this post was submitted on 11 Mar 2024
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[–] [email protected] 13 points 8 months ago* (last edited 8 months ago) (16 children)

I think this is a bit too simplified. The "Government pays the bill" is not how it works at least in Germany. We have "Private health insurance" and "compulsory health insurance". If you decide to leave the later, you do not pay into the system anymore, but have to get a private insurance (and you might not be able to get back into the compulsory insurance when you get older).

Anyway, the way the system works is that there are many insurance companies that you can choose from with different profiles that take care of the bureaucratic underbelly of managing the whole process. These company has thousands of workers to take care of these processes and guide/deny their customers services. My Insurance company alone has 15.000 employees.

If the "Government pays the bill", then you might need something like 30.000 - 80.000 federal workers to take care of the bills/requests to guide the patients and prevent fraud. Will the government hire them? Is the plan like having a NHS like the UK?

My point is, the Government will not pay your bills. A subsidiary with a over decades grown structure will do that. I can already see how people gonna hate the new structure, as it will struggle for the first 10-20 years to define their processes and layout the services. On the other side will be people with deep pockets still using private insurance. These companies will use their money to attack everything this new government system will do and will rile up people against it to gain back the market.

I am absolutely pro-single payer system. I just hope no one is so naive to think it will be just like the graph shows it. It will be much more complex than that and people need to fight for it and endure some "finding phase" for the first two decade before one of their presidents will trash it again. I can already see fox news headlines about how people died because of the new system or how a grandma in ohio did not got the right care at the right time and therefore the whole thing is apparently a bad idea. It will be rough to say the least. I would not always tell people that the "Government" pays the bill, as many people in the us are sadly on the spectrum of cringe conspiracies and have a retention for everything the "Goberment" does. I think it is a bad idea to say the Government does everything, as it will be used against the system: People will claim their grandma died because of the Government ("death panels!!!") and people will say the government be the one who denied their claim to getting a new hip with 90 years ("outrages!!!!") or some of the funds getting wasted for hard-to-communicate reasons (the swamp!!!!) tainting more and more the public opinion of the governments work. You should better start using the subsidiary in your graph communication that will take the praise/blame for the development. Because the Government will not pay your bills.

Will americans have the voice to change the system? Will americans have the patience to overcome the problems? We can only hope so.

EDIT: Because some people missing the point: I would add a shape between the Government and the Doctors on the right. Could you draw a chart about the UK or German Healthcare-System without once mentioning the NHS or Krankenkassen? They are a n essential part of the system to work and employ thousands of workers. I think the chart oversimplified this aspect.

[–] [email protected] 5 points 8 months ago* (last edited 8 months ago) (2 children)

Because this doesn't describe what Germany has. There aren't any insurance companies in the graphic. In Germany we don't pay taxes for our healthcare, we pay contributions. So why would this be oversimplified because Germany?

[–] [email protected] -1 points 8 months ago* (last edited 8 months ago) (1 children)

I did not compare it to Germany. I used Germany only as a step into my post. It is over-simplified as it is not how it will be in the US. Can you draw a chart for the UK Health System without once mentioning the NHS or describe the German Health System without mentioning once the Krankenkassen? Between the government and the Doctors will be at least one institution that most possibly will be named "American Health Service" or something like that. Drawing a line from the Doctors to the Government makes it sound like people gonna send their bills to the White house. The reality is that the Government will only allocate the Funds for a certain subsidiary unit that will handle that worksload. The NHS in the UK employed 1.2 Million people. Leaving out that aspect is critical in a chart like that. In my view, the graph is too simplified. If you feel it is telling all you need to know, good for you. Apparently rough outlines like that are all you need. I would at least insert one shape between the Doctors and the Government as there will be hundrets of thousand of workers who will do the actual work. Government will only decide on the funding.

EDIT: Man you must be mad. Downvoting me one minute after I post this. Using your alt accounts to give yourself 3 upvotes one minute after you posted it? Crazy. But who cares.

[–] [email protected] 4 points 8 months ago* (last edited 8 months ago)

I didn't use any alt or downvote anyone. But why would I draw a chart of Germanys system without insurance companies? That wouldn't be the German system.

And that's my point. This isn't showing the German system. So your initial assessment of this being oversimplified because it's different in Germany doesn't make any sense.

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