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Just a reminder that the european and canadian healthcare systems have abysmal wait times, to the point that people can often expiernce permanent life injuries or even death due to the extreme wait times to be treated. While emergencies are usually treated quickly most things that cause long term injury aren't emergencies.
and the worst wait times, often resulting in harm
% of people waiting more than 2 months for a specialist.
Germany 2x vs USA, new zealand 4x, sweden 3x, australia, 3x, France 3x, canada 5x.. all % of people waiting more than 2 months for a specialist
https://worldpopulationreview.com/country-rankings/health-care-wait-times-by-country
@freemo speaking from italy, I had a mixed experience with universal public healthcare and private one.
necessary disclaimer I am pro universal coverage, if not for quality reasons from an ethical point of view (as in nobody should be left without the right to be cured) and certain conditions made me spend quite some time in medical structures to get treatments but luckily still no surgery.
on a national level we had an ever decreasing budget for healthcare since the 90s because of deficit reasons (thus resources for welfare policies got slightly reduced each year to a point where they are extremely disfunctional) and for years most of the personnel formed in our universities seek job opportunities elsewhere rather than staying here.
Private healthcare now is a bizarre world.
the income inequality here is at an all time record and the private world adapted.
you either get specialized centers that offer you a bunch of high end solutions or you get family owned companies with cheap alternatives to get your stuff done, with often obsolete treatments.
but there is also a more shady form of enterprise, and that is inside the public sector network.
local doctors or primary doctors usually offer their own private services inside public hospitals,
so while they are regularly employed in those public structures they also suggest the wealthy patients to directly pay them in order to be moved to a different list and receive a way more rapid solution.
not only this sounds like some sort of bribery, but it's perfectly legal and the very same people who do this are often in the directive group of these structures so they have a saying in budget decisions for the different sectors.
also worth mentioning they can help decide how many people assume and usually who should be selected.
They even have some influence in universities and there are way too many cases of people passing over in lists because of connections with such people.
This whole stuff happened on a certain degree also before the budget cuts but on a way smaller scale and the main difference now is the availability of personnel for understuffed and underfunded public structures.
If any sort of further deregulation bill was passed now we would almost surely see an huge increase in those public centers and half of the hospitals getting turned in privately shared buildings with little to none coverage of the poor patients.
brief example of how the whole private list works in public structures:
my aunt got her cancer surgery delayed of a month because an other patient paid the doctor to get a skin mole removed, the burocracy did the rest.
some people say the budget cuts were necessary to save our economy, but we aren't thriving after the austerity measures and little to zero effort is getting done to fight wealth hoarders and widespread corruption in the public spheres.
Does that make me distrust my government? absolutely
Does that convince me that we should less government presence and shift to private providers?
Not a chance, they would be by all means the same people who are trying to sink our healthcare system, but with more business opportunities.
@LennyGandolphini It sounds to me like both universal healthcare and private healthcare sucks where your at, and I personally would agree with this as a general statement.
So why be all for tax-paid universal healthcare at all, why feel you have to choose one or the other? Why not consider or suggest alternative systems that are neither of these two but address the concerns of both?
@freemo there is plenty of space and interest for me to speak about alternative systems, but I for one care mostly about the universal coverage, as it is something that, altough with some problems, left none of my relatives without medical help (to reassure you my aunt received her surgery in time when she decided to move to a different hospital).
I mean, to me whatever system endorsed should prioritize giving everybody the best medical support, or at least not letting anybody die.
I like thinking about the japanese constitutional statement that any citizen is entitled to receive the healthcare services they desire, and that means that even uninsured people with no funds can still choose the best opportunity for their issues.
their main issue now is the ever increasing amount of people requiring medical aid for unnecessary reasons, and the agreed approach is to invest more on prevention policies rather than limiting access to uninsured people.
To me that doesnt solve any of the problems we have with either a free-market system or universal healthcare.
The problems as i see it is universal healthcare takes away choice on multiple levels, both of if you pay for insurance, and which insurance you get, as well as the effects of that (such as selection of medications which wound up being bound to what insurance covers and thus certain medications wont be on the market if not covered), as well as quality of insurance and care which comes from being able to select different insurance, or none at all, if you dont feel you get value. Basically it lacks the competitiveness to bring quality.
Now the problem with free market is cost, there is a greed and profit angle that the owners of insurance companies want to make as much money as they can at the expense of others. Normally supply and demand strikes a balance in other areas but when it comes to health insurance demand is infinite because a dying person will pay anything to live in a healthy state for just a few more days. So with supply and demand equations broken you dont have a healthy free market.
Any solution need to address both of these concerns without compromise. The answer to this is simply in my mind.. freemarket, co-op only insurance with strong welfare to assist those too poor to buy into it with "healthcare stamps" similar to foodstamps one can spend on healthcare.
In a co-op system the owners of an insurance company are the people who have policies at that insurance company, and everyone is an equal owner. So the greed aspect is wholly eliminated. Any extra money the company makes goes right back into the policy owners pockets. So the issues with free-market are resolved. Since the system is free market based it also resolves the issue with universal healthcare, that is, there is selection pressure that ensures quality care is given as people can always switch to the insurance companies that provide the best quality of coverage, and has the best doctors within its network.
@freemo it could be a language issue XD.
but yeah that kinda sums it up.
I meant that the coverage should be expanded to everybody, as a requirement for whatever system you adopt.
And from my perspective I'm fine with the public "Universal coverage" because there would be no inequality in services and relatively good salaries, and they would be financed through taxation, but it doesn't happen so we are at an empasse with an underfunded public service which sorta works.
@LennyGandolphini Cant say i disagree.. I see no reason there needs to be equality of service so long as the system ensures everyone can afford all the options.. If i want less coverage and keep more of my money I should have that right. Why should I be forced to have coverage I dont want in some notion of equality.. Thats like forcing everyone to eat vanilla icecream and telling a diabetic they cant abstain just because its more "equal"
@freemo everybody is free to do as they please, the important is having access to that quality.
I mean sure you can keep your money to spend it somewhere else if you want, life is yours.
As long as you dont refuse to provide the funds that grant other people the same choice.
@LennyGandolphini Why would I have to provide the funds for other people? Unless you mean specifically poor people, in which case I agree and that would be through welfare on taxes... but dont expect me to fund people who can afford their own.
@freemo that was what I mean, welfare and taxes 😅 😂
@LennyGandolphini Ok thats fair then.. so then you dont really support universal healthcare at all, just any system where healthcare is an option for everyone (universal implies there is no option it is mandatory)
@freemo yeah.
As long as the people's right to healthcare is ensured I'm cool with that
@LennyGandolphini great... So by that logic my own suggestion for co-op healthcare with strong wefare is also on the table..
I'd argue my suggestion is far superior than universal healthcare as it addresses the problems I mentioned earlier. It also satisfies your priorities (which are also my own priorities)
@freemo yeah if it goes around and works for everybody it is good to me.
my problem usually with deregulation and reforms of healthcare policies is that in my personal national experience they tend towards an accumulation of funds in the private sector with no regards for other ppl.
After all, it is a sector that historically drives huge profits
@LennyGandolphini Remember my proposal was insurance be co-op.. this removes the "greed factor" (what you call accumulation of funds in the private sector).. the insurance poilicy owners are the company owners as well. so any and all profits made go right back to the policy holders.
@freemo splendid.
Also what is up with antisemitism on mastodon?
I mean I got a bunch of messed up stuff on my home.
I mean should I get used to "ironic" shitposting or it's just a small part of the whole ediverse?
@LennyGandolphini From QOTO users or in general?
QOTO will almost never be racist, we dont have much tolerance for that here. However in terms of the wider fediverse (all accounts you can interact with) there are quite a few racist people and servers. That said its easy to address.
So generally each server has its own rules. A few allow everything, and those are the places the racism breeds. The nice thing is here you can block servers not just people. Therefore blocking is far more effective than say, twitter... Just block the 20 or so servers that allow racism and you shouldnt ever come across it in your feed again. Or atleast, very rarely. In fact you could probably block the 5 biggest and eliminate 97% of it.
@freemo splendid and glad to hear that.
Each time I read those rants I get a little aneurysm and I have yet to adapt to this whole federal concept
@LennyGandolphini yea I hate them too, which is why i love the fediverse its so easy to filter out.. Let me know if you ever have any problems I can likely step you through a solution.
@freemo sure thanks buddy
@LennyGandolphini It sounds like you are using universal coverage to mean something more specific than what you really mean.. Universal coverage implies everyone is forced, beyond their own choices, to have insurance, and typically what constitutes insurance is strictly defined or worse yet a specific insurance is forced upon them, usually by tax money...
But your anecdotes about family without coverage suggests to me you mean something else that doesnt equate, necessarily to universal coverage. Correct me if I'm wrong but what you really support is that everyone has access to coverage, should they want it (which is not universal coverage). That is, if you are too poor to afford it it should be free, if you can afford it good quality affordable coverage should be available to you.
If that is correct, then your almost fooling yourself, as you arent asking for universal coverage at all, and thus alternatives are very much an option so long as they accomplish that goal no?