“Medicare for All” would save the U.S $5.1 Trillion over 10 years

[u/The-Lucky-Investor]

https://www.commondreams.org/news/2018/11/30/easy-pay-something-costs-less-new-study-shows-medicare-all-would-save-us-51-trillion

[u/Old_Height_8351]

US healthcare certainly isn’t subpar. Likely the best in the world when the outcome variables are controlled for acuity. Yes it is very expensive though.

I agree on the food part mostly. It is still your choice to eat unhealthy foods at the end of the day.

Our healthcare is very accessible. You can get appointments in a matter of days or a few weeks for the vast majority of services, or you can go to urgent care or an emergency department and get care in minutes/hours.

I don’t think politics has anything to do with how walkable our cities are. Americans like having large houses and yards so they want to live in a suburbs. People that live in big cities can walk to the places they need for the most part.

Nobody was stripped of their health insurance so I don’t understand your point there. Even if people don’t have insurance, under EMTALA you can’t be refused to emergency care. This is how migrants use the healthcare system essentially. They are told to show up at an ED for their care because they can’t be refused. This is obviously a bad system for care but you still have the option

[u/BigPlantsGuy → u/Old_Height_8351]

US healthcare is so far from best in the world. We pay more for worse outcomes. Sure if you are a millionaires you can get good healthcare. That’s true everywhere.

To my knowledge, the US is the only wealthy country in the world where people ration insulin or go into debt for healthcare.

The only rich country where people diagnosed with diseases opt to not get treated because they cannot afford it

[u/Old_Height_8351 → u/BigPlantsGuy]

The “worse outcomes” is a typical talking point I see that doesn’t have much rigor if you dissect it.

If you travel to most other countries, you don’t see as many obese, wheelchair-bound people. Most countries are healthier and that’s why they don’t spend as much healthcare and that’s why their outcomes look better. Americans don’t take care of themselves well, so we have so much cancer and heart disease. Our healthcare system is of much higher quality than almost every country, just go to a hospital or physician abroad and you’ll see that immediately

[u/GeekShallInherit → u/Old_Height_8351]

The “worse outcomes” is a typical talking point I see that doesn’t have much rigor if you dissect it.

Except US outcomes are terrible, and behind all its peers.

https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003013#sec018

And medically avoidable deaths are higher as well.

https://www.commonwealthfund.org/publications/fund-reports/2017/jul/mirror-mirror-2017-international-comparison-reflects-flaws-and?redirect_source=/publications/fund-reports/2017/jul/mirror-mirror-international-comparisons-2017

you don’t see as many obese, wheelchair-bound people.

Many US peers aren't far behind on obesity. Of the other two top health risks, smoking and alcohol, the US is average or better than average vs. its peers. At any rate the outcomes I've cited above are already adjusted for various demographic and health risks, and we can spot check to see if there's any remaining correlation between obesity and the outcomes. There is not.

https://i.imgur.com/ZOkB9ps.png

Most countries are healthier and that’s why they don’t spend as much healthcare

No, it isn't.

Our healthcare system is of much higher quality than almost every country

Citation needed.

US Healthcare ranked 29th on health outcomes by Lancet HAQ Index

11th (of 11) by Commonwealth Fund

59th by the Prosperity Index

30th by CEOWorld

37th by the World Health Organization

The US has the worst rate of death by medically preventable causes among peer countries. A 31% higher disease adjusted life years average. Higher rates of medical and lab errors. A lower rate of being able to make a same or next day appointment with their doctor than average.

https://www.healthsystemtracker.org/chart-collection/quality-u-s-healthcare-system-compare-countries/#item-percent-used-emergency-department-for-condition-that-could-have-been-treated-by-a-regular-doctor-2016

52nd in the world in doctors per capita.

https://www.nationmaster.com/country-info/stats/Health/Physicians/Per-1,000-people

Higher infant mortality levels. Yes, even when you adjust for differences in methodology.

https://www.healthsystemtracker.org/chart-collection/infant-mortality-u-s-compare-countries/

Fewer acute care beds. A lower number of psychiatrists. Etc.

https://www.healthsystemtracker.org/chart-collection/u-s-health-care-resources-compare-countries/#item-availability-medical-technology-not-always-equate-higher-utilization

Comparing Health Outcomes of Privileged US Citizens With Those of Average Residents of Other Developed Countries

These findings imply that even if all US citizens experienced the same health outcomes enjoyed by privileged White US citizens, US health indicators would still lag behind those in many other countries.

When asked about their healthcare system as a whole the US system ranked dead last of 11 countries, with only 19.5% of people saying the system works relatively well and only needs minor changes. The average in the other countries is 46.9% saying the same. Canada ranked 9th with 34.5% saying the system works relatively well. The UK ranks fifth, with 44.5%. Australia ranked 6th at 44.4%. The best was Germany at 59.8%.

On rating the overall quality of care in the US, Americans again ranked dead last, with only 25.6% ranking it excellent or very good. The average was 50.8%. Canada ranked 9th with 45.1%. The UK ranked 2nd, at 63.4%. Australia was 3rd at 59.4%. The best was Switzerland at 65.5%.

https://www.cihi.ca/en/commonwealth-fund-survey-2016

The US has 43 hospitals in the top 200 globally; one for every 7,633,477 people in the US. That's good enough for a ranking of 20th on the list of top 200 hospitals per capita, and significantly lower than the average of one for every 3,830,114 for other countries in the top 25 on spending with populations above 5 million. The best is Switzerland at one for every 1.2 million people. In fact the US only beats one country on this list; the UK at one for every 9.5 million people.

If you want to do the full list of 2,000 instead it's 334, or one for every 982,753 people; good enough for 21st. Again far below the average in peer countries of 527,236. The best is Austria, at one for every 306,106 people.

https://www.newsweek.com/best-hospitals-2021

OECD Countries Health Care Spending and Rankings

Country	Govt. / Mandatory (PPP)	Voluntary (PPP)	Total (PPP)	% GDP	Lancet HAQ Ranking	WHO Ranking	Prosperity Ranking	CEO World Ranking	Commonwealth Fund Ranking
1. United States	$7,274	$3,798	$11,072	16.90%	29	37	59	30	11
2. Switzerland	$4,988	$2,744	$7,732	12.20%	7	20	3	18	2
3. Norway	$5,673	$974	$6,647	10.20%	2	11	5	15	7
4. Germany	$5,648	$998	$6,646	11.20%	18	25	12	17	5
5. Austria	$4,402	$1,449	$5,851	10.30%	13	9	10	4
6. Sweden	$4,928	$854	$5,782	11.00%	8	23	15	28	3
7. Netherlands	$4,767	$998	$5,765	9.90%	3	17	8	11	5
8. Denmark	$4,663	$905	$5,568	10.50%	17	34	8	5
9. Luxembourg	$4,697	$861	$5,558	5.40%	4	16	19
10. Belgium	$4,125	$1,303	$5,428	10.40%	15	21	24	9
11. Canada	$3,815	$1,603	$5,418	10.70%	14	30	25	23	10
12. France	$4,501	$875	$5,376	11.20%	20	1	16	8	9
13. Ireland	$3,919	$1,357	$5,276	7.10%	11	19	20	80
14. Australia	$3,919	$1,268	$5,187	9.30%	5	32	18	10	4
15. Japan	$4,064	$759	$4,823	10.90%	12	10	2	3
16. Iceland	$3,988	$823	$4,811	8.30%	1	15	7	41
17. United Kingdom	$3,620	$1,033	$4,653	9.80%	23	18	23	13	1
18. Finland	$3,536	$1,042	$4,578	9.10%	6	31	26	12
19. Malta	$2,789	$1,540	$4,329	9.30%	27	5	14
OECD Average			$4,224	8.80%
20. New Zealand	$3,343	$861	$4,204	9.30%	16	41	22	16	7
21. Italy	$2,706	$943	$3,649	8.80%	9	2	17	37
22. Spain	$2,560	$1,056	$3,616	8.90%	19	7	13	7
23. Czech Republic	$2,854	$572	$3,426	7.50%	28	48	28	14
24. South Korea	$2,057	$1,327	$3,384	8.10%	25	58	4	2
25. Portugal	$2,069	$1,310	$3,379	9.10%	32	29	30	22
26. Slovenia	$2,314	$910	$3,224	7.90%	21	38	24	47
27. Israel	$1,898	$1,034	$2,932	7.50%	35	28	11	21

[u/Old_Height_8351 → u/GeekShallInherit]

Thanks again for all the sources. I think the first article was linked in error. It has to do with the cost savings of a single payor system.

If you look at the data in the second article, specifically the healthcare outcomes in exhibit 2 you may draw a different conclusion about quality. We actually do very well in several of the outcomes, and several others were very close to other top countries.

There are too many things cited to comment on so I’ll leave it at this: you’ve changed my mind on several things with the cited sources. Thank you for that. I still have some questions about some of the articles but I simply don’t have the time to read all these and digest them

[u/GeekShallInherit → u/Old_Height_8351]

I think the first article was linked in error. It has to do with the cost savings of a single payor system.

It was in error, but it wasn't supposed to have anything to do with cost savings, it was to do with outcomes, which was presented again later, but here it is again for good measure.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30994-2/fulltext

specifically the healthcare outcomes in exhibit 2 you may draw a different conclusion about quality. We actually do very well in several of the outcomes, and several others were very close to other top countries.

We're spending half a million dollars more than our peers. Doing OK on a few metrics, while worse overall, is a travesty however you measure it.