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Comment by qalmakka | Hacker News Reader

I'm European, and I think that healthcare should be considered a human right. Not giving someone in need a potentially life-saving medical treatment is completely unfair, and a big red flag honestly. Life doesn't give the same opportunities to everyone, some people have been born in better environments or have simply been less fortunate then others, and I think it's the state's responsibility to create a system where these things are taken into account. Denying this is plain greed from the richest who don't want to subsidize healthcare for the poorest, without realizing that a society where people are less worried about their future would benefit them too; it puzzles me that so many people on the other side of the pond think of this almost as if it was some form of bolshevism while it is instead just plain and simple basic human decency.

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> plain greed from the richest

Health care is cheaper when it is single payer due to the overhead/collusion of the insurance industry. This overhead is bigger than the inefficiencies of public run hospitals.

So paying only for yourself ends up being more expensive than paying for other people too.

Single payer is literally just health insurance, but it's provided by one entity (the government) which has a monopoly. The way they reduce costs is by rationing care.

That’s not the full story. Insurance companies today already ration care : they won’t pay for expensive brand-name medicines and they often won’t approve surgeries without requiring extensive pre-qualifications and alternate treatments. Which is mostly for the best.

Single-payer would have other effects. One, by ensuring that everyone has access to preventive and non-emergency care, it would reduce the overall cost of care. Today, the uninsured wait until they are horribly ill to show up at the ER where they are treated as public charges. Those people are also not effective at their jobs, and die earlier, which is an added cost. Net-net, a healthier population will be less expensive to care for and will be more productive.

Second, a single-payer system will replace hundreds of independent insurance companies that compete with each other with a single system, increasing efficiency,

Third, a single-payer monopoly can negotiate with providers to reduce cost. When you represent all of the patients in the country, you can demand the lowest rates. The government already does this today with Medicare, which is why many people call this plan “Medicare for All.”

There will undoubtedly be some care rationing, but I expect that as in the UK there will be the option to buy private insurance on the retail market, or to pay cash for procedures that you want but which aren’t covered - as it is today for cosmetic surgery. Insurers dont cover plastic surgery, but that business seems to be booming.

> the inefficiencies of public run hospitals

What inefficiencies? What makes you think that a publicly run hospital is less efficient than some other kind?

This is not about the rich subsidizing the poor. That's not how healthcare works in Europe. Y pay my share as everybody else for our healthcare. If someone can't pay it is still covered by all the other people paying. That doesn't mean the rich are subsidizing us.

The problem with the healthcare in the US goes beyond that. Everything is insanely corrupt to make things expensive. That's why they spent way more per capita that many other countries but get almost nothing in return.

> If someone can't pay it is still covered by all the other people paying. That doesn't mean the rich are subsidizing us.

That’s exactly what it means. The person who couldn’t pay has their costs subsidised by those who do. If nobody in the system pays more than they use, and anyone uses more than they pay, the system tends de-stabilises.

It’s not ‘the rich’ paying in that case. It’s ‘the majority’.

If it's paid for by income tax, people with high income will pay proportionately more. High income people tend to be rich.

But those with high income are very outnumbered. Most of people are not rich and most of the taxes come from them. You get way more money from taxing 20% all working class families than from taxing 50% the wealthiest ones.

My point is, healthcare is being funded by everybody who works (also everybody who consumes, as you have to pay VAT) not only the rich.

I get your point but people with high income are paying proportionately more than people with lower income. In some sense this is a subsidy.

This becomes even more pronounced if you take into account who is using the health care system as low income tends to be tied with bad health (diabetes, smoking related issues, hard physical labour, etc).

Note that I'm not saying this is wrong. Broadest shoulders should bear the largest burdens.

Walked into doctor for a weekly shot. That’ll be $60.00 copay. Balance billed to insurance.

Me: how much without insurance? $15 dollars out the door.

Okay...

Few years later. I need an MRI. I call and ask how much. 750 dollar with insurance. (Deductible) Or $500 without insurance.

I pay 1300 a month, and it’s often still cheaper to not use it.

We need to change the questions that are asked.

  Not just who will pay for it.   Because the same procedure at the same location can have drastically different costs depending on who is paying

The point is that if the reasoning these people do were actually coherent, a person who doesn't have a car should not have to pay taxes for road maintenance, or only people with children should pay for schools, and so on, but I never heard them arguing for this.

> I'm European, and I think that healthcare should be considered a human right.

The problem here isn't healthcare as a human right but healthcare cost. Who should pay for what at first place and how much.

There are all sorts of problems with the US healthcare industry, to me the biggest one is the near impossibility to compare cost between hospitals for instance. In any other sector, a business would give the client some quote before hand instead of billing the client after the service is provided, that's insane.

Obviously, it's not a problem for people with good coverage.

> it was some form of bolshevism while it is instead just plain and simple basic human decency

Should Healthcare be for profit? or not on the other hand is an interesting matter only Americans themselves can answer.

To describe healthcare as a human right misunderstands what a right is. You don't have a right to a doctor's time. You don't have a right to a nurse's time. What you want is a free healthcare plan, calling it a right makes it unworkable.

Couldn’t you say same thing about right to lawyer or a trial?

That's a legal right, not a human right. A human right is something you already have, it just cannot be restricted by someone else.

For example, free speech is a human right. You will always have it innately unless a third party deliberately infringes on that right. If they do so, they are violating your basic human rights.

Following your reasoning having a dwelling, schooling, food or water access are not human rights because they're not innately part of a human being. I understand why you are arguing for a literal application of the term, but I think that doing so fails to capture the intent behind it, that is, that those things might well not be parts of a human being, but they are still an inseverable part of being human.

There are some human needs that inherently depend on resources whose access should be guaranteed to every human being, preferably by the state itself, and I'm deeply convinced that failing to do so is intrinsically a failure at being human. History has shown multiple times that a society that forgets those who are in need is a society where peace is just impossible, plagued by unrest and disparity.

Following this reasoning, justice also should not be a right either, because the same applies (I don't have a right to a police officer's time, I don't have a right to a judge's time, and so on). Obviously everyone should be paid, and everyone deserves to be rewarded for the job they do, it was not what I meant. I think everyone should have the right to access the health care they need without fearing for their financial security or their future. I think it is not unreasonable to call this a basic human right.

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