Let's be honest, as long as the patient in the US system is a product to make profit on and not a human being that needs medical help, nothing will ever change...
That aspect is not really different in Europe, only the financial _structure_ is different. Some individual doctors may care about people, but the system is geared for money flow towards you know who.
The thing that stops universal health care in the U.S. and never really gets discussed by Americans is lobbying. There is no point in fighting for Universal Health Care when your own corrupt system will undermine it. Obama couldn't even pass healthy school lunches in the classroom without lobbying undermining his efforts (i.e. behind closed doors they got pizza put on his healthy food pyramid). Lobbying infects almost every facet of American life and till you fix that nothing else is really worth discussing.
@@tinkerwithstuff its completely different in Europe in every possible way. the average salary in US are 60000 USD, and tho ofc doctors should be paid well because of how hard it is to learn what they doing, you don't need 8-10x higher salary then the average to have a good life. the average specialist doctor in US make up towards 750-800k a year witch is ridiculous . in comparison the same doctor in my country makes around 150-200k a year. tho its far less than in america, they still earn 4x more than the average, and its plenty of money to be able to buy a quite nice house, nice car and whatever. its done alot of studies on as long as you can afford to pay you bills and have bit of extra left in your account, the amount you make above that doesn't really affect your happines lvl at all. when someone have to worry about their wallet before going to see a doctor for any medical reason. the country have failed them misserably.. to put it in perspective. i see a doctor for a heart condition every year, and for that, i pay roughly 50 usd, and if i had more issue the most i would ever pay for health-related issues within a year would be around 200 USD. That also includes free transport with taxi back and forth to the hospital if I was to need it. on top of that, if i need to stay home from work because I'm sick, i would get 100% of my normal salary as if i were at work, and we have no limit on how much you can be sick because that not something we decide after all
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party. USA has everything to learn outside borders. Dont need to create anything. Just need to copy. If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year..
As a self-employed guy for most of my life who had to secure health insurance in the private market-place and as a Vietnam veteran who now is covered by the VA, I think I'm in the almost perfect position to pass judgment on this video. And that is that this is the most honest, unbiased and factual report on this subject I have ever seen! VERY HIGHLY RECOMMENDED FOR ALL.
As long as Medical Care in the US is a business model, instead of a utility, the cost will be crazy high since it has to fill so many pockets that care for money only.
I feel that isn’t true many health care providers in the US care about patience and society. Every health care system even the European versions build on economy and medications, doctors, nurses have to be paid.
Everything in the US is profit oriented. The entire American way of life is built around the profit. Instead of the “In God We Trust” the motto on the dollar banknotes and coins should read “In Dollar We Trust and only for Dollar We Care”.
Being a business model is fine, and would *normally* drive efficiency for the best health care to cost ratio. The problem is that the health care business is completely captured by the pharmaceutical industry. Both doctors and government are captured. Politicians get their money from the pharmaceuticals to pass (or not pass) laws that further entrench big pharmas profits. Doctors are basically drug dealers. They have to prescribe the latest (still under patent $$$$) pharmaceuticals instead of the near equivalent off patent generics. Price diff? Eliquis $500 Warfarin - $17 Yet they prescribe the $500 one through the roof because they may risk a board hearing if they don't prescribe the expensive one and they can forget promotions if they don't push the drug companies product (they are actually allowed to receive "incentives" for meeting quotas), so the whole top level of the health care system is already captured by pharma. Once any "new drug" comes off patent, the pharma companies are quick to both come up with a new drug covered by patent, AND find a flaw in their prior drug so they can "force" doctors to switch their patients. Insurance companies are in on it. Medical procedure- hmmm Defined cost? $9393848489392392 for whatever procedure (obviously exagerrated) Covered by health care? They have a deal/agreement to pay the hospital only $1500 for the procedure and your copay may reduce that for the health care company. So if you don't have health care insurance in the US and need medical help, you are basically guaranteed bankrupt (number one cause of bankruptcy in US? Medical bills) That allows the insurance companies to charge exorbitant rates even though they pay much less than the defined costs (which in most cases, hospitals don't even disclose to patients)
I don’t mind healthcare being a business model, but there have to be decent safeguards to ensure everyone an equal excess to healthcare. Low income workers need excess to healthcare. That is not guaranteed when they earn €1,200 a month and the insurance is €1,000 a month. That is not, what we call in my country, good employership. Employees need a decent salary, enough free time and an approachable employer for regular labor conditions. Employees aren’t resources (despite the ugly name of HR) you throw away at the slightest contradiction. You need well cared for employees to make a clean profit. In the US companies make dirty profit at the cost of employees.
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party. USA has everything to learn outside borders. Dont need to create anything. Just need to copy. If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year.,.-,.,-,.-,.
Im from Norway and belive in universal healthcare, it beeing a reality in the US is probably decades away because of the big changes it would require. What i think is the biggest barrier is something you just briefly mentioned, lobbying is in my opinion just legalized corruption and bad for most people
Also from Norway, and I also believe in universal healthcare. I also interact with our healthcare systems quite a bit due to my own health conditions and am very happy that I live in Norway and not America.
I believe what we will actually "get" .. eventually... will just be a gradual age expansion of the existing Medicare program. Which has co-pays, and even add-on programs that have a monthly premium. It will still be a vast improvement as families with kids and non-working spouses will greatly benefit. It would be FAR too hard to convince the rockheads in the US that a "no skin in the game" model would not be abused by "..x.." and "..y.." (insert whoever their current targets are) After everyone is on or eligible for THAT program we can talk about changes... (I will be on medicare as it already exists well before that day)
@@Ranked_Journey im the same, if i was born in the US in the same family i would probably be dead as a kid due to health complications, or in more debt than i would ever be able to pay off
In the United States "political campaign contribution" is just a euphemism for "legalized form of felony bribery" of politicians. It turns the USA into a system of one dollar=one vote, rather than one person=one vote. I believe most issues in United States politics are symptoms of this problem. The disease is the problem of campaign finance. Time to address the disease rather than the symptoms. (This could be a future video for Ashton: Comparison of campaign finance/election laws. New Zealand may be a good model to start with.)
What I don't understand about the American healthcare system is that the state doesn't want to profit from it. From the state's point of view, healthcare isn't charity. It's keeping your source of income in good shape. Healthy people work and pay taxes. Sick people don't. It's the same reason why a dairy farmer is interested in the health of his cows. The farmer needs to invest in their health, and so does the state in ours.
It’s not just that. The American model also discourages entrepreneurship which is something the state should welcome and encourage. Because in the US health insurance coverage is typically supplied by one’s employer, people are afraid to venture out on their own given fear of losing their insurance coverage and the expense and difficulty of obtaining health insurance on their own. Also, the current scheme is not good for companies and businesses either. Instead of concentrating on say being best at making widgets, companies have to spend considerable resources selecting and negotiating with insurance companies, dealing with health related expenses and catastrophic claims, etc… stuff that’s completely unrelated to their core business. In every other advanced country all that stuff is handled by some outside entity that specializes in ensuring people are provided with the best healthcare coverage suits their needs, relieving that duty from businesses (that have nothing to do with it). The point I am trying to make is that there are multitude of reasons why the current American healthcare model is bad for the state, its citizens, and even its businesses… yet we stick with it 😕
I think something that gets left out of these debates is stress. Even if the costs were the same I'd want the system where I never have to think about money while I'm going through cancer to the system where I have to deal with bills and bankruptcy while going through cancer.
That is what I have here in Denmark. Peace of mind is such a relief. I learned that when I studied in Beijing and my ball sack began to hurt like hell. (It was an air bubble in a blood vessel) the Beijing doctor told me it was cancer and it would spread to my heart unless I had a 50,000RMV surgery soon. I did not believe him. My doctor in Denmark told me, either that doctor tried to scam me, or he was unable to read a simple Ultrasound picture, that means he was incompetent. So yeah peace of mind is such a relief it is amazing. That is why I want dental to be free here as well. I am the sole provider, no job, I am during my master's thesis right now. And I have big holes in my teeth that really need to be fixed.... but I don't feel like I have the funds. But if I wait till I have a job and it gets worse then it might be even more expensive -_-
My mother was lucky enough to be treated for her (now eradicated) cancer with no financial worries. Unfortunately, it took the sacrifice of my now deceased father as a military service member and Vietnam War's Agent Orange exposure survivor to make that happen.
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party. USA has everything to learn outside borders. Dont need to create anything. Just need to copy. If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year.-,.-,-.,-,.
A lot of Australian doctors go to the USA to do post fellowship training. Particularly in specific procedures or subspecialty fields. It's looked upon highly in Australia. But few stay. Our pay is already very good in Australia and the greater pay we could get in the USA isn't much of an incentive to work in what most of us view as an unethical healthcare system.
The main problem in Australia is we aren't training enough doctors and those in training don't want to go into general practice. They prefer the more 'sexy' specialist fields. Those going into general practise, don't want to practice in rural/remote areas. Australia needs to import its health professionals to make up the shortfall. Australia's Medicare is a good system but with shortcomings. I've relied on Medicare all my adult life (now 68) and have always had good service. What's also interesting about the US, Americans are the greatest medical tourists on the planet, by a long shot. They'll travel abroad for even basic treatment because health insurance companies won't allow treatment because of existing illnesses, so they travel to countries like India and Thailand, or cross the border into Mexico for lower cost treatment.
@@anthonyj7989there's similar deficiencies in the States. Like nurse educators so not make as much salary teaching as they do nursing, therefore there are too few nurse educators to teach the next generation 🤷♀️
The bloated pay of nurses in the US certainly explains why we don’t have many US nurses here is Australia. We get plenty of Poms and Kiwis, as well as from south east Asia and the sub continent, but few Americans.
A few years ago my husband had a heart attack we live in Portugal and we had a business in Portugal, he paid tax and the social security at the highest rate...I am English he is Canadian, I had a medical utente number for some reason we didnt get his utente number. He had two stents put in and was in intensive care in a coma. He eventually recovered and was sent hom...he was asked to pay 5,000 euros for his care (which when you think about it is still cheap) but I went to my doctor got his utente number and when he left the hospital all he paid was 25 euros! This included his time in intensive care, the two stents, the ambulance to drive him to one hospital and the ambulance to transfer him to the general hospital where they had a cardiac unit. Had he had lived in the USA we would have been in incredible debt! So we owe Portugal his life!
As a senior Australian, one of my biggest fears is Australia sliding into an American style of healthcare. I've always relied on the Australian public healthcare system and have never had any problems with it. I see my doctor twice a year for a check up and pay only about six bucks for prescriptions. Once a year I have a raft of blood tests which the system covers.
@@pinetworkminer8377 ,, for a start, the US system is a profit driven system . Medications are very expensive over the counter, there is a network system where health professionals, pharmacists etc work within networks. Any treatment outside the network won't be covered by insurance. Also, insurance companies can deny or offer a 'lesser' treatment/medication than your doctor has prescribed. My greatest fear is not being able to afford healthcare when I need it.
The idea of bankruptcy due to medical debts. That sort of overhead is an anchor on just about every business decision one makes, once you get past the invulnerability of youth.
Another great video, thank you for continuing your work! I'm a pharmacist for a large "not for profit" health system in the US and the inefficiency of just the my section of healthcare is astounding. One problem I see in the US is that most citizens cannot fathom the idea that another country is doing something better than us. They refuse to look outside of the box of US exceptionalism for anything that could make their lives healthier, safety, less expensive... it's kind of depressing to know that we waste so much money on everything from healthcare to education to military spending...and the majority of the population won't open their eyes.
I'm Brazilian and Brazil is the only country in the world that has PUBLIC FREE UNIVERSAL HEALTHCARE. Each word here is important. Every citizen has a right to access it, whether he has insurance or not and it covers ALL levels of care, to basic medical care to ANY type of surgery to a heart transplant. You pay ZERO, whatever it is you need. It doesn't work all that well, we do have a private system and anyone that can pay for a private insurance will do it, sometimes you have to wait long, etc, etc. But we are a middle income country in a deep financial crisis with this model, called SUS ("Sistema Único de Saúde"- Unified Health System) inspired on the NHS of the British, a high income country, and we KEEP it!! Never was any question about giving up on it, no matter what. That's to say: There's literally NO REASON that the by far richest country in the word can't have AT LEAST a system like that SINGAPORE that is far to be so far reaching as ours. I hope you all Americans know we make fun of you guys for thinking this is "communism" when even Japan has its Shakai Hokken. To us that's completely MADNESS and there's no way you can even START o defend it.
Well said. You didn't say it, but I will: American's are ignorant, lazy, selfish, uneducated, juvenile. I am not saying that everyone is, but as a whole, that is where we are. We allow stupid people like Trump, Mitch McConnell, MTG, Lauren Boebert, Jim Jordan, Matt Gaetz, Ted Cruz along with many others like them to run our country. Truly, we are doomed for catastrophic failure. We have already crossed the line over that milestone! Sorry, but it's true.
Bravo!!!! My comment is apolitical. I just want to applaud you for a very reasonable, comprehensive explanation. You gave a beautifully unbiased presentation. I love the way you laid everything out and posed your thought-provoking questions at the end.
@@arnodobler1096 nuking hurricanes, stop testing to reduce cases...there's just so. damn. many. My absolute favourite is from 2016 where he told his followers at a rally that he thought his MAGA-slogan was corny and stupid but it tested well in focus groups so he's using it...and the crowd erupted in furious applause. It's just insane.
Ashton, you have actually managed to make me understand for the first time in my life, why the US is not in a position to change the health care system so easily. The way all these things are interwoven there is not much hope to see change in the forseeable future I fear. Let me repeat what I stated earlier this year: You are an excellent teacher!
10:09 Ronald Reagan Advisor "We are in danger of producing an educated proletariat. That’s dynamite! We have to be selective on who we allow [to go through higher education].” So they literally created Student Loan programs "Before Reagan became governor of California, tuition was free for California residents... Reagan began cutting state funding of public universities by 20%... His justification was that colleges have become too liberal" "When Reagan became president, he continued his efforts to dismantle the public education system, targeting federal aid to students. In his campaign for the presidency, he advocated for the total removal of the U.S. Department of Education." Project 2025... Trump is planning on dismantling the Dept of Ed Uneducated people do what they are told and don't question authority
The US is not in a position to change it, simply because about half the country doesn't want to change it, and any time progress is made towards changing it, the other half undoes the progress.
Her video isn’t really that great, a lot of mistake and overlooking big issues that would get in the way of medicine here. We have a unique population those European models wouldn’t work here
MIXED healtcare system where GOV decides what can & can't be. 60% of all dollars in the system is from TAXPAYERS. OBAMACARE the UNaffordable Health Care Act is a preponderance of GOV regulations FORCING the private sector into offering what it doesn't want to. Alex Epstein 's "FOSSIL FUTURE" on sale now.The Moral Case for Fossil Fuels. HUMAN FLOURISHING
Love your delivery, and how you really make some complex issues easier to understand and to explain to others when debating a subject. I must say I never really considered the tie in with education and tort reform in trying to reform Americas health care system.
It bugs me that people don’t realize that we’re all in this together. If I have a medical emergency and can’t pay for the treatment they already performed, that loss gets passed on to the community. It’s a big game and the loser is everyone who is struggling to keep up.
The most ridiculous of all is that USA is already spending similar % of tax payer money on healthcare compared to European countries with mostly tax funded healthcare, yet it's still expensive AF and we haven't even started to count the money patients have to pay on top of that tax money. Everyone would benefit from cutting out private middlemen from the equation, healthcare would be affordable or even almost free for pretty much the same price as everywhere else... you just don't have to pay yourself sick dealing with private companies. But alas, that cannot happen because it's "evil socialism". The idea of paying for healthcare of somebody else and yourself is just too much for some people to handle, even if it ends up being cheaper for themselves too.
@@spugelo359 all that shows is that americans are selfish and dont care about their citizens. A healthy society is so much cheaper than a sick society!
🎯. Truer words have never been spoken! If US had both a better fully funded public education system as we did in the 40s-80s & unions, I believe the idea of unity, fellow Americans working together for the common good would be possible. The uber greedy rich oligarchs have changed all that by being able to buy politicians to change our laws, our workplace, and educational system. It's mostly privatized and under their control. Too few Americans understand what "common good," even means. If they don't see that you're filing medical bankruptcy doesn't effect them directly, they stay apathetic and ignorant...until it happens to them. Which it can because no one is guaranteed any right to healthcare in our country like other countries are. Greedy oligarchs. They have been our problem Day 1.
I’m in Texas. It’s amazing how much I pay for my own health insurance through my employer and costs on my own. I feel I’m being ripped off monthly, but too busy working to slow down. I’m too busy working to slow down for sick days. I look at how many people are uninsured or can’t go to a doctor or buy medicine & actually feel lucky. This just grinds the working class down. Then we have elite anti-abortion groups pushing for more babies to be born by the poor (rich will have abortion access), and I wonder how anyone pays for prenatal care, birth in a hospital, postnatal care. Give me a break. Literally.
@@armandaneshjoo the Democracy Index ranks the US #26 (out of 167) - as 'flawed democracy'. Nestled between Estonia and Chile...not that great. *cough* _electoral college_ *cough*
Thanks Ashton. Being in close contact with Americans from the age of 7 (living near Ramstein air base) I thought I knew a thing or two about the US. You raised so many issues I never even thought about. Looking forward each week to your publication.
As somebody who essentially lives on both sides of the Atlantic, the most important thing it always boils down to, is education. I mentioned this so many times in your videos, that the education system in the US is just the worst. It should not be for profit at all, period. Good education is most important. Let me give you an example: In Germany, after Highschool, I can decide to become a doctor because I want to help sick people. Or maybe I want to become a historian, because I like history. Or, how about a geological specialist... Due to the fact that high quality education is free, I can decide what I want to do because I LIKE IT, thus, if I want to become a doctor, a nurse... I do it, not because of the higher pay, but because of that is what I want to do in live. In contrast to the US, becoming a doctor, nurse or a lawyer, will cost a lot of money, so you better earn a lot of money. When I ask my grandkids, they want to have a job that pays a lot of money, not really sure what job that would be. What I am saying is, in Europe/Germany, people become a doctor or nurse because they want to help people. In the US, most do it because they can make more money. In addition, the system is just so over-bloaded in the US. I was at the Urologist just 3 weeks ago. You walk into the office and there are 3 receptionists, just taking your info. Then you have a nurse taking your vitals. Than another bringing you to the examination room and talking with you for a minute if all is fine and after that, the doctor comes in for 5 minutes and talks to you about the results. The funniest part was this: I was at the Urologist due to testosterone issues. Now, in the US, doctors always prescribe things and this one was kind of expensive. It would have cost me $300 per month for 3 month to see how it works since my health insurance wouldn't pay for it. I did not buy it! However, I moved to Spain to a small village and can exercise every day outside by hiking in the mountains. So, when I came back and saw mu Urologist, he was all excited how good the drug worked because my testosterone level went up 110 points! I didn't tell him that I just lived a better, more healthy lifestyle;-) When I compare US to German doctors, the German doctors always want to help you by doing something to improve your health a natural way and often do NOT prescribe medication or just the bare minimum. However, the US healthcare system is all about money, and if the doctors prescribe stuff, they make more money and that is all that matters.
The fact that you did not tell your doctor is an issue of and by itself. The fact that you think it is better NOT to tell is scary to me. I went to doctor in Europe and he asked if I was willing to change my lifestyle in turn to get a longer life. I declined and he said "ok". Now he knows. Not being honest would be more dangerous in the long term, because he might diagnose me with the wrong thing if he has the wrong information. NEVER lie to your doctor. Not about ANYTHING.
A pill is the faster option, I assume that's why pain killer could do that much harm. You can't afford to burn your sick days what you can fix with a pill.
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party. USA has everything to learn outside borders. Dont need to create anything. Just need to copy. If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year..-..
@@houghi3826 Depends on the life-style changes, I suppose. If its what you eat and how you eat it, that's a life-style change one should be willing to accept. Choosing to use tobacco, or other drug use could be another. I am non absolutist about that issue though. Entirely individual choices. I have made choices that have extended my life, other choices that could shorten it. Its good to know the odds. That information is not always available. Or wanted. I tell the medical staff everything, including my opinion of our subsidized-profit medical care system. Agreement is near universal.
Summary: what you don't want to pay in taxes at a group rate, you endup paying out of pocket at single customer rates. US people scoff at the lower salaries in Europe, forgetting that at this point, healthcare, retirement and taxes have already been taken into account. Remove that from your USA salary to have an equivalent EU range.
Add to that family leave, suck leave and vacation time off…I lived in Norway for a decade, it’s so worth the taxes!! One of the best times of my life!!
@@jessicaely2521 But to compare the salary, you have to include these costs in your calculation. There mustn't be a "But I don't want to have health insurance". Otherwise it's not comparable. And this mustn't be a insurance plan with exclusions, copays, deductables,... But an all inclusive plan. Including your whole family. Being indebted after having an accident, being sick,... is unknown here in Europe. Having to sue others to recove the money you spent on medical treatment after an accident? No way. And a lot of severe cases start with a small "irregularity" that I would get checked and fixed by my physician, because I don't have to think about "how can I afford this?". I simply make an appointment, get it checked, cured and am done. Just look at some reality-med-channels here on YT. E.g. Dr pimple popper or something like this. A fist sized cyst growing for 10 years, because you didn't have the money to get it removed when it was the size of a nickel in diameter? Really?
@@lisa5249suck leave? Smellchucker problems? I'm UK. Agree 100% on universal social healthcare being much cheaper to run than insurance based systems. Which are based on the Con that insuring a large enough pool of people will enable everyone to be covered for everything. Insurance Companies exist to make a profit so 1st their premiums creep up to ensure that the company won't make a loss. Then that they make more profit than last year. They can make even more profit with copay.,excluding existing illnesses, capping what they'll pay on longterm illness & restricting which hospitals, surgeons, gp's you csn use to the one's they hsve done financial deals with. Sorry for the rant but our government has been heading us in this US direction since long before the current shambolic lot gained power.
I must admit that I a am deeply impressed by your thorough comparisons that you post! By coincidence, after having seen (firstly for fun) later the algorithms popped up other reaction videos, I kept liking your particularly. And this, I say as a European (Austrian, French resident) political science specialist Chapeau (oder Hut ab, wie man halt sagt) warm regards from Lyon, Michael
The ironic part of that statement is you actually get pretty good self and family health coverage if you go work on those bombs, drones, etc. You know actually earn that cover instead of demanding it for free.
@@swampcastle8142 The bombs aren't free either and spending megabucks on bombs that are gone when used is a waste of money. Universal single-payer healthcare builds a healthy population. Why do you think Bismarck provided healthcare to the German people back in the 1883? To build a strong, healthy population.
@@swampcastle8142Americans spend 18% of our GDP on healthcare. Most wealthy nations spend about 9-10% and have better outcomes and universal coverage.
@brianfleury1084 Every country that I was stationed in that had single source or universal health care had the worst care for the local population. So no thanks. Rather have the bombs. (Unhealthcare)
@@swampcastle8142yeah sure, "EARN IT" its not like the millions of people workin around the USA, serving your food, building your houses, raising your children, educating said children have actually done ANYTHING to earn healthcare... bunch of lazy MFs... amirite?😊
I have been saying for years that the U.S. should look at other health care systems around the world and just "cherry pick" what would work best for them! It's not rocket science!
There are LOADS of different models, many of which that also utilize a public and a private insurance system simultaneously. You don't have to reinvent the wheel.
The problem is this, Americans do not like their fellow Americans. If an American thought their neighbour was getting something for nothing they would blow a gasket. Europeans think differently, if their neighbour benefits from a system set up to benefit everyone then the system is working properly.
To be fair, that thinking is coming to an end when a system is more and more exploited. And people are getting more and more annoyed, when they have to pay higher social security contributions and taxes and othe people that would be fully capable of working an earning money are benefiting from it.
This was pretty good video, quite a balanced take which I really appreciate. You brought up the most important thing IMO which is labor costs. According to WAPO average doctor makes $350k with $405k average in peak earning years. That needs to be cut by 2/3 but along with that cost of medical degree needs to be cut by 2/3 or even fully subsidized.
Grossartige Analyse, wie in allen Ihren Videos. Endlich einmal jemand, der Deutschland - Ausland- Vergleiche gut recherchiert und nicht nur eine Ansammlung einseitiger Eindrücke wiedergibt.
This topic is so huge and all-inclusive that it resembles the car-dependency situation in the US of A. “Fixing it” would entail so many changes that it next to impossible to imagine where to start. To me the basic line is the people themselves, the voters. Only when they no longer accept the current situation and demand a different, a better system things can start to improve. Your nurse example was revealing. She is not willing to give up her humongous salary in favour of a better system. Understandable, since it is the foundation of her life choices. These things can never be made individual but need to be universal. Hence the term universal healthcare. If it is your personal responsibility not to get killed in traffic, you buy a giant SUV and make sure YOU are safe, high and dry in your vehicle. The fact that other road users may get killed in the process is their problem, not yours. The same applies to healthcare.
It’s not as hard as you think. It takes one step. Get rid of capitalist intrestgroups from politics. Aka ban fucking lobbing and corporate donations. US has a massive real economy and a fiat currency. Which means money and goverment spending never could be an issue. The more the goverment spends on projects the better. It would eat into capitalist’s profits tho, that’s why it’s not happening. Same goes to US car dependancy, scarsity of housing, poverty and inequality and so god damn many other problems. Just fucking take back politics from the corporations...
@@azpont7275 the biggest problem of universal healthcare isnt that its not affordable but rather that the moment you implement it so many people that are currently not able to get real care would use the system that for the first dozens of years or maybe a bit more it would be incredible pricey. the US basically fucked itself with such a bad system that it cant change it without massive spendings now.
The three highest paid jobs in Australia are surgeons followed by anaesthesiologists followed by specialist physicians. We have universal healthcare but with the option of buying private health insurance if we want some of the non-critical extras like private room, choice of doctors, shorter waiting time for elective surgery. You'd probably find that preventative health care gets a higher priority as well, which will keep costs down.
@@rey6708The US pays already far too much for Medicare, Medicaid and VA Medic. They (poor, elderly and veterans) represent about 20% of the population and it costs the same (percentage of GDP) as other countries pay for all citizens. Your healthcare system pushes up prices up to five times as high (for medication, operations, treatments, medical aids) as in other western countries. The US is doing something wrong here and employers and healthcare insurance companies are profiting from this mistake.
An acquaintance of mine was going to die without a certain operation. His insurance (prior to Obamacare) wouldn't pay for it. He couldn't afford to pay for it himself (in the USA). He and his wife flew to France, he had the operation, stayed two weeks and flew home. That he could afford. Something wrong when Americans need to resort to medical tourism in order to live.
A very interesting video, thank you very much for that. It is one of my favorite topics. I worked for a German employer here in the US for many years. Just recently I became a US citizen as a retiree and this way enjoyed the benefits of the German healthcare system all my working life as well as now Medicare. My impression is, that mainly the political will is not there. And as long as so many people believe it is against their freedom to be 'forced' into a health insurance contract without seeing the benefits of worry free healthcare, there does not seem to be a path forward. However, in respect to your question: some of the cost could be cut by changing the insurance system; create a non-profit insurance system like in Germany the public health funds/Betriebskrankenkassen. By law they are not allowed to make a profit; if they do, they have to return the money to the insured. The ACA, has something similar if I understand that correctly. If the US insurance company pays out less than 80% of what they took in in premiums, they have to give that back. Then in respect to education, my daughter is a PhD candidate in medical research. She received her science bachelor from a modestly priced state school and enjoyed from her first day on in graduate school a salary that provides her with a modest living in Manhattan. Students in Science, Technology, Engineering and Math (STEM) are being paid for their research and training they give to younger students. If that is possible for STEM why not for for medical school? But walking with those ideas into nowadays Congress would probably cause you great bodily harm - and cost for deductibles to have the bodily harm fixed again :-))
Politicians use the word "socialist" to scare people away from universal healthcare. Medical and pharmacist lobbies give those politicians campaign contributions to prevent their cash cow from being popped. The politicians spread hysteria that healthcare will go away and your taxes will go up and it will create a totalitarian state if we move to universal healthcare.
One of the travesties of the American health insurance industry in the past several decades involves turning very large not-for-profit insurance companies to for-profit companies. Such a huge step backwards. The biggest example is Anthem (now called Elevance) which acquired Blue Cross affiliates in about a dozen different states and turned them into for-profit companies. Luckily, Blue Cross and affiliated companies in most states still operate as not-for-profit organizations.
As a US citizen, this video was very educational and explained in layman's terms quite well the failure of the healthcare system that does not break you financially. I have lived in Hungary for 3 years now and am thankful that I can see a doctor or dentist when I need to and not have anxiety about going into financial ruin.
You have done a very good job with this video, as you do in all your videos. Thoroughly researched too & unbiased. You should consider a job in a responsible media organization.
I think you did a great job of summarizing they key issues in a mere 26 minutes. I’m a health economist and everything you say is spot on. The only thing I’d like to add is that Europeans often have a difficult time understanding the nature of our federation. You cannot really talk about a national healthcare system in the context of a constitution that fundamentally assigns health policy to the states. I live in Maryland. For decades, my state has regulated the price hospitals can charge. We have gone from being one of the most expensive states in the country for inpatient services to very middle of the pack. Our system pays hospitals more only when they deliver higher quality care; for this reason, there are generally no for-profit hospitals in the state. It may look like we have a “broken” insurance market, because our nonprofit health insurer dominates the market. However, this is largely because for-profit insurance companies cannot dramatically change their costs by manipulating their network of covered hospitals. Massachusetts has achieved near universal health coverage. Other states are also working on demonstration projects to move away from a fee-for-service model. Reform is possible in the US, but the magical will happen at the state level.
Many of us know know from deathplenity to abortion. You less state and too much local state i too many things. By that You lack of needed reforms. And a kind of funny You fear the state. Its the privates which are the problems in these matters as well.
I live in the Netherlands. I have been fortunate to live with this great system. Not just healthcare, but many more universal benefits. It always suprised that the US never copied it. Thanks for making me understand better that a big factor is this bloated system of profit. That is very difficult, and time consuming to rebuilt. Great informative video!
Not watched the full video yet but the quality of production is going up so much and i assume the content is well researched again that we can all watch until this channel becomes massive. Content creators like you two is what makes the internet work as it should a open playing field for people not just big content companies (and i worked for national tv and partly owned a production company) .. Keep going... now back to watching the video.
@@TypeAshton you are welcome its easy for us viewers to overlook how much work goes into making these videos at this level for a small content creator. I hope you are also having fun making them and that stays over time that seems to be the hard part for many once they add teams of people they need to support.
The "new" Ashton is getting better and better with in-depth research and analysis and, by the way, the elaborate presentation. How much time would it take only to find all these clips? Comparing the pay of nurses and paramedics, however, it must be said that here in Germany underpayment and staff shortages are a big problem.
Main reason why I'm leaving Germany. It's good to live here, but as a healthcare worker, specifically a nurse, and to be a foreign one at that, it sucks.
I think the biggest impact we could make very quickly without disrupting the system too much is by forcing the healthcare system to put all of their prices out to the public. They will not tell me how much it cost to do anything until a month or two after services have been rendered. If we're going to live in a free-market society or something anything close to that we need transparency so we can exercise choice. From there the market forces can start to kick in and these healthcare companies will have to respond with actual competition.
I see the push for free markets as a Friedman fantasy. Doctors, clergy and lawyers were termed "professionals" because their services were necessarily beyond the money of the market system.
I have no idea how to change it but I do have one clear opinion: Earning money off the sick and injured is evil and inhumane. Its sickening 🤢 Good morning Ashton, thank you for this one, very interesting ❤🤙
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party. USA has everything to learn outside borders. Dont need to create anything. Just need to copy. If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year.
I'm Brazilian and Brazil is the only country in the world that has PUBLIC FREE UNIVERSAL HEALTHCARE. Each word here is important. Every citizen has a right to access it, whether he has insurance or not and it covers ALL levels of care, to basic medical care to ANY type of surgery to a heart transplant. You pay ZERO, whatever it is you need. It doesn't work all that well, we do have a private system and anyone that can pay for a private insurance will do it, sometimes you have to wait long, etc, etc. But we are a middle income country in a deep financial crisis with this model, called SUS ("Sistema Único de Saúde"- Unified Health System) inspired on the NHS of the British, a high income country, and we KEEP it!! Never was any question about giving up on it, no matter what. That's to say: There's literally NO REASON that the by far richest country in the word can't have AT LEAST a system like that SINGAPORE that is far to be so far reaching as ours. I hope you all Americans know we make fun of you guys for thinking this is "communism" when even Japan has its Shakai Hokken. To us that's completely MADNESS and there's no way you can even START o defend it. So, if a country like BRAZIL can do it surely it's not hard AT ALL for the BY FAR THE RICHEST COUNTRY IN THE WORLD to do it. It's al excuses.
Thank you for this objective perspective in our healthcare system. You're right, their is no one solution to fix this issue. We need to create goals to achieve to help slow down the rising cost of healthcare. This could take a couple of decades for the US to catch up with canada, Australia and Europe.
one interesting aspect of healthcare in the US is that your insurance in your home state, does not automatically cover you in another state. in reality this just means that going to a doctor in a different state, say while you are traveling for work, will result in a potentially astronomic 'out of network' bill. Imagine having a heartattack in a different state, and then getting a bill afterwards that will give you a stroke.....
Europe regulates cost of each medical procedure to prevent price gauging by the hospitals. Medical degree is free and students are expect to service the society in public hospitals who paid for their degree. Medical staff are given a comfortable income, not a crazy high income Yes it's not perfect , but the society sounds much more fair than USA
The problem is that a lot of hospitals are now run by private companies, basically equity funds. They have to maximize profits so they try to keep salaries and number of staff low. That's why al lot of nurses are fed up and actually quit their job during or after covid.
There is also the issue of administrative waste, specifically in the insurance side of things. The itemization, collation, billing, price 'negotiation' with insurance companies and so on are a ridiculous affair compared to European style healthcare systems. The hospitals are incentivized to micro-itemize and vastly overcharge because that's how they make their money, they then have a few rounds of negotiations with the insurance companies and they decide between themselves what the real price is and what is covered or not, if the doctor or specialist was out of network or not etc, etc at the end they decide on a figure that the customer will have to pay.
@@birgitlucci9419there is an issue solution to that problem. Buy them out. Either make private hospital care illegal, or make sure that they can not be run for profit at all. This mean they can not use the money they earn to invest in anything else but the hospital where the money comes from. No you can't use that money to make a new hospital, that is the same as for profit. Here in Denmark private hospitals can be forced to take on normal people whenever we see it fits. This is almost only used for long waiting times. But we could just send them to the private places if we wanted to, in principle. And they are still here. They need to provide better care than what non-private provides, or specialty care, dental, beauty surgery and so on. The high standards should never be lower. It should not be profit driven, but driven to provide above normal service or specialty service. That is what I want to see for the school system as well in the USA. Here it is supposed to be like that, if it is like that? Eh it depends. Some are money hungry, who don't care about the education of the kids..
@@Sindrijo You're exactly right - And the right try to claim nationalisation leads to administrative waste and "big government". In reality it's always the opposite! It's increasingly going that way here in the UK too, with every little hospital department having to consider itself as a small business. It's shockingly bad, un-cost-effective management, but due to right wing interference trying to gradually privatise the NHS over several decades. Everything has to be cost controlled and within certain budgets etc. when it's supposed to be a service that's already paid for. I can see first hand how the whole system is getting ready to be able to provide itemised bills when they finally start charging patients here.
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party. USA has everything to learn outside borders. Dont need to create anything. Just need to copy. If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year.,..-,.-,.-,.-,.,
Good friend of mine is from UK. He got moved around as an exec for his company, from UK to France to Italy and finally to the USA. He has a wife and three sons so his family fully experienced all four systems. I asked him how does the US system of healthcare compare? His succinct reply - "Healthcare in America is arbitrary cruel and frightening"
Our country (Slovenia) has universal healthcare system and similar outcomes (life expectancy, child mortality) to more developed countries in Europe but with a bit lower healthcare spending in comparison with more developed countries. Preventable deaths aren't only due to healthcare system but also because of lack of possibility to eat healthy, to exercise, etc.
It could be interesting to see a breakdown of expenses. I guess that a German nurse earns more than a Slovenian nurse. So the German system will naturally be more expensive. I expect that German hospitals are willing to pay more for very expensive treatments, but some people say that it would be better to spend the money on more nurses.
Don’t forget preventative healthcare. Many Americans are reluctant to seek preventative healthcare as it is too expensive. This lowers life expectancy (together with gun shootings).
I am from Austria which has nationalized health care with a private option. In essence that means the government decides what you get (in terms of health care) otherwise you need to pay the difference out of pocket or via private insurance. A friend of mine (a orthopedic surgeon) did a study several years back. The gist is people with puplic option only, often don't get hip replacement surgery usually opting for less invasive treatment. While people with private insurance can opt for the surgery whenever they want and have them much more often. Turned out the live expectation of people with private insurance is significantly lower then people who don't have it, because of the risk factor of surgeries. Unsurprisingly technocrats, doctors and statisticians have a better grasp on health care than grandma.
This is really interesting! I wonder if there is a similar research made here where I live (Finland). The system is very similar, and the private sector definitely pushes people to have more invasive treatments than the public sector, including things like x-rays when they are not really needed.
In America, I was sold on a couple of joint replacement surgeries, mostly because it made the practitioners a lot of money. None of them worked out as promised and I sincerely regret agreeing to these surgeries, they have ruined my life.
@@Llortnerof That's a problem here to, it's in my experience more a problem with pharmacies. They tend to push herbal treatments, homeopathy, etc. really hard because prices and profit margins for real medicine is fixed. So if you opt for the herbal treatment they earn more. Doctor tend to give homeopathy to people when nothing would be the best option but grandma wants something so she feels better, hence the sugar pills.
That's actually one of the realizations that led to the plan for the Affordable Care Act (before it was watered down 100 times): by providing evidence based treatments only, the cost can be significantly reduced because with private insurance there is little incentive to avoid unnecessary treatments.
This lady makes exceptionally well researched and high quality videos. She's obviously very smart and hard working. Some of the best videos on RUclips.
As someone living in the UK it is my opinion that the USA won't get universal health care because too many individuals and corporations make so much money off poorer people they won't allow it to change, that's what I think.
I lived in Saudi Arabia most of my life. Though a third world world country, healthcare has been fairly accessible even to the poor. My father once told us that story about an African guy (that had used to work for him) after he had died in his home-country in Africa. My father said, "the guy went to the hospital. Well, if you go to the hospital in Africa, you know you're already dying, because you won't go there unless it is THAT urgent". Years later after I was in the US, I remembered what my father said, and I was like, "Thank God I'm not in Africa but in the US. Oh wait."
The US hasn't been able to give healthcare to its own citizens for over a century. RWANDA now has universal healthcare. Thats a country where they were butchering each other with machete's just twenty years ago, and THEY now have universal healthcare. I have to say one thing about social media now, is that its no longer like when social media first started and it was full of americans talking about how its the greatest country in the world. Now I don't see those kinds of comments very often.
I like apples and I like oranges,but America and Sweden or Finland or Germany America under Obama almost got it right but insurance companies won and now are eating away at your social security system 😅
You are doing a great job on healthcare and urban planning, two areas I watch everything that Google /RUclips presents to me on the sidebar. It makes me doubt the effectiveness of their algorithms that I never saw your work until about 2 weeks ago when they listed your vid about your mother's injury. Now they present your work frequently on the sidebar.🧙♂
Once again, a hugely important topic, Ashton! One thing I wasn't aware of was that US insurance costs for health care personnel were so huge. I've been working in obstetrics and gynecology for 40 years by now. In Sweden, the insurance was taken care of, originally the doctors'union, which also insured midwives and nurses. I've NEVER paid more than around 1,000 € per year! (Now, a "private" company has taken over these insurances, but the fees are the same). In EVERY respect I can find, outcomes of US healthcare is considerably worse than Swedish, or other European outcomes. The most horrific example I've found is MATERNAL DEATH. Sweden 4.5 per 100,000 births USA 21 per 100,000 !!! The reason, arguably, MUST have to do with accessibility. Sweden introduced the maternity program, free of charge for every pregnant woman, already in 1940, which was the first in the world. It has remained free of charge ever since, whether provided for by local government or private companies. This also includes specialist maternity care, like for instance care for diabetic mothers, The question in my mind is, how much worse must the outcomes be in the US before there is a real popular demand for universal healthcare, affordable for everyone. If it's big law the idea is battling like you said, then my heart sinks. That seems one hard nut to crack, and presumably, that's why so many americans think that universal healthcare is more expensive than the present system, even though in reality it COULD be very much less expensive!
I agree - I think a lot of the conversation is a bit misguided since many discussions about "taxes doubling" are mostly scare tactics. Americans pay twice per capita for healthcare per capita with their current system but do not get doubly better outcomes for it.
@@f0rth3l0v30fchr15t It sounds like Sweden over 100 years ago. Around 1900 - 1910. you could find newspaper clips telling about the horrific finds of dead newborn babies set out in the forests, And it happened more than once ...
It could be less expensive and great….but most Americans lack trust in their government to do *anything*. And the ones that appear to do so have a hefty chunk of dissonance going on.
HAHAH - i like these comments ,,, sorry to say : the big US companies will deny this idea at all costs ! they earn too much in the actual system ..and normal people will never ever have a say in the US .... ask those people who dislike/condemn gun violance ... any change in the us so far ?? nothing , right - because the NRA will not allow it !! so simple ..... rich companies and people rule - not votes !
So why don't you, we, call our system in US what it really is: Corporate greed. Look who benefits when we get sick: Greedy uber rich CEOs. Private Equity firms are buying out healthcare companies. They are buying up mom/pop dental offices. The care you get now is all about saving the Board of Directors money. They cut corners, & more comes out of our pockets. Our housing is at a crisis because Private Equity forms are buying up rental properties, driving up rents, buying up homes for cash and affordable housing is now harder to find. Corporate greed. We are being ruled by greedy oligarchs all over again. And Citizens United helped them even more!
The problem is this, Americans do not like their fellow Americans. If an American thought their neighbour was getting something for nothing they would blow a gasket. Europeans think differently, if their neighbour benefits from a system set up to benefit everyone then the system is working properly.
A family from the US, living in the UK made a video about some of the differences between the two countries. One thing they mentioned was how people in the UK were much more socially minded, caring about other people.
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party. USA has everything to learn outside borders. Dont need to create anything. Just need to copy. If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year.,.-,.-,.-,.-,.-,.,-
Here it pops up again. American exceptionalism. Well drop it. Americans like their neighbors just as much as other people. Forget the idea that America is a reflexion of how americans are different or exceptional. The american democracy is corrupted in several ways. Fix the democracy, and all the other problems will disappear.
I've been in healthcare finance for 25 years. One element missing in many analysis is the piece of the economic pie that goes to investor-owned insurance plans. What would be the effect of making all of healthcare a non-profit activity? Also, the discussion about higher taxes seems to never include the offset for premiums saved. Depending on how it was structured, it would also tend to make healthcare a significantly less regressive cost, since it would be based on a percentage of income, rather than a flat fee.
That's what I was thinking. What happens if the insurance company middleman is out of the picture? People would still pay for access to healthcare and doctors/nurses would still make decent salaries, but the $41B currently going to insurance company profit margins could be used to pay for actual medical services instead.
I have never seen anyone go so much in depth on this issue. You made me realise that there is no quick fix. I believe that the government negotiating prices on medication is a good start, but so far they only negotiate a limited amount of medications. I know there are caveats to that mandate, as having to take into account the cost of research and development, something that limits the bargaining power. Here in Norway, we have no such caveats, and the government negotiate prices of every medication in the country. I know, the pharmaceutical lobby and all of that, but to me that would be the place to start. And again, astonishing and in depth video, I don't know how you are able to do it.
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party. USA has everything to learn outside borders. Dont need to create anything. Just need to copy. If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year..,-,-,,-,.-,.-,.-
You make an excellent point at the end. The US needs to look at what other countries are doing. All of them have lower costs and many have better care than we do. One of the different models used by these countries will work here, especially if we ever get tort reform. However, one thing that needs to happen is campaign finance reform that will limit the influence corporations will have on Congress.
IMAGINE the rest of the world without US innovation,equipment,medications,knowledge, etc.. 60% of the money in the so-called for-profit healthcare is TAXPAYER dollars. OBAMACARE the UNaffordable Health Care Act. Alex Epstein 's "FOSSIL FUTURE" on sale now.The Moral Case for Fossil Fuels. HUMAN FLOURISHING
Another great video and you mentioning obgyns made me think that you talking/discussing healthcare with Mama Doctor Jones would make for a fantastic video/collaboration (she is a texas obgyn currently working in New Zealand so she has the experience of both healthcare systems). As to solutions, i firmly believe that any society that wants to advance needs to determine/answer the question: What services do each person have a right to (i.e. healthcare education, police, fire department, unemployment, pension, housing etc) and provide the greatest benefit to all (i.e. teachers should make more money than politicians because they contribute more to society). This discussion should be held based on really data and not some vague threat (all doctors will leave for instance). A small anecdote, years ago there was a massive uproar here in the Netherlands about public servants earning more than the prime minister (Balkende) and there (like the banks did during the baniking crisis) the argument was made that all good servants/bankers/doctors/nurses/etc would leave the country. This has never been proven and defies logic (who would uproot their entire family and live when they actually have a good life already). Anyways would love to see you and Mama Doctor Jones collaborate, have a great sunday and see you next week
Of course medical care works. The strange thing is that the payment method changes the validity of anything according to many Americans. Challenging that concept would need to change the American education system as well.
Living in Austria with a Brother in the US I am still stunned what he tells me about medical costs once in a while. A broken finger from a Basketball game and you end up with a bill of a few thousand dollars. This is so unreal from a European perspective. Anyway your video is great and I have a much better understanding of the difficulties to change the us system for the better of the people. Does not look like an easy job :)
Your brother must have gone to the emergency room. Tell him the following 1) Unless the bone was poking out the skin, or dislocated, you can go to your general Doctor and skip the high bill. 2) Emergency room prices are negotiable. Meaning you can go over the bill with a person at the hospital and get better pricing if you are paying out of pocket.
@@GrandpasPlace For a normal person with only a reasonable income and responsibilities for other people you just have to. You can not afford just to throw away so much money. For you maybe not
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party. USA has everything to learn outside borders. Dont need to create anything. Just need to copy. If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year..,,-,-,.--,-.-,.
Universal healthcare might never ever work in the United States. But that has nothing to do with the nature of universal healthcare, rather it has something to do with the United States of America.
Correct. Most of the medical breakthroughs and medical technology and pharmaceuticals have come about BECAUSE of the “for profit” model that is used in the US.
Wow. That was so interesting ! I am glad that we have had universal health care for so long here in Germany. I think to implement such a system in todays complex world and in a democracy is next to impossible. But I would think that just a little more regulation on the prices (for medicine at least) should be possible , or not ?
There needs to be an incremental plan drawn in advance. As there can't be one overhaul to fix it all, there need to be time-set milestones for the next 15-20 years so the system can adapt. The most essential coverage must be given as soon as possible (maternity care, antibiotics and life threatening emergencies [including ambulances], and regular blood/urine tests should all be completely free without conditions). The rest can follow in 5,10,... years when the financial burden of the transition relaxes. Most likely, lawsuits would reduce if healthcare was less expensive to the individual, as people sue for minor things in desperation to get some money back on their expenses. Salaries can be just frozen (so the rest catch up with inflation), instead of reduced. Regulations can cap the administrative cost per patient of a hospital in order to be eligible to participate in the program. And most importantly, pharmaceuticals must be made for a fraction of the current cost (with conditions that the cheaper produced, but equivalent quality medications *must* be chosen by the doctor). Long timeframe is also required so the mentality of the people can change.
You are generally right. The entire health infrastructure in the US is fundmentally broken except for the wealthy and needs to be overhauled to move to a universal health care system. Ashton touched on it when referring to the ridiculous education costs racked up by students which then drives a bunch of other behaviour such as favouring specialisation over general and public health. The US has the highest health outcomes costs for the lowest outcomes in the developed world. For example, pharmaceuticals are insanely expensive as there is no PBS or equivalent scheme and medical systems are not working together to bulk-buy and price negotiate pharmaceuticals for lower prices. Another example is the high cost of medical insurance driven from the high payouts of medical claims. If peoples' medical outcomes from bad decisions were still covered by the medical system, and people didn't need to sue to get enough money to cover their future medical costs, then insurance costs would drop. If there is ever a strong will in the US to improve health outcomes, it will require long-term planning as many existing structures need to be torn down and rebuilt. The current US failure of understanding universal health care is that they just see it as someone else paying for their insurance, and not actually getting insurance companies out of the picture altogether and dramatically lowering the cost of delivering high-value healthcare.
Every time I watch one of your videos, Ashton, I'm glad I live here in Germany, and not the US. I think, the US needs to realise that unchecked capitalism does not work. At least not for 95% of the population. But as long as there is a system, that requires political candidates to have a lot of money to get elected, you will either get these millionaires in power who just serve themselves and not the people, or you get politicians who owe to millionnaires who financed their campaign, and no matter how much they want to make politics who help the poorer people, they will to some extend pass laws that just serve the rich, and they will not change the system.
The average rate of increase for health insurance premiums almost halved for individuals after the passing of Obamacare. It went from 7.9% to 4%. Yes, more money was spent in healthcare but we are covering more people
Could there be room for a small change, like f.i. start a cooperative health insurance company where at least the usual profitmargin is circumvented and then go from there in small steps ?
Absolutely. I recently spoke to a friend of mine who is a neurologist in California. One of the big things he talked about was how medical billing on the insurance side of things often makes no sense. The costs are outrageous because they can be outrageous and the patient (usually) doesn't feel the full financial weight. I think oversight of pricing would be a good place to start.
Where will you find staff who is willing to take a paycut to work there? And will patients sign waiver forms to not ask for 10M compensation because the pillow is too uncomfortable?
Like that CostPlus pharmacy? Could work. You'd need enough angel investors, or startup capital, to survive the attempts of the for-profit company's attempts to squash you though.
I really liked the example with the nurses, as it shows well how many things are interconnected. But talking of nurses, I don't think it's fair to compare wages with nurses in Europe while in fact in many European countries nurses complain that pay and working conditions are far from ok for the kind of work they do. So yes, US nurses certainly have inflated paychecks but then European nurse wages do need a raise.
@@markusschafer4895 yea I think in Switzerland working conditions are also a big concern but pay is also a topic. I guess the mix has to be right and if neither working conditions nor pay is very good, noone will stick around for long. Which is one of the biggest issues: huge turnover and many leaving the profession which puts even more strain on those who remain.
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party. USA has everything to learn outside borders. Dont need to create anything. Just need to copy. If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year.,,.-.,-,,.-.-,
I’m from Australia and it’s a question of values. You can defend the American system if you simply don’t care about all of the people needing healthcare. From what I see in most defending their system, it’s about what they themselves can get, not about what’s best for everyone. No point arguing with people who think that way.
Interesting to know that thanks to something that happened not so long ago (Obamacare) young adults in the US can be insured through their parents until they are 26. This has been a norm in Europe (I can generalize here for the entire continent) for many decades.
@Sine-gl9ly Because a portion of those expenses for low income parents must be born by the other, higher income tax payers. Better to have no regulatory requirements and allow the lowest risk persons have the lowest insurance costs. How is it my civic duty to help the adult children(or any age children) of others recieve healthcare?
By the way, as a fellow American abroad, you are one of the ones that I proudly call "fellow". Your videos are thought-provoking, factual, and intelligent. We have quite a few nitwit Americans abroad. An American living abroad has an obligation to be informative to people back home, without the US brainwashing. You seem to have broken the brainwash well. Keep up the good work.
No one here in Canada likes long wait times! It is because a shortage of doctors and nurses which exists in the US. Here in Canada, there are steps being taken in many provinces to improve situations. I’ve not waited long for good care. Some places are better than others.
What an excellent video, thankyou. I trained as a nurse in Britain and I've worked for 20 years in France. I earn about 30,000 euros a year, but I have the satisfaction of being proud of providing a public service, while knowing that my family will have their health needs covered.
Like I was saying, people engage in medical field in Europe with commitment and devotion to heal, not to get rich. At least, for the most part. The ambitious ones go to private path and the greedy one go to the US. In Europe, and pretty much in most part of the world, doctors heal people, they're not accountants before being a medecine man.
Not sure that the first cab of the rank for addressing cost should be worker costs.. e.g. nurses. They at least work for their living. Insurances, pharma profiteering, hospital overcharging are all lower hanging fruit.
Just because you asked: 1. Free education. My US dentist wanted $ 800 for a tiny front tooth filling, because she 'owes 265K in education cost'. 2. Forget about malpractice suits. I hate folks who get rich on other folk's misery. Should have sued Kaiser 7 years ago, when they misdiagnosed the staph infection in my knee as 'gout', and the nurse I met the next day, with a red swollen knee the size of a newborn's head told me: 'you were lucky you came here in time, you would have died a painful and horrible death within 24hours'.
Nations whose national defense is effectively funded by another nation can well afford to spend that money somewhere else, and need to recognize that their benefactor doesn't have this luxury.
America is like a job with crappy benefits. Most Americans have never traveled and lived outside the country and are none the wiser about what life in other countries is like. Like a job, you can always leave it for a better one if you are brave enough, and wise enough to know there is something else better out there for you.
Very cool and interesting explanation! Basically it says: All the huge amount of money in the US healtcare system lands in somebodys pocket ..... and nobody wants to lose that. Very cool the connection to the education and law system - I didn't connect the dots until now.
@@johnp139 That doesn't contradict my post at all. (and it doesn't explain why other countries could afford a healthcare system with their own pharmaceutical R&D for much less money)
It seems to be an attitude problem. US is somewhat unique in terms of the whole "manifest destiny" mentality. If you truly believe that everything is under your control and you can be extremely successful based on the merit of your work and abilities only, it doesn't make sense to build systems aimed at social support. And changing perception of your identity is a very tough thing to do. Unfortunately, realistically, I don't see how this changes, without things getting so bad in US that society would be forced to re-examine basic assumptions about itself. You need to admit that your labour and talents are not enough, and that there are things outside of your control, and that investing into the common pot makes sense, becase there might be a day where you'll need that help. Europe went through that process by virtue of having a lot more time and being a lot more compact than US. I honestly wish there was an easier way.
I was about to comment: "The problem with the US is the US", which is more or less what you said. Indeed, the famous quote: "America is the only nation which has gone from barbarism to decadence without the usual interval of civilization"
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party. USA has everything to learn outside borders. Dont need to create anything. Just need to copy. If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year.
In Australia... A problem with UHC is the hospitals make patients wait for attention anywhere between 4 to 8 hours, making sure patients don't want to attend again. Private Doctor visits are fine but you might still have to pay a high % of the Bill.
I would suggest first establishing _one_ non-profit health insurance fund in _one_ US state, along the lines of the German health insurance funds. Without profit motive, it can provide the same services as for-profit health insurance companies and be always cheaper in premiums. It will stimulate competition and customers will flock to the new insurance company. Then other states will follow the trend and set up their own non-profit insurance companies.
Problem is that this will be litigated all the way up to the supreme courts (state and federal) and even then face severe political opposition (campaign contributions need to come from somewhere)
@@PauldeVriezelet it happen. If insurance companies won't spend its billions on actual human healthcare, at least they can help a few lawyers stimulate their local economies. Conservatives and capitalists spend decades and ungodly sums of money eroding rights and protections. That doesn't mean we should stop trying fighting the good fight. The more damage people see certain people continue to do, the more people are turned off and stop supporting them.
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party. USA has everything to learn outside borders. Dont need to create anything. Just need to copy. If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year..-,--,.-,,-,.-,
@@kevinreynolds7125 Why should they pay less? Just cut the profits of the insurance company itself, and perhaps streamline the administration a bit, and non-profit health insurance will outperform all for-profit companies. The doctors and hospitals, etc., will all stay the same, including their profits. And yet, the rates can be made cheaper for the -customer- patient. Once you have enough insured people, you can start haggling with the pharmaceutical industry and the hospitals, doctors and ambulances to drive down prices (and thus premiums) even more. This way you gain even more members and it becomes a positive feedback loop. Yay, capitalism!* *Yes, it is still capitalism because non-profits are perfectly fine in capitalism, aren't they? If a billionaire with half a brain and real philanthropy, not just for looking good, would establish a foundation like that tomorrow, it would work from the get-go, without any governmental involvement (apart from laws and regulations), just like here in Germany.
That sounds pretty scary. I am wondering, with the density of medical practitioners already low, what happens if you have an accident or some other medical emergency somewhere in the boonies in the US? But we do have our own set of problems here in Germany. Similar problem, everybody wants everything anywhere anytime. Recources are limited. So they do have to be managed in some way or other. And that management is also strictly politically motivated and dominated. Examples: - Being a general practitioner or a pediatrician is on the lower end of the reimbursement scale. Hence there are much fewer GPs and pediatricians than needed. - Being a general practitioner in the countryside is even worse. So lots of practices with the current GPs hitting the retirement age are now closing down for lack of successors. - OTOH larger cities swarm with lots of the same specialty doctors next to each other. And they all want to make a living. - Certain types of treatment are being paid better than others. Leading to treatments with may pay better, but are not necessarily better for the individual patient. The notorious example are spinal disc surgeries. Less aggressive treatments would often be more in the interest of the patients, but they pay worse - and might be more expensive upfront. - Everybody wants to have the full service hospitals and pharmacies nearby, nobody wants to pay for it, and nobody wants have to make do with “only” basic services locally and having to go somewhere else for the specialty services. Even the argument that is much better for you to have your new hip done at a hospital that is making 300 of them every year 80 kilometres away rather than being one of eight such patients locally does not really wash. Typical response: “I want that hospital to be in my town! Period!”. Currently the discussion is about concentrating extreme perinatal care at hospitals which do at least 25 cases every year below 1,250 grams birth weight. According to the studies this would improve the outcome for the newborns - but, well, I think you will guess the general response to that. - Local politicians revel in "saving the local hospital". Never mind that it is neither medically nor financially viable. - The medical role model is still the self-employed registered MD with his or her own mom-and-pop practice. Group practices or syndicates are not quite a thing yet. - And so on. It is kind of a Gordian knot. Too much government meddling makes things excessively expensive for suboptimum overall performance. Too little oversight does the same, just with a slightly different flavour.
With an NHS you have a process by which a Doctor can achieve the status of an expert sometimes called a consultant. The expectations of quality are peer-reviewed. The expectation is that of higher quality. In the U.S. with no NHS how do you know you are getting the best or at least an expected quality of service? I do not see this happening, reputations are a result of little m or big M marketing. Not so elsewhere. Does this make the average U.S. Doctor have a worse standard?
In Germany they have universal healthcare. They take 15% of your paycheck to pay for this service. The quality of service is ok. My problem with it was that someone else decides if you need medical care. Once you get too old, they stop care. My father-in-law died because of this.
Eh there's some mis-information here. The total is 15%, but that's only if you could the half paid by your employer. Most Americans also have their healthcare subsidized by their employer. But there is a key difference: the 7.5% you pay out of your paycheck is capped. Once you earn over (roughly) $56,000 per year in income, your income is no longer taxed for healthcare contributions. Plus, healthcare is all inclusive for your whole family. You don't pay more if you have 1 kid or 8 kids. And if your wife/husband is a stay at home parent - they are covered at no extra cost. There are no copays, no deductibles, and no out of pocket costs. So if you get sick, injured or require care - you never have to worry about a bill. It is for these reasons that the average German family pays less for healthcare than American families. And also why GoFundMe doesn't exist here. Quality of service has regularly been rated higher than the US by numerous international agencies and absolutely no one "decides" if you need care. You just get it. And you can choose any doctor you want. "In Network" isn't a thing here.
@@TypeAshtonThere really NEEDS to be things like copays and deductibles in order to discourage waste and to get something back from the people that use the system more than others. Nothing ridiculous, but some equity.
Thank you for your explanation of American healthcare system. We have our own problem with healthcare in Canada, like long wait times. At least I did not go broke due an emergency gallbladder surgery.
In US the nurse example NEEDS $ 120k per year to survive. $ 60k per year in Germany is worth a lot more than $ 120k in the US. When I take myself as example: I would need to earn about three times as much to have somewhat the same quality of living - actually more.
@@Bookhermit Simple groceries is about three times as expensive. And if you look for fresh herbs, which are common here, you won't find them. The dried herbs are 4x or 5x as expensive. If the $ were not a world currency the exchange rate would reflect ist. Hence the reason for more dedollarization pressure than ever before. BRICS might have a real outcome.
When you mentioned the share of 18.3% of the US economy, I began to ask myself, how much of this really 'helped' in any way. Is it used to support people that might need this money (school meals, housing support, ...)? Or is it going mostly to shareholders accounts of the top 5%? Does it create new jobs (except maybe a dozen researchers)? Or does it advance automation and that way reduces the number of jobs? In any case, would a change to universal health care make any real difference to the economy (ignoring the changing numbers)
This was surprisingly a great take. I will say a few things as someone who is currently paid more than my international counterparts in my field. The first thing we need to change is the stanglehold that Doctors and medical professionals have on the industry. Think of how competitive Med School is, and think of how there is a constant shortage of doctors and advanced healthcare practitioners. That is by design. Limiting the supply ensures a lack of competition and subsequently a high salary. If there is one thing we should put government money to fund it is Medical Schools. Increase the supply whether or not the industry wants it. The second biggest issue I see is that everything im the US promotes seeking the best possible doctor/hospital regardless of cost. If you pay a small percentage and then have an out of pocket max, you wont be concerned as much about the value of where you go. Any universal health insurance (I think that Universal Health Systems are currently out of consideration) should focus on giving a base amount for services rather than a percentage as well as forcing the industry to supply quotes for service in advance rather than charge them after the fact. There is so much more wrong with the US healthcare system, but those are the top two in my opinion.
Excellent points. My take is that the biggest issue is the profit motive coupled chillingly with the greed of the insurance executives and shareholders.
The stranglehold GOV has on the industry. 60% of the money in the so-called for-profit healthcare is taxpayer money. OBAMACARE aka the UNaffordable Healthcare Act. Alex Epstein 's "FOSSIL FUTURE" on sale now. The Moral Case for Fossil Fuels. HUMAN FLOURISHING
I'm Brazilian and Brazil is the only country in the world that has PUBLIC FREE UNIVERSAL HEALTHCARE. Each word here is important. Every citizen has a right to access it, whether he has insurance or not and it covers ALL levels of care, to basic medical care to ANY type of surgery to a heart transplant. You pay ZERO, whatever it is you need. It doesn't work all that well, we do have a private system and anyone that can pay for a private insurance will do it, sometimes you have to wait long, etc, etc. But we are a middle income country in a deep financial crisis with this model, called SUS ("Sistema Único de Saúde"- Unified Health System) inspired on the NHS of the British, a high income country, and we KEEP it!! Never was any question about giving up on it, no matter what. That's to say: There's literally NO REASON that the by far richest country in the word can't have AT LEAST a system like that SINGAPORE that is far to be so far reaching as ours. I hope you all Americans know we make fun of you guys for thinking this is "communism" when even Japan has its Shakai Hokken. To us that's completely MADNESS and there's no way you can even START o defend it.
As a physician, I think the potential exodus and shortage of physicians as well as ancillary team members is often understated by proponents of a Medicare for all plan. The pandemic has shown that there is a limit to a healthcare worker's willingness to make sacrifices, and reducing take home pay could end up being the last straw for many, especially since the student debt issue is constantly mired in political uncertainty. I've seen state governments use timely access mandates as an attempt to cushion the current fallout, but there's going to be a limit where more people leave the field due to unrealistic demands on the system. "Adding more paying customers to increase pay through volume" as Obamacare emphasized in its initial phase won't fly now, as there's only so much harder you can get people to work before they vote with their feet.
It would be a tragedy if the US had universal healthcare : Breaking Bad and dozens of TV shows and movies wouldn't make sense anymore ! More seriously, until the US political system is fixed, I don't see any possibility.
Hell, yes, it would work... if only Americans weren't so indoctrinated to misunderstand that 'social' programm does not mean 'socialist' programm. There are many different ways to make a universal healthcare system work; Germany's being one of them. Yes, it's not perfect, by no means. But it certainly is better than what the USA currently exhibit. That's my honest opinion BEFORE I watched the video. Let's see how this plays out.
It's super interesting.... the quote "sicko socialism" comes into play in the final chapter, as its a quote from the Fox News Anchor I used in the video. Interestingly it is in reference the expansion of Medicare - which has been in place for almost 60 years.
The problem exists, because the State interferes automatically with the US principle of individual liberty. In Germany you have the same principle, but as it is one country, your individuality is embedded in being a people, what makes one person to an extend more social. In the US, you are not or far less and communitarian only in the traditional States in the middle of the country. Especially at the coastal areas, individual greed thrives in a more and more anomic area, which is a pull factor created by the State's interference. Germany also had it's Obamacare after 1998 (Red-Green) by Ulla Schmidt, what was a horror and got refinanced with a lot of closures of doctor offices in the countryside, so that basically migrants can get free stuff in the city and it's not crashing instantly.
@@urlauburlaub2222 I think there is a big difference in mindset between the USA and Germany. Americans (as a group) usually are talking about their 'rights' and 'choices'. Germans have 'obligations', restricting their 'freedom' like in not defaming your opponents (Artikel 2, Grundgesetz: "Jeder hat das Recht auf die freie Entfaltung seiner Persönlichkeit, soweit er nicht die Rechte anderer verletzt und nicht gegen die verfassungsmäßige Ordnung oder das Sittengesetz verstößt."), not shooting at people, yielding your right of way on the street (§1, STVO: "Wer am Verkehr teilnimmt hat sich so zu verhalten, dass kein Anderer geschädigt, gefährdet oder mehr, als nach den Umständen unvermeidbar, behindert oder belästigt wird.")
@@wora1111 Hmm, no. The US Constitution doesn't say anything else than the German one, but the US is far more multicultural and Socialistic than Germany. So, the average German is more social. Younger generations are different, because they are not homogenous anymore and so they are more like the US Americans and want less community.
@@urlauburlaub2222 "the US is far more multicultural", hmm, willing to take a ride with the Straßenbahn with me in Karlsruhe? Those that can be called 'Germans in second generation' are the absolute minority - even though all will talk German among themselves, usually fluently, many without any accent. Even more so with the younger people (30 and below). I know fewer 'young' people but those I know are not less social, they usally hvae thought about the subject less that the older ones. But when watching their behavior they are just like us 'old ones': Getting up to make room for older people, moving to the side of the road to let others pass more easily, and so on. And yes, that includes immigrants and refugees (after they acquired some German).
My (Canadian) wife is currently in hospital in Manchester (England) after an horrendously bizarre accident in a car park. She was attended by two ambulance crews, airlifted out by helicopter, in intensive care for the first week, moved to a high dependency unit for the next, and is now in a trauma ward, recovering. We expect she will be there another two weeks at least. Thanks to the NHS, there has been no question of cost because all A&E coverage is free. I cannot imagine having such an accident happen in America, having to decide on the spur of the moment whether we could afford any of that. We are retired, with no health insurance of our own, totally and happily reliant on universal healthcare both in England and Canada. Words like co-pay and pre-existing condition are simply not in our dictionary. And I have to say that neither of us want to cross the border into America any more, because of the crazy healthcare problems you have there.
One solution would be to have the US government lawmakers pay their own healthcare, just as they expect the rest of society to do. than we would be getting somewhere.
“No society can legitimately call itself civilised if a sick person is denied medical aid because of a lack of means.” --- Aneurin Bevan, British Minister of Health (1945-51)
You asked for input in how a universal healthcare option could be implemented in the US, so here is one option I have thought of. The road to become a licensed physician is very costly, and as you pointed out in the video, often leave the newly minted doctor with a substantial student debt. If the government could build community hospitals with emergency rooms, or somehow use or create positions in existing private hospitals (nonprofit?) for newly minted doctors fresh out of medical school. These doctors could have attended medical school for no cost, or at least very low cost, courtesy of the US government, who will foot the bill for their education. In return said new doctors would contractually work for a period of years, perhaps a dozen, for much lower wage, similar to the pay level for doctors in other western countries. This model could also be applied to other professionals in the medical field. There would be a lot of details to work out, but it could be a start. Thanks for yet another great video.
"That doesn't mean that we as American's don't have a lot to learn from other countries and how they operate." Sadly that is one of the impossible thoughts ever for American's to swallow. I honestly think the world map for most Americans is a map of the Continental United States and beyond that is just says, Here be Monsters. So we almost never learn from other nations.
I am Australian. A couple of years ago I had heart valve replacement surgery.All of the tests, appointments etc. leading up to the operatation, my time in hospital and the on going care have not cost me anything.
Wow! What a great piece on this important topic and especially for wading into some of the associated factors like costs and tort reform. US healthcare is not a fix one thing problem! I’m not very optimistic that we will make meaningful changes in my lifetime.
Let's be honest, as long as the patient in the US system is a product to make profit on and not a human being that needs medical help, nothing will ever change...
Price gouging is an American failure that is necessary for their supposed richest country narrative.
That aspect is not really different in Europe, only the financial _structure_ is different.
Some individual doctors may care about people, but the system is geared for money flow towards you know who.
The thing that stops universal health care in the U.S. and never really gets discussed by Americans is lobbying. There is no point in fighting for Universal Health Care when your own corrupt system will undermine it. Obama couldn't even pass healthy school lunches in the classroom without lobbying undermining his efforts (i.e. behind closed doors they got pizza put on his healthy food pyramid). Lobbying infects almost every facet of American life and till you fix that nothing else is really worth discussing.
@@tinkerwithstuff its completely different in Europe in every possible way. the average salary in US are 60000 USD, and tho ofc doctors should be paid well because of how hard it is to learn what they doing, you don't need 8-10x higher salary then the average to have a good life. the average specialist doctor in US make up towards 750-800k a year witch is ridiculous . in comparison the same doctor in my country makes around 150-200k a year. tho its far less than in america, they still earn 4x more than the average, and its plenty of money to be able to buy a quite nice house, nice car and whatever. its done alot of studies on as long as you can afford to pay you bills and have bit of extra left in your account, the amount you make above that doesn't really affect your happines lvl at all. when someone have to worry about their wallet before going to see a doctor for any medical reason. the country have failed them misserably.. to put it in perspective. i see a doctor for a heart condition every year, and for that, i pay roughly 50 usd, and if i had more issue the most i would ever pay for health-related issues within a year would be around 200 USD. That also includes free transport with taxi back and forth to the hospital if I was to need it. on top of that, if i need to stay home from work because I'm sick, i would get 100% of my normal salary as if i were at work, and we have no limit on how much you can be sick because that not something we decide after all
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party.
USA has everything to learn outside borders. Dont need to create anything. Just need to copy.
If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year..
As a self-employed guy for most of my life who had to secure health insurance in the private market-place and as a Vietnam veteran who now is covered by the VA, I think I'm in the almost perfect position to pass judgment on this video. And that is that this is the most honest, unbiased and factual report on this subject I have ever seen! VERY HIGHLY RECOMMENDED FOR ALL.
In the UK they are privatising our NHS by the back door. So in the last 12 years the Tories have destroyed the service.
As long as Medical Care in the US is a business model, instead of a utility, the cost will be crazy high since it has to fill so many pockets that care for money only.
I feel that isn’t true many health care providers in the US care about patience and society. Every health care system even the European versions build on economy and medications, doctors, nurses have to be paid.
Everything in the US is profit oriented. The entire American way of life is built around the profit. Instead of the “In God We Trust” the motto on the dollar banknotes and coins should read “In Dollar We Trust and only for Dollar We Care”.
Being a business model is fine, and would *normally* drive efficiency for the best health care to cost ratio.
The problem is that the health care business is completely captured by the pharmaceutical industry. Both doctors and government are captured.
Politicians get their money from the pharmaceuticals to pass (or not pass) laws that further entrench big pharmas profits.
Doctors are basically drug dealers. They have to prescribe the latest (still under patent $$$$) pharmaceuticals instead of the near equivalent off patent generics. Price diff? Eliquis $500 Warfarin - $17 Yet they prescribe the $500 one through the roof because they may risk a board hearing if they don't prescribe the expensive one and they can forget promotions if they don't push the drug companies product (they are actually allowed to receive "incentives" for meeting quotas), so the whole top level of the health care system is already captured by pharma.
Once any "new drug" comes off patent, the pharma companies are quick to both come up with a new drug covered by patent, AND find a flaw in their prior drug so they can "force" doctors to switch their patients.
Insurance companies are in on it.
Medical procedure- hmmm Defined cost? $9393848489392392 for whatever procedure (obviously exagerrated)
Covered by health care? They have a deal/agreement to pay the hospital only $1500 for the procedure and your copay may reduce that for the health care company.
So if you don't have health care insurance in the US and need medical help, you are basically guaranteed bankrupt (number one cause of bankruptcy in US? Medical bills) That allows the insurance companies to charge exorbitant rates even though they pay much less than the defined costs (which in most cases, hospitals don't even disclose to patients)
I don’t mind healthcare being a business model, but there have to be decent safeguards to ensure everyone an equal excess to healthcare. Low income workers need excess to healthcare. That is not guaranteed when they earn €1,200 a month and the insurance is €1,000 a month. That is not, what we call in my country, good employership. Employees need a decent salary, enough free time and an approachable employer for regular labor conditions. Employees aren’t resources (despite the ugly name of HR) you throw away at the slightest contradiction. You need well cared for employees to make a clean profit. In the US companies make dirty profit at the cost of employees.
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party.
USA has everything to learn outside borders. Dont need to create anything. Just need to copy.
If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year.,.-,.,-,.-,.
Im from Norway and belive in universal healthcare, it beeing a reality in the US is probably decades away because of the big changes it would require.
What i think is the biggest barrier is something you just briefly mentioned, lobbying is in my opinion just legalized corruption and bad for most people
Also from Norway, and I also believe in universal healthcare. I also interact with our healthcare systems quite a bit due to my own health conditions and am very happy that I live in Norway and not America.
I believe what we will actually "get" .. eventually... will just be a gradual age expansion of the existing Medicare program. Which has co-pays, and even add-on programs that have a monthly premium. It will still be a vast improvement as families with kids and non-working spouses will greatly benefit.
It would be FAR too hard to convince the rockheads in the US that a "no skin in the game" model would not be abused by "..x.." and "..y.." (insert whoever their current targets are)
After everyone is on or eligible for THAT program we can talk about changes... (I will be on medicare as it already exists well before that day)
I’m from Germany and I feel the same.
@@Ranked_Journey im the same, if i was born in the US in the same family i would probably be dead as a kid due to health complications, or in more debt than i would ever be able to pay off
In the United States "political campaign contribution" is just a euphemism for "legalized form of felony bribery" of politicians. It turns the USA into a system of one dollar=one vote, rather than one person=one vote. I believe most issues in United States politics are symptoms of this problem. The disease is the problem of campaign finance. Time to address the disease rather than the symptoms. (This could be a future video for Ashton: Comparison of campaign finance/election laws. New Zealand may be a good model to start with.)
What I don't understand about the American healthcare system is that the state doesn't want to profit from it. From the state's point of view, healthcare isn't charity. It's keeping your source of income in good shape. Healthy people work and pay taxes. Sick people don't. It's the same reason why a dairy farmer is interested in the health of his cows. The farmer needs to invest in their health, and so does the state in ours.
It’s not just that. The American model also discourages entrepreneurship which is something the state should welcome and encourage. Because in the US health insurance coverage is typically supplied by one’s employer, people are afraid to venture out on their own given fear of losing their insurance coverage and the expense and difficulty of obtaining health insurance on their own. Also, the current scheme is not good for companies and businesses either. Instead of concentrating on say being best at making widgets, companies have to spend considerable resources selecting and negotiating with insurance companies, dealing with health related expenses and catastrophic claims, etc… stuff that’s completely unrelated to their core business. In every other advanced country all that stuff is handled by some outside entity that specializes in ensuring people are provided with the best healthcare coverage suits their needs, relieving that duty from businesses (that have nothing to do with it).
The point I am trying to make is that there are multitude of reasons why the current American healthcare model is bad for the state, its citizens, and even its businesses… yet we stick with it 😕
I think something that gets left out of these debates is stress. Even if the costs were the same I'd want the system where I never have to think about money while I'm going through cancer to the system where I have to deal with bills and bankruptcy while going through cancer.
The patients health should always come first.
That is what I have here in Denmark. Peace of mind is such a relief. I learned that when I studied in Beijing and my ball sack began to hurt like hell. (It was an air bubble in a blood vessel) the Beijing doctor told me it was cancer and it would spread to my heart unless I had a 50,000RMV surgery soon. I did not believe him. My doctor in Denmark told me, either that doctor tried to scam me, or he was unable to read a simple Ultrasound picture, that means he was incompetent.
So yeah peace of mind is such a relief it is amazing. That is why I want dental to be free here as well. I am the sole provider, no job, I am during my master's thesis right now. And I have big holes in my teeth that really need to be fixed.... but I don't feel like I have the funds. But if I wait till I have a job and it gets worse then it might be even more expensive -_-
My mother was lucky enough to be treated for her (now eradicated) cancer with no financial worries. Unfortunately, it took the sacrifice of my now deceased father as a military service member and Vietnam War's Agent Orange exposure survivor to make that happen.
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party.
USA has everything to learn outside borders. Dont need to create anything. Just need to copy.
If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year.-,.-,-.,-,.
You can always set up a crystal meth lab in an old RV in the desert with Jessie.
A lot of Australian doctors go to the USA to do post fellowship training. Particularly in specific procedures or subspecialty fields. It's looked upon highly in Australia. But few stay. Our pay is already very good in Australia and the greater pay we could get in the USA isn't much of an incentive to work in what most of us view as an unethical healthcare system.
The main problem in Australia is we aren't training enough doctors and those in training don't want to go into general practice. They prefer the more 'sexy' specialist fields. Those going into general practise, don't want to practice in rural/remote areas. Australia needs to import its health professionals to make up the shortfall. Australia's Medicare is a good system but with shortcomings. I've relied on Medicare all my adult life (now 68) and have always had good service.
What's also interesting about the US, Americans are the greatest medical tourists on the planet, by a long shot. They'll travel abroad for even basic treatment because health insurance companies won't allow treatment because of existing illnesses, so they travel to countries like India and Thailand, or cross the border into Mexico for lower cost treatment.
@@anthonyj7989there's similar deficiencies in the States. Like nurse educators so not make as much salary teaching as they do nursing, therefore there are too few nurse educators to teach the next generation 🤷♀️
What’s unethical about the US system?
@@manniefresh3425Just about everything, my friend.
The bloated pay of nurses in the US certainly explains why we don’t have many US nurses here is Australia. We get plenty of Poms and Kiwis, as well as from south east Asia and the sub continent, but few Americans.
A few years ago my husband had a heart attack we live in Portugal and we had a business in Portugal, he paid tax and the social security at the highest rate...I am English he is Canadian, I had a medical utente number for some reason we didnt get his utente number. He had two stents put in and was in intensive care in a coma. He eventually recovered and was sent hom...he was asked to pay 5,000 euros for his care (which when you think about it is still cheap) but I went to my doctor got his utente number and when he left the hospital all he paid was 25 euros! This included his time in intensive care, the two stents, the ambulance to drive him to one hospital and the ambulance to transfer him to the general hospital where they had a cardiac unit. Had he had lived in the USA we would have been in incredible debt! So we owe Portugal his life!
As a senior Australian, one of my biggest fears is Australia sliding into an American style of healthcare. I've always relied on the Australian public healthcare system and have never had any problems with it. I see my doctor twice a year for a check up and pay only about six bucks for prescriptions. Once a year I have a raft of blood tests which the system covers.
What are the reasons for your fears?
@@pinetworkminer8377 ,, for a start, the US system is a profit driven system . Medications are very expensive over the counter, there is a network system where health professionals, pharmacists etc work within networks. Any treatment outside the network won't be covered by insurance. Also, insurance companies can deny or offer a 'lesser' treatment/medication than your doctor has prescribed.
My greatest fear is not being able to afford healthcare when I need it.
The idea of bankruptcy due to medical debts. That sort of overhead is an anchor on just about every business decision one makes, once you get past the invulnerability of youth.
60% of the money used in American healthcare is taxpayer funded. OBAMACARE aka the UNaffordable Healthcare Act.
@@pinetworkminer8377 The obvious. A sick care system based on private "insurance", driven by greed.
Another great video, thank you for continuing your work! I'm a pharmacist for a large "not for profit" health system in the US and the inefficiency of just the my section of healthcare is astounding. One problem I see in the US is that most citizens cannot fathom the idea that another country is doing something better than us. They refuse to look outside of the box of US exceptionalism for anything that could make their lives healthier, safety, less expensive... it's kind of depressing to know that we waste so much money on everything from healthcare to education to military spending...and the majority of the population won't open their eyes.
I'm Brazilian and Brazil is the only country in the world that has PUBLIC FREE UNIVERSAL HEALTHCARE. Each word here is important. Every citizen has a right to access it, whether he has insurance or not and it covers ALL levels of care, to basic medical care to ANY type of surgery to a heart transplant. You pay ZERO, whatever it is you need. It doesn't work all that well, we do have a private system and anyone that can pay for a private insurance will do it, sometimes you have to wait long, etc, etc. But we are a middle income country in a deep financial crisis with this model, called SUS ("Sistema Único de Saúde"- Unified Health System) inspired on the NHS of the British, a high income country, and we KEEP it!! Never was any question about giving up on it, no matter what. That's to say: There's literally NO REASON that the by far richest country in the word can't have AT LEAST a system like that SINGAPORE that is far to be so far reaching as ours. I hope you all Americans know we make fun of you guys for thinking this is "communism" when even Japan has its Shakai Hokken. To us that's completely MADNESS and there's no way you can even START o defend it.
Well said. You didn't say it, but I will: American's are ignorant, lazy, selfish, uneducated, juvenile. I am not saying that everyone is, but as a whole, that is where we are. We allow stupid people like Trump, Mitch McConnell, MTG, Lauren Boebert, Jim Jordan, Matt Gaetz, Ted Cruz along with many others like them to run our country. Truly, we are doomed for catastrophic failure. We have already crossed the line over that milestone! Sorry, but it's true.
@@JohnnyLynnLee As an American I agree. Socialism is not Communism.
@@JohnnyLynnLeeWhy do you think that Brazil is the only country that has that?
Capitalism:The UNKNOWN Ideal by Ayn Rand. Alex Epstein 's "FOSSIL FUTURE" on sale now. The Moral Case for Fossil Fuels. HUMAN FLOURISHING
Bravo!!!! My comment is apolitical. I just want to applaud you for a very reasonable, comprehensive explanation. You gave a beautifully unbiased presentation. I love the way you laid everything out and posed your thought-provoking questions at the end.
"Nobody knew that healthcare could be so complicated..."
The guy had so many...let's say _interesting..._ quotes, but this one always stood out to me.
Same.
3. August 2020: 'Trump promised a health-care plan in two weeks.' That aged well.
I mean: "bleach" "Biden is leading us into WW2".......🐵
@@arnodobler1096 nuking hurricanes, stop testing to reduce cases...there's just so. damn. many.
My absolute favourite is from 2016 where he told his followers at a rally that he thought his MAGA-slogan was corny and stupid but it tested well in focus groups so he's using it...and the crowd erupted in furious applause. It's just insane.
@@knietiefimdispo2458 probably under audit for bonespur infection. He could release it at any point just by thinking about it, though.
Ashton, you have actually managed to make me understand for the first time in my life, why the US is not in a position to change the health care system so easily. The way all these things are interwoven there is not much hope to see change in the forseeable future I fear.
Let me repeat what I stated earlier this year: You are an excellent teacher!
10:09
Ronald Reagan Advisor "We are in danger of producing an educated proletariat. That’s dynamite! We have to be selective on who we allow [to go through higher education].”
So they literally created Student Loan programs
"Before Reagan became governor of California, tuition was free for California residents... Reagan began cutting state funding of public universities by 20%... His justification was that colleges have become too liberal"
"When Reagan became president, he continued his efforts to dismantle the public education system, targeting federal aid to students. In his campaign for the presidency, he advocated for the total removal of the U.S. Department of Education."
Project 2025... Trump is planning on dismantling the Dept of Ed
Uneducated people do what they are told and don't question authority
The US is not in a position to change it, simply because about half the country doesn't want to change it, and any time progress is made towards changing it, the other half undoes the progress.
Her video isn’t really that great, a lot of mistake and overlooking big issues that would get in the way of medicine here. We have a unique population those European models wouldn’t work here
MIXED healtcare system where GOV decides what can & can't be. 60% of all dollars in the system is from TAXPAYERS. OBAMACARE the UNaffordable Health Care Act is a preponderance of GOV regulations FORCING the private sector into offering what it doesn't want to. Alex Epstein 's "FOSSIL FUTURE" on sale now.The Moral Case for Fossil Fuels. HUMAN FLOURISHING
The US isn't changing the system because it makes excuses not to do so, not because of its size or the number of people.
Love your delivery, and how you really make some complex issues easier to understand and to explain to others when debating a subject. I must say I never really considered the tie in with education and tort reform in trying to reform Americas health care system.
It bugs me that people don’t realize that we’re all in this together. If I have a medical emergency and can’t pay for the treatment they already performed, that loss gets passed on to the community. It’s a big game and the loser is everyone who is struggling to keep up.
The most ridiculous of all is that USA is already spending similar % of tax payer money on healthcare compared to European countries with mostly tax funded healthcare, yet it's still expensive AF and we haven't even started to count the money patients have to pay on top of that tax money. Everyone would benefit from cutting out private middlemen from the equation, healthcare would be affordable or even almost free for pretty much the same price as everywhere else... you just don't have to pay yourself sick dealing with private companies. But alas, that cannot happen because it's "evil socialism". The idea of paying for healthcare of somebody else and yourself is just too much for some people to handle, even if it ends up being cheaper for themselves too.
@@spugelo359 all that shows is that americans are selfish and dont care about their citizens. A healthy society is so much cheaper than a sick society!
🎯. Truer words have never been spoken!
If US had both a better fully funded public education system as we did in the 40s-80s & unions, I believe the idea of unity, fellow Americans working together for the common good would be possible.
The uber greedy rich oligarchs have changed all that by being able to buy politicians to change our laws, our workplace, and educational system. It's mostly privatized and under their control.
Too few Americans understand what "common good," even means. If they don't see that you're filing medical bankruptcy doesn't effect them directly, they stay apathetic and ignorant...until it happens to them. Which it can because no one is guaranteed any right to healthcare in our country like other countries are.
Greedy oligarchs. They have been our problem Day 1.
It's more expensive for society in general for private healthcare...Somebody pays..
I’m in Texas. It’s amazing how much I pay for my own health insurance through my employer and costs on my own. I feel I’m being ripped off monthly, but too busy working to slow down. I’m too busy working to slow down for sick days. I look at how many people are uninsured or can’t go to a doctor or buy medicine & actually feel lucky. This just grinds the working class down. Then we have elite anti-abortion groups pushing for more babies to be born by the poor (rich will have abortion access), and I wonder how anyone pays for prenatal care, birth in a hospital, postnatal care. Give me a break. Literally.
Calling the US an advanced Democracy is a bit of a stretch.
@@armandaneshjoo the Democracy Index ranks the US #26 (out of 167) - as 'flawed democracy'. Nestled between Estonia and Chile...not that great.
*cough* _electoral college_ *cough*
@@armandaneshjooif any country "helps" yours to stay a "democracy" - it means u are under colonial rule, and not in the democratic country
US democracy is the Model T among democracies. It was there early, but there have been newer, better, more reliable models since.
@@armandaneshjooUS comments: "We don't care what others (Europe) do!" Thousands of times
@@armandaneshjoo You might want to search for "Alabama, gerrymandering" for a recent example of what "democracy" is in the USA.
Thanks Ashton. Being in close contact with Americans from the age of 7 (living near Ramstein air base) I thought I knew a thing or two about the US. You raised so many issues I never even thought about. Looking forward each week to your publication.
As somebody who essentially lives on both sides of the Atlantic, the most important thing it always boils down to, is education. I mentioned this so many times in your videos, that the education system in the US is just the worst. It should not be for profit at all, period. Good education is most important.
Let me give you an example:
In Germany, after Highschool, I can decide to become a doctor because I want to help sick people. Or maybe I want to become a historian, because I like history. Or, how about a geological specialist... Due to the fact that high quality education is free, I can decide what I want to do because I LIKE IT, thus, if I want to become a doctor, a nurse... I do it, not because of the higher pay, but because of that is what I want to do in live.
In contrast to the US, becoming a doctor, nurse or a lawyer, will cost a lot of money, so you better earn a lot of money. When I ask my grandkids, they want to have a job that pays a lot of money, not really sure what job that would be. What I am saying is, in Europe/Germany, people become a doctor or nurse because they want to help people. In the US, most do it because they can make more money.
In addition, the system is just so over-bloaded in the US. I was at the Urologist just 3 weeks ago. You walk into the office and there are 3 receptionists, just taking your info. Then you have a nurse taking your vitals. Than another bringing you to the examination room and talking with you for a minute if all is fine and after that, the doctor comes in for 5 minutes and talks to you about the results.
The funniest part was this:
I was at the Urologist due to testosterone issues. Now, in the US, doctors always prescribe things and this one was kind of expensive. It would have cost me $300 per month for 3 month to see how it works since my health insurance wouldn't pay for it. I did not buy it! However, I moved to Spain to a small village and can exercise every day outside by hiking in the mountains. So, when I came back and saw mu Urologist, he was all excited how good the drug worked because my testosterone level went up 110 points! I didn't tell him that I just lived a better, more healthy lifestyle;-)
When I compare US to German doctors, the German doctors always want to help you by doing something to improve your health a natural way and often do NOT prescribe medication or just the bare minimum. However, the US healthcare system is all about money, and if the doctors prescribe stuff, they make more money and that is all that matters.
Private companies in USA dont see the education as investment.
The fact that you did not tell your doctor is an issue of and by itself. The fact that you think it is better NOT to tell is scary to me. I went to doctor in Europe and he asked if I was willing to change my lifestyle in turn to get a longer life. I declined and he said "ok". Now he knows. Not being honest would be more dangerous in the long term, because he might diagnose me with the wrong thing if he has the wrong information. NEVER lie to your doctor. Not about ANYTHING.
A pill is the faster option, I assume that's why pain killer could do that much harm. You can't afford to burn your sick days what you can fix with a pill.
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party.
USA has everything to learn outside borders. Dont need to create anything. Just need to copy.
If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year..-..
@@houghi3826 Depends on the life-style changes, I suppose. If its what you eat and how you eat it, that's a life-style change one should be willing to accept. Choosing to use tobacco, or other drug use could be another.
I am non absolutist about that issue though. Entirely individual choices. I have made choices that have extended my life, other choices that could shorten it.
Its good to know the odds. That information is not always available. Or wanted.
I tell the medical staff everything, including my opinion of our subsidized-profit medical care system.
Agreement is near universal.
Summary: what you don't want to pay in taxes at a group rate, you endup paying out of pocket at single customer rates. US people scoff at the lower salaries in Europe, forgetting that at this point, healthcare, retirement and taxes have already been taken into account. Remove that from your USA salary to have an equivalent EU range.
Not everyone buys health insurance. I feel this is why the US doesn't want to force everyone to put money into health insurance.
Add to that family leave, suck leave and vacation time off…I lived in Norway for a decade, it’s so worth the taxes!! One of the best times of my life!!
@@jessicaely2521 But to compare the salary, you have to include these costs in your calculation. There mustn't be a "But I don't want to have health insurance". Otherwise it's not comparable. And this mustn't be a insurance plan with exclusions, copays, deductables,... But an all inclusive plan. Including your whole family.
Being indebted after having an accident, being sick,... is unknown here in Europe. Having to sue others to recove the money you spent on medical treatment after an accident? No way. And a lot of severe cases start with a small "irregularity" that I would get checked and fixed by my physician, because I don't have to think about "how can I afford this?". I simply make an appointment, get it checked, cured and am done.
Just look at some reality-med-channels here on YT. E.g. Dr pimple popper or something like this. A fist sized cyst growing for 10 years, because you didn't have the money to get it removed when it was the size of a nickel in diameter? Really?
@@lisa5249suck leave? Smellchucker problems?
I'm UK. Agree 100% on universal social healthcare being much cheaper to run than insurance based systems.
Which are based on the Con that insuring a large enough pool of people will enable everyone to be covered for everything. Insurance Companies exist to make a profit so 1st their premiums creep up to ensure that the company won't make a loss.
Then that they make more profit than last year. They can make even more profit with copay.,excluding existing illnesses, capping what they'll pay on longterm illness & restricting which hospitals, surgeons, gp's you csn use to the one's they hsve done financial deals with.
Sorry for the rant but our government has been heading us in this US direction since long before the current shambolic lot gained power.
You will only get retirement in Europe if there's someone to pay for it when you're old. I'd rather have money in my own account than a Ponzi scheme.
I must admit that I a am deeply impressed by your thorough comparisons that you post! By coincidence, after having seen (firstly for fun) later the algorithms popped up other reaction videos, I kept liking your particularly. And this, I say as a European (Austrian, French resident) political science specialist
Chapeau (oder Hut ab, wie man halt sagt)
warm regards from Lyon,
Michael
I really don't like my free bombs, drones, missiles, and nuclear weapons. I would much prefer free healthcare.
The ironic part of that statement is you actually get pretty good self and family health coverage if you go work on those bombs, drones, etc. You know actually earn that cover instead of demanding it for free.
@@swampcastle8142 The bombs aren't free either and spending megabucks on bombs that are gone when used is a waste of money. Universal single-payer healthcare builds a healthy population. Why do you think Bismarck provided healthcare to the German people back in the 1883? To build a strong, healthy population.
@@swampcastle8142Americans spend 18% of our GDP on healthcare. Most wealthy nations spend about 9-10% and have better outcomes and universal coverage.
@brianfleury1084 Every country that I was stationed in that had single source or universal health care had the worst care for the local population. So no thanks. Rather have the bombs. (Unhealthcare)
@@swampcastle8142yeah sure, "EARN IT" its not like the millions of people workin around the USA, serving your food, building your houses, raising your children, educating said children have actually done ANYTHING to earn healthcare... bunch of lazy MFs... amirite?😊
I have been saying for years that the U.S. should look at other health care systems around the world and just "cherry pick" what would work best for them! It's not rocket science!
There are LOADS of different models, many of which that also utilize a public and a private insurance system simultaneously. You don't have to reinvent the wheel.
The problem is this, Americans do not like their fellow Americans. If an American thought their neighbour was getting something for nothing they would blow a gasket. Europeans think differently, if their neighbour benefits from a system set up to benefit everyone then the system is working properly.
To be fair, that thinking is coming to an end when a system is more and more exploited. And people are getting more and more annoyed, when they have to pay higher social security contributions and taxes and othe people that would be fully capable of working an earning money are benefiting from it.
@@christianfischer9990 That's the fault of the system, not the people, there should be penalties put in place to penalise people who abuse the system.
@@christianfischer9990Can you elaborate what you mean? Who is profiting without paying and which country are we talking about?
This was pretty good video, quite a balanced take which I really appreciate. You brought up the most important thing IMO which is labor costs. According to WAPO average doctor makes $350k with $405k average in peak earning years. That needs to be cut by 2/3 but along with that cost of medical degree needs to be cut by 2/3 or even fully subsidized.
Grossartige Analyse, wie in allen Ihren Videos. Endlich einmal jemand, der Deutschland - Ausland- Vergleiche gut recherchiert und nicht nur eine Ansammlung einseitiger Eindrücke wiedergibt.
This topic is so huge and all-inclusive that it resembles the car-dependency situation in the US of A. “Fixing it” would entail so many changes that it next to impossible to imagine where to start. To me the basic line is the people themselves, the voters. Only when they no longer accept the current situation and demand a different, a better system things can start to improve. Your nurse example was revealing. She is not willing to give up her humongous salary in favour of a better system. Understandable, since it is the foundation of her life choices. These things can never be made individual but need to be universal. Hence the term universal healthcare. If it is your personal responsibility not to get killed in traffic, you buy a giant SUV and make sure YOU are safe, high and dry in your vehicle. The fact that other road users may get killed in the process is their problem, not yours. The same applies to healthcare.
It’s not as hard as you think.
It takes one step. Get rid of capitalist intrestgroups from politics. Aka ban fucking lobbing and corporate donations.
US has a massive real economy and a fiat currency. Which means money and goverment spending never could be an issue. The more the goverment spends on projects the better. It would eat into capitalist’s profits tho, that’s why it’s not happening.
Same goes to US car dependancy, scarsity of housing, poverty and inequality and so god damn many other problems.
Just fucking take back politics from the corporations...
@@azpont7275exactly.
@@azpont7275 the biggest problem of universal healthcare isnt that its not affordable but rather that the moment you implement it so many people that are currently not able to get real care would use the system that for the first dozens of years or maybe a bit more it would be incredible pricey. the US basically fucked itself with such a bad system that it cant change it without massive spendings now.
The three highest paid jobs in Australia are surgeons followed by anaesthesiologists followed by specialist physicians. We have universal healthcare but with the option of buying private health insurance if we want some of the non-critical extras like private room, choice of doctors, shorter waiting time for elective surgery.
You'd probably find that preventative health care gets a higher priority as well, which will keep costs down.
@@rey6708The US pays already far too much for Medicare, Medicaid and VA Medic. They (poor, elderly and veterans) represent about 20% of the population and it costs the same (percentage of GDP) as other countries pay for all citizens. Your healthcare system pushes up prices up to five times as high (for medication, operations, treatments, medical aids) as in other western countries. The US is doing something wrong here and employers and healthcare insurance companies are profiting from this mistake.
An acquaintance of mine was going to die without a certain operation. His insurance (prior to Obamacare) wouldn't pay for it. He couldn't afford to pay for it himself (in the USA). He and his wife flew to France, he had the operation, stayed two weeks and flew home. That he could afford. Something wrong when Americans need to resort to medical tourism in order to live.
BS!
A very interesting video, thank you very much for that. It is one of my favorite topics.
I worked for a German employer here in the US for many years. Just recently I became a US citizen as a retiree and this way enjoyed the benefits of the German healthcare system all my working life as well as now Medicare. My impression is, that mainly the political will is not there. And as long as so many people believe it is against their freedom to be 'forced' into a health insurance contract without seeing the benefits of worry free healthcare, there does not seem to be a path forward.
However, in respect to your question: some of the cost could be cut by changing the insurance system; create a non-profit insurance system like in Germany the public health funds/Betriebskrankenkassen. By law they are not allowed to make a profit; if they do, they have to return the money to the insured. The ACA, has something similar if I understand that correctly. If the US insurance company pays out less than 80% of what they took in in premiums, they have to give that back.
Then in respect to education, my daughter is a PhD candidate in medical research. She received her science bachelor from a modestly priced state school and enjoyed from her first day on in graduate school a salary that provides her with a modest living in Manhattan. Students in Science, Technology, Engineering and Math (STEM) are being paid for their research and training they give to younger students. If that is possible for STEM why not for for medical school?
But walking with those ideas into nowadays Congress would probably cause you great bodily harm - and cost for deductibles to have the bodily harm fixed again :-))
Politicians use the word "socialist" to scare people away from universal healthcare. Medical and pharmacist lobbies give those politicians campaign contributions to prevent their cash cow from being popped. The politicians spread hysteria that healthcare will go away and your taxes will go up and it will create a totalitarian state if we move to universal healthcare.
3.9642857142857142857142857142
One of the travesties of the American health insurance industry in the past several decades involves turning very large not-for-profit insurance companies to for-profit companies. Such a huge step backwards. The biggest example is Anthem (now called Elevance) which acquired Blue Cross affiliates in about a dozen different states and turned them into for-profit companies. Luckily, Blue Cross and affiliated companies in most states still operate as not-for-profit organizations.
That was a really interesting analysis, showing the systemic problems of US healthcare reform. Thank you for that
As a US citizen, this video was very educational and explained in layman's terms quite well the failure of the healthcare system that does not break you financially. I have lived in Hungary for 3 years now and am thankful that I can see a doctor or dentist when I need to and not have anxiety about going into financial ruin.
You have done a very good job with this video, as you do in all your videos. Thoroughly researched too & unbiased. You should consider a job in a responsible media organization.
She has a job in a responsible media organization. Her own :)
I think you did a great job of summarizing they key issues in a mere 26 minutes. I’m a health economist and everything you say is spot on. The only thing I’d like to add is that Europeans often have a difficult time understanding the nature of our federation. You cannot really talk about a national healthcare system in the context of a constitution that fundamentally assigns health policy to the states. I live in Maryland. For decades, my state has regulated the price hospitals can charge. We have gone from being one of the most expensive states in the country for inpatient services to very middle of the pack. Our system pays hospitals more only when they deliver higher quality care; for this reason, there are generally no for-profit hospitals in the state. It may look like we have a “broken” insurance market, because our nonprofit health insurer dominates the market. However, this is largely because for-profit insurance companies cannot dramatically change their costs by manipulating their network of covered hospitals. Massachusetts has achieved near universal health coverage. Other states are also working on demonstration projects to move away from a fee-for-service model. Reform is possible in the US, but the magical will happen at the state level.
Many of us know know from deathplenity to abortion.
You less state and too much local state i too many things. By that You lack of needed reforms.
And a kind of funny You fear the state. Its the privates which are the problems in these matters as well.
Good to know, the info is appreciated!
"Only when the deliver higher quality care."
That sounds extremely subjective. It sounds like a scam.
@@jensholm5759 good grief. Can you type whole sentences? I'll likely still disagree with you, hut damn.
Sorry I has a bad spelling day not born the spoon.
I live in the Netherlands. I have been fortunate to live with this great system. Not just healthcare, but many more universal benefits. It always suprised that the US never copied it. Thanks for making me understand better that a big factor is this bloated system of profit. That is very difficult, and time consuming to rebuilt. Great informative video!
Not watched the full video yet but the quality of production is going up so much and i assume the content is well researched again that we can all watch until this channel becomes massive. Content creators like you two is what makes the internet work as it should a open playing field for people not just big content companies (and i worked for national tv and partly owned a production company) .. Keep going... now back to watching the video.
This comment made my day - thank you.
@@TypeAshton you are welcome its easy for us viewers to overlook how much work goes into making these videos at this level for a small content creator. I hope you are also having fun making them and that stays over time that seems to be the hard part for many once they add teams of people they need to support.
The "new" Ashton is getting better and better with in-depth research and analysis and, by the way, the elaborate presentation. How much time would it take only to find all these clips?
Comparing the pay of nurses and paramedics, however, it must be said that here in Germany underpayment and staff shortages are a big problem.
Main reason why I'm leaving Germany. It's good to live here, but as a healthcare worker, specifically a nurse, and to be a foreign one at that, it sucks.
I think the biggest impact we could make very quickly without disrupting the system too much is by forcing the healthcare system to put all of their prices out to the public. They will not tell me how much it cost to do anything until a month or two after services have been rendered. If we're going to live in a free-market society or something anything close to that we need transparency so we can exercise choice. From there the market forces can start to kick in and these healthcare companies will have to respond with actual competition.
I see the push for free markets as a Friedman fantasy. Doctors, clergy and lawyers were termed "professionals" because their services were necessarily beyond the money of the market system.
I have no idea how to change it but I do have one clear opinion:
Earning money off the sick and injured is evil and inhumane. Its sickening 🤢
Good morning Ashton, thank you for this one, very interesting ❤🤙
Capitalism is exploitation.
There is no fix for it. That’s the main purpose. The only way to handle it is to destroy it.
Welcome aboard comrade.
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party.
USA has everything to learn outside borders. Dont need to create anything. Just need to copy.
If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year.
"The rich stay healthy while the sick stay poor."
My Healthcare is free, in America.
And when I was raising a family I had good insurance so I didn't pay medical bills then either.
I'm Brazilian and Brazil is the only country in the world that has PUBLIC FREE UNIVERSAL HEALTHCARE. Each word here is important. Every citizen has a right to access it, whether he has insurance or not and it covers ALL levels of care, to basic medical care to ANY type of surgery to a heart transplant. You pay ZERO, whatever it is you need. It doesn't work all that well, we do have a private system and anyone that can pay for a private insurance will do it, sometimes you have to wait long, etc, etc. But we are a middle income country in a deep financial crisis with this model, called SUS ("Sistema Único de Saúde"- Unified Health System) inspired on the NHS of the British, a high income country, and we KEEP it!! Never was any question about giving up on it, no matter what. That's to say: There's literally NO REASON that the by far richest country in the word can't have AT LEAST a system like that SINGAPORE that is far to be so far reaching as ours. I hope you all Americans know we make fun of you guys for thinking this is "communism" when even Japan has its Shakai Hokken. To us that's completely MADNESS and there's no way you can even START o defend it.
So, if a country like BRAZIL can do it surely it's not hard AT ALL for the BY FAR THE RICHEST COUNTRY IN THE WORLD to do it. It's al excuses.
Thank you for this objective perspective in our healthcare system. You're right, their is no one solution to fix this issue. We need to create goals to achieve to help slow down the rising cost of healthcare. This could take a couple of decades for the US to catch up with canada, Australia and Europe.
one interesting aspect of healthcare in the US is that your insurance in your home state, does not automatically cover you in another state. in reality this just means that going to a doctor in a different state, say while you are traveling for work, will result in a potentially astronomic 'out of network' bill. Imagine having a heartattack in a different state, and then getting a bill afterwards that will give you a stroke.....
That sounds crazy. I guess the insurance companies will use every trick to pay less and make more $$$s.
That depends on which insurance policy chooses.
Europe regulates cost of each medical procedure to prevent price gauging by the hospitals.
Medical degree is free and students are expect to service the society in public hospitals who paid for their degree. Medical staff are given a comfortable income, not a crazy high income
Yes it's not perfect , but the society sounds much more fair than USA
The problem is that a lot of hospitals are now run by private companies, basically equity funds. They have to maximize profits so they try to keep salaries and number of staff low. That's why al lot of nurses are fed up and actually quit their job during or after covid.
There is also the issue of administrative waste, specifically in the insurance side of things. The itemization, collation, billing, price 'negotiation' with insurance companies and so on are a ridiculous affair compared to European style healthcare systems.
The hospitals are incentivized to micro-itemize and vastly overcharge because that's how they make their money, they then have a few rounds of negotiations with the insurance companies and they decide between themselves what the real price is and what is covered or not, if the doctor or specialist was out of network or not etc, etc at the end they decide on a figure that the customer will have to pay.
@@birgitlucci9419there is an issue solution to that problem. Buy them out. Either make private hospital care illegal, or make sure that they can not be run for profit at all. This mean they can not use the money they earn to invest in anything else but the hospital where the money comes from. No you can't use that money to make a new hospital, that is the same as for profit.
Here in Denmark private hospitals can be forced to take on normal people whenever we see it fits. This is almost only used for long waiting times. But we could just send them to the private places if we wanted to, in principle. And they are still here. They need to provide better care than what non-private provides, or specialty care, dental, beauty surgery and so on.
The high standards should never be lower. It should not be profit driven, but driven to provide above normal service or specialty service. That is what I want to see for the school system as well in the USA. Here it is supposed to be like that, if it is like that? Eh it depends. Some are money hungry, who don't care about the education of the kids..
@@Sindrijo You're exactly right - And the right try to claim nationalisation leads to administrative waste and "big government". In reality it's always the opposite!
It's increasingly going that way here in the UK too, with every little hospital department having to consider itself as a small business. It's shockingly bad, un-cost-effective management, but due to right wing interference trying to gradually privatise the NHS over several decades. Everything has to be cost controlled and within certain budgets etc. when it's supposed to be a service that's already paid for. I can see first hand how the whole system is getting ready to be able to provide itemised bills when they finally start charging patients here.
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party.
USA has everything to learn outside borders. Dont need to create anything. Just need to copy.
If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year.,..-,.-,.-,.-,.,
Good friend of mine is from UK. He got moved around as an exec for his company, from UK to France to Italy and finally
to the USA. He has a wife and three sons so his family fully experienced all four systems.
I asked him how does the US system of healthcare compare?
His succinct reply - "Healthcare in America is arbitrary cruel and frightening"
Our country (Slovenia) has universal healthcare system and similar outcomes (life expectancy, child mortality) to more developed countries in Europe but with a bit lower healthcare spending in comparison with more developed countries. Preventable deaths aren't only due to healthcare system but also because of lack of possibility to eat healthy, to exercise, etc.
Hello from slovenia
It could be interesting to see a breakdown of expenses. I guess that a German nurse earns more than a Slovenian nurse. So the German system will naturally be more expensive.
I expect that German hospitals are willing to pay more for very expensive treatments, but some people say that it would be better to spend the money on more nurses.
Don’t forget preventative healthcare. Many Americans are reluctant to seek preventative healthcare as it is too expensive. This lowers life expectancy (together with gun shootings).
Your English is better than most people in the US! 👍🏼 Great job to Slovenia for caring for its people! ❤
@@rhmendelson thanks!
I am from Austria which has nationalized health care with a private option. In essence that means the government decides what you get (in terms of health care) otherwise you need to pay the difference out of pocket or via private insurance. A friend of mine (a orthopedic surgeon) did a study several years back. The gist is people with puplic option only, often don't get hip replacement surgery usually opting for less invasive treatment. While people with private insurance can opt for the surgery whenever they want and have them much more often. Turned out the live expectation of people with private insurance is significantly lower then people who don't have it, because of the risk factor of surgeries. Unsurprisingly technocrats, doctors and statisticians have a better grasp on health care than grandma.
This is really interesting! I wonder if there is a similar research made here where I live (Finland). The system is very similar, and the private sector definitely pushes people to have more invasive treatments than the public sector, including things like x-rays when they are not really needed.
In America, I was sold on a couple of joint replacement surgeries, mostly because it made the practitioners a lot of money. None of them worked out as promised and I sincerely regret agreeing to these surgeries, they have ruined my life.
What annoys me about the German system is that they still allow Homeopathic woo "medicine". At least it generally doesn't make things actively worse.
@@Llortnerof That's a problem here to, it's in my experience more a problem with pharmacies. They tend to push herbal treatments, homeopathy, etc. really hard because prices and profit margins for real medicine is fixed. So if you opt for the herbal treatment they earn more. Doctor tend to give homeopathy to people when nothing would be the best option but grandma wants something so she feels better, hence the sugar pills.
That's actually one of the realizations that led to the plan for the Affordable Care Act (before it was watered down 100 times): by providing evidence based treatments only, the cost can be significantly reduced because with private insurance there is little incentive to avoid unnecessary treatments.
This lady makes exceptionally well researched and high quality videos. She's obviously very smart and hard working. Some of the best videos on RUclips.
Thank you!
As someone living in the UK it is my opinion that the USA won't get universal health care because too many individuals and corporations make so much money off poorer people they won't allow it to change, that's what I think.
You are correct
That's about the size of it....
Exactly...and the voter's are stupid.
I lived in Saudi Arabia most of my life. Though a third world world country, healthcare has been fairly accessible even to the poor.
My father once told us that story about an African guy (that had used to work for him) after he had died in his home-country in Africa. My father said, "the guy went to the hospital. Well, if you go to the hospital in Africa, you know you're already dying, because you won't go there unless it is THAT urgent".
Years later after I was in the US, I remembered what my father said, and I was like,
"Thank God I'm not in Africa but in the US.
Oh wait."
How is saudi a third world country
Saudi Arabia is a 1st world country & very wealthy
The US hasn't been able to give healthcare to its own citizens for over a century. RWANDA now has universal healthcare. Thats a country where they were butchering each other with machete's just twenty years ago, and THEY now have universal healthcare.
I have to say one thing about social media now, is that its no longer like when social media first started and it was full of americans talking about how its the greatest country in the world. Now I don't see those kinds of comments very often.
I like apples and I like oranges,but America and Sweden or Finland or Germany America under Obama almost got it right but insurance companies won and now are eating away at your social security system 😅
Can you please expand on that? I don't understand what this story about an African guy has to do with Saudi-Arabia, a rich developed country.
You are doing a great job on healthcare and urban planning, two areas I watch everything that Google /RUclips presents to me on the sidebar. It makes me doubt the effectiveness of their algorithms that I never saw your work until about 2 weeks ago when they listed your vid about your mother's injury. Now they present your work frequently on the sidebar.🧙♂
Once again, a hugely important topic, Ashton!
One thing I wasn't aware of was that US insurance costs for health care personnel were so huge.
I've been working in obstetrics and gynecology for 40 years by now. In Sweden, the insurance was taken care of, originally the doctors'union, which also insured midwives and nurses.
I've NEVER paid more than around 1,000 € per year!
(Now, a "private" company has taken over these insurances, but the fees are the same).
In EVERY respect I can find, outcomes of US healthcare is considerably worse than Swedish, or other European outcomes. The most horrific example I've found is MATERNAL DEATH.
Sweden 4.5 per 100,000 births
USA 21 per 100,000 !!!
The reason, arguably, MUST have to do with accessibility. Sweden introduced the maternity program, free of charge for every pregnant woman, already in 1940, which was the first in the world. It has remained free of charge ever since, whether provided for by local government or private companies.
This also includes specialist maternity care, like for instance care for diabetic mothers,
The question in my mind is, how much worse must the outcomes be in the US before there is a real popular demand for universal healthcare, affordable for everyone. If it's big law the idea is battling like you said, then my heart sinks. That seems one hard nut to crack, and presumably, that's why so many americans think that universal healthcare is more expensive than the present system, even though in reality it COULD be very much less expensive!
I agree - I think a lot of the conversation is a bit misguided since many discussions about "taxes doubling" are mostly scare tactics. Americans pay twice per capita for healthcare per capita with their current system but do not get doubly better outcomes for it.
And with the increasing instances of effective bans on abortion, maternal death in the US is only going to increase in the forseeable future.
@@f0rth3l0v30fchr15t It sounds like Sweden over 100 years ago. Around 1900 - 1910. you could find newspaper clips telling about the horrific finds of dead newborn babies set out in the forests, And it happened more than once ...
It could be less expensive and great….but most Americans lack trust in their government to do *anything*.
And the ones that appear to do so have a hefty chunk of dissonance going on.
HAHAH - i like these comments ,,, sorry to say : the big US companies will deny this idea at all costs ! they earn too much in the actual system ..and normal people will never ever have a say in the US .... ask those people who dislike/condemn gun violance ... any change in the us so far ?? nothing , right - because the NRA will not allow it !! so simple ..... rich companies and people rule - not votes !
As long as our healthcare system is based in private insurance it will remain intrinsically designed to avoid sick people
So why don't you, we, call our system in US what it really is: Corporate greed.
Look who benefits when we get sick: Greedy uber rich CEOs. Private Equity firms are buying out healthcare companies. They are buying up mom/pop dental offices. The care you get now is all about saving the Board of Directors money. They cut corners, & more comes out of our pockets.
Our housing is at a crisis because Private Equity forms are buying up rental properties, driving up rents, buying up homes for cash and affordable housing is now harder to find.
Corporate greed. We are being ruled by greedy oligarchs all over again. And Citizens United helped them even more!
Always amazed at the breadth of your knowledge. Very well researched and very fair/balanced viewpoints.
The problem is this, Americans do not like their fellow Americans. If an American thought their neighbour was getting something for nothing they would blow a gasket. Europeans think differently, if their neighbour benefits from a system set up to benefit everyone then the system is working properly.
A family from the US, living in the UK made a video about some of the differences between the two countries. One thing they mentioned was how people in the UK were much more socially minded, caring about other people.
@@grahvis Exactly.
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party.
USA has everything to learn outside borders. Dont need to create anything. Just need to copy.
If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year.,.-,.-,.-,.-,.-,.,-
Here it pops up again. American exceptionalism. Well drop it. Americans like their neighbors just as much as other people. Forget the idea that America is a reflexion of how americans are different or exceptional. The american democracy is corrupted in several ways. Fix the democracy, and all the other problems will disappear.
Maybe because they think of themselves as belonging to the same tribe, whereas Americans think very individualistically
I've been in healthcare finance for 25 years. One element missing in many analysis is the piece of the economic pie that goes to investor-owned insurance plans. What would be the effect of making all of healthcare a non-profit activity? Also, the discussion about higher taxes seems to never include the offset for premiums saved. Depending on how it was structured, it would also tend to make healthcare a significantly less regressive cost, since it would be based on a percentage of income, rather than a flat fee.
That's what I was thinking. What happens if the insurance company middleman is out of the picture? People would still pay for access to healthcare and doctors/nurses would still make decent salaries, but the $41B currently going to insurance company profit margins could be used to pay for actual medical services instead.
Another great video, fair and balanced as always, keep up the good work
I have never seen anyone go so much in depth on this issue. You made me realise that there is no quick fix. I believe that the government negotiating prices on medication is a good start, but so far they only negotiate a limited amount of medications. I know there are caveats to that mandate, as having to take into account the cost of research and development, something that limits the bargaining power. Here in Norway, we have no such caveats, and the government negotiate prices of every medication in the country. I know, the pharmaceutical lobby and all of that, but to me that would be the place to start. And again, astonishing and in depth video, I don't know how you are able to do it.
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party.
USA has everything to learn outside borders. Dont need to create anything. Just need to copy.
If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year..,-,-,,-,.-,.-,.-
You make an excellent point at the end. The US needs to look at what other countries are doing. All of them have lower costs and many have better care than we do. One of the different models used by these countries will work here, especially if we ever get tort reform. However, one thing that needs to happen is campaign finance reform that will limit the influence corporations will have on Congress.
IMAGINE the rest of the world without US innovation,equipment,medications,knowledge, etc.. 60% of the money in the so-called for-profit healthcare is TAXPAYER dollars. OBAMACARE the UNaffordable Health Care Act. Alex Epstein 's "FOSSIL FUTURE" on sale now.The Moral Case for Fossil Fuels. HUMAN FLOURISHING
It looks like people are beginning to express their fury beyond words towards the pathological corporate/shareholder greed$$.
Too bad that not much will get done over it. Especially since most of us are blaming one or few individuals when we're all part of the problem.
Another great video and you mentioning obgyns made me think that you talking/discussing healthcare with Mama Doctor Jones would make for a fantastic video/collaboration (she is a texas obgyn currently working in New Zealand so she has the experience of both healthcare systems).
As to solutions, i firmly believe that any society that wants to advance needs to determine/answer the question:
What services do each person have a right to (i.e. healthcare education, police, fire department, unemployment, pension, housing etc) and provide the greatest benefit to all (i.e. teachers should make more money than politicians because they contribute more to society).
This discussion should be held based on really data and not some vague threat (all doctors will leave for instance).
A small anecdote, years ago there was a massive uproar here in the Netherlands about public servants earning more than the prime minister (Balkende) and there (like the banks did during the baniking crisis) the argument was made that all good servants/bankers/doctors/nurses/etc would leave the country.
This has never been proven and defies logic (who would uproot their entire family and live when they actually have a good life already).
Anyways would love to see you and Mama Doctor Jones collaborate, have a great sunday and see you next week
Of course medical care works. The strange thing is that the payment method changes the validity of anything according to many Americans. Challenging that concept would need to change the American education system as well.
Living in Austria with a Brother in the US I am still stunned what he tells me about medical costs once in a while. A broken finger from a Basketball game and you end up with a bill of a few thousand dollars. This is so unreal from a European perspective. Anyway your video is great and I have a much better understanding of the difficulties to change the us system for the better of the people. Does not look like an easy job :)
Your brother must have gone to the emergency room.
Tell him the following
1) Unless the bone was poking out the skin, or dislocated, you can go to your general Doctor and skip the high bill.
2) Emergency room prices are negotiable. Meaning you can go over the bill with a person at the hospital and get better pricing if you are paying out of pocket.
@@GrandpasPlaceI live in the Netherlands and the whole idea that you have to negotiate in the emergency room sounds horrible to me.
@@arjan2777 You dont have to, you can pay the higher prices. However, those are the published prices for insurance reasons.
@@GrandpasPlace For a normal person with only a reasonable income and responsibilities for other people you just have to. You can not afford just to throw away so much money.
For you maybe not
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party.
USA has everything to learn outside borders. Dont need to create anything. Just need to copy.
If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year..,,-,-,.--,-.-,.
Universal healthcare might never ever work in the United States. But that has nothing to do with the nature of universal healthcare, rather it has something to do with the United States of America.
Correct. Most of the medical breakthroughs and medical technology and pharmaceuticals have come about BECAUSE of the “for profit” model that is used in the US.
@@johnp139 Baloney
@@WLBarton4466 Not really!
Wow. That was so interesting ! I am glad that we have had universal health care for so long here in Germany. I think to implement such a system in todays complex world and in a democracy is next to impossible.
But I would think that just a little more regulation on the prices (for medicine at least) should be possible , or not ?
There needs to be an incremental plan drawn in advance. As there can't be one overhaul to fix it all, there need to be time-set milestones for the next 15-20 years so the system can adapt. The most essential coverage must be given as soon as possible (maternity care, antibiotics and life threatening emergencies [including ambulances], and regular blood/urine tests should all be completely free without conditions). The rest can follow in 5,10,... years when the financial burden of the transition relaxes. Most likely, lawsuits would reduce if healthcare was less expensive to the individual, as people sue for minor things in desperation to get some money back on their expenses. Salaries can be just frozen (so the rest catch up with inflation), instead of reduced. Regulations can cap the administrative cost per patient of a hospital in order to be eligible to participate in the program. And most importantly, pharmaceuticals must be made for a fraction of the current cost (with conditions that the cheaper produced, but equivalent quality medications *must* be chosen by the doctor).
Long timeframe is also required so the mentality of the people can change.
You are generally right. The entire health infrastructure in the US is fundmentally broken except for the wealthy and needs to be overhauled to move to a universal health care system. Ashton touched on it when referring to the ridiculous education costs racked up by students which then drives a bunch of other behaviour such as favouring specialisation over general and public health.
The US has the highest health outcomes costs for the lowest outcomes in the developed world. For example, pharmaceuticals are insanely expensive as there is no PBS or equivalent scheme and medical systems are not working together to bulk-buy and price negotiate pharmaceuticals for lower prices.
Another example is the high cost of medical insurance driven from the high payouts of medical claims. If peoples' medical outcomes from bad decisions were still covered by the medical system, and people didn't need to sue to get enough money to cover their future medical costs, then insurance costs would drop.
If there is ever a strong will in the US to improve health outcomes, it will require long-term planning as many existing structures need to be torn down and rebuilt. The current US failure of understanding universal health care is that they just see it as someone else paying for their insurance, and not actually getting insurance companies out of the picture altogether and dramatically lowering the cost of delivering high-value healthcare.
As usual very informative. Every Sunday part of my ritual is to check your vlog. Have a good holiday season. Take care.
Happy holidays! Thanks for watching!
Every time I watch one of your videos, Ashton, I'm glad I live here in Germany, and not the US.
I think, the US needs to realise that unchecked capitalism does not work. At least not for 95% of the population. But as long as there is a system, that requires political candidates to have a lot of money to get elected, you will either get these millionaires in power who just serve themselves and not the people, or you get politicians who owe to millionnaires who financed their campaign, and no matter how much they want to make politics who help the poorer people, they will to some extend pass laws that just serve the rich, and they will not change the system.
60% of US healthcare is taxpayer funded. OBAMACARE aka the UNaffordable Healthcare Act. Capitalism:The UNKNOWN Ideal by Ayn Rand
The average rate of increase for health insurance premiums almost halved for individuals after the passing of Obamacare. It went from 7.9% to 4%. Yes, more money was spent in healthcare but we are covering more people
Singapore model adapted to the US? With emphasis on Direct Primary care?
Could there be room for a small change, like f.i. start a cooperative health insurance company where at least the usual profitmargin is circumvented and then go from there in small steps ?
Absolutely. I recently spoke to a friend of mine who is a neurologist in California. One of the big things he talked about was how medical billing on the insurance side of things often makes no sense. The costs are outrageous because they can be outrageous and the patient (usually) doesn't feel the full financial weight. I think oversight of pricing would be a good place to start.
Where will you find staff who is willing to take a paycut to work there? And will patients sign waiver forms to not ask for 10M compensation because the pillow is too uncomfortable?
@@zurielsss The staff don't have to take a paycut, because the patient fees can be reduced by not paying shareholders dividends.
Like that CostPlus pharmacy? Could work.
You'd need enough angel investors, or startup capital, to survive the attempts of the for-profit company's attempts to squash you though.
I really liked the example with the nurses, as it shows well how many things are interconnected. But talking of nurses, I don't think it's fair to compare wages with nurses in Europe while in fact in many European countries nurses complain that pay and working conditions are far from ok for the kind of work they do. So yes, US nurses certainly have inflated paychecks but then European nurse wages do need a raise.
Absolutely.
Essentially nurses in Germany would rather like better working conditions than more money. In comparison to other workforce they don't earn to bad.
@@markusschafer4895 yea I think in Switzerland working conditions are also a big concern but pay is also a topic. I guess the mix has to be right and if neither working conditions nor pay is very good, noone will stick around for long. Which is one of the biggest issues: huge turnover and many leaving the profession which puts even more strain on those who remain.
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party.
USA has everything to learn outside borders. Dont need to create anything. Just need to copy.
If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year.,,.-.,-,,.-.-,
I’m from Australia and it’s a question of values. You can defend the American system if you simply don’t care about all of the people needing healthcare. From what I see in most defending their system, it’s about what they themselves can get, not about what’s best for everyone. No point arguing with people who think that way.
Bingo
Interesting to know that thanks to something that happened not so long ago (Obamacare) young adults in the US can be insured through their parents until they are 26.
This has been a norm in Europe (I can generalize here for the entire continent) for many decades.
Which is not a good thing.
@@diggernash1Why not?
@Sine-gl9ly Because a portion of those expenses for low income parents must be born by the other, higher income tax payers. Better to have no regulatory requirements and allow the lowest risk persons have the lowest insurance costs. How is it my civic duty to help the adult children(or any age children) of others recieve healthcare?
By the way, as a fellow American abroad, you are one of the ones that I proudly call "fellow". Your videos are thought-provoking, factual, and intelligent. We have quite a few nitwit Americans abroad. An American living abroad has an obligation to be informative to people back home, without the US brainwashing. You seem to have broken the brainwash well. Keep up the good work.
I'm satisfied with the status quo. I enjoy Big Pharma, For-Profit Hospitals, For-Profit Insurance, gouging us when we're the most vulnerable.
Wait times in Canada & in Finland are Longer than I have heard of in the USA. That is also my experience
No one here in Canada likes long wait times! It is because a shortage of doctors and nurses which exists in the US. Here in Canada, there are steps being taken in many provinces to improve situations. I’ve not waited long for good care. Some places are better than others.
I am 70 a Canadian and never suffered from any wait time!
What an excellent video, thankyou. I trained as a nurse in Britain and I've worked for 20 years in France. I earn about 30,000 euros a year, but I have the satisfaction of being proud of providing a public service, while knowing that my family will have their health needs covered.
Like I was saying, people engage in medical field in Europe with commitment and devotion to heal, not to get rich. At least, for the most part. The ambitious ones go to private path and the greedy one go to the US. In Europe, and pretty much in most part of the world, doctors heal people, they're not accountants before being a medecine man.
Not sure that the first cab of the rank for addressing cost should be worker costs.. e.g. nurses. They at least work for their living. Insurances, pharma profiteering, hospital overcharging are all lower hanging fruit.
Just because you asked: 1. Free education. My US dentist wanted $ 800 for a tiny front tooth filling, because she 'owes 265K in education cost'. 2. Forget about malpractice suits. I hate folks who get rich on other folk's misery. Should have sued Kaiser 7 years ago, when they misdiagnosed the staph infection in my knee as 'gout', and the nurse I met the next day, with a red swollen knee the size of a newborn's head told me: 'you were lucky you came here in time, you would have died a painful and horrible death within 24hours'.
I would start with education as well. It would have so many benefits to the society overall. But of course, that is not simple either.
Nations whose national defense is effectively funded by another nation can well afford to spend that money somewhere else, and need to recognize that their benefactor doesn't have this luxury.
America is like a job with crappy benefits. Most Americans have never traveled and lived outside the country and are none the wiser about what life in other countries is like. Like a job, you can always leave it for a better one if you are brave enough, and wise enough to know there is something else better out there for you.
Very cool and interesting explanation!
Basically it says: All the huge amount of money in the US healtcare system lands in somebodys pocket ..... and nobody wants to lose that.
Very cool the connection to the education and law system - I didn't connect the dots until now.
No! Most of that money goes into R&D to develop new pharmaceuticals and treatments!!!
@@johnp139 That doesn't contradict my post at all.
(and it doesn't explain why other countries could afford a healthcare system with their own pharmaceutical R&D for much less money)
It seems to be an attitude problem. US is somewhat unique in terms of the whole "manifest destiny" mentality. If you truly believe that everything is under your control and you can be extremely successful based on the merit of your work and abilities only, it doesn't make sense to build systems aimed at social support. And changing perception of your identity is a very tough thing to do.
Unfortunately, realistically, I don't see how this changes, without things getting so bad in US that society would be forced to re-examine basic assumptions about itself.
You need to admit that your labour and talents are not enough, and that there are things outside of your control, and that investing into the common pot makes sense, becase there might be a day where you'll need that help.
Europe went through that process by virtue of having a lot more time and being a lot more compact than US.
I honestly wish there was an easier way.
I was about to comment: "The problem with the US is the US", which is more or less what you said.
Indeed, the famous quote: "America is the only nation which has gone from barbarism to decadence without the usual interval of civilization"
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party.
USA has everything to learn outside borders. Dont need to create anything. Just need to copy.
If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year.
In Australia...
A problem with UHC is the hospitals make patients wait for attention anywhere between 4 to 8 hours, making sure patients don't want to attend again.
Private Doctor visits are fine but you might still have to pay a high % of the Bill.
I would suggest first establishing _one_ non-profit health insurance fund in _one_ US state, along the lines of the German health insurance funds. Without profit motive, it can provide the same services as for-profit health insurance companies and be always cheaper in premiums. It will stimulate competition and customers will flock to the new insurance company. Then other states will follow the trend and set up their own non-profit insurance companies.
Problem is that this will be litigated all the way up to the supreme courts (state and federal) and even then face severe political opposition (campaign contributions need to come from somewhere)
@@PauldeVriezelet it happen. If insurance companies won't spend its billions on actual human healthcare, at least they can help a few lawyers stimulate their local economies. Conservatives and capitalists spend decades and ungodly sums of money eroding rights and protections. That doesn't mean we should stop trying fighting the good fight. The more damage people see certain people continue to do, the more people are turned off and stop supporting them.
You will never change anything in USA, as while you dont abolish the winner takes all the seats election system, that perpectuate forever in power the 2 party dictatorship. 2 elected wings full controled by the same not elected eagle group. The zero point of any USA problem are on that system. USA citizens should demand for the proportional representation parliament democracy system, to abolish both corrupted parties. USA are not a true democracy because of that. The diference between China and USA, is that at least China dont lie to their citizens. They are a 1 party dictatorship. USA are a 1 not elected party dictatorship, that guives the ilusion of choice with 2 parties pretending to not be the same party.
USA has everything to learn outside borders. Dont need to create anything. Just need to copy.
If one day USA become a multiparty system, like all democracies should be, corporations loose their government control, because both democrats and republican parties will disapear and be replaced by new ones with new people, like we do around all europe year after year..-,--,.-,,-,.-,
And how do you get doctors to participate in a plan that will pay them less than a for profit insurance company?
@@kevinreynolds7125 Why should they pay less? Just cut the profits of the insurance company itself, and perhaps streamline the administration a bit, and non-profit health insurance will outperform all for-profit companies. The doctors and hospitals, etc., will all stay the same, including their profits. And yet, the rates can be made cheaper for the -customer- patient. Once you have enough insured people, you can start haggling with the pharmaceutical industry and the hospitals, doctors and ambulances to drive down prices (and thus premiums) even more. This way you gain even more members and it becomes a positive feedback loop. Yay, capitalism!*
*Yes, it is still capitalism because non-profits are perfectly fine in capitalism, aren't they? If a billionaire with half a brain and real philanthropy, not just for looking good, would establish a foundation like that tomorrow, it would work from the get-go, without any governmental involvement (apart from laws and regulations), just like here in Germany.
That sounds pretty scary. I am wondering, with the density of medical practitioners already low, what happens if you have an accident or some other medical emergency somewhere in the boonies in the US?
But we do have our own set of problems here in Germany. Similar problem, everybody wants everything anywhere anytime. Recources are limited. So they do have to be managed in some way or other. And that management is also strictly politically motivated and dominated. Examples:
- Being a general practitioner or a pediatrician is on the lower end of the reimbursement scale. Hence there are much fewer GPs and pediatricians than needed.
- Being a general practitioner in the countryside is even worse. So lots of practices with the current GPs hitting the retirement age are now closing down for lack of successors.
- OTOH larger cities swarm with lots of the same specialty doctors next to each other. And they all want to make a living.
- Certain types of treatment are being paid better than others. Leading to treatments with may pay better, but are not necessarily better for the individual patient. The notorious example are spinal disc surgeries. Less aggressive treatments would often be more in the interest of the patients, but they pay worse - and might be more expensive upfront.
- Everybody wants to have the full service hospitals and pharmacies nearby, nobody wants to pay for it, and nobody wants have to make do with “only” basic services locally and having to go somewhere else for the specialty services. Even the argument that is much better for you to have your new hip done at a hospital that is making 300 of them every year 80 kilometres away rather than being one of eight such patients locally does not really wash. Typical response: “I want that hospital to be in my town! Period!”. Currently the discussion is about concentrating extreme perinatal care at hospitals which do at least 25 cases every year below 1,250 grams birth weight. According to the studies this would improve the outcome for the newborns - but, well, I think you will guess the general response to that.
- Local politicians revel in "saving the local hospital". Never mind that it is neither medically nor financially viable.
- The medical role model is still the self-employed registered MD with his or her own mom-and-pop practice. Group practices or syndicates are not quite a thing yet.
- And so on.
It is kind of a Gordian knot. Too much government meddling makes things excessively expensive for suboptimum overall performance. Too little oversight does the same, just with a slightly different flavour.
With an NHS you have a process by which a Doctor can achieve the status of an expert sometimes called a consultant. The expectations of quality are peer-reviewed. The expectation is that of higher quality. In the U.S. with no NHS how do you know you are getting the best or at least an expected quality of service? I do not see this happening, reputations are a result of little m or big M marketing. Not so elsewhere. Does this make the average U.S. Doctor have a worse standard?
In Germany they have universal healthcare. They take 15% of your paycheck to pay for this service. The quality of service is ok. My problem with it was that someone else decides if you need medical care. Once you get too old, they stop care. My father-in-law died because of this.
Eh there's some mis-information here.
The total is 15%, but that's only if you could the half paid by your employer. Most Americans also have their healthcare subsidized by their employer.
But there is a key difference: the 7.5% you pay out of your paycheck is capped. Once you earn over (roughly) $56,000 per year in income, your income is no longer taxed for healthcare contributions.
Plus, healthcare is all inclusive for your whole family. You don't pay more if you have 1 kid or 8 kids. And if your wife/husband is a stay at home parent - they are covered at no extra cost.
There are no copays, no deductibles, and no out of pocket costs. So if you get sick, injured or require care - you never have to worry about a bill.
It is for these reasons that the average German family pays less for healthcare than American families. And also why GoFundMe doesn't exist here.
Quality of service has regularly been rated higher than the US by numerous international agencies and absolutely no one "decides" if you need care. You just get it. And you can choose any doctor you want. "In Network" isn't a thing here.
@@TypeAshtonThere really NEEDS to be things like copays and deductibles in order to discourage waste and to get something back from the people that use the system more than others. Nothing ridiculous, but some equity.
Thank you for your explanation of American healthcare system. We have our own problem with healthcare in Canada, like long wait times. At least I did not go broke due an emergency gallbladder surgery.
I had emergency gallbladder surgery in the US, and because I had health insurance, I also didn’t go broke.
@@johnp139 That is good. At least you had health insurance. to add to my comment above, the wait time for my emergency gallbladder surgery was none.
In US the nurse example NEEDS $ 120k per year to survive. $ 60k per year in Germany is worth a lot more than $ 120k in the US. When I take myself as example: I would need to earn about three times as much to have somewhat the same quality of living - actually more.
But medical insurance is much of WHY we need so much more to survive
@@Bookhermit Simple groceries is about three times as expensive. And if you look for fresh herbs, which are common here, you won't find them. The dried herbs are 4x or 5x as expensive. If the $ were not a world currency the exchange rate would reflect ist. Hence the reason for more dedollarization pressure than ever before. BRICS might have a real outcome.
When you mentioned the share of 18.3% of the US economy, I began to ask myself, how much of this really 'helped' in any way.
Is it used to support people that might need this money (school meals, housing support, ...)? Or is it going mostly to shareholders accounts of the top 5%?
Does it create new jobs (except maybe a dozen researchers)? Or does it advance automation and that way reduces the number of jobs?
In any case, would a change to universal health care make any real difference to the economy (ignoring the changing numbers)
This was surprisingly a great take. I will say a few things as someone who is currently paid more than my international counterparts in my field.
The first thing we need to change is the stanglehold that Doctors and medical professionals have on the industry. Think of how competitive Med School is, and think of how there is a constant shortage of doctors and advanced healthcare practitioners. That is by design. Limiting the supply ensures a lack of competition and subsequently a high salary. If there is one thing we should put government money to fund it is Medical Schools. Increase the supply whether or not the industry wants it.
The second biggest issue I see is that everything im the US promotes seeking the best possible doctor/hospital regardless of cost. If you pay a small percentage and then have an out of pocket max, you wont be concerned as much about the value of where you go. Any universal health insurance (I think that Universal Health Systems are currently out of consideration) should focus on giving a base amount for services rather than a percentage as well as forcing the industry to supply quotes for service in advance rather than charge them after the fact.
There is so much more wrong with the US healthcare system, but those are the top two in my opinion.
Excellent points. My take is that the biggest issue is the profit motive coupled chillingly with the greed of the insurance executives and shareholders.
The stranglehold GOV has on the industry. 60% of the money in the so-called for-profit healthcare is taxpayer money. OBAMACARE aka the UNaffordable Healthcare Act. Alex Epstein 's "FOSSIL FUTURE" on sale now. The Moral Case for Fossil Fuels. HUMAN FLOURISHING
I'm Brazilian and Brazil is the only country in the world that has PUBLIC FREE UNIVERSAL HEALTHCARE. Each word here is important. Every citizen has a right to access it, whether he has insurance or not and it covers ALL levels of care, to basic medical care to ANY type of surgery to a heart transplant. You pay ZERO, whatever it is you need. It doesn't work all that well, we do have a private system and anyone that can pay for a private insurance will do it, sometimes you have to wait long, etc, etc. But we are a middle income country in a deep financial crisis with this model, called SUS ("Sistema Único de Saúde"- Unified Health System) inspired on the NHS of the British, a high income country, and we KEEP it!! Never was any question about giving up on it, no matter what. That's to say: There's literally NO REASON that the by far richest country in the word can't have AT LEAST a system like that SINGAPORE that is far to be so far reaching as ours. I hope you all Americans know we make fun of you guys for thinking this is "communism" when even Japan has its Shakai Hokken. To us that's completely MADNESS and there's no way you can even START o defend it.
As a physician, I think the potential exodus and shortage of physicians as well as ancillary team members is often understated by proponents of a Medicare for all plan. The pandemic has shown that there is a limit to a healthcare worker's willingness to make sacrifices, and reducing take home pay could end up being the last straw for many, especially since the student debt issue is constantly mired in political uncertainty. I've seen state governments use timely access mandates as an attempt to cushion the current fallout, but there's going to be a limit where more people leave the field due to unrealistic demands on the system. "Adding more paying customers to increase pay through volume" as Obamacare emphasized in its initial phase won't fly now, as there's only so much harder you can get people to work before they vote with their feet.
It would be a tragedy if the US had universal healthcare : Breaking Bad and dozens of TV shows and movies wouldn't make sense anymore !
More seriously, until the US political system is fixed, I don't see any possibility.
the majority of our hospitals are non-profit. but non profit does not equal non expensive...
Hell, yes, it would work... if only Americans weren't so indoctrinated to misunderstand that 'social' programm does not mean 'socialist' programm.
There are many different ways to make a universal healthcare system work; Germany's being one of them. Yes, it's not perfect, by no means. But it certainly is better than what the USA currently exhibit.
That's my honest opinion BEFORE I watched the video. Let's see how this plays out.
It's super interesting.... the quote "sicko socialism" comes into play in the final chapter, as its a quote from the Fox News Anchor I used in the video. Interestingly it is in reference the expansion of Medicare - which has been in place for almost 60 years.
The problem exists, because the State interferes automatically with the US principle of individual liberty. In Germany you have the same principle, but as it is one country, your individuality is embedded in being a people, what makes one person to an extend more social. In the US, you are not or far less and communitarian only in the traditional States in the middle of the country. Especially at the coastal areas, individual greed thrives in a more and more anomic area, which is a pull factor created by the State's interference. Germany also had it's Obamacare after 1998 (Red-Green) by Ulla Schmidt, what was a horror and got refinanced with a lot of closures of doctor offices in the countryside, so that basically migrants can get free stuff in the city and it's not crashing instantly.
@@urlauburlaub2222 I think there is a big difference in mindset between the USA and Germany. Americans (as a group) usually are talking about their 'rights' and 'choices'. Germans have 'obligations', restricting their 'freedom' like in not defaming your opponents (Artikel 2, Grundgesetz: "Jeder hat das Recht auf die freie Entfaltung seiner Persönlichkeit, soweit er nicht die Rechte anderer verletzt und nicht gegen die verfassungsmäßige Ordnung oder das Sittengesetz verstößt."), not shooting at people, yielding your right of way on the street (§1, STVO: "Wer am Verkehr teilnimmt hat sich so zu verhalten, dass kein Anderer geschädigt, gefährdet oder mehr, als nach den Umständen unvermeidbar, behindert oder belästigt wird.")
@@wora1111 Hmm, no. The US Constitution doesn't say anything else than the German one, but the US is far more multicultural and Socialistic than Germany. So, the average German is more social. Younger generations are different, because they are not homogenous anymore and so they are more like the US Americans and want less community.
@@urlauburlaub2222 "the US is far more multicultural", hmm, willing to take a ride with the Straßenbahn with me in Karlsruhe? Those that can be called 'Germans in second generation' are the absolute minority - even though all will talk German among themselves, usually fluently, many without any accent. Even more so with the younger people (30 and below).
I know fewer 'young' people but those I know are not less social, they usally hvae thought about the subject less that the older ones. But when watching their behavior they are just like us 'old ones': Getting up to make room for older people, moving to the side of the road to let others pass more easily, and so on. And yes, that includes immigrants and refugees (after they acquired some German).
My (Canadian) wife is currently in hospital in Manchester (England) after an horrendously bizarre accident in a car park. She was attended by two ambulance crews, airlifted out by helicopter, in intensive care for the first week, moved to a high dependency unit for the next, and is now in a trauma ward, recovering. We expect she will be there another two weeks at least. Thanks to the NHS, there has been no question of cost because all A&E coverage is free. I cannot imagine having such an accident happen in America, having to decide on the spur of the moment whether we could afford any of that. We are retired, with no health insurance of our own, totally and happily reliant on universal healthcare both in England and Canada. Words like co-pay and pre-existing condition are simply not in our dictionary. And I have to say that neither of us want to cross the border into America any more, because of the crazy healthcare problems you have there.
It’s NOT FREE!!!!
That’s why you should always get travel insurance!
One solution would be to have the US government lawmakers pay their own healthcare, just as they expect the rest of society to do. than we would be getting somewhere.
They are on Obamacare
“No society can legitimately call itself civilised if a sick person is denied medical aid because of a lack of means.”
--- Aneurin Bevan, British Minister of Health (1945-51)
What’s your point??? Anyone in the US needing medical care is provided with it.
You asked for input in how a universal healthcare option could be implemented in the US, so here is one option I have thought of.
The road to become a licensed physician is very costly, and as you pointed out in the video, often leave the newly minted doctor with a substantial student debt.
If the government could build community hospitals with emergency rooms, or somehow use or create positions in existing private hospitals (nonprofit?) for newly minted doctors fresh out of medical school.
These doctors could have attended medical school for no cost, or at least very low cost, courtesy of the US government, who will foot the bill for their education.
In return said new doctors would contractually work for a period of years, perhaps a dozen, for much lower wage, similar to the pay level for doctors in other western countries.
This model could also be applied to other professionals in the medical field.
There would be a lot of details to work out, but it could be a start.
Thanks for yet another great video.
"That doesn't mean that we as American's don't have a lot to learn from other countries and how they operate." Sadly that is one of the impossible thoughts ever for American's to swallow. I honestly think the world map for most Americans is a map of the Continental United States and beyond that is just says, Here be Monsters. So we almost never learn from other nations.
I am Australian. A couple of years ago I had heart valve replacement surgery.All of the tests, appointments etc. leading up to the operatation, my time in hospital and the on going care have not cost me anything.
Wow! What a great piece on this important topic and especially for wading into some of the associated factors like costs and tort reform. US healthcare is not a fix one thing problem! I’m not very optimistic that we will make meaningful changes in my lifetime.