Are socialized healthcare and higher education inevitable?

[alani123]

I think that the debate of public healthcare and education in the U.S. getting a lot of heat lately.

Democrat party candidate Bernie Sanders has been arguing that public medicaid, healthcare and tertiary education are not radical notions. In the U.S., government has been having increasing involvement in both sectors. Student loans keep increasing every year and so does their value as part of the GDP. Medicaid budgeting is also becoming a larger part of the annual GDP through time.

The main question is: If the goal is to make access to medicine, healthcare and education easier to everyone, what would be the best option? What should be considered for instance?

I would say that cost efficiency and the extent the entire population has ease of access to such services are the most important factors. Is a completely free market system better at achieving those? Accounting for increasing public sector involvement in Medicare, Medicaid and student loans, in the US, free market principled don't appear to be cutting the government any slack. Citizens are still advised to hold emergency funds and are still required to pay some of the world's most expensive prices for medicine, healtcare and education. Access to primary care is still considered a luxury and many people can't help but miss out on it due to their income status.

An argument against making such services public would be that the contribution to GDP might decrease. Economists agree that infrastructure contributes positively to GDP growth in the long term. Arguing about the extent of the effect, but positive nevertheless. However, a value chain with profit in mind at every step and the intent of extracting maximum profit out of the final customer surely produces more revenue along the way. Maybe corporate profit be the reason change isn't coming in the U.S.?

For medicine, it's actually a reality that with a single-payer system, where companies can be denied access to a country market if they don't negotiate rates with the government, medicine is actually cheaper. Governments negotiate buying medicine in bulk and get better rates, other than allowing companies to set prices. Also, generic medicine replaces brand names after patents expire, thus also introducing competition to an otherwise social system. In Europe, patients usually buy by substance other than brand name and that's just another factor driving prices down.

As of education, it could be argued that removing profit from the equation simply makes the process more frictionless and removes conflicts of interests. Universities don't have to worry about revenues more than research and educational outcomes, they don't have to attract donors or dedicate staff to scholarship assistance. Professors won't be pressed to pass more students to present better metrics to shareholders, students won't need to be plastered with advertisements etc. I'm not saying that purely public education doesn't come with its problems. But it sorely doesn't lack quality academically speaking (as evident by the standard of research worldwide) and surely can be more cost efficient.

Some of the above principles apply to healthcare also, but a more important argument here would be that as basic healthcare is necessary for survival, wide and affordable access to it is more important as it increases social welfare. Everything else can be a luxury, but a public healthcare system still doesn't impede private hospitals for those after more upmarket services. And moreover, hospitals can's cover every specialty so privately practicing doctors still get a decent revenue (although not being guaranteed millionaires like in the US).

Bottom line is, if public healthcare, medicare and education are more cost efficient, increase ease of access and social welfare as a result and can also co-exist with free market elements, then what's stopping the U.S. from adopting such a system? Especially given the continuous increase in public involvement to those sectors. Is the socialization of these services eventually inevitable?

[Febo]

Democrat party candidate Bernie Sanders has been arguing that public medicaid, healthcare and tertiary education are not radical notions.

I believe to not provide healthcare and education to your citizens is a very radical notion. It is hard to believe some think opposite. Of course there has to be a line. What education is and what healthcare is. Some cults not an education same as plastic surgeries are not a healthcare.  Healthy and educated citizens will make county economy flourish.

[exstasie]

The main question is: If the goal is to make access to medicine, healthcare and education easier to everyone, what would be the best option? What should be considered for instance?

Healthcare and education are very separate issues. I'll address the first one.

The most important factor is probably cost. We want the most efficient system possible so we can reduce costs for all parties. Let's look at the costs of other systems that employ some form of universal health care:

https://www.thebalance.com/universal-health-care-4156211

• In 2018, health care cost 9.3% of Australia's gross domestic product. That’s fairly low. The per capita cost was US$5,005, about average for developed countries.
• In 2018, health care cost 10.7% of Canada’s GDP. The cost per person was US$4,974.
• In 2018, health care cost 11.2% of (France's) GDP. That was US$4,965 per person.
• In 2018, health care cost 11.2% of (Germany's) GDP. It averaged US$5,986 per person. Both figures are about average.
• In 2018, health care spending was 12.2% of (Switzerland's) GDP. It was USD $7,317 per person.
• In 2018, health care costs were 9.8% of (the UK's) GDP. The cost was US $4,069 per person.

Compare this to the United States:

In 2018, health care cost 16.9% of GDP. That was a staggering US$10,586 per person.

The main criticism opponents of universal health care have is wait times for specialists, but in that department, the US is on par with Germany and Switzerland despite much higher costs. What is even worse is:

Despite this cost, the quality of care in other areas is worse than comparable developed countries. The infant mortality rate was 5.6%, almost double that of Australia and Germany. The third leading cause of death was a medical error.

The takeaway I get is virtually any of the above examples would be superior to the current health care system in the US.

[gantez]

Health is an important and integral aspect of human life, likewise education but education is more of human growth and development but health is death related and the pursuit of being alive. Therefore, they are separately related. I think education has to be the ways to keep a healthy life, that is, if we are trying to link them both but for academic education, I don't think is wholly related to health.

Talking about socialized health like having a universal health system and global education pattern, I don't think it is going to be decentralized. We can have health or education terrorism.

[alani123]

The main question is: If the goal is to make access to medicine, healthcare and education easier to everyone, what would be the best option? What should be considered for instance?

Healthcare and education are very separate issues. I'll address the first one.

The most important factor is probably cost. We want the most efficient system possible so we can reduce costs for all parties. Let's look at the costs of other systems that employ some form of universal health care:

https://www.thebalance.com/universal-health-care-4156211

• In 2018, health care cost 9.3% of Australia's gross domestic product. That’s fairly low. The per capita cost was US$5,005, about average for developed countries.
• In 2018, health care cost 10.7% of Canada’s GDP. The cost per person was US$4,974.
• In 2018, health care cost 11.2% of (France's) GDP. That was US$4,965 per person.
• In 2018, health care cost 11.2% of (Germany's) GDP. It averaged US$5,986 per person. Both figures are about average.
• In 2018, health care spending was 12.2% of (Switzerland's) GDP. It was USD $7,317 per person.
• In 2018, health care costs were 9.8% of (the UK's) GDP. The cost was US $4,069 per person.

Compare this to the United States:

In 2018, health care cost 16.9% of GDP. That was a staggering US$10,586 per person.

The main criticism opponents of universal health care have is wait times for specialists, but in that department, the US is on par with Germany and Switzerland despite much higher costs. What is even worse is:

Despite this cost, the quality of care in other areas is worse than comparable developed countries. The infant mortality rate was 5.6%, almost double that of Australia and Germany. The third leading cause of death was a medical error.

The takeaway I get is virtually any of the above examples would be superior to the current health care system in the US.

In accordance to everything you've also noted, if the desired result was to maximize the entrance in higher education and minimize costs, increasing the state's involvement in higher education could have positive effects in these regards. Perhaps the result in reducing spending might not be as impactful as for healthcare and medicaid because for universities big part of the budget is loans. But overall, the US already spends a comparatively big part of its GDP in higher education, even compared to countries without non-public universities.

The U.S. currently has one of the highest per-student spending for overall education and highest tuition fees. It's reasonable to assume that a large percentage of potential students never enroll due to the associated costs. Such infrastructure projects can have a long term impact on GDP also, and more no-cost position in public institutions would surely also drive tuition fees down along with demand, without eliminating the market for private/non-government universities.

[alani123]

Paul Krugman writes on the NY Times about Bernie Sanders. I'll add some quotes I feel are relevant:

These days, if you call for something like universal child care, conservatives accuse you of wanting to turn America into the Soviet Union.

So why does Sanders call himself a socialist? I’d say that it’s mainly about personal branding, with a dash of glee at shocking the bourgeoisie. And this self-indulgence did no harm as long as he was just a senator from a very liberal state.

But if Sanders becomes the Democratic presidential nominee, his misleading self-description will be a gift to the Trump campaign. So will his policy proposals. Single-payer health care is (a) a good idea in principle and (b) very unlikely to happen in practice, but by making Medicare for All the centerpiece of his campaign, Sanders would take the focus off the Trump administration’s determination to take away the social safety net we already have.

Makes you think, is the world's biggest economy ready to embrace the benefits of a single-payer healthcare and medicare program? Could the crowds be swayed by Republican attempts to sideline this issue? Perhaps if more people were thinking in an economic sense the benefits could have been more apparent.

[gentlemand]

It is hard to believe some think opposite.

These are Americans we're talking about. As a Brit I used to think they were us lot with a different accent then I spent a few months there and realised it was the most foreign place I'd ever been. I have more in common with a Bulgarian goat herder.

America is the only country in the world with that form of health service. It costs the government more than anywhere else, it costs the people more than anywhere else, the actual results they get are worse than the majority of developed nations. That should say enough. If they don't want to believe it and keep voting against improving it then they get what they deserve.

[exstasie]

These are Americans we're talking about. As a Brit I used to think they were us lot with a different accent then I spent a few months there and realised it was the most foreign place I'd ever been. I have more in common with a Bulgarian goat herder.

It's a strange place alright.

America is the only country in the world with that form of health service. It costs the government more than anywhere else, it costs the people more than anywhere else, the actual results they get are worse than the majority of developed nations. That should say enough. If they don't want to believe it and keep voting against improving it then they get what they deserve.

A couple years ago, universal health care was gaining lots of support. Now that it's election time, everyone seems to be veering back towards the center. Joe Biden is way ahead in the polls and he's pushing another Obamacare-like plan that people seem to like. More of the same is the most likely outcome.

[sheenshane]

As far as I know, socialized healthcare and higher education are the two things that are really needed to be supported in a country.

In my honest opinion, the US must keep socialized healthcare and higher education as it is fairly considered as a long term investment. The reason why countries mostly grow is just because the people in the country are the majority educated. In contrast, poor countries tend to be poor because of a lack of education and healthcare access.

It really is hard to live a life when you have no finances and proper education. But I guess the government is trying to miss an important one. The financial literature. I don't imagine a country with financially literate/educate fellow countrymen. It would be the best country of all. IMO.

[alexeev.tosha0109@yandex.]

Medicare for All is something essential. Most developed countries already have such programs. Why is somebody against it?

[tbterryboy]

I guess that is an American issue to be honest. Socialized healthcare is a must because the topic is people's life, not like roads or something, when you collectively all pay a higher tax, that kind of returns back to you as profit in the long run because there are less dead people who keep contributing to the economy, there are less bankrupted people who keep working to contribute, there are less sick and unable.

So, basically in the long run when you remove all the middleman with insurance, when you remove all paper work, when you cap the profits of the big pharma that can sell a vial of insulin for 8 bucks in Canada but cross the border to 300 type of stuff, when your hospital doesn't charge you 20k for a toothache type of stuff.

You will see that it doesn't cost that much and it is actually quite cheap. Why it costs so much in USA is just pure profit purposes, when you regulate and limit those, eventually stuff that costs 10 trillion now would cost couple hundred billion at most, and when people who pay thousands and thousands of dollars in insurance and other stuff will in return pay less for taxes.

ALL of us in other nations are currently capable of doing this and we actually provide a good quality service as well. It is bonkers that Americans think that is not possible over there.

[alani123]

It seems like there's some high level collusion and conspiracies to block Sanders from his nomination, very strategically targeting him because of his healthcare policies. Slate has an article on it today:

Superdelegate pushing convention effort to stop Sanders is health care lobbyist who backed McConnell
William Owen gave $8,500 to the Senators Classic Committee, a joint fundraising committee backing Mitch McConnell
[...]
William Owen, a former Tennessee lawmaker and Democratic National Committee member, was among the superdelegates quoted in a New York Times article revealing an effort among party insiders to block Sanders' path to the nomination if he wins a plurality of pledged delegates but not enough to secure a win on a first ballot.

Source: https://www.salon.com/2020/02/29/superdelegate-pushing-convention-effort-to-stop-sanders-is-health-care-lobbyist-who-backed-mcconnell/

You know that something goes too much against the system when even democrats are enabling mechanisms within their own party to allow for blocking a democratically chosen candidate for getting the nomination. The left likes to portray itself as ethically fair and listening to the voice of the poor etc. But would universal healthcare be too radical even for democrats? The potential of losing corporate support might scare them. This news just confirms worries that the Democrat party might play dirty tricks and collude with corporations against Sanders' plans for socialization of services.

[fiulpro]

It all depends on you Personally , what you feel , at times there are people who didn't get into highschool at all and they are millionaires and then also there are people who are holding as many as 50 degrees ! !
It depends on what you prefer , how you prefer to live your life and what's your plan about it .
I see no need for a person to pursue studies if they are not going to be using that in a future life , yes people walk the sheep walk often but it's okay for your to show them a new way once in a while .

[bitbunnny]

Democrat party candidate Bernie Sanders has been arguing that public medicaid, healthcare and tertiary education are not radical notions.

I believe to not provide healthcare and education to your citizens is a very radical notion. It is hard to believe some think opposite. Of course there has to be a line. What education is and what healthcare is. Some cults not an education same as plastic surgeries are not a healthcare.  Healthy and educated citizens will make county economy flourish.

Such ideas not to provide education and health care are very dangerous. That remiinds me on medeval times and very dark parts of human history.
I would say that someone with such attitude doesn't want anything good either to the his citizens or to his country and these two categories are among most important and also basic human rights. How could any country without wide spread education go forward and develope?

[exstasie]

So, basically in the long run when you remove all the middleman with insurance, when you remove all paper work, when you cap the profits of the big pharma that can sell a vial of insulin for 8 bucks in Canada but cross the border to 300 type of stuff, when your hospital doesn't charge you 20k for a toothache type of stuff.

You will see that it doesn't cost that much and it is actually quite cheap.

I'm from Canada and my experience was prescription drugs were cheap and emergency care was there for people who needed it but it's not a perfect system. Getting in to see specialists was like pulling teeth compared to my experiences in the US.

The best choice is probably a mixed system like Germany has. Everyone has basic and pretty comprehensive public insurance, but wealthy people can opt for even better private insurance because there is a market for that. The best of both worlds?

[FanatMonet]

Free healthcare and education should be anyway. Another thing is that coexistence of paid and free medicine and education is also possible. One could, for example, make it so that 70% of university places would be allocated for free, and 30% would remain paid.

[redsun114]

Higher education seems to be creating some sort of trouble for the advanced nations nowadays. Socialized healthcare is a simple thing as long as you can keep the insurance companies and hospitals from charging you 100 dollars for a simple test type of greed moves, if they stop doing that you won't even need a universal healthcare neither, all you would need is paying a lot less compared to the staggering absurd prices they are paying now and it would be over.

However education is not like that, when everyone is college graduate with debt, there is no workers around, they are not really helping the nation in regards that no country needs 1 million arts graduates per yer, we need more car mechanics and farmers and so forth as well but all of those peoples kids went to college and now they are blaming other people of other nationality from stealing their jobs but they are simply willing to do jobs Americans are not willing to do.

I support a more directly job related schools and I don't know if there is such a thing in USA (maybe there is, I don't know) studying in those places could improve a nation a lot.

[alani123]

So, basically in the long run when you remove all the middleman with insurance, when you remove all paper work, when you cap the profits of the big pharma that can sell a vial of insulin for 8 bucks in Canada but cross the border to 300 type of stuff, when your hospital doesn't charge you 20k for a toothache type of stuff.

You will see that it doesn't cost that much and it is actually quite cheap.

I'm from Canada and my experience was prescription drugs were cheap and emergency care was there for people who needed it but it's not a perfect system. Getting in to see specialists was like pulling teeth compared to my experiences in the US.

The best choice is probably a mixed system like Germany has. Everyone has basic and pretty comprehensive public insurance, but wealthy people can opt for even better private insurance because there is a market for that. The best of both worlds?

Pretty much any country with public insurance nd single payer medical care also allows private insurance. It's a common theme kn Europe. In my view it wouldn't make sense to do anything different. Why completely block a potential aspect of the economy from functioning? Naturally it only makes more sense for those wishing to have extra services for example, but still leaves space for a market.

To me though, the biggest achievement of a single payer system can be the price of medicine. Greece for example, has had a single payer system and anyone with employment can't opt out from having his primary insurance with the public funds. So it is a pretty strict system. But this system along with some smart legislation has allowed for Greece to have enough bargaining power with big pharma and now we have some of the cheapest medicine in the west.