Tweet is from around February 2022; I’m not visiting that cesspool to find the exact date.

  • Revan343@lemmy.ca
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    Americans pay more for healthcare than any other country, for worse results than any country with universal single-payer healthcare. Moving to the same model as Canada or the UK would mean paying less for healthcare, and getting better healthcare.

    Which is obvious once you understand how private health insurance works.

    • Norah - She/They@lemmy.blahaj.zone
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      My friend, you’ve been sold a story about Canadian healthcare that is a complete lie. It’s a province-based system that is in complete shambles. Just look at what Doug Ford, the premier (equiv. to governor) of Ontario has done: https://www.ona.org/news-posts/20221124-healthcare-union-sos/

      What would likely work the best in the US is a system akin to Australia’s. It’s federal-based, and is a combination of public and private. Private health insurance still exists to cover “gap” fees and similar, but, similar to medicaid, low/no-income earners don’t pay. America is already doing most of this, but nationalising most hospitals would be required, as well as forcing private health insurers to divest ownership of other medical clinics. This would be to eliminate the inane “in-network” crap, which we don’t have in Australia (for the most part).

      Doctors here aren’t employed by the government like with the NHS in the UK either. They’re able to run private clinics, and can charge above the government “bulk-billing” rebate. That government rebate is set nation-wide for all services in a master price-list, and is always paid out for those services whether the patient has private health or not. Then the provider and insurance negotiate for what is paid above and beyond that only. This gap fee can be paid directly by the patient, or by private health insurance. Clinics generally waive these fees for both disability and aged pensioners.

      It’s far from perfect, but I think the US would need to follow a system like this. Otherwise doctors, used to a certain wage and lifestyle, would likely revolt in some fashion.

      • rasakaf679
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        1 month ago

        Its not the doctors who are reaping the benefits its the insurance companies and hospital administration that make most of the money

        • Norah - She/They@lemmy.blahaj.zone
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          This take really completely misses the point of my comment. US doctors still make much more money than UK ones who work under the NHS. Obviously insurance companies and hospital administration make the vast majority of it. They can safely be ignored if you were transitioning the system, as they provide literally no value. If you try and pay all the doctors less though, and they revolt, you won’t have anyone to do the actual work.

          • PriorityMotif@lemmy.world
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            1 month ago

            My doctor wants me to come in monthly just to see him for 5-10 minutes just so I can get refills. The price is over $200, but I only pay $65. Plus the cost of perscriptions. Over the course of a year I am paying over a weeks pay just so I can have meds.

      • Drivebyhaiku@lemmy.world
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        1 month ago

        Alberta adopted this model and saw an increase in public health wait times and a sharp increase in the required government spending required to run the public system.

        Creating a two tiered system means that it bleeds doctors, nurses and admin into the private sector which is fundamentally at odds with the philosophy that everyone deserves the right to life sustaining care. If the rich want to dodge the cue then they can quite frankly afford the plane ticket. If the system is being undermined by politicians - oust the politicians. Let them know that that system is of the highest priority and should be first to see reinvestment.

        But we should all be aware that Canada is one of the most challenging landscapes for delivery of any kind of health care. We are diffuse over a large landmass and the commitment to the system means that if you live in a remote place 2 hours away from the nearest surgery then the government is on the hook to spend an outsized amount of budget to uphold the commitment of care for you. The temptation to cut corners is always there and each Provincial trust is its own battleground. That we have the level of service we do is a credit to the efficacy of public health systems… Which means upping the costs to create competitive private sector development hurts us all.

        It may be a step up for Americans to have any system at all as a right to health safety net but it’s a sharp step down for anywhere running a full public system.

        • Norah - She/They@lemmy.blahaj.zone
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          The point of my comment is that doing it that way would be far more likely to actually be supported in the US politics, given the current state of their system. It feels like so many people there want to skip straight to single-payer. Having that goal is counter-productive, it’s never going to happen.

      • kerrypacker@lemmy.world
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        I know nothing about Canada but the way this person described our Australian health care system is correct and it works well…those who can pay more (me!) but those who can’t are still 100% covered. It’s not perfect but it’s 100 times better than the US.

      • _core@sh.itjust.works
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        All that would do is set a baseline pricing model, hospitals would price everything above it and people would be on the hook for the difference. It doesn’t solve anything and let’s politicians say “look we have national healthcare!” All while maintaining the same overly expensive, inefficient, less effective system we currently have.

        • Norah - She/They@lemmy.blahaj.zone
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          Except, that doesn’t happen in Australia. Places will “bulk bill” to be competitive, aiming for volume to make their profits.

          Otherwise, good luck convincing those politicians to transition to a fully nationalised system I guess. I just strongly believe that’s never going to happen in the US, and that something is better than nothing. If we can’t even manage that in Australia, what hope do you all have?

    • EldritchFeminity@lemmy.blahaj.zone
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      This is the thing that drives me crazy. Especially with those “I don’t want my money going to pay for the wrong kind of person’s healthcare” idiots. It already does. You already pay for that. Private healthcare is socialized healthcare except with some rich dumbass acting as a middleman so he can scrape a ton of money out while denying grandma that new hip she needs in the name of profits.

      Just because you call it an “insurance fee” and pay more than if it was called a “tax” doesn’t somehow make it better.

    • GraniteM@lemmy.world
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      1 month ago

      Here’s Life Expectancy vs. Healthcare Expenditure, and there you can see Americans on average living about as long as people in Turkey or Poland while spending dramatically more than people in Germany or Switzerland.

    • Forbo
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      We’re already paying more money for worse care. So dumb.

    • DrMorose@lemmy.world
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      With my portion and my companies portion, it would almost be the equivalent of what Germans pay in taxes for all the programs they have over there. I think most are in the same boat we just don’t realize that we are getting fucked or we do but we don’t realize by how much.

      It was an eye opener to actually look at it since your health insurance is taken from your paycheck before you actually see it so most people don’t even think about it.

  • ZILtoid1991@lemmy.world
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    Libertarians be like “But with free healthcare, I would pay for liver treatment for alcoholics, and lung treatment for cig smokers! No one will incentivized to live healthy lives!”

    • funkless_eck@sh.itjust.works
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      They already do, though, that’s what insurance is. They’re just paying for the premium luxury version of liver treatment.

      • zbyte64@awful.systems
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        American Libertarians would be okay with many of the contracts we consider illegal, like ejecting people with pre-existing conditions.

    • pyre@lemmy.world
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      I think I found a way to convince them. we can say that with free healthcare kids under 18 will be able to go to a hospital and ask for treatment b without their parents because they won’t need money anyway and doctors would want to keep their medical history confidential.

      if kids can make healthcare decisions without their parents getting involved, that would be a first step towards lowering the age of consent!

      I made it up but if we make it sound convincing they’ll be advocating for free healthcare in no time.

      • Zink@programming.dev
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        Unfortunately i think “Medical privacy” is going to scream “abortion” to your target audience.

        • Twista713@lemmy.world
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          Not to mention that anything mentioning minors making their own medical decisions without parental consent will be interpreted as confused kids allowed to get trans surgeries en masse. It makes no sense but that fear is already there.

  • Uriel238 [all pronouns]@lemmy.blahaj.zone
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    Funny how Reagan ran on fiscal responsibility, gutted social programs and then spent all that money on military crap and subsidies for industrialist pals. It’s never been different. Even the tea-party was miserly about social programs but happy to give the military everything it wanted (but not to improve the DVA and things to improve the lives of soldiers were right out.)

    And yet somehow who’s going to pay for it is regarded as a valid argument even though these social programs would be a tiny fraction of what we spend on our toys for killing people.

    • EdgeOfDistraction@lemmy.world
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      Reagan didn’t just spend the money from social programs: he changed the US from the biggest creditor nation to the biggest debtor nation to fund the military.

  • qjkxbmwvz@startrek.website
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    You can also take a fairly selfish view and come to the same conclusion. Like, I don’t want to see homeless encampments, or really sick and untreated people, or panhandlers, or (…) while I’m walking around in my city. I can solve this problem by 1) moving to a nice suburb, or 2) having my tax dollars go to fix a problem that affects me. 1) is off the table because I want to live in the city, and 2) — while it helps the greater good — also helps me directly. (2 can also be addressed in a draconian fashion, which is not what I’m advocating at all.)

    I think one problem is looking at things as zero sum. It’s not. If you are healthy and housed and fed then you’re not — to be very crass — an eyesore, you’re adding to the fabric of the city. I want street musicians who are playing for fun, not because they’re trying to make enough to afford dinner.

    • HubertManne@moist.catsweat.com
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      This is something I just don’t get how so many folks don’t seem to get it. Social safety nets make just a better overall environment to live in. Most people work jobs interacting with other people and have all sorts of things outside of work interacting with people. Ideally they are clean, healthy, educated, and are happy in the sense they are not worried about their prospects for basic necessities like food and shelter.

      • YtA4QCam2A9j7EfTgHrH@infosec.pub
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        There is some percentage of people that simple can not think in any other way than zero sum games. Every transaction, interaction, etc needs to have winners and losers. They can’t see that some spending is good because it helps people which in turn helps them. It is a completely alien world view that I also don’t understand. They are the foot soldiers for fascism.

        • zea@lemmy.blahaj.zone
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          I was gonna joke that they must not have friends then, but that’s actually a pretty common problem.

  • WaxedWookie@lemmy.world
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    1 month ago

    The US has by far the most expensive healthcare in the world, and for all that expense, achieves outcomes comparable with the third world.

    Negotiating with providers as a single payer massively shifts the dynamic by putting the negotiating power in the hands of the people representing patients, and allows a huge amount of bloat to be removed from the system - like the entire insurance industry.

    Single payer will deliver huge savings, better healthcare, and better access. The people that lose are the grifters draining the system for profit.

  • UraniumBlazer@lemm.ee
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    Ok, so I completely support universal healthcare. However, it still is true that you are paying for “someone else’s healthcare”. How?

    Let’s assume that there’s a flat tax percentage - 30% for all. (Actually most developed countries have progressive tax systems, but let’s ignore that for now). The more your income, the more tax you pay. Therefore, some people pay more tax than others. This means, that some people contribute more to fund the healthcare system compared to others.

    Some people have pre-existing conditions. Some people may just be unhealthy due to bad lifestyle choices. I might be incredibly fit. The probability of me falling sick would be very less. If there were a multi payer healthcare system, then perhaps I might not need to spend much money on healthcare. A universal single payer system might be forcing me to pay more for others’ healthcare. Therefore, saying that I’m paying for someone else’s healthcare isn’t inaccurate.

    That being said, healthcare is a human right. Every human, regardless of financial status deserves timely access to good healthcare. That’s why I support it.

    • burgersc12@mander.xyz
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      Right now we pay for other peoples healthcare and we also pay some shitty middlemen who tell us what treatments they think are necessary. If we cut out the middlemen its literally cheaper than our current system.

      • UraniumBlazer@lemm.ee
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        We pay the middlemen, yes. I don’t see how we pay for other people’s healthcare. The private insurance that I’ve experienced takes many factors into account (age, quality of health, pre-existing conditions and so on). Thankfully because I’m both young, and don’t have pre-existing conditions, I pay less insurance premiums than a kid born with diabetes.

        Remember, we’re talking about technicality here. We aren’t talking about ethics. Strictly from a money standpoint, we’re not paying for other people’s insurance.

        • Strykker@programming.dev
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          If you pay for insurance you are paying for other people’s Healthcare. The whole reason to do insurance is that you have the ability to use more money from it than you ever put in, but will hopefully never need to. Otherwise it would make more sense to just have a health savings account.

          • UraniumBlazer@lemm.ee
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            What about the premiums though? Say the insurance premiums for x amount of coverage are 100 dollars. Doesn’t matter if I’m a billionaire or if I’m homeless. The premium stays the same.

            In a single payer universal healthcare system however, the premium would be a percentage of my income (collected via taxes). Suddenly, the 100 dollars becomes hundreds of thousands of dollars. Therefore, from my perspective, I am “paying for someone else’s healthcare”. This is the technicality that I’m talking about.

            Now of course, fuck my perspective because fuck billionaires. This however, is out of scope of the discussion.

            • Zink@programming.dev
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              You also have to consider that the healthcare is worth a lot more money to the billionaire than the homeless guy. Just like the roads and the protection of the armed forces worth more money to him. I’m sure the billionaire is a fan of price discrimination too, conveniently enough!

              • UraniumBlazer@lemm.ee
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                Sure! The homeless guy is very likely uninsured. They might die in the streets because of this. The billionaire on the other hand would get higher quality healthcare. What would not be happening though, is the billionaire paying for the homeless guy’s healthcare.

                Now of course, a consequence of that is the homeless man dying. Ethically, this is an incredibly shitty system. THAT’S why we need single payer universal healthcare. However, a consequence of that would be the rich paying for the poor people’s healthcare.

                • Zink@programming.dev
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                  Yeah I didn’t comment on the “person A paying for person B” technicality because that’s always part of the deal. It happens with private insurance too. If the lowest paid worker at a company is healthy, and the billionaire CEO has a multitude of health problems, then if they’re using the same company insurance the poor person is paying for the rich person. It doesn’t matter that they’re paying the same premiums — the healthy poor person is getting less out than they paid in, and the sick rich person is getting more out than they paid in.

        • Podunk@lemmy.world
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          Yes you are. The insurance company takes money from healthy people, scoops some off the top for themselves, and then distributes the rest to pay for grandmas hip replacement.

          Unless you use the same or more than what you paid into insurance, you are subsidizing someone elses healthcare.

      • UraniumBlazer@lemm.ee
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        1 month ago

        Agreed. The ethical argument for universal healthcare triumphs everything else, assuming that we value human life equally.

        • Uriel238 [all pronouns]@lemmy.blahaj.zone
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          Except the US clearly has a stratified society, even when it tries to lighten that with myths of fair pay, opportunity and get-rich-quick schemes (all the old American dreams before the post WWII townhouse family.)

          Part of the rise of fascist rhetoric (targeting minorities like trans folk and immigrants) is to distract from the failure of these myths. Millennials and Zoomers know they’re probably never going to own a home, or get to retire well, which not only discourages the Protestant work ethic (see quiet-quitting) but also elevates civil unrest (see the Great Depression).

          So the Republican response is to kill elections and install one-party autocracy backed by a police state. That way they don’t even have to listen to fellow Republicans, after they realize getting benes from being party loyalists are not actually soon to arrive. This is literally a return to monarchy, as Representative and constitutional historian Jamie Rasken has observed.

        • SpaceNoodle@lemmy.world
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          Well it also helps that it would be overall cheaper, with the only difference being that a few assholes wouldn’t be getting rich off it at everyone else’s expense.

    • lad@programming.dev
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      For some reason everyone thinks they are the healthy ones that don’t and never will need healthcare, not like those unhealthy everyone else

      • UraniumBlazer@lemm.ee
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        True. I’m playing Devil’s advocate here. These r arguments that I’ve heard that make sense technically, but not ethically. I’m not saying that real life me would want to give up my universal healthcare lol. It’s a safety net that I absolutely want in my life (for selfish reasons as well)

        • TotallynotJessica@lemmy.world
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          No. These arguments don’t even make sense technically. Hospitals generally don’t deny emergency care, often leaving people with huge bills after their stay. If someone doesn’t pay, insurance needs to recoup the cost by charging higher rates for everyone. On top of that, preventative care is often cheaper than emergency care, with poorly insured people usually receiving less of it.

          Without socialized healthcare, you pay for the care of everyone that can’t pay through your insurance AND people receive worse care overall. The healthcare system functions worse, even when money isn’t as much of a concern. Unless you’re a billionaire with private doctors on payroll 24/7, anyone can get fucked over when emergency care is shit.

          There is no logical argument for our system unless you believe wealth can always protect you. They think the foundation can rot away without ever hurting them, but that’s the fantasy of people who believe in perpetual free lunches.

          • UraniumBlazer@lemm.ee
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            Insurance premiums are flat. They don’t give a shit about your income. The insurance premium for a minimum wage worker and a billionaire would be the same for a given coverage.

            When you make it universal and single payer, the billionaire has to pay more money for the same quality of healthcare compared to the minimum wage worker. Therefore, the billionaire is essentially subsidizing the minimum wage worker’s healthcare.

            Now of course, you can argue about the ethics of private property, how the billionaire became a billionaire by wage theft and so on. The point is, within the capitalist system that we have, universal healthcare is still the rich person paying for the poor person’s healthcare. This is the technicality that I’m talking about.

            Remember, I support universal single payer healthcare. I am merely talking about technicality here.

            To address the emergency room situation, what happens when the person being admitted lacks any sort of insurance? If they can’t cough up money, then they go into debt. Their credit scores get screwed. Life becomes hell.

            • TotallynotJessica@lemmy.world
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              The minimum wage worker simply doesn’t have the same quality insurance. They could never afford the best plans, as those are more than they can pay, so they get more limited plans with less coverage, fewer options, and longer wait times. You often need to pay out of pocket to get acceptable care for certain issues, even if you have decent insurance.

              With the emergency room issue, most of that debt the uninsured people take on never gets paid by them. This isn’t just their problem, but a problem for hospitals and doctors and banks who don’t get paid for their work. The banks don’t just shrug their shoulders and accept the systemic loss, but recoup the costs from the entire medical industry. It costs more than 2x for a bandage here because those banks make the cost of providing care higher at every possible step.

              As more become uninsured or unable to pay, even the hospitals can’t stay out of the red, shuttering care for millions. Many areas have zero options for hundreds of miles as a result, meaning many people die preventable deaths because it takes hours to get it. The US has a geographic scale you cannot comprehend as someone elsewhere. It’s on the scale of the EU. State politics serve country size populations, but the relative homogeneity of culture betrays this fact.

              You have absolutely no idea how a world without single payer works because you assume we have basic shit you take for granted. You once again demonstrate that arguments against single payer MUST IGNORE facts to work, cutting out the bigger picture to keep you from recognizing the scale of the problem. It’s why capitalism is so impossible to tackle in general.

              • UraniumBlazer@lemm.ee
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                The minimum wage worker simply doesn’t have the same quality insurance.

                THERE! So the billionaire pays more to get higher quality insurance. In a single payer universal healthcare system, the billionaire and the minimum wage worker both get the same quality of healthcare despite paying different amounts. This is what I mean.

                You have absolutely no idea how a world without single payer works because you assume we have basic shit you take for granted.

                I have experience with the Indian multi payer, non universal healthcare system. It sucks a lot more than the US. U guys at least have the affordable healthcare act, which prohibits discrimination against ppl with pre-existing conditions by insurance companies. Indians don’t even have that. The universal single payer healthcare system that I have experience with is the Canadian one.

                Now, of course the arguments against universal healthcare fall flat on ethical grounds, as you explained above. I am not saying that universal healthcare is bad or whatever. However, that does not change the fact that universal healthcare follows the “from each according to their ability to each according to their need” thing. Rich or poor, everyone gets the same quality of healthcare despite paying different prices. The rich here are subsidizing the poor.

                Now, there’s nothing wrong with that. The concepts of private property themselves cause trouble, where we lose all sight of humanity, blah blah blah. That’s a discussion for another day.

                The point is, if you are rich and want a better life for yourself, you probably should be against universal healthcare. If u r anything but that, and want a better life for everyone- u, ur family, ur friends, or just society in general, universal healthcare is a common sense choice.

                • TotallynotJessica@lemmy.world
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                  That doesn’t change the fact that selfishness in this case is measurably less prudent in the long run. This is often the case for capitalist ills, but being selfish is only in one’s self interest if they ignore the bigger picture. The effects of our broken healthcare system are more well documented and understood, but it’s also the case with poverty and climate change. They make things worse for even the wealthiest people.

                  Even though the collective class of wealthy people is smaller and more capable of working together, they often got there by refusing to think about the collective, while those who were less selfish tended to get filtered out. It’s all too easy to undercut others who try to work together, so they choose the worse option consistently and fuck over everyone in the process. It’s the prisoner’s dilemma, with no one having the guts to risk the others getting ahead.

                  That is the fundamental reason why no major country will abandon fossil fuels. All our kids would be better off, but there’s too much risk of losing out to someone who didn’t do their part.

                  However, part of the problem is that the capitalists in charge refuse to acknowledge the benefits of not being selfish. To avoid the internal conflict of questioning their choices, we easily ignore unfortunate truths. It happens everywhere, from comedy entertainment to the highest levels of science. Repeated game theory does not favor the most selfish strategies, but people think that selfishness pays off in the long run, so they refuse to consider the most prudent options.

                  So no, you are actually wrong about what’s in rich people’s self interest, but you’re wrong in the same way they are. Capitalists are not more logical than average people; they’re actually quite stubborn and stupid. They’ll drink lead and die from it before they’ll accept that they’re wrong about it being safe.

    • bdonvr@thelemmy.club
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      it still is true that you are paying for “someone else’s healthcare”.

      Yeah but that’s ALREADY how it works. With private insurance some people pay their premium month after month after month and make no claims. Some people get paid out more than they’ll ever pay in. That’s how insurance works. Plus with private insurance toss in shareholder profits and millions of dollars in quirky commercials off the top of that.

      • UraniumBlazer@lemm.ee
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        Insurance premiums aren’t decided by my income. They are decided by my probability of needing the coverage offered. Therefore, if I am rich, I end up paying a smaller percentage of my income on insurance premiums for the same coverage compared to a poor person.

        Single payer universal healthcare makes healthcare more expensive for rich people and cheaper for poor people. I’m not saying that’s bad ofc.

        • friedmag
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          This is true for any real insurance, but not health insurance. Health Insurance premiums are decided by your employer, someone who has no reason to even be involved. It’s entirely based on how much “benefit” they think they need to give you compared to their peers.

    • Ultraviolet@lemmy.world
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      You’re already doing that with insurance premiums. Universal healthcare is that but cheaper because the government doesn’t have a profit incentive to price gouge.

      • UraniumBlazer@lemm.ee
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        1 month ago

        Universal healthcare is that but cheaper because the government doesn’t have a profit incentive to price gouge.

        Cheaper for everyone except higher income folk. They would benefit from a multi payer, private insurance system as they would end up paying less.

        You’re already doing that with insurance premiums.

        Insurance premiums aren’t decided based on my income. They’re decided based on the probability of me needing healthcare. Therefore, we kinda are not doing that right now. Universal, single payer healthcare would mean that healthcare expenditure would increase with my income. If I’m rich, I would be very sad.

        But I’m not. Also, eat the rich. Healthcare is a human right. I am very happy with the universal healthcare that I have lol. I wouldn’t want it to go away at all. But again, I was talking about the technicality here.

        • Strykker@programming.dev
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          1 month ago

          Guess who tends to need Healthcare most often, the poor and the elderly, two groups that don’t tend to have much income to spend on health premiums.

          But don’t worry it’s not like ‘you’ will ever be poor or elderly so you shouldn’t care about health coverage for those groups.

          • ShareMySims@sh.itjust.works
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            1 month ago

            But don’t worry it’s not like ‘you’ will ever be poor or elderly so you shouldn’t care about health coverage for those groups.

            Spot on. This person isn’t playing devils advocate, they’re playing self defence of their own cognitive dissonance.

            • UraniumBlazer@lemm.ee
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              1 month ago

              Huh??? I never even presented my own ethical position. We were talking about TECHNICALITIES here. Suddenly u’r accusing me of holding a shitty ethical position? Fuck right off.

              I rlly try to be as polite as possible online. But jeez r u guys fkin stupid. We’re having a logical argument about technicalities for fuck’s sake. I said a thousand times that I support single payer universal healthcare. I love it, and I don’t want to lose it. I’m just pointing at the economic exchange here and how it is different from a non-universal multi payer healthcare system. That’s it. But NOOOOOOO how could I do that??? Ugh

        • Strykker@programming.dev
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          1 month ago

          Oh boo hoo the poor 0.01 percent erst and their extra thousand dollars going to Healthcare sure is going to ruin them.

          • UraniumBlazer@lemm.ee
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            1 month ago

            Oh fuck right off. My political positions r my political positions because I’ve formed synthesis by evaluating both, thesis and antithesis. I consider myself a leftist. This however does not mean that I shouldn’t talk about antithesis for leftist theses. We’re not in a cult, uk.