they could) for free.

It was part of living in that village.

So no, under modern less-personal systems this hasn’t been the case.


>>> Keeping your people healthy should just be a given.

>> For the entirety of human history, up to and including this point, it hasn't been.

> For the majority of human history, health care was done by village shamans etc (that did actually treat most ailments they could) for free.

Would you be OK with universal shamanistic healthcare? Because I don't think that would count as succeeding at "keeping your people healthy" by any reasonable definition. My strong hunch is that village shamans could successfully treat far, far fewer aliments than you could with OTC medications and first aid supplies.

Things start getting expensive once you try to be more effective than that.

And the shamans almost certainly weren't doing it "for free," but a village like that almost certainly is primarily a non-market economy, so their compensation could be obscure to modern eyes (e.g. for a more modern example and easy-to-understand example, Jewish priests were compensated by being entitled to a portion of religious sacrifices).


I expect that healthcare to be given with the standards of the day universally.

If we have resource constraints (not enough doctors, hospitals, medications) then one of our top priorities should be to solve the shortages.




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