You don't even need socialized healthcare, really. What you need is a system that doesn't exhibit the insane amount of regulatory capture that's on display in the US.
I lived in Hong Kong for a while. In Hong Kong:
(1) If you want to see a doctor, you just pay cash. Fees are reasonable. (~$50-80 for a GP up to $350-400 for a top specialist.)
(2) There's no other way to pay. (If you have insurance, they might reimburse you later.)
(3) You don't need referrals for anything. (If you need to see a specialist, you call a specialist directly and make an appointment. Many of them will see you on the same day you book an appointment.)
(4) You don't need a prescription for just about anything. (Antibiotics and steroids -- and all the the most powerful non-recreational drugs -- are available OTC.)
(5) ERs, emergency services, and things like childbirth are covered by the government, but the service is generally worse than you'd get if you pay out of pocket.
The US system isn't more "capitalist" -- it's captured by special interests and middlemen to a mind boggling extent. And you don't necessarily need "socialized" healthcare -- you need a system that gives both patients and doctors more agency.
> (4) You don't need a prescription for just about anything. (Antibiotics and steroids -- and all the the most powerful non-recreational drugs -- are available OTC.)
IMO antibiotics and antibiotic resistance are one of the strongest arguments in favor of gating certain medications behind a prescription.
> And you don't necessarily need "socialized" healthcare -- you need a system that gives both patients and doctors more agency.
You can get something sort of like that here in the US - direct primary care. I pay ~$125 per month to my doctor. This can be paid from an HSA/FSA as well. It is not as expensive as "concierge health care", but you get most of the perks and immediate access.
Appointments are usually available next day or even same day - as many times as I want. No co-pays. The doctor has far fewer patients so you can actually talk to them for an hour or two during your appointment. They can charge insurance (if you have it) for most lab-work or you can pay them reasonable rates out of pocket.
They can refer you to specialists if necessary (who may require insurance), or even consult with specialists with your permission, at no extra cost.
The on-going care/prevention aspect will probably help save money and keep me healthier in the long run as well.
But... The amount of money I spent on medical care in Hong Kong, per year, was probably 1/10th of what I'd have to spend on medical insurance alone if I were in the US. Because patients and practitioners have more agency, and because pricing is transparent, there's actual competition in the market.
Sure, you need money, but it's less than you think, and there are fewer hoops to jump through, fewer roadblocks to treatment.
The optimal system is probably something like that. A public system for emergencies, child delivery, and absolutely necessary treatments -- and a transparent, open, private system for everything else.
By definition, when talking about access to healthcare a person of means is someone who can afford it. What is true is that there are lots of people who think they are “middle class” who can’t afford access to the system.
13% of the people don’t have a usual place to get healthcare in the U.S.
> By definition, when talking about access to healthcare a person of means is someone who can afford it.
Correct. Either a person has the dollars to pay or they don’t.
> What is true is that there are lots of people who think they are “middle class” who can’t afford access to the system.
What people think doesn’t really matter when the bill arrives. We might be better off thinking in terms of “qualifies for financial assistance”. Those who have just enough income to disqualify them from assistance will have more trouble paying, obviously. Some of those will forgo or delay treatment due to cost concerns.
When I visited, it seemed like there was a good government healthcare system in Hong Kong, and a network of very good public hospitals. Just the private docs are not in that system. I don't know the specifics but I am pretty sure Queen Mary and Pamela Youde Nethersole Hospitals and others were public hospitals.
Oh yeah, but for routine outpatient stuff the government health system is generally not widely utilized. If you get into an accident or receive a cancer diagnosis, then I know from experience that it's top tier.
I remember seeing a survey of different health systems and the ones people liked most were Hong Kong and Singapore. Brits and American on the other hand don't like their systems that much.
I lived in Hong Kong for a while. In Hong Kong:
(1) If you want to see a doctor, you just pay cash. Fees are reasonable. (~$50-80 for a GP up to $350-400 for a top specialist.)
(2) There's no other way to pay. (If you have insurance, they might reimburse you later.)
(3) You don't need referrals for anything. (If you need to see a specialist, you call a specialist directly and make an appointment. Many of them will see you on the same day you book an appointment.)
(4) You don't need a prescription for just about anything. (Antibiotics and steroids -- and all the the most powerful non-recreational drugs -- are available OTC.)
(5) ERs, emergency services, and things like childbirth are covered by the government, but the service is generally worse than you'd get if you pay out of pocket.
The US system isn't more "capitalist" -- it's captured by special interests and middlemen to a mind boggling extent. And you don't necessarily need "socialized" healthcare -- you need a system that gives both patients and doctors more agency.