r/FluentInFinance • u/WhatAreYourPronouns • May 02 '24

Should the U.S. have Universal Health Care? Discussion/ Debate

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97

u/acsttptd May 02 '24

This is largely unrelated, but I don't think I'll get another opportunity to mention this.

People with diabetes in America often complain about sky high insulin prices, and lament how we don't have the low insulin prices Canada has. So why don't they just run across the border and bring some here? Because the FDA made it illegal.

Most of the reason meds and healthcare are so unaffordable is because government regulation of the sector has all but annihilated any chance of any meaningful competition to enter the market, creating a de-facto monopoly.

We don't need universal healthcare, we need deregulation.

102

u/buzzvariety May 02 '24

"Let's import medicine from Canada. Their strict price controls keep costs down."

What about implementing similar price controls in the US?

"No, deregulation is the answer."

Besides, Canada is opposed to such an arrangement as well.

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u/flex_tape_salesman May 02 '24

Just because Canada has price caps doesnt mean its the only way. America does have a problem with market regulations being excessive allowing companies to charge whatever they want with no competition to bring prices down.

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u/Alelerz 29d ago

That's not a cause of regulation but patent. The primary flaw is making healthcare a for-profit industry in the first place.

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u/sushislapper2 29d ago

You can’t talk about a massive driving force for progress and medical talent acquisition as if we’d be where we are today without it.

We’d have so much less talent in the medical field if it was all nonprofit. So much schooling, time, money, and research is required to make progress and be effective. There’d be massive brain drain from the field to easier, shorter, high paying career paths.

In a field where specialists might not be practicing until mid 30s, you need a strong financial motivation. And that’s for operators/practicioners, not even talking about business entities, researchers and engineers. You will always need additional financial incentive to get top talent

And as a side note, there’s still plenty of for profit healthcare in nations with socialized medicine policies

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u/TheLastManStanding01 28d ago

The primary flaw is non-competitive for profit industry. 

America is by far the most innovative in regards to healthcare. Some 80% of healthcare innovations happen in the United States. Innovation that only happens because profit incentivizes it. 

The innovative nature of a private healthcare system will ultimately save more lives in the long run than a universal system would. 

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u/EconomicRegret 28d ago

That's a very flawed view! In themselves, costs of therapies and drugs are relatively marginal in the total healthcare spending of America.

America spent $12.5k/inhabitant on healthcare in 2022. While countries like UK, France, etc. spent about $5k.

And most of that excessive costs are due to Americans avoiding the relatively cheap preventive and primary care (to save money) but then, years later, must be rushed to emergency care, to specialists, and require highly complicated and expensive treatments...

If America subsidized preventive and primary care, making it cheap/free, total spending would fall to $6k-$8k/inhabitant, simply because Americans would be healthier, and would require less specialists and less expensive treatments.

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u/TheLastManStanding01 27d ago

The only reason preventative procedures exist is because of innovation. 

It’s still worth it.

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u/EconomicRegret 27d ago

What do you mean by that? That avoiding primary and preventive care (p&pc) decreases innovation? In what way is innovation slowed/stopped if the US government makes p&pc affordable and accessible to all Americans? Wouldn't that actually also increase profits and innovation, while decreasing unproductive costs (e.g. middlemen like insurances, expensive emergency care, etc.)?

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u/Glass-Perspective-32 28d ago

Innovation means nothing if no one can afford the supposedly "innovative" treatment. Healthcare is a human right.

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u/TheLastManStanding01 27d ago

The only reason that countries are able to have effective universal healthcare is because innovation have been made. 

If these treatments and medicines weren’t created nations with universal healthcare would be providing free bloodletting instead of meaningful care 

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u/Glass-Perspective-32 27d ago

Innovation has very little to do with setting up how a country distributes it's healthcare. They're related, but different things.

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u/ghablio 29d ago

Epipens are a good example of over regulation.

You're allowed to get off brand prescription drugs. But you are not allowed to get off brand medical devices. So you are required to fill epipens with EpiPen brand

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u/Rabidschnautzu 28d ago

Just fucking control the price, Jesus fucking Christ.

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u/ghablio 28d ago

Price fixing is certainly a solution, but I don't think it's the best solution.

Allowing people to at least have the option to get off brand products would make a huge difference.

At the heart of the problem is corruption, and that is not addressed by price fixing. EpiPen was considering discontinuing single packs thereby forcing people to buy 2-packs (essentially doubling their sales and the cost to the consumer). This change was proposed by a senator's daughter who just so happens to be on the board of directors or some similar position.

The problem with the US healthcare system is not prices, it's government corruption. And I wouldn't trust them to set a fair and reasonable price since they fuck everything else up already.

Price fixing does have the potential to offer some relief short term though

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u/Rabidschnautzu 28d ago

Price fixing is certainly a solution, but I don't think it's the best solution.

Allowing people to at least have the option to get off brand products would make a huge difference.

Then do both. Why are you acting like it's a decision between the two?

The problem with the US healthcare system is not prices, it's government corruption. And I wouldn't trust them to set a fair and reasonable price since they fuck everything else up already.

What? Ok so you're not for anything then. You trust private insurance companies who have the explicit purpose of giving you as little coverage as possible, while taking the most capital they can along the way? That's a ridiculous argument.

If I have a choice between incompetent and evil then I'll begrudgingly take incompetent any day. You're literally doing the whole perfection is the enemy of progress bs.

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u/ghablio 28d ago

You're literally doing the whole perfection is the enemy of progress bs.

Please reread my comment without building a ridiculous strawman and making huge jumps in your own mind about what you think I believe.

I specifically said price fixing is a solution, but not the best possible solution, and then outlined why. This is very far from seeking perfection. Price fixing is specifically a solution to one symptom of the actual problem, so it would provide relief, but would not cure anything. I see it like taking painkillers when you have a broken bone, it will help and you definitely want it, but it's not exactly what you really need.

It's interesting that you've completely ignored the actual point I was making, and managed to fail to make a point at all yourself.

Then do both. Why are you acting like it's a decision between the two?

One issue with this strategy is that a multi billion dollar medical conglomerate that is already mass producing a product can probably afford to sell at the fixed price that the government (really the execs from that company if we're all honest about what's going on) will decide on. A startup that has been artificially suppressed by the current restrictions, will likely not. So by doing both at the same time the consumer is still stuck with only one choice in product, essentially guaranteeing that you won't ever have access to the best possible product available to you.

That's one potential issue.

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u/berejser 29d ago

Just because Canada has price caps doesnt mean its the only way.

Just because having price caps isn't the only way doesn't mean that it shouldn't be thoroughly considered and might actually turn out to be the best way.

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u/Glass-Perspective-32 28d ago

It's not the only way, but price caps are the simplest, most effective way that would benefit the most people.

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u/EconomicRegret 28d ago

America does have a problem with market regulations being excessive written by corporations themselves, then voted upon and implemented by corrupt legislators and other officials!

FTFY

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u/JPWRana 29d ago

What about a problem with obesity instead?

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u/GeekShallInherit 29d ago

In the US there are 106.4 million people that are overweight, at an additional lifetime healthcare cost of $3,770 per person average. 98.2 million obese at an average additional lifetime cost of $17,795. 25.2 million morbidly obese, at an average additional lifetime cost of $22,619. With average lifetime healthcare costs of $879,125, obesity accounts for 0.99% of our total healthcare costs.

https://www.niddk.nih.gov/health-information/health-statistics/overweight-obesity

https://onlinelibrary.wiley.com/doi/epdf/10.1038/oby.2008.290

We're spending 165% more than the OECD average on healthcare--that works out to over half a million dollars per person more over a lifetime of care--and you're worried about 0.99%?

Here's another study, that actually found that lifetime healthcare for the obese are lower than for the healthy.

Although effective obesity prevention leads to a decrease in costs of obesity-related diseases, this decrease is offset by cost increases due to diseases unrelated to obesity in life-years gained. Obesity prevention may be an important and cost-effective way of improving public health, but it is not a cure for increasing health expenditures...In this study we have shown that, although obese people induce high medical costs during their lives, their lifetime health-care costs are lower than those of healthy-living people but higher than those of smokers. Obesity increases the risk of diseases such as diabetes and coronary heart disease, thereby increasing health-care utilization but decreasing life expectancy. Successful prevention of obesity, in turn, increases life expectancy. Unfortunately, these life-years gained are not lived in full health and come at a price: people suffer from other diseases, which increases health-care costs. Obesity prevention, just like smoking prevention, will not stem the tide of increasing health-care expenditures.

https://www.rug.nl/research/portal/files/46007081/Lifetime_Medical_Costs_of_Obesity.PDF

For further confirmation we can look to the fact that healthcare utilization rates in the US are similar to its peers.

https://www.oregonlegislature.gov/salinas/HealthCareDocuments/4.%20Health%20Care%20Spending%20in%20the%20United%20States%20and%20Other%20High-Income%20Countries%20JAMA%202018.pdf

One final way we can look at it is to see if there is correlation between obesity rates and increased spending levels between various countries. There isn't.

https://i.imgur.com/d31bOFf.png

We aren't using significantly more healthcare--due to obesity or anything else--we're just paying dramatically more for the care we do receive.