Originally Posted by Piobaire
This is a difficult issue for me to handle diplomatically. You see, I do think limited universal healthcare should be treated as a public good, but I stress the word "limited" I do not think the taxpayers should fund unlimited healthcare particularly in end of life situations. I also believe a Bismarck system is far superior to a Canadian or UK style one, and given the rankings of some of the world's biggest Bismarck systems (France, Germany, Japan), I feel empirical evidence supports this. The Bismarck system places the players (funders, the insured, the providers) into a more capitalistic stance and removes government from allocating tax dollars which I feel is always a sure road to moral hazard.
So while I believe in universal health I do not believe in the vision of it 99.9999% of liberals in the US have. The "SINGLE PAYER HURR DURR" is deafening and the assholes are so sure they have "The Way" figured out yet do not even know there are more choices than single payer. I want to punch people that are surprised the ACA is a fucking mess and I really want to punch people that are upset now only because they've found that they are in the pool of people that are being told, "You got yours but fuck you we're taking some of it." It's the height of hypocrisy and I hate those smug fucking assholes that self-righteously feel they can dig their fat greasy fingers into my wallet yet get twisted when they get it too.
I agree with you. I think the Bismarck system would suit the us the best. But from what I understand the government does allocate the "tax" (mandated premiums) dollars. In Germany's case people pay premiums to sickness funds. Sickness funds give that money to the central health fund. The chf then pays out sickness funds according to what it thinks is fair (which at the core is based on prices from regional negotiations between healthcare providers and representatives of the state). Also germany is seen as the poster child of competition among healthcare insurers but 90% of the population is in a public plan. In fact reforms were introduced in 2009 to intensify competition in a pretty static system and from what I understand so far it hadn't really done that. Even in japan the 3000 or so private plans are more so quasi public because they have to provide uniform benefits and can't do anything about premiums. I think the biggest advantage Bismarck plans hold besides freedom of choice is that administrative costs are about half of what us currently pays. Negotiations of prices happen at the state level instead of separate agreements for every possible combination of health insurers and health providers. Payment is quick, centralized, unchallengeable, and accounts for regional differences, administrative costs, and margin of profit.