@hasmis yea monopolies can form in any system, the USA isnt immune. But its a big different when “single payer” by definition means you intentionally create monopolies of one form or another.

@Dimestorehalo I cant speak to your specific case, But statistically speaking wait times in the USA are less than almost all other socialized systems.

For example in Australia, canada, france, germany, Netherelands, new zealand, and the UK 20% to 42% of patients with chronic conditions needed to wait more than 2 months to get care.. these are people who are already diagnosed and suffering who need routine care to alleviate that suffering (so its particularly heinous).. In the USA half to a quartyer as many people (10%) have similar wait times.

for comparison In those same countries you have on average about 50% of the people who could get seen in less than 4 weeks, compare that to the USA where 75% of people can be seen in less than 4 weeks.

Specialized doctor referals arent really “centralized” because you dont really “need” it.. just get a ppo and you dont need referals at all. And we already have tons of private systems that are opt-in and centralized for finding doctors (do telehealth and go online and youll get seen super fast as you have a huge centralized database of docotrz)

All that said I do agree with you that there is a LOT of room for improvement and in certain states or regions the problem is likely a lot worse than others.

@freemo Thank you for all the stats and it just may be my state and my semi-rural area but all specialists require a referral from someone and it has to be faxed, even though my private insurance allows me to see anyone within my network. And then there’s the issue with hospital requires a referral, the insurance doesn’t, and won’t pay for the doctor visit to get the referral.

Telehealth is a great idea and I’ve used it, except for the faxing black hole, I have even brought telehealth orders into a facility and they weren’t accepted because they had no way to get them into the system.

Even my GP, thru a telehealth visit last week, says that when the specialists finally receive the referral, it will be sometime in the summer before I’ll be able to see anyone. 4-6 months seems to be the average wait time, even with going down to the largest city in the state (150 miles).

I know this is anecdotal evidence (and I know of others with similar experiences), but I’m an experienced consumer of the healthcare system and I see the US system getting worse and worse.

@Dimestorehalo That is very odd that all specialists require a referal. That would be true of course if you have an HMO, but the whole point of a PPO is that you dont need referrals. I’d love to talk to a doctor in your area to know the details on that, its the first time I heard that.

I cabnt imagine why your case is so unusual for the american average but im sorry to hear that, it sounds awful!

I dont think you are wrong about the healthcare system in the USA getting worse, I’ve seen the same. I certainly wouldnt praise the american system. Like I said while on average it does fix some problems of socialized healthcare it also introduces just as many of its own problems too. So its hardly a system worthy of praise.

@freemo @Dimestorehalo I have roughly the same experience. And all that at 3 times the cost of a comparable system in any other 1st world nation.

Give me Iceland. Although that weird public/private system in Singapore seems to be generating a lot of fans.

@JonKramer @freemo I'm going to have to investigate the Singapore system!

@Dimestorehalo @freemo , to be very fair, I do not fully comprehend it myself, or why it is effective. I tend to view most systems as most efficient with a profit motive, IE a free market system. Libertarian, if you will. Healthcare and education are two counter examples. To me at least. But, the results seem to speak for themselves in the case of Singapore: https://en.wikipedia.org/wiki/Healthcare_in_Singapore

@admitsWrongIfProven There are lots of options in theory, but as I said few people talk about alternatives. The one that seems the best solution I ever heard of, and as the benefit of being put into action on small scales to see it work, is co-op based solutions. A co-op is where the clients of the service comprise the only owners of that service eliminating the greed element and addressing costs while still allowing for a somewhat free market to drive innovation and competing services. In the case of health insurance this means the policy holders are also the sole owners of the company.

@freemo That makes sense, but if you could establish such systems all around, you would have solved the capitalism destroys us all problem - what i’m saying is you are right, but it makes no sense to limit this to healthcare ^^

@admitsWrongIfProven Well thats a matter of opinion. I dont think capitalism is as evil as you do and feel systems that are mostly capitalism based, but not absolutist, are ideal. Capitalism, at least as one component in reasonable perportion, is not only not evil but good.

The reason healthcare is special is because healthcare doesnt follow the supply-demand rules where capitalism thrives. A person on their deathbed would give or pay everything they have to live just a bit longer (without suffering). So demand is infinite and thus equilibirum can not be reached in healthcare as it can with other goods and services. So while it is good for health care I would not go so far as to apply it to everything. That said it is often used when it comes to foods and farms and has been quite successful in that regard as well.

@freemo Hmm, i doubt that healthcare is still special. After all, demand can be increased nowadays. How else would the phenomenon of compulsive amazon orders or a new smartphone every year be possible?

And by capitalism, i do not mean using money as exchange for goods, but what it has become.

For what i know of the timeframe roughly 100 years ago, i might agree with you.

@admitsWrongIfProven

If I told you that you were going to die in 24 hours, but if you gave me everything you owned you would live another 20 years, would you do it? Most people would.

Demand for iphones may be high but they dont approach infinite… If you learned today all your cellphones were destroyed and the only way for you to get one was to give up everything you owned and you’d get an iphone for 20 years, most people wont do it.

Ever increasing demand is not the same as infinite demand, there is still an equilibrium point. There are many cheap phones and a great many people will reject expensive iphones and get a much more affordable phone. Very few people would pay less if they knew paying less meant dying for healthcare, if they have a choice.

I think “What capitalism has become” is a very misleading and harmful choice of language… capitalism doesnt become things, its a core principle among thousands of other principles that make up a government. Capitalism doesnt exist in any pure form. Governments have become corrupt, corperations get away with things they shouldnt, this is likely what you mean and it has nothing to do with the idea of capitalism, which is just a fancy term for “fair markets where all players get a fair shake”. Capitalism just means “free markets”, and what “capitalism has become” is a fancy way of saying “the markets arent free anymore”… which really is anti-capitalism and not some neo new age capitalism at all :)

@freemo I think your 20 year scenario is quite unrealistic. If withholding care would lead to death, and this would be a common occurance, it would not be socialized healthcare. Either private or just a scam.

And maybe the demand for iphones specifically is not possible to drive to infinity, but there is always something else pushed on people - if there is not, the system goes into a crisis.

So i would say this is more of a “feels” thing, where neither of us can prove conclusively what is right.

I do concede, that in extreme cases, healthcare can be more effective than consumer goods to extort people, but i still think that either will be abused to push people into unfair deals if not either regulated or community-owned.

I would turn that last paragraph of yours around: the markets have become so unregulated that capitalism shows what it’s made of: human greed.

What would be a reason against businesses being owned by the workers? After all, those would have an innate incentive to keep the world livable for all of us. Aside from understanding the craft, which is sorely missing in more hierarchical structures.

@admitsWrongIfProven The point here is not if the scenario is realistic or not. The point is you would pay anything for that 20 years, and most people would pay anything for ayear or even a month.. If someone is dying and they need an antibiotic no one will go “I’d rather die than spend 100$, just too expensive”… the demand for life is infinite, and no matter how much demand there is for something like an iphone it simply isnt infinite no matter how excessive it may be.

Now that doesnt mean you cant extort people with consumer goods, nor am I saying there isnt an issue in consume goods that is unhealthy… but the issues of overpriced goods is in another class of discussion than that of infinite demand.

@freemo Ah, but the demand is only there if someone has a treatable condition. Just like nobody would want a new smartphone every day, nobody wants daily antibiotics while not sick.
Of course, theoretically there could be some longevity treatment in the future. But that does not exist yet, and is thus not relevant to discussing the status quo and in which way things should be changed.

@admitsWrongIfProven Yes the demand is for healthcare (access to tools that extends one life).. not for a specific quantity of pills.

@freemo I have not heard of the general access being in question, except for a silly period in germany where we had to pay 10€ to visit a doctor. What i know about is treatment (no matter if surgery or pills or other) being expensive. After all, healthcare is partly selling goods and services.

While i agree that it is more important than abundand consumer goods, i cannot see a fundamental difference of if equal access should be granted.

@admitsWrongIfProven I’m not sure I get your point… In a totally unregulated market you have to pay to get healthcare, the demand for healthcare is infinite and thus people will pay extortion level prices to get it.. If they dont pay thoseprices you dont have access.

In a socialized system you have access regardless of if you can afford it, thats what makes it socialized. The demand is still infinite (people would pay anything to live longer healthier lives), but the costs are fixed.

Consumer goods arent remotely similar, the demand isnt infinite.

@freemo Well, you said the healthcare provider would be owned by the people themselfs, not a single person or small group.
So socialized healthcare still has companies trying to make money, giving rise to the problem that artificially high prices could lead to higher profits. Have healthcare providers owned by the people, problem solved.
I do not see how this exact same problem could not be solved the same way for other things.

It would be different for a state led socialized healthcare system: that, i could see as possible. After all, healthcare is not so much about taste, but science. Could be regulated/led by the state. (As an alternative to people-owned healthcare providers).

What would not work is state-owned consumer goods production. That would be whack!

@admitsWrongIfProven

I am not saying co-ops cant solve other problems, as I said it seems to work well for farms… I am just saying that in most cases its not the right solution, or describing the problem correctly.

For example we dont have a problem with iphones, yes they are expensive, but there are cheap alternatives and most people just buy the cheap alternatives, a few people buy expensive iphones.. its not really an issue that iphones are super expensive because it simply lowers demand and drives people to buy other products, creating a healthy marketplace with competitors at all sorts of price ranges.

@freemo Hmm, to be frank, i see the problem with consumer goods rather with too much pushed at people.
Devices that are good for a long time would be better environmentally.

So while co-op healthcare could take the problem with ease of acces away, co-op production of non-essential goods could put some good sense back in that process. After all, a co-op would consist of people that feel the consequences of uncapped growth much sooner than a single individual isolated from such.

@admitsWrongIfProven id be curious to see hiw a coop based apple performs… yYou shoukd start one ;)

@freemo Ah, i suppose you are readying the popcorn to watch the show when the non-coop apple comes in for the kill? :-)

@admitsWrongIfProven haha i mean thry sued a company with a logo of a pear… so not much thry wont stop at ;)

@freemo What i mean is that fair competition is not a thing that works in our time…
Most notable example being Amazon, recreating successful designs and ranking their rippoff products higher.

@freemo What i mean is that fair competition is not a thing that works in our time…
Most notable example being Amazon, recreating successful designs and ranking their rippoff products higher.

@bot I am not sure I would pick that particular language, but short answer, yes.. I think anyone too poor to afford health insurance should have it provided by the government along with tools to get them out of poverty.

I dont like the word "entitled" here, however and prefer to say that it is in the best interest of society to look after those in society who are struggling.

@freemo @bot Interesting.

I don't think the government should be forced to provide folks with healthcare, but a government's competence should be judged on their ability to enhance the economy to the point where healthcare is affordable for everyone.

If health care is too expensive, it gets inaccessible, but if it's too cheap, the quality suffers and the system eventually crumbles.

I don’t think anyone is entitled to anything, but I think it’s ok for the government to provide it if someone is legitimately disabled (not just some fat useless mobility scooter hog) and doesn’t have any resources. Otherwise it is just socialised healthcare, though “insurance” is also cancer.

uncle tom ass nigga...

@bot @freemo @realcaseyrollins Are you Albanian bot?

@bot @freemo The problem is that you'd have to quantify "legitimately disabled", and things that are quantified can be somewhat gamified and exploited, and a program where entry is easy can just as easily become overwhelmed

@realcaseyrollins

I just dont think letting people die for being poor, even if they are lazy, is going to give us the best society for all involved.

@bot

@freemo @realcaseyrollins @bot

"History will judge societies and governments — and their institutions — not by how big they are or how well they serve the rich and the powerful, but by how effectively they respond to the needs of the poor and the helpless."

~César Chávez

@JonKramer @freemo @bot How's #Canada doing with that?

@realcaseyrollins @freemo @bot

https://i.pinimg.com/564x/ee/63/91/ee6391c6aa4bbbae3763bd04834b1bb3.jpg

@JonKramer @freemo @realcaseyrollins @bot Would be nice, but how do you source this? Hope?

@admitsWrongIfProven @freemo @realcaseyrollins @bot , I honestly have no idea. I susp[ect it is education, and the teaching of ethics and logic in schools that is the base knowledge needed to address the healthcare problem.

@JonKramer @freemo @realcaseyrollins @bot Eh, did you have any contact with the education system lately?

@admitsWrongIfProven @freemo @realcaseyrollins @bot , my last teaching job was several years ago, why?

@JonKramer @freemo @realcaseyrollins @bot Teaching ethics implies a functioning education system.
I do not know where you are from, but from where i live this sounds ludicrous.

@admitsWrongIfProven @freemo @realcaseyrollins @bot , I find the idea of a functioning education system rather attractive. I can't picture how I wouldn't. If you expect that where I live HAS such, no, it doesn't. I think it SHOULD. This opinion of mine doesn't change with any contact or lack thereof with any education system.

@JonKramer @freemo @realcaseyrollins @bot So what you wanted to say was "History _should_ [...]", correct?

@admitsWrongIfProven @freemo @realcaseyrollins @bot , when I quoted César Chávez? No. I think he made the absolutely correct word choice when he said history WILL judge, not "should".