Indeed. And we are all born disabled (in that we are unable to sustain our own independence and wellbeing without assistance), and will likely all be disabled at the door of death. For such a universal experience, you’d think healthcare was more central a tenet of civilisation… As available and freely usable as the roads we drive on. Not just that, but our very way of work. 40+ hours a week is plainly ableist yet it persists as an almost unshakable norm. If my brain can only handle a couple hours a day, finding regular employment is nigh impossible.
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The problem is you can’t go into a “healing tube” like from sci-fi movies and get fixed. Medical workers are real people with their own wants and opinions on their compensation, just as we are as technologists. It’s so funny that everyone on HN expects to make tons of money for little effort, but when doctors and nurses want to be paid huge bucks society balks.
America’s model is where the UK, Canada, and other subsidized healthcare systems are going. Our doctors make way more, but there is recognition that every doctor is not a replaceable cog - the good ones build up names and reputations for themselves. We have quietly built a large system of cheaper options including tele health, urgent care, and primary care (like CVS Minute Clinic) while enabling nurse practitioners to handle ever more procedures and tests. This is how the system will have to scale given the increasing safety net and huge immigration inflows.
Medical care costs money. I’d rather have choice and options than pretend it’s free, which it isn’t.
Private and well-compensated medical workers still don't offer a sci-fi "healing tubes". Private healthcare is maybe marginally better for 1% of the population, but far more expensive.
Of course there are diminishing returns, the world famous brain surgeon billing at $10k per operating room hour isn't going to deliver a 20x better outcome then the average brain surgeon billing at $500, or however much the ratio is.
Yet some folks still choose to seek out the world famous brain surgeon when they desire that extra quantum of assurance and if they can afford it.
There are still expensive private clinics in all countries with public healthcare.
Did you intend to reply to a different comment?
What does the mere existence of 'expensive private clinics' in X countries have to do with the diminishing return on higher priced brain surgeons?
No. I am pointing out that rich people still can and do spend all their money on private healthcare for some tiny increase in countries with public healthcare.
How does that relate to my comment?
It's possible for at least 1 person in any given country to hop on a plane or recruit world experts to come, with enough money, even in Somalia or Afghanistan, which don't have functioning systems of any kind.
I wasn't making any claims to the contrary, if you misread.
Medical tourism into the US is extremely common. I own a rental unit near a major hospital and rent to many foreigners who travel in for treatment, particularly Canadians. Everything has trade offs.
USA is world-best of many things. But I don't think the healthcare is so good because it is funded by exploiting the poor. And if so, that would be quite a macabre defense.
“Exploiting the poor” is one of those philosophical arguments I disagree with. The US is supposedly so bad for the poor yet they are breaking down the door to come here, month after month.
> The US is supposedly so bad for the poor yet they are breaking down the door to come here, month after month.
The hope of most poor coming into the US isn't that the US is better for poor people, it's that by coming to the US they can stop being poor. And in most cases it doesn't work.
In fact, the American dream of "anyone can become rich" is a lie which exists specifically to justify why we've let America become such a shitty place for poor people. After all, why do we have to improve conditions for the poor if they can just become rich? It's their own fault they've chosen to be poor--they must like it, right?
Really, rich people have no idea what's going on with poor people, and you should really stop talking about things you don't understand.
The fact that it's worse in the third world doesn't make it morally right.
There is also medical tourism the other way to EU, Mexico, and other countries.
US is really good for the top 10%, who can afford it. However, a minimum wage worker has a really tough time getting good results because the cost is astronomical even with decent insurance.
> America’s model is where the UK, Canada, and other subsidized healthcare systems are going
Well there are other ways to scale - look to China' system - which has a massive throughput of patients in large regional medical centers - primary doctors there see like hundreds of patients a day - but don't do anything but recommend and if you can't get it resolved, they have an escalation mechanism where you see more and more specialized doctors (same day) until you either stump the most specialized docs or they have an action plan for you.
So you could automate the work away or you could create a system that scales through production-line efficiency.