Whereas the software industry, with near zero government involvement, has had enormous improvements in function and has pushed the cost to literally zero.
The US health care system is broken because health care is a natural monopoly that US free-market ideology dictates be run with (fake) "free markets" with result being a variety of companies profiting by abusing the system.
USA is very very good at complicated, cutting edge medical care but not efficient at delivering routine care.
What's most frustrating about this-- just take the poultry industry. To bring the cost to zero, all it would take is a single hacker to steal one government-regulated chicken and click "Copy" in its elusive little context menu[1].
Try telling that to a young person today. If you're like me you'll get the so-called "Gen Z Stare" in response.
1: Assume a 2d chicken.
That's not true by the definition of "nationalization" (government ownership)
Switzerland and Netherlands are entirely private insurance. Most European countries have a public system and private system. It's very common for people to purchase supplemental insurance on top of what the government provides.
> health care is a natural monopoly
It obviously isn't, because it wasn't a monopoly before the 1960s when the government got involved in it.
Yes, VCs do put money into pharma, but that's private money very much expecting an (overall) profitable return. (Ironically most of that profit comes from Americans who have little or no way to collectively bargain on pricing.)
And yes, for bigger companies, there are tax breaks etc, but most of those are regular tax breaks that any company gets.
I won't get into the chronic disease stats. Other than to say that good primary Healthcare tends to reduce the incidence of chronic diseases.
Quality of care is hard to gauge on a national basis. It's a highly localized product, so experience can be different in very small geographic areas. Equally "quality of care" is s metric with many axies.
Naturally for-profit medical advertises a lot, and they strongly push the "quality of care" message. So the general perception of that is "private is better". How much of that is true, how much is perception, is up for debate. My personal experience (which counts for nothing) having experienced both, is that the standard of medical care is the same. (Fewer tvs in public care though.)
I'm not sure what importing doctors has to do with anything, or if it's even true. Personally I don't really care where a Dr is from.
Prices do vary between companies but many people just use the official insurance comparison tool and choose the cheapest as the services are completely identical. I'm completely against that system and would prefer a national health insurance like Japan.
This is utterly false. Agencies like NIH, BARDA, and NSF fund early-stage biomedical R&D by providing SBIR/STTR grants to biotech and pharma startups. They also fund basic research and clinical trials as well as translational studies.
There is the Orphan Drug Tax Credit and R&D Tax Credit. Also, access to NIH labs, etc.
There is a whole plethora of funding. Moderna’s mRNA platform was heavily backed by NIH and BARDA even before COVID.
Thats what i meant by US subsidizing pharma for the whole world. I didn't mean the us govt.
Would they continue to exist if every single country in the world is doing "collective bargaining"?
Yeah even your high net worth client that pays 50k in premiums every year wipes you out when they get some complicated form of cancer.
Edit this actually came up in a videogame called Cyberpunk. A lot of people here on HN consider themselves code wizards indispensable to their employer. Google will replace your multiple sclerosis ass.
And, well, it sucked. People died, black people got injected with radiation, and we experimented on humans.
Ultimately, I don't want poor people to just... die. Because that's bad. So we need some sort of guarantees.
Or, we don't: in which case, I hope you're content scraping bodies off the freeway for free. Someone has to do it if we're not paying for their healthcare and disposal costs. Hope you're not busy next weekend!
curious. what kind of statistics would that show up?
When i was looking into clinical trials for prostate cancer. almost 80% of experimental cutting edge medicine was in usa. They even have spl k2 visa for International patients to participate.
Those were experiments done by the government or funded by the government.
If someone can't afford healthcare, and in your vision we should refuse to provide it, then they die. That means, unfortunately, you are advocating for their death.
Which is fine, maybe. Except that we still have to deal with that. If they can't afford to dispose of their own bodies, now what?
No matter how you cut it, we either go back to the government or everything is awful.
Me asking you if you want to scrape bodies off the freeway isnt rhetorical. It might seem that way, because it's so extreme, but that's the reality here.
Someone, somewhere, has to pay for that. We already established that the person themselves cannot do it.
Should it be you? Should it be me? Or should it be everyone? If you answer everyone, congratulations, you've reinvented taxes.
The issue here is that these are already solved problems. Why do you think governments invented taxes hundreds of years ago? To steal from you? Look at the big picture.
Look how cheap your cell phone is, despite the amazing engineering that went into it. Pretty much everyone has a cell phone, both rich and poor.
This isn't an argument - this is an ideology, a pure faith.
There's no mechanism for this. Some things are just expensive.
Performing a surgery is expensive no matter what. It requires advanced machines and multiple humans with ideally decades of specialized training.
There may be "cheap" surgeries if there's no regulation, in the same way we have cheap shit on Temu - it's junk and doesn't work.
The cell phone reference you made kind of says it all - yes we have cheap cell phones. Most of them are shit.
We don't want shit medicine, shit surgeries, or shit chemotherapy. We want stuff that works.
Also, elephant in the room: products and services are necessarily different.
A phone is a PRODUCT. Medical care is a SERVICE. The difference being cheap products are good, sometimes, cheap services are bad.
We don't want a surgery to cost 100 dollars because that means the doctors are making, like, 2 bucks an hour. Which means we're living in a third world shit hole.
You don't want to live in a third world shit hole, do you? Great, then we're on the same page.
And, elephant number 2: healthcare can never, under any circumstances, be a free market. No matter how hard you try.
When you get sick and need to go to the hospital you might naively think the market of hospitals is thousands. This is wrong. Its actually a monopoly - there is only one hospital you can go to.
This is because of what healthcare is fundamentally - a service to keep you alive. You will go to whatever hospital is closest, because the human will to live transcends markets and even money as a concept.
This means, in a free market, it's not free at all - it's filled with only monopolies who can effectively charge whatever they want - which is exactly what we see.
The only places this doesn't happen is in places in which healthcare is nationalized. Because said countries know a free market is impossible, they don't even try, and they avoid the monopolization that's inevitable.
Some other people will naively point to systems in which there are both public and private options - and note that the private options are cheap and effective.
But that's only the case because of the public options. When private care has to compete with low cost public care, it will be cheap. If you remove that competition by privatizing all healthcare, then they can, once again, effectively charge whatever they want.