But there are plenty of countries with functioning healthcare systems that are private? The Swiss, for instance. Moreover depending on what counts as "government’s gotta run it" (paying for it? administering it? actually providing care?) you can argue that the German or even Canadian systems aren't government run, at least to some degree.
In the Swiss system the private insurance companies are required to be non-profits. The government sets the standard for care and coverage and all the companies can do is compete on price.
Basically what Obamacare was originally intended to be before they had to compromise to get it passed.
They were trying to get Republican votes so that the law would be bipartisan. In the end it passed on a party line vote, so maybe the compromises were a mistake...
The parties weren't yet ideologically sorted. The Democratic majority included dozens of members of the Blue Dog coalition, a conservative group who (among other things) didn't support healthcare reform.
Also the us Congress is blocked by the senate needing 60 votes/supporters to reach cloture on every single bill, except the once per year thing that got the bbb passed. So it's very easy to block the other side. https://en.wikipedia.org/wiki/Reconciliation_(United_States_...
I've heard good things about the Dutch system of healthcare and that it may be adoptable to the US. I'd totally agree that healthcare corporations become non profit like Kaiser here in the US. They aren't perfect, but they seem to be better than the their for profit competitors.
Dutch system and original Romney care (and early versions of Obama care) had a lot in common. Health care providers are private, insurance companies private, gov dictates a basic list of treatments which count as "basic care" and must be covered by insurance, sets max deductible / copay etc, insurance companies are not allowed to refuse any customers, everyone must have insurance, if you can't afford it gov will pay for your insurance.
Afaik that's the gist of it. The ACA has been maimed on various fronts (e.g. the mandate "everyone must have health insurance" is no longer practically in effect), but it originally started out very similar. Far more than to, e.g., the UK's NHS which is fundamentally quite different.
If you only ever look at the way a system works at a specific point in time you only observe it at that point in time.
America has had multiple attempts at solutions for healthcare over the years, each started with good intent and then waylaid by various causes to produce what we have right now.
A sibling comment mentions political compromise to pass the ACA, as an example of this.
Another example is that HMOs were started with inherent goodness, but got “corrupted” (in my mind) by profit seeking.
To directly answer your question: a core tenet of the Republican tent is minimal government involvement in day to day lives of the citizenry. Ergo, the Swiss system won’t work because it involves a lot of bureaucracy. Republicans link bureaucracy to cost, and feel this is not an appropriate use of tax payers dollars.
The holes in this political doctrine are not part of my answer here fwiw. Please no “but…” comments to that end :)
To be fair the tenet is minimal involvement in the day to day operations of the economy and maximal involvement in the day to day lives of the citizenry.
I do find the ironies in political platforms quite beautiful. I also love how they provides endless fodder for largely fruitless internet discussion ^_^
In speaking with my republican father in law on his opposition to universal healthcare, it dawned on me that he views it as a sort of zero sum game. If he has healthcare today, and then universal healthcare offers it to folks that don't have it today, it is a loss for him.
It’s absolutely the case that public health coverage will benefit some people who make bad health decisions at the cost to some of those who make good decisions (or the decisions themselves must be made by a central authority).
That doesn’t make it the wrong policy decision. Lots of systems we happily manage with similar dynamics. But I don’t think denying that basic fact is the right path forward. The moral hazard is real and worth acknowledging.
Ironically the people who make bad health decisions are often benefiting the medical system by dieing more often around retirement age rather than going on to live 20+ years past retirement with age-related healthcare problems that cost WAY more than any other health conditions they could encounter when they are younger.
Smokers for example have more lung disease and cancer which cost money to treat, but usually not until they are in their 60s so they still spend their entire life paying into the system, but then they die soon after, saving on age related healthcare costs. And that is on top of smoking disqualifying someone from many treatments and surgeries, making smokers a net-win for healthcare costs to society.
Being really fat also seems to have similar effects, although the the finances are much closer so perhaps the second order effects from being fat cancel them out. But on paper they are still a bit cheaper than the average person.
Many people will argue against it because it "feels wrong" and they think unhealthy people should be punished (for example with higher insurance fees) and don't want to admit that unhealthy people are subsidizing their own healthcare, doubly so if you add in the sin taxes they have been paying their whole life that often result in more state income than their entire life-time medical costs add up to. But there has been numerous studies across the decades in Europe and the US showing how much cheaper unhealthy people that die earlier are to care for compared to the 90 year old granny walking everyday and risking broken hips and taking 30 different medications a day.
The problem is we're already doing that, just worse.
Insurance is just risk-pooling. The most effective risk-pooling requires a bigger pool. That's why we have big insurance companies and bigger companies offer better employer healthcare plans.
Well, the biggest pool is the entire US population. So, we should just do that.
We already have socialized medicine. If my coworker smokes, I pay for that. If we're going to do socialized medicine, we should do it right.
This is going to be the ultimate issue if we do achieve some sort of post scarcity world where human labor is redundant. The idea that it’s not someone’s fault their indenture is unnecessary let alone a moral failing deserving of punishment is foreign to a lot of American thinking. The puritanical labor is godly mentality combined with the long term warping of anti Soviet propaganda is going to lead to some serious wide spread suffering that would take what should be the greatest achievement of man kind and turn it into a scourge.
Obamacare was a replica of Romneycare, which was implemented in Massachusetts. It was the republican approach of leveraging private enterprise and encouraging consolidated medical networks.
The difference now is the republicans have changed, and nuanced issues are just not welcome on the platform of a party following a cult of personality.
They were advocating for it before Obama tried to get it done. It was implemented in Massachusetts and termed "Romneycare" as Mitt Romney was the governor. Once Obama tried to implement it, it was government overreach and had to be watered down to get consensus. Personally I think we should have a govt option along side others, but all healthcare should be nonprofit (as in the Swiss model). Profit extraction is antithetical to healthcare.
Because it's any amount of government spending for one. And for two (this one is more of my opinion than the last one) the US has a problem where we, as a culture, view poor people as somehow morally or ethically broken, which is what causes them to be poor. Therefore, we shouldn't spend money that could positively impact them, regardless of its overall benefit. I got mine, so anyone can, but as the cultural zeitgeist.
Almost nobody in US politics who talks about something doesn't understand it or thinks it through. That's for people on the left and and on the right. They just repeat talking points that are given to them by wealthy party donors.
But there are plenty of countries with functioning healthcare systems that are private? The Swiss, for instance. Moreover depending on what counts as "government’s gotta run it" (paying for it? administering it? actually providing care?) you can argue that the German or even Canadian systems aren't government run, at least to some degree.