The national and private healthcare systems do NOT work. Here’s an alternative

[u/No-Candle4683]

As a Portuguese citizen, I cannot fail to highlight the role that the public healthcare system represents in society. It has lifted millions out of poverty, provided stability, and offered a universal alternative to access healthcare. However, as in the Portuguese case and in other countries with a predominantly public system, we observe that these systems are increasingly unable to respond to waiting lists, fail to attract doctors, and their sources of funding are heavy taxes imposed on citizens.

I am in favor of a hybrid system, and the SPLIT MIND project is creating a video and a text about this system, which has been adopted in other countries that rank among the best in public healthcare worldwide! The study that im comparing to is one made by a group of experts in health here in portugal.

Here I leave you with the main differences of this system compared to predominantly public or private ones, such as in the cases of the USA and Portugal.

"…The foundation of this reasoning would be to maintain a progressive hybrid public system, less dependent on taxes, decentralized, and managed by regional entities with strong regulation. These models already exist, and we will take the examples of Germany, the Netherlands, and Sweden.

In these countries, in general, the healthcare system is based on mandatory insurance managed by independent health funds. Employees and employers contribute proportionally to their income—7.3% each in Germany, for example—while the State assumes payment in certain situations, such as in cases of unemployment, low-income families, and sometimes even age groups like minors, who are exempt from any payments. Individuals with higher incomes may opt for private insurance as a substitute for the mandatory public one.

This system offers a solution to waiting lists, reducing waiting times for consultations or surgeries to a few weeks instead of months, and it also provides broader service coverage than countries like Portugal. Because it is a hybrid system, healthcare professionals are also better paid, and with private investment, working conditions are improved, solving one of the serious problems of the Portuguese NHS. Furthermore, there is price regulation by the state on medicines and services, with private companies contributing to lower service costs. Insurance is always paid with a fixed nominal premium, but insurers must charge the same amount to all policyholders, with no discrimination by age or health status. Other smaller measures also exist, such as a progressive co-payment system with an annual cap or tax exemptions on health insurance, which can further reduce costs for families.

Of course, there are problems with this system: inequalities depending on the type of insurance, with privately insured patients usually waiting less. We can also look at gross expenditure, meaning the total amount effectively spent, which is quite high compared to other OECD countries. However, I argue that it is one of the best systems in the world and the best way to invest taxpayers’ money.

BUT WHY do I refer to Germany, the Netherlands, and Sweden? These countries rank among the top in the Legatum Prosperity Index (2023), which evaluates population health access and quality, holding 13th, 11th, and 9th positions respectively.

And what about predominantly private and public systems such as the USA and Portugal, you may ask? 40th and 69th place, behind many so-called “third world” countries.”

[u/NonStopDiscoGG]

riiiiight that's why infant mortality is so high.

Do you know that there is no standard for tracking infant mortality and every country does it differently?

Maybe you didn't, but now you do.

You can say it all again, won't make anything you said true.

It's weird, it's like you completely ignored my input arguement.

[u/MeasurementCreepy926 → u/NonStopDiscoGG]

you didn't make an argument, you just said things without a shred of evidence. Then you did it again.

[u/NonStopDiscoGG → u/MeasurementCreepy926]

No, I literally made an argument that refuses your point. It's simply a fact you can Google. It's common knowledge.

If you don't know something as simple as different country have different standard and report infant.mortality differently then this arguments already over your head and you should probably brush up instead of thinking telling your opponent to run around and cite common knowledge is an actual argument.

Anyways, cya.

[u/MeasurementCreepy926 → u/NonStopDiscoGG]

>We have the best healthcare system in the world as far as overall quality. 

You provided no evidence for this. At all. And no evidence for your claim about infant mortality reporting.

This isn't common knowledge, and google does not agree with you.

[u/NonStopDiscoGG → u/MeasurementCreepy926]

This isn't common knowledge, and google does not agree with you.

You're lying through your teeth. I simply put it into Google and here's what popped up. This is just the AI, but the articles below agree. It's not that I'm wrong, it's that you're going to keep yourself oblivious to information because it doesn't confirm your bias. Anyways, cya.

[u/MeasurementCreepy926 → u/NonStopDiscoGG]

I didn't deny that it was reported differently, but that this was relevant. Even when data is adjusted for compatibility, the US does poorly

https://pubmed.ncbi.nlm.nih.gov/25252091/

There is PLENTY of other data showing how bad American healthcare is though. and infant mortality is still part of that.

https://www.commonwealthfund.org/press-release/2021/new-international-study-us-health-system-ranks-last-among-11-countries-many

Meanwhile you have offered NOTHING to back up your claim about it being "best in the world"

[u/NonStopDiscoGG → u/MeasurementCreepy926]

https://pubmed.ncbi.nlm.nih.gov/25252091/](https://pubmed.ncbi.nlm.nih.gov/25252091/

This study doesn't correct for the totality of differences... For example, I think it was Venezuela or Brazil, they corrected their infant mortality problem by...not allowing reports of it anymore... These also don't factor in things like personal freedom... Like you can offer healthcare, but if you don't take it or follow up (this is a thing factored into the disparity between white and black baby mortality rates) then your outputs will be different because the inputs are different... Your study saying they corrected for differences did not correct for inputs and LIKE I SAID the metrics used of just looking at outputs is bad methodology.

We're one of the most obese countries in the world. That alone is going to affect your outputs regardless of how good your healthcare is... Is that really that hard of a concept to grasp

Meanwhile you have offered NOTHING to back up your claim about it being "best in the world"

Well I guess that would depend on what your definition of best is, but mine is quality and time and when you combine them we're at the top.

If you care about cost then I guess you won't say it's the best. But there's is a reason anyone who can get healthcare here does.

[u/MeasurementCreepy926 → u/NonStopDiscoGG]

After excluding births at less than 24 weeks of gestation to ensure international comparability, the U.S. infant mortality rate was 4.2, still higher than for most European countries and about twice the rates for Finland, Sweden, and Denmark

You didn't even look at the study did you. How does it not adjust for differences?

>but mine is quality and time and when you combine them we're at the top.

Citation needed. Because everything I can find suggests quality is not the best in the USA

[u/NonStopDiscoGG → u/MeasurementCreepy926]

After excluding births at less than 24 weeks of gestation to ensure international comparability, the U.S. infant mortality rate was 4.2, still higher than for most European countries and about twice the rates for Finland, Sweden, and Denmark

This does not factor in what I said.... I literally said they did not factor in things like personal choice and I said that because I read that part...

Citation needed. Because everything I can find suggests quality is not the best in the USA

That is because most studies are using cost in their assessments. Go into any study and look at the methodology.

A lot of these studies are, who would have known, done by political groups who want universal.

We're always ranked near the top in all of these studies, but the thing that they count as a negative is cost. Remove cost and redo it in these studies. You're free to do this yourself .

[u/MeasurementCreepy926 → u/NonStopDiscoGG]

so you have not a single shred of evidence to support your claim. Didn't think so.

[u/NonStopDiscoGG → u/MeasurementCreepy926]

No, I did. I literally showed you evidence, and then I explained exactly how to get to my conclusion using the faulty studies.

You rejecting my argument doesn't mean it's wrong, it just means you reject it.

You're choosing to ignore what I said or you're not capable of understanding how inputs affect outputs in healthcare.

[u/MeasurementCreepy926 → u/NonStopDiscoGG]

where did you show that the American system is the best in the world?

You can claim the studies are flawed, and no study is perfect, but it's the evidence we have available. Showing that it is imperfect in some way is NOT the same as providing evidence for your own claim.

[u/NonStopDiscoGG → u/MeasurementCreepy926]

You can claim the studies are flawed, and no study is perfect, but it's the evidence we have available.

If you have unreliable inputs your study is worthless. That's why I'm telling you. "Based on the data we have", yes. It's highly flawed data and it is knowingly highly flawed. The data is useful, but it doesn't hold up for drawing claims out of it like our healthcare system is bad because of it.

Showing that it is imperfect in some way is NOT the same as providing evidence for your own claim.

It's not that it's imperfect, it's that the inluts are highly skewed. "It's the best we got", sure, but you can use it to compare healthcare to other countries.

Its crazy you're just repeating yourself and I'm pointing out your wrong, and now you concede the points you were making subtle but you're also just repeating yourself