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Comment by yipeedipee | Hacker News Reader

Just thought I would mention in Scotland with NHS Scotland we pay no prescriptions charges.

Also Wales.

Defend your public services and safety nets at all costs; vultures await an apathetic electorate.

I think we're 15 years too late to recognise this. We've been pushing healthcare budgets down and into private hands (PFI, tendered provision contracts) for at least that long. And while it's demonstrably failed, we keep pushing that way.

We have too many politicians with too many fingers in too many pies telling too many lies about the "dream" that is American healthcare.

Politicians that can’t be reasoned with can be replaced.

Run for office. Failing that, support candidates that support your views. Democracy exists as a function of effort.

Political will isn't enough. The NHS needs tens of billions to backpeddle years of decline, to re-in-house services and surge-hire staff where they're need with appropriate incentives.

Doing that in a climate of contracting economical growth and leaving the EU (where 40% of our nurses come from) makes this impossible without politically suicidal borrowing.

Raising taxes on vacant real estate owned by non-residents/non-citizens is one option to raise revenue. Russian and Chinese nationals who are using vacant, valuable UK real estate as an asset store don't vote.

We can’t argue the money doesn’t exist. It exists. You just need a majority of people to decide that efficient healthcare is worth paying for.

You're preaching to the choir. I'm not saying it's impossible, just that wanting to do this stuff isn't enough.

Case in point, current opposition leadership would do all this in a heartbeat but between center-leaning members and a very Conservative press, they'll always be portrayed as Nazi-sympathising Communists.

Brexit hasn't helped this either.

I was blown away at the intensity of the propaganda blitz when the Obama administration was working on healthcare - I haven’t seen so much manipulation outside an election cycle. The ‘American healthcare is the best in the world!’ line that was oft repeated stands out to me, since by most objective standards it is far from the best.

The more I read about it the more convinced I am that there is no way to know who is right, both sides are so invested in their arguments and both sides have so many incentives to skew the numbers are play with the outcomes that it's become impossible to get any sort of definitive answer on this.

You say that the US is objectively worse, but I can bring you to 10 people who will argue convincingly that it's objectively better, and then turn you around to 10 people who will convince you of the opposite again. All with real numbers and facts that don't contradict each other.

Then bring this argument. Or don't.

Insisting that "10 people will argue convincingly that four is prime" isn't a convincing argument that four is or even might be prime.

Objectively worse? To what end? What really matters?

Do you care more that your healthcare is 10% more effective at its peak, or that 30% of the population is uninsured, without access to good preventative care? From there you have to extrapolate because nobody can predict the cost of these societal schisms, or that of the cost to heal them.

There is no objectivity to be had here; just morality, hope and fear.

I was sick for years as a growingly impoverished self employed person with no non-emergency healthcare access. This situation is, as far as I know, unique to the US as other countries don’t tie health benefits to private employment.

And if a modest use charge makes the spending more efficient and results in the delivery of more care?

(efficient in terms of medical benefit delivered per unit of spending)

[removed by poster]

My mistake, I thought the thread was about the prescription charges mentioned in the top level comment.

No mistake at all. Subthread went off the beaten path, your argument is still sound. Apologies!

That’s a rather large and unproven if.

If nothing else more complex transactions have higher costs due to the complexity. So, the benifit would need to be rather large and easy to measure to offset this. Until that data shows up it’s rather pointless to argue about.

PS: Also, the effort/tine investment to collect prescriptions is already a modest fee.

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