Blogging this tweet because this explains SO MUCH about the mindset of pretty much all the folks I’ve known who’re against single-payer, it’s not even funny…
This….
This never occurred to me. Not once. That Americans are against Health Care because they think it actually costs tens of thousands of dollars for a broken arm, hundreds of thousands for a complicated birth, millions for cancer treatment.
Because they’ve never known anything different. The idea that a broken arm is only a couple hundred bucks; a complicated birth a couple thousand; cancer treatment only tens of thousands; all easily covered by existing tax structures.
This explains a lot. And it’s a good example of what I was talking about in my post on scarcity being used to prop up ableism – always question the idea that a resource is genuinely scarce. Even if it seems obvious that it is, quite often that’s the result of careful manipulation and misconceptions that you’re not even aware of.
And never think you’re too smart to be fooled by that kind of thing, it doesn’t work like that. Similarly, don’t think people who are fooled by something are stupid. Nobody can have all the information about everything, and nobody has the time and energy to investigate and put together conscious conclusions about every piece of information they’re given. It doesn’t take being stupid, or even just gullible, to believe something like this.
I currently live in a country without free medical care and still, it’s enormously cheap compared to the USA. An American expat wrote a piece for our English language paper about how she paid more for parking at the hospital than giving birth to her baby that’s pretty interesting:
https://grapevine.is/mag/articles/2016/01/06/healthcare-in-iceland-vs-the-us-weve-got-it-so-good/
If price fixing was actually enforced against medical providers…
If this is difficult to assimilate, consider the humble aspirin. There are no aspirins on Earth that are worth the money that USA hospitals charge. Aspirin – a simple cheap form of salicylic acid – is worth less than pennies and the formulation doesn’t vary. You can buy packets of aspirin for less than a dollar and a lot of that is packaging. In market value, individual aspirins are worth fractions of cents. Hospitals in the USA will make a spirited attempt to charge you wild amounts for them. Ten dollars apiece! Twenty dollars? Thirty? Who knows! Hurray!
I … did not realize this
I do need to add here that part of the reason medications cost so much more in hospitals is because the cost includes helping to pay for the people preparing (the pharmacy staff) and administering them. It may sound like giving an aspirin to a patient isn’t a big deal, but it actually is, because aspirin is generally used these days as an anticoagulant rather than as a pain reliever.
Which isn’t to say that drugs aren’t massively over-priced here in general. They are. But part of not having universal health care means paying out a lot of money to coders and billers, which takes money away from things like nursing care, which is way more important. Seriously, one of the biggest issues that we have here is how many people and how much money we have to spend to deal with the byzantine craziness that is all the different insurance companies–negotiating with them, following their guidelines for what they will & won’t pay for, etc. The money to pay nursing staff (and the patient care techs, the pharmacy techs, etc.) has to come from somewhere, and it’s the nurses who, with a lot of care and skill and background knowledge, administer the medications to the patients.
Oh see in the NHS, the nurses just cast a spell to materialize the aspirins from raw fundament, already in a little paper cup, and we pay them in acorns that we leave under toadstools.
Sorry, that was uncalled for, I just liked the mental image.
So we are actually agreeing with each other, I think you possibly got confused (probably my fault) and took a different angle.
Let’s say that the cost of making a burger is $5, and a restaurant burger costs $15. Everyone says, “hey, that’s pretty fair. Five dollars goes for the burger, five for restaurant overheads – salaries and electricity and decor and so on – and five for the restaurant to make a profit.”
In the UK, they said “okay, we’ve decided that burgers are a human right, not something you should squeeze profit from. We will charge $10 for a burger. That’s the cost of the ingredients, plus the admin fees of making and serving it and so on. It’s a nonprofit, a National Burger Service. but you can still pay $15 for a private one at a premium restaurant if you choose.”
America looked at that and said “burgers are $45.”
“But America,” everyone said, “but …why?”
“Because burgers cost a lot.”
“Er, could you show your math?” Everyone asked, except they probably said “maths.”
“Yes. $5 for the ingredients, $5 for salaries and electricities and the restaurant decor and whatnot. $20 for profit. And another $15 to collect the profit.”
Everyone else says “huh, how … interesting!” And continue to provide their citizens with $10 burgers, which somehow functions.
So then some American citizens say “oh, we like the look of the UK’s National Burger Service. Should we do that too?”
And America goes, “what, suddenly you can afford to hand out $45 burgers to every random fucker you know? Burgers are $45, you fools.”
And the citizens say “oh, you’re right, that sounds expensive, sorry. Let’s not do that.”
And this thread, including Elodie, says, “by the way – burgers themselves, as burgers, are worth more in the $10 range, which is what other countries charge.”
And you’re like “NO ELODIE BURGERS ARE $45 BECAUSE YOU NEED TO PAY FOR THE CARPETS, AND THE BURGER BILLING DEPARTMENT, AND THE COLLECTIONS AGENCIES, OTHERWISE HOW WILL WE PAY THE POOR SERVERS?.”
But that is not QUITE what we are talking about. Healthcare costs in countries with socialised medicine do not include the paying for the cost of the salaries of the billing departments because billing doesn’t work that way under socialised medicine.
So one way we could start working towards that is by saying “the $10 burger is possible, and indeed it is practiced in many economies.” Then, I think, people will feel more relaxed about it, and will start to consider it without panicking.
“Always question the idea that a resource is genuinely scarce”. Words to live by.
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