Make no mistake, the tories are abandoning the NHS so that when it catastrophically fails they can push a switch to an American style private insurance system, and people will simply die for being poor. Fuck those guys.

@quinn even if the tories were the reason, it just goes to show exactly why the government shouldnt get involved with healthcare, it will always be incompetant, the tories wont go away.

I dont think the american system works but ive lived in many coubtries and been subject to many socialized healthcare systems. If one thibg is obvious to me its thst socialized healthcare doesnt work either (not talking about helpibg out poor people financially with healthcare costs, that part i support)

@freemo omg I’m alive because you’re wrong. Socialized care is awesome and how I got spinal surgery in ‘18. Unless you don’t think single payer counts as socialized, all of the data is against your theory.

@freemo saying government shouldn’t be involved in infrastructure, what else is government for?

@quinn never clained government shouldnt be involved in healthcare or in infrastructure. I said it socialized healthcare has huge issues and isnt the best solution (though i also said neither is free market solutions). I never went ibto detail as to what the solution is, though happy to discuss that.

@freemo i don't know how you define socialized, but i can't see any definition of not socialized that includes care for the poor and children without cost to them, and any system that doesn't serve the poor or children while controlling costs as a successful system.

@quinn thats a very fair criticism, and in my ideal sokution there is still an element of socialization, just much less so.

Basically let insurance be free market but require insurance companies to exist as co-ops (so the owners are always thr insurance holders). Otherwise free market rules apply.

The social aspect in my plan woukd be that anyone is below the poverty line would get discoubted or free insurance by being given credit equal to the averave cost of insurance.

Important in all this is that no one is required to have insurance and can opt out of the costs if they wish. Its also not single payer obviously.

@freemo but you have to have price controls, because it's not an optional or fungible good... people will pay anything to stay alive, so markets inevitably fail.

@quinn

> but you have to have price controls

This part i woukd say is incorrect.

> it's not an optional or fungible good... people will pay anything to stay alive, so markets inevitably fail.

This part is correct in a purely unregulated market. But as i said in my system all insurances are co-ops, so any profits made go back to the patients themselves. So it addresses the very problem you point out, all without needing to pice fix and maintaining free market pressures and freedom of choice.

@freemo doctors and hospitals charge by procedure and book it as income. if a neurosurgeon charges 100k for your surgery, you're going to pay, so without any regulation, why wouldn't providers charge a bunch? it's what they do in america. when governments say "this is how much we reimburse" they are essentially fixing a price, both logistically and socially. You want to might say a provider wouldn't do that but my partner got charged 140k for an appendectomy. in america.

@quinn Two reasons.. 1) the insurance companies decide what doctors are in their network and which arent. So insurance companies ultimately decide what doctors can charge and expect to still get patients (if they charge too much insurance companies drop them from their network). 2) While not needed because point #1 alone would be enough, you can also simply require hospitals to be co-ops as well and the ones participating in the hospital co-ops are the insurance companies that put them in-network in the first place.

@freemo so this doesn't actually stand up to research, and it has been researched, there's an extensive body of literature on this. one of the papers to look at is "it's still the prices stupid" which is the actual name of a journal article and it's fabulous. health policy isn't mysterious at all, and i've personally reviewed a lot of the research. the AMA is an actor here, (and ADA too) the hospital trusts, small time providers, etc.

@freemo insurance companies simply don't have the power to regulate the market, even when they have the incentive, if they did, prices would be much more in line with the rest of the world. insurance companies aren't totally the bad guys they've been made out to be, and in a well-regulated market they could made a sustainable profit, but in the weird free for all of America, all the incentives at every level are wrong.

@freemo health economics is its own field now, and it's a complicated one.

@quinn Yes it is, and one that I have worked in as a Data Scientist.

@freemo free markets don't work in medicine unless you're just fine with torturing and killing the poor. if that is fine for you, let's just never speak again.

@quinn What does that have to do with what I proposed... If healthcare is required to be co-ops than it is not a truely free market (there are restrictions in place).

@quinn As I stated BOTH systems torture and kill people.. america tortures and kills the poor, socialized medicine tortures and kills people equally... if your ok with that lets never speak again...

Luckily I'm proposing a system that solves the problems that both types of healthcare have.

@freemo the outcomes are well documented, and you are ignoring that. that takes a lot of motivated reasoning. by any score other than % of GDP the US has worse outcomes than any other high income nation in the world, and we also have the only free market system in that group. people in our peer nations live longer and healthier then we do. unless you're rich.

i suppose you've always been right group of people to get good care.

@freemo if that's not part of your data, you're pretty bad at your job if you're a health economics data scientist.

france, for instance, is a place where the medical system, being made of people, experiences failures and problems. but i wouldn't call it a system that tortures people. the US actually does. like seeking care is punished. like good options are only available for the rich.

@quinn

Jesus christ dude you went from having a respectful argument to nothing but fallacies and hyperbole... check yourself, you are better than that if the first part of your conversations is any indiciation.

You are style of discourse sounds like im arguing with a trumper now, come on now.. either walk away or discuss in good faith, your better than this.

@freemo look i've been homeless in america, i've been sick, uneducated and a single mother. i know what it is to be poor under unrestrained neoliberal capitalism, and i just don't have a lot of patience for both-are-equally-bad comparisons of models like rhenish. european systems could improves, but they haven't failed. maybe the NHS is, but that's straight tory murder, not an indictment of the NHS.

@quinn I grew up in abject poverty living in a home where we couldnt feed ourselves most days and an uncle in the next room with a heroin problem.. in america.

Neither of us have any love for the american system,, As I said three times now I dont **care** which of the two is worse, at no point was that the focus of the discussion and ifyour going to argue one sucks more than the other, sure, thats not any conversation im engaging in so stop repeating it to me.

Either argue my point, which is that co-op based healthcare would be a better solution than either hte american or the european healthcare systems, or simply walk away... insisting I argue you about a point I couldnt care less about is just childish and as I said if your earlier part of the conversation is any indiciation you are better than that.

@freemo i just find it a little ridiculous to say the most medically successful nations have failed, are routinely torturers because they don't have enough capitalism in their systems.

@quinn Other than stating the fact that they failed, none of the rest of your statement is what I said.. Do you know what fallacy it is called when you do what you just did? Seriously look at **how** you are arguing now, can you not see you devolved from being respectful to a bad-faith argument?

@freemo do have any implementation of this undefined hybrid model which you are calling co-op to point at? let's even say a subnational level, but please at least few million people.