The last sentence I quoted below caught my eye. I don’t doubt that is true, especially after living through COVID when many Americans saw prudent precautions as infringement on their freedom – to do what I never quite understood.
I never saw Medicare as infringing my rights, nor did I view employer health insurance as a problem even though the employer got to pick the coverage and the insurance company and I had no say in the matter. (Actually personally I did have a say-I was in charge of employee benefits 😎)
As governments in many countries came to be associated—especially over the last century—with the promotion and protection of people’s rights, their responsibilities grew. For example, they were increasingly expected to implement regulations in areas like occupational safety, meat inspection, and pharmaceuticals.
Many governments also built public-health establishments to fight infectious disease and, in most advanced economies, health-care systems that ensured coverage for all. The United States is an exception here: many Americans view the provision of universal health care as an intrusion on their individual rights.
Excerpt from article on the meaning of limited government from Project Syndicate
Americans are unique
Most Europeans—and especially people in Scandinavia—say they are satisfied with their health care systems despite frustrations over waiting times. Surveys generally find:
- Scandinavia: about 70–90% satisfied
- Continental Europe: about 60–85% satisfied
- United Kingdom: currently much lower, around 20–30%, largely because of long waits in the public system (keep in mind the UK system is a delivery system not insurance system)
The trade-off many Europeans describe is that they accept longer waits for some non-emergency care in exchange for universal coverage and very low out-of-pocket costs. Surveys also show that relatively few Europeans would prefer to switch to a U.S.-style health insurance system, even while many support reforms to improve access and reduce waiting times.
The thing is, there is no US health insurance system. We have different systems, non-integrated systems, systems that shift costs from one to the other … and we have waiting times too. Not as bad as the UK for sure, but call for an appointment as a new patient, or visit an emergency room and see what happens. I needed surgery a few years ago and waited a month.
The thing is we pay a high price for the convenience we expect, but then we don’t expect to pay the high price.
Will Americans ever decide what they want and are willing to pay for? I’m not hopeful, we rather complain, criticize and look for ways for someone else to foot the bill so we can have “free” healthcare.
One thing for sure, we have total freedom to regularly be stressed over our high premiums, deductibles and out-of-pocket costs.
QUINNSCOMMENTARY 
Well, I can tell you that healthcare is changing. As a doctor I used to be able to spend more time with patients. Now with the EHR (Electronic Health Care) that we have been using since 2019, it’s all about billing and documentation. Administrators are running the healthcare, at least where I work. It’s no longer patient-centered care, it’s administrator-centered care. I am glad I’ll be retiring soon.
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I have no doubt it has and is changing. We experience it every week. Most of the time we see a PA or nurse practitioner although when necessary to see the doctor, there is no rush and always time for questions.
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“the costs are spread fairly”? What does that mean? Whose definition of “fair” are you using? What you believe to be fair is all but certain NOT to match mine, or 340MM other Americans.
And, why don’t you make the same argument about food, shelter, and other essentials of life? How willing would you be to have someone take your property, your home, and distribute it to others based on their definition of “fair”.
Well, in this our 250th anniversary, as it did 250 years ago, property includes your money, your possessions and your home.
I have no problem splitting the cost of health treatment where each individual is personally responsible for a base level of coverage for preventive and primary and other care (via insurance as desired, perhaps up to $15,000 or $25,000 a year) and where catastrophic care costs (amounts in excess of that attachment point, which probably represents 33+% of all medical spending) is assigned to a societal pool funded with a per capita premium. No exceptions. Base and stop loss coverage limited to all who are indefinitely (not temporarily or conditionally) lawfully present in America. All others limited to EMTALA.
“Fair” must incorporate some personal responsibility, and pooling of risks should only occur where the risks are common.
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You quote the surveys of people in the European healthcare systems as to whether they are satisfied. A majority are in most cases. Not all however, 60% satisfied is not all by any means. You don’t quote the figures for the Americans. Why not? You launch into criticism of what we expect and who we want to pay for it but no survey data. Why not?
What of the the large numbers in continental Europe who didn’t check the satisfied box. Are they just complainers like Americans?
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I designed and managed health plans of all types for nearly fifty years. These days I read everyday the complaints and perceptions of Americans about their health insurance. About their desire to have it all “free” complaints about premiums and their inaccurate ideas why they are high, they don’t like pre-approval, they don’t want M4A because it’s “socialized medicine.”
Never will 100% be satisfied and never will it meet everyone’s perception of affordable , but we can assure everyone is covered and financially protected and that the costs are spread fairly as opposed to what happens now with some programs underpaying and others picking up the slack.
What is wrong with those goals?
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