There is a step 4: pay exorbitant tax rates.
Can you describe some aspect of US healthcare that you think is good?
However due to a minimum below which no taxes are paid and other features, the effective rax rate for a $35k salary is ~15%. For a $90k salary it’s about 32%. A median salary is about $70k.
This is excluding pension (the employer pays that on top to a pension fund).
Public services are pretty good and not expensive for me, they are even cheaper for people in lower income levels. (Putting a kid in kindergarten is about $100-200/month for example)
If you take everything into account, I suspect it’s the US system is a much worse deal for everyone except the top 5-10%.
A thing that sucks in both systems can not legitimately be used to argue against only one of them.
So, how about all of the not-California parts of the US that have the same kinds of problems (which is, last I checked, more or less "all of them")?
Because, the thing is, only one of my examples was, you know, from California.
... and had no PT within the county with a <10 week wait time.
I guess we're close to Canada though, so maybe it's contagious?
https://www.fraserinstitute.org/studies/waiting-your-turn-wa...
Take 1000 men over 50 and give them PSA screening for prostate cancer for about 11 years.
Take 1000 different men over 50 and don't give them PSA screening for prostate cancer for about 11 years.
For the group without screening about 7 die from prostate cancer. But for the group who do have screening we see the same number of deaths. The screening hasn't prevented deaths from prostate cancer.
The group without screening didn't have any false alarms and didn't have any needless biopsies. 160 men in the group with screening had false alarms and unnecessary biopsies. 20 men in the screening group had treatment (which can include incontinence and impotence) for non-progressive prostate cancer.
https://www.harding-center.mpg.de/en/fact-boxes/early-detect...
Over-testing leads to over-diagnosis which leads to over treatment, and harm is caused at each step.
Margaret McCartney or Gerd Giggerenzer talk about this.
So sure, the amount of patients is pretty much guaranteed to be higher once they can afford the care. If you optimise only for wait times, then the obvious solution is to have no doctors and 0 wait time.
Do you think this doesn't happen in the US?
If you're about to say "but in the US we can pay for healthcare", well that's true everywhere. Anyone with enough money can pay for healthcare.
Yes, like I said, anybody who can afford it can travel to get healthcare elsewhere.
Travelling from US to UK and paying 150% of the English tariff price for health care turns out to often be cheaper than getting care in the US, even if you include the travel costs.
Whether or no wait time varies greatly, the overall quality of care can be assessed in terms of patient outcomes life expectancy which are generally very similar while spending significantly less money. In fact many countries with socialized healthcare actually surpass the US on some factors like infant mortality, in part because the US has a higher poverty rate and those in poverty have less access to healthcare.
I once worked in the US and in Canada (Connecticut) in the same year.
My tax rate was lower in Canada for the same salary.
For comparison in my income bracket:
Ontario income tax rate: 12.16% Canada federal tax rate: 26% Employment Insurance and Social Security are deducted seperately and made up the rest of my deductions.
Connecticut state income tax rate: 5.50% US federal tax: 22%
Unless social security rates are worse than Canada, I don't see how your situation is possible.
The United States is not a free market healthcare system - it's literally the worst parts of both capitalist and socialized systems with none of the benefits of either.
Also: I am Canadian, I spent nearly 50% of my earned income last year on just taxes. I also live in the most expensive city in the country. 90% of my medical expenses I've had in the past 10 years came from private practices that I paid out of pocket with a smidgen of private insurance that cushioned the blow a bit. The Canadian system is nowhere near as great as ignorant Americans like to believe.
I appreciate the value of debate, but i ask that you please do your homework before you start citing the evidence
I've had a relative with a treatable condition wait so long for a surgery that her condition worsened and it couldn't be fixed and now she is permanently physically disabled.
Private hospitals and health insurance are still allowed. Here in Canada, every public hospital still has a billing department for the uninsured & those with private insurance (foreigners, etc.) (I wonder if you can opt to pay to "skip the queue" here?)
While the US by some measurements has a lower overall tax rate than other developed countries [1], the difference between us and, say, Canada, who enjoy high quality socialized health care, is far from "exorbitant".
There's a very reasonable argument for considering all of the consequences of our systematically broken health care system as a "tax" -- it amounts to a massive financial and quality-of-life burden for most Americans.
Health care in the United States is more expensive than in other developed countries for identical procedures [2]. Medical costs are the worst kind of lottery, where an overnight visit for tonsillitis can get you a nice little $100,000 bill [8]. Do you not consider that a tax? Why not?
Medical bills account for 60% of bankruptcies in the US [3]. High medical costs are literally causing people to commit suicide [4] or to die of entirely preventable causes [5] while others just forego care entirely [9]. For those people who do jump through the hoops to get private medical insurance, there are entire bureaucracies dedicated to denying claims [6]. There are so many perverse incentives involved that some doctors are taking it into their own hands to try to lower medication costs, and pharmaceutical companies are responding by tripling the costs of the medication [7].
Meanwhile tons and tons of Americans stay in jobs they don't like just to maintain their employer-sponsored health insurance [10], strangling their wages and preventing positions from being opened up to more enthusiastic employees.
These things are all taxes. They are taxes on American society, impacting all of us. Anybody that's opposed to socialized health care "because muh taxes" is defending this system, this embarrassing, broken, corrupt system that endangers and kills countless people every year and acts as a massive multi-faceted anchor on our economy.
[1]: https://www.taxpolicycenter.org/briefing-book/how-do-us-taxe...
[2]: https://www.washingtonpost.com/news/wonk/wp/2013/03/15/why-a...
[3]: http://www.cnn.com/2009/HEALTH/06/05/bankruptcy.medical.bill...
[4]: https://www.reddit.com/r/news/comments/co21rt/elderly_couple... -- linking to Reddit here because there are a lot of comments there worth reading.
[5]: https://www.snopes.com/fact-check/shane-patrick-boyle-died-a...
[6]: https://splinternews.com/a-glimpse-into-the-bureaucratic-hel...
[7]: https://arstechnica.com/science/2018/04/doctors-tried-to-low...
[8]: https://www.reddit.com/r/WTF/comments/ngngy/merry_fucking_ch...
[9]: https://www.fool.com/investing/2017/06/09/sick-of-high-healt...
[10]: https://www.theguardian.com/commentisfree/2017/nov/13/fear-o...