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this post was submitted on 14 Oct 2026
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politics
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How about the US finally implement universal health-insurance?
It goes to show just how far down the fucking rabbit hole we are, that even sarcastic remarks like yours talk about "insurance" instead of "care."
My remark wasn't sarcastic.
Ultimately, the thing that is needed, the thing that inhibits care, and the thing the government ought to provide is insurance. A single payer system is ultimately insurance. That is ultimately what every other developed nation has.
People can't afford care when insurance denies the claim. Insurance is a publicly traded industry. Publicly traded companies are duty bound to maximize profit and minimize costs. The easiest way to do that is to deny claims.
If you think of it, the thing people are asking for is for the government to step in an pay the bill. They're not asking for the government to provide the actual care. That could actually politicize care. Cancer? Congress won't allow for doctors to treat beyond stage 2. Have a drug problem? That's jail, not treatment. Transgender? Get fucked. With universal insurance, pick your doctor and the government pays the claim. Doctor patient privilege would still exist with universal insurance.
Medical care is the one area you can rack up a bill with no ability to say no, and doctors are ethically bound to provide the care anyway. In a comma? You can't contract for medical care like you can with buying a car. You can rack up a ton of medical debt without even being awake to realize it.
Yeah, sorry, that wasn't the right word. Maybe "cynical?"
I could be wrong, but I'm under the impression that care actually is provided by the government directly in a bunch of countries, and that those systems work just fine (or at least much better than our system does here in the US). Why does there even need to be a bill (in the sense of keeping track of costs on a per-patient basis) to begin with?
Your assertion that government-provided care isn't even an option on the table is true, but that only goes to prove my point about us being terminally capitalism-pilled.
There doesn’t need to be a bill that the patient sees or has access to, but the costs need to be tracked so that governments can adequately budget for healthcare. Governments need to be able to make educated assumptions about future costs so that they can align their tax schedules to ensure that the monies are there to pay for the costs involved in healthcare. Individualising the costs per-patient and per-issue assists with forecasting costs when governments also have access to good data about prevalence. It also assists with ensuring that the correct number of specialists are available for a given issue.
Yes, but making "what care for which patient" fall under the government's determination in the US's system of government is a bad idea. Maybe if there was a slowing of the changeover after elections, but the US's political situation is too bipolar to implement that level of government control of care (see my examples from above).
Because doctors need to pay their student loans? Because IV fluids need to be clean and put in bags? Because no single patient's care is standardizable? Maybe theres guidelines and standards of care, but biology is too messy for cookie-cutter care.
Paying the doctor a salary doesn't require itemizing the costs by patient. All the government really needs to know is the total aggregate demand in order to employ the correct number of doctors, not which patient required what care.
not good insurance, either. the American "left" doesn't want dental, mental, or vision, just the life saving stuff, and is willing to accept a $4000 OOP maximum right now, and if we got it, right now, trump would win again, and he'd dismantl it before leaving office in 2032
How about the US just balkinize already.
I don't trust this government to implement toast, much less a complete overhaul of the national health care aparatus.
Because there are a lot of impoverished people who the Epstein class exploits that, if the country broke up, would be too poor to escape the rapists to get to a better land.
I'd love to if we can manage to keep the Red Hands off/out of it. I just know they'll either grift off it or gut it or both.
So, better to have people die in bankruptcy as they are now because we can't ensure some people won't fuddy-duddy?
Oh no it's terrible now. I am for universal healthcare, or at the very least Medicare for all. I'm just very depressed about the way the Wrong Wing ruins everything all the time, decade after decade.
Medicare for all isn't universal health care?
Not my comment, but I think it's more that Medicare fucking sucks. But if everybody has it that would be better than now.
Medicare isn't bad. It's the original version of what we old folks have, there's a fee and copays but it covers a lot including hospitals etc, you can go to any doctor, and you can get a supplement plan to cover the copays for a lot less than ordinary health insurance.
"Medicare Advantage" is a ripoff, it's privatized and has all the limitations (network of doctors, approval /rejection of care bullshit, etc) of an HMO.
Medicaid is for poor people and its main problem is that a lot of doctors won't take Medicare patients because it pays them so much less for the same work. That sucks.
Please understand when I say that Medicare sucks it is because it is literally my job to deal with CMS regularly. Medicare is a politicized and inefficient bureaucratic nightmare. Both fee-for-service and Advantage. Just go look up how BvsD determinations work and you'll see why doctors would be reticent to take Medicare patients even if the reimbursement rate wasn't shit.
It is still better than the current system. But let's not pretend it's awesome, it is extremely wasteful and if we got Medicare for All there would need to be some sweeping changes for it to actually improve health outcomes.
What we need is a cross between the two. Medicaid lacks doctors, but it also lacks copay. For all its inconveniences when I was on it it was easier to get care than some employer provided insurances.
Really what we need is a government owned corporation akin to the NHS, except with standards of care directly pinned to the AMA/APA to prevent meddling in politicized healthcare.
I'd vote for that.
You really think that could happen in today's political sphere? You have voters like these
who elect politicians like this
because they want this
Oh well, since we've got a bunch of evil assholes we should just talk ourselves down real quick instead of expressing a clear plan that would have a wide range of palatability. Of course it'll be a fight, but it's a fight worth having.
Medicare is more like government -sponsored insurance, see my reply to Spitefire. I still pay a monthly premium but it's about a fifth of my old insurance, and I still get the silly "THIS IS NOT A BILL" paperwork in many languages telling me what they have been charged, what they paid, and what I paid/will get a bill for, just like with a PPO insurance company. Only so far my copays have been much less, so that's nice.
With universal health care, the government would pay doctors and hospitals directly, they'd save paper and processing , and I wouldn't even get involved. If we ever managed to get it here, I'm sure the GOP would insist we'd have some kind of monthly fee separate from other taxes so they could bitch about it and have an ID card so poor or immigrant people could be excluded.
Would be better, but is both near-impossible to pass with the current state of the US Empire's falling global domination, and would still perpetuate imperialism if it was passed without a transition to socialism.