- Joined Jul 20, 2009
The closest thing to M4A is probably Taiwan, which was designed by an economist, and their healthcare system's major problem is that people over consume healthcare.@dwalk I agree that deductibles makes insurance either sub optimal or almost worthless for all but the most catastrophic of situations. That’s the point. Obamacare is structured on the conservative argument that without deductibles, Insured people will over consume healthcare. What’s the GOP answer? The same but more of everything wrong with Obamacare. GOP in 2017 was a tax credit not based on income, higher deductibles and far more people without even catastrophic coverage thus a heavier burden on ERs.
I exaggerate only a little when I say that a truly good healthcare plan would not be crafted by economists because it takes a lot of schooling to be able to forget that no deductible insurance has its own built in safeguard against over use, most people don’t like going to the doctor.
After the revolution, when health insurance companies are no more, ill set up a citizen’s task force to craft a good healthcare policy. Who knows bout doctor visits more than anyone? Old people. But we can’t have Republican old people shaping this. So @aepps20 and RustyShackleford get me an invite to the next cookout where I’ll get the elders to form a task force, all the elders but especially your great uncle Zel, dudes got life experience like you would believe. I’ll also bring napkins and paper plates.
The first in a Vox series on how countries around the world achieve universal health care.
Taiwanese patients use a lot of health care, and it puts a strain on providers
It is not just about people not liking going to the doctor. If it cost the same to go to primary care, urgent care, or the emergency room, then people with minor **** are gonna be different to what there to go, and hospitals will become crowd. And for a health insurance plan to be sustainable we need for people to consume less healthcare in the long run.What it all adds up to is a system that patients seem broadly happy with — maybe too happy, according to doctors and economists I met.
“I believe we are too kind to our patient,” says Shou-Hsia Cheng, a health economics professor at National Taiwan University (NTU) who has worked at NHIA on and off over the years, “which is not a good thing, actually.”
Taiwanese people take advantage of their cheap, accessible health care. The average number of physician visits per year (12.1) is nearly twice that of other developed economies. There was a dramatic spike in use after single-payer was passed: A 1997 JAMA research paper led by Shou-Hsia Cheng found that physician visits among the newly insured doubled in the first year of the program compared to the year before.
That has had predictable downsides: Hospitals get crowded in Taiwan. The capacity of health care providers to attend to everyone in need can be stretched pretty thin.
I visited the National Taiwan University Hospital, a red-brick building in the heart of Taipei from the Japanese colonial period, one weekday afternoon. All of the clinic lobbies were full. The registration desk, run take-a-number style, was bustling, beeps constantly pinging over the PA system as patients’ numbers were called.
On another morning, inside a north-central Taipei primary care clinic, several patients were already sitting along the walls, hooked up to machines receiving infrared therapy for chronic pain, just a few minutes after the doors opened. The one doctor on site looked a bit frazzled as he showed me around before his clinic filled up any further.
The scenes bring to mind something I heard from trauma surgeon Li-Jian Chien, a member of the Taiwanese doctors union that formed in 2012 out of the frustrations felt in the medical profession.
In Taiwan, he says, “the patient [is] in heaven” — but “the doctor is in hell.”
If you want a free at the point of service healthcare plan, then you have to address capacity issues, not doing so is reckless. Plus we call nurses and doctors essential for their work during their pandemic, so I don't know why protecting them from being overworked is still an issue people handwave.
I don't say this to be disqualifying. I just wish people would include letting foreign doctors and nurses come practice in the US as long as the spend a required amount of time working in underserved communities. And let us just ****ing start Federal medical schools where we educate more doctors and nurses for free, instantly give green cards to international students that graduate from medical school and starts practicing in America. Plus other **** to increase the amount of healthcare providers we have.