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Do you think we’ll get universal health care in the USA?

Discussion in 'Chit Chat' started by Andrew99, Aug 24, 2018.

  1. Andrew99

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    I would like to see your opinions if you think we will ever get universal health care in the USA and if so what year do you predict it will happen?
     
  2. HM03

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    I feel like the US is far behind on lots of things. Maybe in several decades. The Canadian one has been kicking around for a bit, but still needs work itself.
     
    #2 HM03, Aug 24, 2018
    Last edited: Aug 24, 2018
  3. Destin

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    No, not for a very long time at least. There's way too much money involved in the healthcare industry for that to be allowed to happen. What people don't seem to understand about this is that universal healthcare means physicians will all be forced to take a huge salary decrease by being made to accept whatever the government pays them instead of what their actual rates are currently. It already happened once with Obamacare, the salaries for some medical specialties were knocked down dramatically (Radiologist and Anesthesiologist salaries went from $400,000 to $250,000 in literally one year because the government only allowed them to have very low reimbursement rates on most of their work).

    Would you be happy about your salary nearly being cut in half just because the government said so? All physicians I know are extremely opposed to universal healthcare because of that and the medical + pharmaceutical communities have a gigantic amount of political influence which they'll use to prevent this from happening as long as possible.

    Also yea I know it still looks like a super high salary, but when you consider what it takes to get there, how much student loan debt they have, how hard they work, how heavily they get taxed, and how much in fees they have to pay like medical malpractice insurance.... $250,000 really doesn't end up being that much - after all the stuff I mentioned gets paid, they might have $80,000 left in take home pay for working 60+ hours a week in an extremely stressful environment and knowing if they mess up a single time ever they can get sued and lose their medical license.

    If the salaries get reduced much further than they already have been, people will stop becoming physicians because it'll no longer be worth the 12 years in college and half a million dollars in student loan debt + opportunity cost that it takes to become one.

    Canada is a great example of it - yes they have universal healthcare, but it also takes like 3-6 months to schedule an appointment with your doctor because the system is so massively overwhelmed due to a lack of physicians. People won't like their free healthcare so much anymore when they can't get a doctor to see them for days even in an emergency situation (which happens already in some countries that have it).

    Point blank, it's not a good idea for the United States to have universal healthcare - it will cause a huge shortage of physicians, worse quality physicians, and extremely long wait times for any medical care.
     
    #3 Destin, Aug 24, 2018
    Last edited: Aug 24, 2018
  4. Andrew99

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    I see what’s you’re saying. I could still see it happening though. It is kind of hard though because in order for everyone to have access someone will be getting screwed. I could see it happening in the next 20 years or so.
     
  5. Lin1

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    I unfortunately don't think it will happen any time soon. The point made above is the main problem I believe. Not potential shortage of physicians but because there seems to be a certain selfish mentality in the USA that one's personal interests and rights is above and more important than the interest of the community as a whole (it works with guns right, healthcare etc...)

    The fact that it is mentioned that most physicians don't want it to happen due to financial reasons says it all. I am from a country with what's considered one of the best healthcare system in the world and most surgeons are paid well under 100000K, yet you don't hear about surgeons complaining about their salary even though they go through the same training and drastic hours as US surgeons simply because you can't be a doctor for financial reasons. You have to do it for the love of helping others and saving lives but in the US it seems like this goal is secondary to salary and money.

    It's such a shocking concept to me that in such a modern (supposedly) country like the US, doctors actually turn away patients, that insurance don't cover most people with pre-existing conditions or at such a price that many have to live without insurance. That a visit to the hospital can put you in debt for the rest of your life. That often people know they will be dying because they can't afford to pay for their cancer treatment (I know someone to which that happened in the US) it is appaling! How can any of those doctors sleep well at night (let alone big pharma and insurers) knowing their self-chosen salary is causing people to die or go without. What kind of medicine is that where doctors would begrudge saving a life for a lesser fee?


    The system won't change until people who can make it change are impacted by it. Unfortunately those have enough money that they will never actually have to worry about affording healthcare. So no, unfortunately I don't see it happening anytime soon as there would need to be a massive switch in mentality which doesn't seem to be happening at all.
     
  6. Biguy45

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    I sincerely hope not
     
  7. Lin1

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    Why don't you want universal health care?
     
  8. Biguy45

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    Rationed healthcare is poor healthcare. I prefer to let the markets sort it out. It goes agains my capitalist philosophy
     
  9. ThatBorussenGuy

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    Not with Republicans in charge. Get them AND the corporate Democrats out of Washington and it has a real shot.

    Meanwhile it works just fine for the vast majority of Europe. "Letting the markets sort it out" ends up with a lot of people with no healthcare because the insurance companies price gouge and refuse you coverage because of a "pre-existing condition". No, thank you. "Letting the markets sort it out" has failed utterly.
     
  10. Biguy45

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    Europe is a much smaller population, and it has serious problems there as well. Market solutions have never truly been tried. This is my last post on this subject. I will not change anyone’s mind and I see no benefit in arguing pointlessly. Believe whatever you want to believe, I don’t care
     
  11. Totesgaybrah

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    I could go for some universal health care. It might not be the perfect solution but considering I don’t have health insurance I haven’t been to a doctor in YEARS.
    Please excuse me for not weeping about someone only making 250k a year instead of their well deserved 400k.
     
  12. HM03

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    I haven't died yet :joy:
     
  13. Destin

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    The key difference here is student loan debt and risk. University tuition in Europe and most other places is very cheap compared to the United States. Your surgeons probably only have maybe $50,000 in debt at the end of their medical training. In the United States all physicians have about $300,000+ in student loan debt between their undergraduate and medical educations. Then when you add on the interest that gets charged on top of it, that turns into more like $650,000 over the course of their lifetime. Then you also have to add opportunity cost. They spent an extra 8 years in medical school and residency they could have been working after college. Any physician could have been making at least $50,000 per year straight out of college, so $50,000 times 8 years = $400,000 in lost wages + the $650,000 in student loan debt and interest.

    That means our physicians have literally gone over a million dollars into debt and lost wages before they even get their first job in their 30's (and still have to pay $15,000 per year in medical malpractice insurance for life). They still have to pay for a house, car, family etc. on top of it.

    It is not in any way possible for any new American doctor to live off of less than $100,000 per year like your surgeons do unless their family paid for their education, they would end up in poverty almost immediately. It's a completely different financial situation.

    American physicians are also sued way, way more than other countries are because our legal system rewards leeches. The average doctor here who has done absolutely nothing wrong gets sued 5+ times a year for their entire career on average. At any time they could lose their medical license and still have that million dollars in debt but not have a job to pay it off with if a court case goes badly.
     
    #13 Destin, Aug 25, 2018
    Last edited: Aug 25, 2018
  14. Chip

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    This is a persistent lie perpetrated by the Repubs (and the healthcare industry) to push back on the inevitable.

    There's voluminous data showing the opposite. I also have a number of friends in Canada. There is no wait for typical day-to-day care in Canada. Emergency care is excellent. Even in most specialties, there is little wait for appointments. The only waits are for elective procedures, some complex tests (especially MRIs) and some specialty services in remote areas. The stories about people coming to the US for procedures are mostly lies; the only exceptions are for things like MRIs for people who have less-urgent need and don't want to wait; those with urgent need are seen quickly.

    Comparing that to the US: Kaiser (the largest healthcare system in the US) *also* has waits for complex procedures, some surgeries, appointments with specialists, some MRIs and the like. And many areas of the US have waits for specialty appointments. In northern CA, a one-to-two month wait to see a psychiatrist, *any* psychiatrist, is common, because there is a shortage.

    Universal healthcare is inevitable, and probably will not take decades, because the current system (with or without Obamacare) is exploding, inefficient, ridiculously overpriced, and simply doesn't work. We are the only major economy in the world without it. And the higher-ups within the healthcare system all know it, and are basically bleeding the system as much as they can, for as long as they can, until the system crashes, because they know it is inevitable.

    Yes, our education system is completely broken as well. Student debt in this country is the next looming crisis, not just for physicians, but for everyone. Again, the powers-that-be have allowed an opportunistic system that gouges students, many of whom have no idea the debt they are signing up for. But this is eventually going to get solved also, or it, too, will crash the economy. Most likely, a huge amount of student debt will simply get wiped out. And when that happens, physicians will no longer have crushing debt.

    All of this assumes that we can actually get the greedy congresspeople out of office who are basically in the pockets of big business. That will take some doing. But in the current political climate, it may be possible.
     
    #14 Chip, Aug 25, 2018
    Last edited: Aug 25, 2018
  15. Lin1

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    @Destin But the problem with the US is that it has soooo many problems to tackle as a country but it all comes down to what I have said in my first post.

    Americans are "happily" getting themselves into medical and educational debts when a system where everyone pays more taxes and direct them towards education and medical care for all would benefit everyone. Such system would drastically lower uni fees meaning doctors wouldn't get in as much debt, therefore could charge less and down the line everyone could afford healthcare but no, people who have the funds do not want to pay for "others" (even though they would pay for themselves as much as others and vice versa). The US as a country has it's priorities all wrong.

    An educated population is so important for the well being of a country yet it's again capitalised so that only richer people can afford and access it. Same with healthcare, the government/people would rather see half its population die than pay towards a system that would benefit others. It's fucked up.
     
    #15 Lin1, Aug 25, 2018
    Last edited: Aug 25, 2018
  16. BMC77

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    Thanks, @Chip for your excellent post!
     
  17. BMC77

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    As for my opinion... I honestly can't even begin to guess. A lot, I think, depends on the political climate over the coming years. It could be a long wait if we end up with a totalitarian state run by far right Republicans and headed by President For Life Trump, On the other hand, if progressives win Congress and the White House by the end of 2020, then we could have single payer in a matter of a few years.
     
  18. Tritri

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    Considering the fact that neither of the two major political parties support it, it seems extremely unlikely. Even the much milder Affordable Care Act had to be watered down in order to get a lot of Democrats to support it, and it still caused a lot of outrage among Republicans, to the point where they tried repealing it over 60 times under Barack Obama.
    Unless the overton window in America shifts further left, it will never happen.
     
  19. Skaros

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    Probably not. And to be perfectly honest, universal healthcare probably isn't the answer the United States is looking for. I do think more affordable healthcare programs should be made though. A step towards making it more affordable is a step in the right direction.

    The United States is far too capitalist to go with universal coverage on a national level. Too much money is in the healthcare industry.


    Aside from that, it's interesting to note that the United States is actually very very good in mental healthcare. We've come a long way with stigma, and we're surprisingly ahead of other developed countries on that issue.
     
  20. InbornGame

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    I'm about to graduate from a US medical school, so I thought I'd share my perspective and hopefully dispel some myths.

    I agree that the US probably is not going to have universal healthcare anytime soon. Restructuring the US healthcare system would be a huge undertaking and there are lots of powerful interests that would potentially lose (physicians, though, are probably not near the top of that list -- we're talking insurance companies and drug manufacturers). What I do see happening (and what is already happening, in some areas) is a change in the way physicians are reimbursed from a system that is based on volume (how many patients you see or how many procedures you do) to a system that reimburses for quality. Our current system devotes a ton of resources into specialized medical care and tends to neglect the more basic services (things like primary care and preventive medicine). These are areas that have tremendous potential to dramatically reduce the cost of healthcare in the US, but they're things that are currently poorly reimbursed by insurers and the government (which means that there's little incentive for physicians to dedicate time to them). Hopefully, moving toward a focus on quality will allow doctors to focus more on better outcomes for their patients with less expense to the system as a whole.

    Low reimbursement rates have been a thing for a long time prior to the Affordable Care Act, and it's not just the government. It's true that Medicare and Medicaid reimbursement is generally poor, but insurance companies get to negotiate discounts with providers, as well. It's also not clear that reimbursement rates directly translate into physician salaries. Data actually argues against your claims about salary -- physician salaries as a whole have been increasing relatively steadily since at least 2011. Some specialties have seen a decline in average salary, but not radiology or anesthesiology, and not to the extent that you mention above.

    Some probably are. It's been my experience that most would strongly support improving access to equitable and affordable care, and I think a lot of physicians would probably support universal care if a solution were presented that was plausible and ensured reasonable reimbursement and allowed them to provide the care that their patients need without unreasonable restrictions.

    That's probably a little overstated for most. I'll graduate with just shy of $250,000 in student loans, and I'll be making about $57,000/year when I have to start repaying my loans. It'll take a maximum of about 20 years, and I'll wind up paying no more than about $200,000 in interest, but my monthly payment will be based on my income and its totally doable. Licensing fees and malpractice insurance are expensive, but few US physicians are self-employed these days--most are employees of or contracted by hospitals or health systems, and extra expenses are often included as part of their benefit package.

    I strongly disagree that this is how most physicians in the US feel. Frankly, training and working in medicine is grueling, and I don't think there is any amount of money that can compensate for it. I would argue that most physicians who survive a career in medicine in the US do so because they cannot possibly be happy doing anything else -- otherwise, there are much more lucrative and less stressful options, and some people do leave medicine to pursue other careers.