Well, this thread has an interesting title, but the posts so far were just pulled from another location so it hasn't really got much traction yet. I suppose I should throw on a bucket of petrol and a match just because it could be an interesting discussion if it gets a good kickstart...
I generally consider myself a libertarian, in theory. However, in practical reality, I actually see many benefits to socialism, particularly when it comes to the expensive end of medicine (specialist medication, hospital operations etc).
New Zealand has a socialised healthcare system, while the USA has a privatised one. Comparing the two, the New Zealand system is both cheaper financially and achieves better outcomes statistically. Basically, GPs are private, and you pay for appointments (some are subsidised). Dentistry is also private (subsidised for the poor). But all prescribed medications, specialist appointments, hospital stays, operations etc are free.
- Medication is bulk-purchased by a single national purchaser, Pharmac, which tries to get high quality generic equivalents as much as possible rather than purchasing from the major brands, and is a large enough customer to negotiate the price when it has to buy from them. The US government hates Pharmac and repeatedly tries to destroy it as part of international trade negotiations, as it seriously harms the profit margins of US pharmaceutical giants.
- As a result, all prescribed medication is available for free, or a nominal processing fee. This is affordable because the government has driven down their purchasing price far enough to be able to afford it.
- Central organisation allows relatively efficient provision of hospital services, again allowing these to be free.
- Midwifery services are also free, including for homebirth and in-home support post-birth.
- As treatment is free, even poor people can access treatment at the start of their illness, rather than only seeking treatment once their condition is serious and harder to treat.
Now, this is far from perfect. There are obviously many problems in any system, and NZers complain about them a lot. For instance, waiting lists for publicly funded specialist appointments and operations can be long. An ongoing serious issue is that midwives are paid so poorly they struggle to actually stay in business. There are always issues with stupid decisions made somewhere in the bureaucracy, debates about precisely which medications should be publicly funded and which should not be, all sorts of issues. But bad details are seen in all systems.
Basically, the government is not only acting as the insurer, but also owning and operating every part of the treatment process, for maximum efficiency. Anyone can also purchase private insurance that will allow them to jump the queues in the public system and get immediate treatment - but everybody can fall back on the public system, which is generally adequate.
Compare that to the USA. Public healthcare is funded by insurance companies, that are very expensive. Not everyone can afford them. Healthcare without insurance is horrifically expensive. The USA spends far more money on healthcare per capita than most other countries - and has some of the worst outcomes. The rates of infant mortality in US hospitals for instance are atrocious by Western standards. The entire system is completely dysfunctional. The government's ideas of providing care for the poor is to provide state-funded insurance to pay for this horrendously expensive treatment, meaning the government's "solutions" simply add to the expense without solving any problems.
This dysfunction can actually be greatly reduced through central management.
Obviously prevention is better than cure, natural health remedies are wonderful and all that. I fully agree. But sometimes people do actually need to resort to hospitals and medication for specific reasons, so large healthcare systems do always exist in every country. The question is how these should be organised and funded, given they are inevitable.
Dropping match now and starting to run...
