ForumTouchy Subjects ► Why is UHC controversial in the US but normal everywhere else?
Focusing only on healthcare implies a lack of familiarity with his overall platform, frankly.
I'm not familiar with any of their overall platforms. Health-care is what I've seen come up the most in the bits I've seen, and given UHC has been the standard in every other Western country mostly since the 1940s, that's what I'm the most confused about and interested in when the US acts like it's dangerous and weird and controversial.

I am interested in what the root cause of that difference is. Because I support tax-payer-funded health-care where you don't need "heath-insurance" at all. You just go to the hospital and get treated and it's free. No different to calling the police. If I call the police I don't get a bill for that, nor do I need special insurance for it.
I think there are three main types who don't want the government to pay for all healthcare: (1) the people paying for it, (2) people who object on principle to forcing someone to pay for someone else's healthcare, and (3) people who think the resulting healthcare system would be less efficient or result in worse outcomes.
Why are these people (presumably) such a large proportion of the US population and (presumably) such a small proportion of the CANZUK population, where UHC has been normal our whole lives and mostly our parents' and grandparents' whole lives?

  
New Zealand was the first country to adopt universal healthcare in the 1930's. It has never been controversial and health insurance exists for the wealthy to cut lines at private hospitals and get elective surgery cheaper. Why it's controversial in the states absolutely baffles me, especially considering conservative countries like Canada and Australia similarly view it as a non-negotiable fact of life.
  
Could you source that map? I don't understand exactly what the legend means and also can't make out some of the smaller countries. Wikipedia's categorization seems more nuanced, and it indicates that some of the countries that are apparently marked green in that map (e.g. Germany, I think) do in fact utilize private insurance.

As a sort of cop-out answer to the thread topic, Americans are much more ideologically conservative (both socially and fiscally) generally than most other English-speaking countries.
  
Germany is very conservative as far as western nations go for reference, but their system is quite complex: the short version is that government insurance (Medicare for all!) is income based, private insurance is entirely optional for anyone earning under a threshold income.
  
@Hydrogen777

The map is from wiki, here is a full-size one with legend.

In this and the other thread, you've drawn a dichotomy between countries having private heath insurance and countries having state health-care. But the two can and do co-exist, they're not mutually exclusive. Grayseff mentioned New Zealand. In New Zealand, ordinary people use free state health-care, but rich people can choose to have private health insurance if they don't want to rub shoulders with the hoi polloi. So private health insurance still exists, but it's a luxury not a necessity.
  
The UK is similar. Most people rely on the NHS, but there is a strong private healthcare sector.
  
I keep mentioning private insurance because you've been conflating universal healthcare with single-payer systems (which not all of the dark green countries have). Among Democrats at least, UHC is uncontroversial, but single-payer is not because many wish to continue using their current insurance. Note that wealthy people will pay for their own healthcare either way - it's just a matter of the level of access, quality, wait times, etc.
  
Single-payer doesn't preclude insurance. In the UK and New Zealand you still pay into the single-payer pool, and can still access the services associated with it since private hospitals can't necessarily provide all services as well as the public system.

What even Germany (and Australia) does is require insurance, and provide it to all citizens through an income-dependent levy for a nationwide (or statewide) government insurance pool. It only makes sense to use private insurance if you have a lot of money or are very low risk. It's barely different to single-payer (off the top of my head 85-90% of people use government insurance) and their healthcare costs per capita are still higher than New Zealand or the UK.

Edit: the only differences are these:

  • in single payer systems insurance is supplemental for the rich, in the German system it's necessary.
  • people see their medical levy and can opt out if they have other insurance.
  
So yeah, you've pretty much explained the differences between the two. And a lot of Americans who already have insurance they're satisfied with do not want to give it up to switch to public funding for basic health services. Bringing back the individual mandate (while likely also expanding Medicare and Medicaid to improve coverage rates) would constitute a form of UHC - one not that different from the system now in place in Germany and elsewhere.
  
I keep mentioning private insurance because you've been conflating universal healthcare with single-payer systems (which not all of the dark green countries have). Among Democrats at least, UHC is uncontroversial, but single-payer is not because many wish to continue using their current insurance.
I have, I don't understand this other system people have brought up. So in this other system, the government buys people health insurance, and people have to claim on that health insurance to get treatment? Why create this unnecessary middle-man?

I think it makes much more sense to bypass the middle-man and fund health-care directly the same way we fund schools, police, army, etc.
  
Grayseff said:
Germany is very conservative as far as western nations go for reference

That's not been my experience working in Germany and with Germans. Germany seems to have very progressive healthcare, labor laws and social programs relative to the US or even Canada or Australia. Admittedly, I'm not an expert, though.
  
I mean, relative to Australia and Canada* most western countries are liberal, they would be the most conservative countries in the English speaking world bar America.

I call Germany conservative mostly on the basis of
1) late acceptance of LGBT rights
2) private healthcare playing a large role
3) austerity policies and
4) having a conservative government for half of my life.

edit: * Canada is much less conservative than Australia and is not a contender for a top spot in that list.
  
Millpond said:
given UHC has been the standard in every other Western country mostly since the 1940s, that's what I'm the most confused about and interested in when the US acts like it's dangerous and weird and controversial.
Something like one per hundred American adults work in health insurance. That's over 2xas many Americans who work in fossil fuel and pretty close to the number of people employed in the entire entertainment industry.
Millpond said:
I am interested in what the root cause of that difference is.
Momentum from previous policy, a historically more free-market culture and the impact of lobbying/advertising.
Millpond said:
Because I support tax-payer-funded health-care where you don't need "heath-insurance" at all. You just go to the hospital and get treated and it's free. No different to calling the police. If I call the police I don't get a bill for that, nor do I need special insurance for it.
I don't think that is radical by a broader standard, but it's a big jump from where the USA is, especially if put alongside dozens of other similarly large shifts in public policy. Obama would not have been able to pass universal healthcare, which is why we got Obamacare. In the US, these types of major shifts happen in increments over several administrations, which has to do with our political system being less fluid and therefore more resistant to change.
  
Millpond said:
So in this other system, the government buys people health insurance, and people have to claim on that health insurance to get treatment? Why create this unnecessary middle-man?
I don't think it's really a "middle-man" if the government itself is also the insurer. But there can be substantive differences between the government simply paying the bill outright vs. the beneficiary making an insurance claim, i.e. the existence (depending on the program) of premiums, deductibles, copayments, and coinsurance rates. Theoretically, those four components could help keep total costs down and reduce frivolous healthcare spending, at the cost of accessibility.
Millpond said:
I think it makes much more sense to bypass the middle-man and fund health-care directly the same way we fund schools, police, army, etc.
Interestingly, even these are not all funded the same way in the US.
  
As long as copayments and deductibles exist, you can't really call it universal healthcare since access is denied to the poor. The big failure of Obamacare according to most interview pieces from Vice to BBC to PBS seems to be that networks still exist (I found out about them in full yesterday and it sounds like the most barbaric and cruel part of your whole healthcare system) and low-tier coverage is deeply inadequate.


I don't think overall costs can be reduced while profit incentives like low-tier coverage and networks exist, as much as the illusion of lower costs could be preserved.
  
These are half-remembered anecdotes, but I have a US friend who is poor, living pay-to-pay. And she told me she had to opt out of Obamacare because she couldn't afford it or it didn't cover her or something, and that she had to pay a fee to opt out of it. So all Obamacare did was cost her money. There's another guy I talk to who's working part-time and he says he'll lose his insurance if he goes full-time, so he doesn't.
  
Grayseff said:
As long as copayments and deductibles exist, you can't really call it universal healthcare since access is denied to the poor.
This is a matter of semantics. I think it's fair to call a system with out-of-pocket expenses for certain people or for certain procedures "universal healthcare" as long as the thresholds are reasonable. Even the NHS has restrictions on what it will pay for. Medicaid already forbids out-of-pocket payments for "emergency services, family planning services, pregnancy-related services, or preventive services for children" (source), and you can imagine an American version of UHC that simply expands these categories.

The individual mandate was repealed in 2017, but yes, it was flawed for that reason: that it was sometimes more cost effective for poor people to just pay the tax and then pray they don't have any major medical expenses that year. I think it's fixable though by a combination of (1) expanding Medicaid to cover people who legitimately cannot afford health insurance and (2) raising the tax to at least the level of the lowest-available health insurance premiums, to effectively force those who can afford it to get insurance. Otherwise it's not much of a "mandate", after all.
  
That's fine, I don't see why the headline makes out like that's unusual or a problem. Countries with UHC, even "single-payer", have private insurance too.

I think there's some confusion about what "abolishing" private insurance means. I'm not saying it should be banned. It would still be available if people wanted it.

Implementing universal healthcare doesn't require abolishing private insurance.
  
Sorry for not contributing much, but how much money about did everyone here pay in 2019 for doctors’ visits, prescription and otc medications, surgeries, ER visits, etc?
  
Nothing. The UK has universal healthcare.
  
A pretty rough break out of my medical expenses last year. Overall I was pretty lucky since I didn't have any medical issues on the whole.

Prescriptions: $18/month
Eye exam: $150
Contacts: $220, $10/month supplies
New glasses: $250
Insurance: $230/month
Dentist: $100
  
Quick question, does uhc here stand for ultra hard core or united health care.
  
Universal/United health care.
That's ~$3596 from Zia for medical expenses.
Sorry.
  
I’m pretty sure we’re talking about universal healthcare.
  
Heck, maybe rebranding it as united healthcare wouldn't be a bad idea. United healthcare for the United States of America.
  
Forum > Touchy Subjects > Why is UHC controversial in the US but normal everywhere else?