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Comment by jlangenauer | Hacker News Reader

These are not "something for nothing" services. They are paid for by taxes. And in doing so, these services are generally supplied on a cheaper basis with better social outcomes than the private sector is able to.

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But from the perspective of the users of these services, they are. With a socialised medical system, you don't pay upfront for your medical treatment. It's paid for from taxes from the whole population - and if your income is low enough, you may consume more resources than you provide towards the system - in which case you are getting something for nothing! The combination of these factors - obfuscation of payment, and disconnection of amount paid/good received - create the perverse incentives causing economic decline seen in the countries pursuing these policies.

And the argument about socialised services being more efficient definitely needs a citation.

Because the people who "get something for nothing" already do so today, and you already pay those costs. People check themselves into the ER with injuries and infections that have progressed to the point where they are life-threatening because the injured and sick could not afford to see a doctor at the time they received the injury.

The reason they can go to the ER is because the ER has to treat you if your case is life-threatening. They then proceed to not pay the resulting bill, get taken to collections, and file for bankruptcy, which has the effect of giving them free medical treatment.

Only it wasn't free preventative care, or a free doctor's visit. It was a free visit to the ER and free inpatient treatment. Guess which is more expensive, a doctor's visit or a visit to the ER?

Given that you, the person with money, end up footing the bill either way, would you prefer the less expensive or the more expensive option?

In a fully private medical system people would bear the consequences of failure to invest wisely in medical goods and services (i.e. prevent worse health problems with cheap early treatment.) There would be the strongest incentives possible (your own wallet, not society's) for making the right decision. Sounds fine to me.

You are reaping the rewards of this now.

When you go to the ER without insurance, you get patched up and kicked out ASAP. This creates other complications... People can't work, they seek out social services, etc. So you have a situation where a chronic condition that you could manage for $4,000 a year costs exponentially more when you price in food stamps, disability payments, temporary assistance payments and other programs.

Sounds fine if you want the sick and dying decaying in the streets because they didn't have access to good education.

If your main concern is cost, then why is it that healthcare per capita (including the taxes being used to pay for it) is lower in these countries than in ones where the people have to foot the bill through privatised mechanisms?

If your main concern is cost, empirically socialised systems cost less and generate better results.

I would love to see some citations for these claims.

This is just one of many such charts:

http://media.economist.com/images/20090627/CBB677.gif

Unfortunately it's impossible to make a proper comparison since essentially all developed nations except for the USA have adopted some sort of socialized medicine or (i.e. Switzerland) an extremely regulated private system. So USA has essentially been alone in its experiment towards private healthcare.

Given that the one system which is much more privatized than the rest has had such poor efficency outcomes I would say that the burden of proof is on anyone who would claim that privatizing even more wouldn't just make the problem worse.

It's pretty commonly known. See:

http://en.wikipedia.org/wiki/List_of_countries_by_total_heal...

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