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1. joe_th+(OP)[view] [source] 2025-08-03 02:37:30
Most other advanced nations have nationalized health care which works much better.

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.

replies(3): >>apwell+G2 >>refurb+P3 >>Walter+g6
2. apwell+G2[view] [source] 2025-08-03 03:17:06
>>joe_th+(OP)
other nations get benefits from 1. US subsidizing pharma startups and 2. less people with chronic diseases 3. offer lower quality of care at lower price point 4. import doctors vs solely rely on homegrown

USA is very very good at complicated, cutting edge medical care but not efficient at delivering routine care.

replies(2): >>bruce5+I9 >>concep+K9
3. refurb+P3[view] [source] 2025-08-03 03:28:45
>>joe_th+(OP)
> Most other advanced nations have nationalized health care which works much better.

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.

replies(1): >>Pooge+mp
4. Walter+g6[view] [source] 2025-08-03 04:05:52
>>joe_th+(OP)
If they're fake free markets then free market ideology doesn't apply.

> 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.

replies(2): >>tim333+HC >>Yeul+VG
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5. bruce5+I9[view] [source] [discussion] 2025-08-03 05:12:46
>>apwell+G2
It's complicated, yes, but simplifying somewhat the "US" does not subsidize pharma startups.

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.

replies(2): >>lenkit+qA >>apwell+SB
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6. concep+K9[view] [source] [discussion] 2025-08-03 05:13:22
>>apwell+G2
“USA is very very good at complicated, cutting edge medical care” - i hear this but haven’t seen it in practice or in statistics. Everyone I know that has needed such things has had the same poor quality of care that primary care providers have - long waits, insurance issues and mediocre outcomes.
replies(1): >>apwell+YG1
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7. Pooge+mp[view] [source] [discussion] 2025-08-03 09:00:50
>>refurb+P3
In the case of Switzerland, basic health insurance is provided by private companies but the price is mostly fixed by the Federal government.

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.

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8. lenkit+qA[view] [source] [discussion] 2025-08-03 11:38:41
>>bruce5+I9
> It's complicated, yes, but simplifying somewhat the "US" does not subsidize pharma startups.

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.

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9. apwell+SB[view] [source] [discussion] 2025-08-03 12:05:00
>>bruce5+I9
> (Ironically most of that profit comes from Americans who have little or no way to collectively bargain on pricing.)

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"?

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10. tim333+HC[view] [source] [discussion] 2025-08-03 12:16:18
>>Walter+g6
It's actually kind of refreshing to use free market lightly regulated medicine. I live in the UK where it's NHS government funded or related but travelling in Asia without insurance you can actually shop around and buy stuff - how much for a doc, how much for an xray etc. It's mostly quite cheap too. If you remove most of the regulatory barriers things work quite well. Obviously doctors and the like should pass exams for competence but I'm not sure you need to restrict it to only x people through y colleges in z country to restrict the supply. If the US said that to practice medicine and all you needed was a medical qualification from any respectable country it could drop costs like 10x I'd guess.
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11. Yeul+VG[view] [source] [discussion] 2025-08-03 13:01:48
>>Walter+g6
You cannot free market healthcare because quite frankly there is no real profit in this industry.

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.

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12. apwell+YG1[view] [source] [discussion] 2025-08-03 21:49:18
>>concep+K9
> i hear this but haven’t seen it in practice or in statistics

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.

replies(1): >>concep+cj2
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13. concep+cj2[view] [source] [discussion] 2025-08-04 05:56:36
>>apwell+YG1
I suppose it’s semantics but i wouldn’t consider experimental research “medical care”.
replies(1): >>apwell+3X2
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14. apwell+3X2[view] [source] [discussion] 2025-08-04 12:37:02
>>concep+cj2
even outside clinical trials. for prostate cancer, only doctors i found practicing newer therapies was in usa.
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