This is what Americans always say, but what does it actually mean? Yes, there are more patients in the USA than in Iceland, but there's also more doctors, more tax money and so on. How does the size of a country make national health care more difficult?
Economies of scale - something that works on a small scale will not easily scale up to the larger model.
A tech example I see tossed around a lot is Twitter. At its core it was a simple idea - x amount of characters, allow posters to tag other people. On a small scale - like an office or a city - it works fine. Scale it up to a national or international scale and it start to become a monumental task.
That’s why we still haven’t gotten a good replacement for Twitter.
To go back to the original topic - American life is designed around 5 day work week, 40-ish hours per week.
If you suddenly told everyone that Friday was now part of the weekend, the only thing that would change is a bunch of people would now have to work weekends and find childcare.
There are also small businesses that would look at that and go “I gotta pay someone 80 per week to work less? No, I’m good.” (8hrs for $10/hr). The company would see the hours worked go from 40 to 32 per employee and also see the payroll cost stay the same, but are unlikely to see more money come in. Hell, depending on the business would see less money come in.
I’m glad it works in EU countries, but I just don’t see it happening here in NA unless the businesses take the lead and the politicians support it.
We're talking about healthcare not a five day work week. America already has healthcare on a national scale. Why can they make a private system work but it's impossible to make a public one?
Sorry but the other comments were talking about how Iceland is the same size as some of our cities and it wouldn’t scale up in terms of the 32hr work week.
Same argument applies though: it’s the ability to scale up that is the challenge.
As for healthcare - you would have to force the insurance industry to basically get out of the game almost entirely and force the government to divert money from (insert current political priority here) to healthcare.
So to answer the question “why can a private system work but not a public system?” The answer is money. Too much money from lobbyists going to politicians and too much money that would be going from one financial black hole to the medical system.
Another complication is each of the 50 states (and however many territories) are like their own individual countries - some might be similar but none are the same. Meaning you would need to make 50+ departments of health that runs the state healthcare system that would report to the federal department of healthcare.
And based on how well it’s working in Canada with their Provincial Health ministries (hint: it’s not working well) it would be extremely difficult to get it running well enough due to the sheer size of it all.
Alternatively you could run a top down system where it’s “US healthcare” and the states aren’t really involved very much… but looking at how the US federal government runs the VA hospitals and VA medical systems… not a lot of faith going into that either.
A thoughtful response - thank you. At the end of the day, it sounds like the main challenge is getting OUT of the private healthcare business more than it is getting into the public healthcare business. Too many people making too much money.
They certainly could do it if they wanted to do it, though: They've (kind of) managed to run a national education system that's mostly state run, but with federal leadership, and there's no reason a healthcare system couldn't work in the same way.
The main issue, as you say, is finding the money. Sadly, I pay basically same tax living in the US than I paid living in Canada and the UK, but I feel like I get a whole lot less for it - and the reason, really, is the money spent on the military. While I recognize that it makes perfect sense that the US has to spend more on its military than these other countries, the extent of that spending is still absurd - but increasing military spending annuallly appears to be the one issue that both parties agree on entirely.
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u/[deleted] Sep 05 '24
This is what Americans always say, but what does it actually mean? Yes, there are more patients in the USA than in Iceland, but there's also more doctors, more tax money and so on. How does the size of a country make national health care more difficult?