A comparative perspective from the U.K. #DAresists #Medicare4all

I want to take some time to talk about usual discussions comparing different healthcare systems: Most comparisons in the US are between the US system and nationalized systems (in Canada, UK, Germany, Australia, Sweden, France...etc); often times such comparisons talk about waiting times of elective procedures. (1) Talking about Elective Procedures is the wrong measure/yardstick! Just because a country has a national healthcare system does not mean it has no private healthcare -- all the countries (Canada, UK, Germany, France..) have private healthcare and citizens can choose to have private in addition to their nationalized systems (talk about CHOICE). (2) Talking about waiting times for procedures (elective or non) is also the wrong yardstick: Waiting times in nationalized systems are related to the amount of funding (or lack thereof) in the system; in the UK, funding cuts in the last several years have led to increased waiting times -- if cuts did not happen (especially in highly populated areas), wait times would not have increased. Same as MN having better bridges if the capital spend had been approved. (3) Competition reduces costs and improves products/services: While competition is good in general, it is better to reserve the competition for more complex/elective needs while offering a universal healthcare for at least the basic health services (level to be defined). This way, one can have the benefits of competition AND have the citizenry access basic healthcare. Current not-for-profit hospitals are not a low cost delivery method of healthcare, certainly not basic care. Not-for-profit hospitals employ large finance teams, issue and refinance bonds almost annually, hoard billions of dollars of cash reserves (2x level of debt) in order to get favorable Moodys and S&P credit ratings so they can issue bonds, therefore hire other finance teams and asset managers and consultants to manage those cash reserves, etc -- in essence everything but "basic and essential care". All these points have something in common -- dialogues in US comparing the systems appear to be all-or-nothing-at-all (black-or-white) while there are several shades of grey (I have heard the number 50 thrown around). It does not need to be only-private or only-national. Let us get our American can-do attitude and solve this elegantly. US systems in general appear to be very complicated (128% of Federal poverty level -- who comes up with numbers and tables like that) and complexity adds costs to any system. Just as the Government is trying to simplify and overhaul our tax system, we should also consider removing complexity from our healthcare system.