Submitted 2 weeks ago by otacon239@lemmy.world to [deleted]
I could see it going either way.
With free access, people would be more inclined to go to the doctor for simple and small things, but in return would probably catch more serious issues early and have better access to treatment, therefor reducing the need for intensive and specialized healthcare.
Without, people avoid going to the doctor for small stuff, but end up having to go in with more complicated issues later on.
Heres some studies if you want to do some reading:
Impact of Universal Health Care Coverage on patient demand for health care services in Thailand
To preface this comment, I’m very, very tired, and I am providing no sources for this as I am very, very tired and just don’t want to go digging.
I remember reading a study or 3 in 2015/16 when Bernie first ran and talked about Medicare for all. The consensus from them seemed to be that a single payer system that was free at the point of use would drastically increase the number of people going to the doctor, for about 5 years. Basically, the idea was that the US system incentivizes us to wait to see a doctor until things get Real Bad, Man™, and if we switched it would take about 5 years per group/stage (Bernie’s plan was to lower the age of Medicare enrollment in stages) before things normalized. People would be jumping on the opportunity to get seen for things that they never would have considered before, and would be basically using the hell out of the new system, and each time the age was lowered it would take about 5 years for that group of people to get through that initial stage of doctor-seeing. But once that was done and things normalized, the stark increase in preventative care would grossly overshadow our current system of basically only treating trauma and chronic conditions. The strain on the medical field as a whole would be significantly lessened over time, because preventative care is often easier and cheaper.
So, again, no studies linked here, but iirc, the consensus was that there would be more people going to the doctor and being seen, especially in the first several years of the new system, but that medical professionals themselves would have less strain (and, my assumption here, less strain means probably less staff needed). I imagine it would change the staffing dynamics, too. We would need more primary care doctors, nurse practitioners, RNs willing/desiring to work in those offices, and probably less need for chronic pain clinics and specialized care units, potentially even things like cancer units and such. If people are seeing their doctors regularly, getting healthier, and generally being less sick, then the need for staffing in situations for people who have allowed things to get Real Bad, Man™ is lessened, and the need for staffing in preventive care is hightened.
Also, just as an aside, I remember watching this french television show once, dubbed, and there being a thing about a stop smoking campaign, with a tax incentive if you quit. Blew my fucking mind back then, but it makes sense. If the government is backing your healthcare, they want you to less costly to that system, and can offer incentives in other systems they also control. Think about it, “join a gym and get a tax credit for half the cost!” Or “lose 30 pounds this year and get an extra 200 back on your income taxes!” I have no idea if that french cigarette thing actually exists in real life, but the idea of it has always stuck with me.
staffing issues aside, generally, “free” healthcare (or rather, government provided healthcare) generally reduces the over all costs- in part, as you noted, by allowing far more prevention and efficiency. Also remember, in places with health insurance like the US, you also have staffing for the insurance agency, and the half-dozen agencies providing support to them, as well.
I think it would be complicated.
The demand for GPs and family doctors would increase.
The demand for hospital beds would decrease.
In the long term, things would stabilize into a new ratio of services.
There was a study years ago about putting up Jersey walls on parts of US interstate highways, to see if they increased or decreased the number and severity of accidents. The conclusion was that it increased the number of minor accidents, and decreased the number of serious accidents.
My guess is that universal healthcare would be the same: increasing the number of minor visits and (by noticing and addressing issues before they became serious) decreasing the number of serious visits.
I believe short term there is an increase, give that a lot of people are braving stuff they can’t afford to fix. But it stabilizes and reduces in the long term cause as society becomes healthy, and with other health initiatives like healthy eating, exercise and preemptive healthcare, it normalizes with a general reduction in staff numbers.
There are other disincentives besides price that keep people from going to the doctor if they don’t need to
I used the health care services at my home town once this summer, and I spent two months there. Basic care is free at the point of service there. And I only went because I had had a concussion. Didn’t seem that the other people were there for no reason either.
“Free healthcare” doesn’t exist. You can spread the cost differently. Either you pay what you need - which could be a lot - or you pay less but consistently into a big pool along with other people and then that pool money gets distributed to health care providers. That smaller but regular contribution will go up if everybody goes to see their family doctor unnecessarily so there is a bit of a feedback gauge. It isn’t all milk and honey in socialized health care.
No matter what system your country uses, you will have heard about the same problems. Not enough staff, lacking qualifications, people being overworked and underpaid - in particular on the lower rungs of the ladder. That leads me to think that the staffing levels are about the same. Maybe one system has more work hours invested in preventative care while the other needs more in mop-up crews for those who fall through the cracks.
The indirect savings of people going to the doctor earlier etc actually mean some of the healthcare ends up being free.
Also, saying that you’ll have the same problems regardless the system is both factually incorrect and unnecessarily nihilist.
Honestly, in my state (Australia), the hospital system is crumbling because people are going to hospital for minor shit that could easily be treated at their GP. The amount of ambulance ramping at the ED is crazy. People are waiting 6-7 hours after being taken by ambulance to hospital. People often die because they are being ramped. A stroke victim died recently here because they had to wait like 5 hours, and the stroke killed them.
Living somewhere where the healthcare is not free but heavily subsidised people do not go to the doctor for minor issues because when I tried to call and book an appointment I got an answering machine telling me that they don’t have time to answer the phone today, try again tomorrow. And of course the online booking did not work.
When doing comparisons of the nature posed by the title, it is all-important to establish the baseline criteria. That is, what does the landscape look like just prior to implementing the titular policy?
If starting from the position of the present-day USA, then it is almost certain that free-at-time-of-service universal health care would cause the Bureau of Labor Statistics (BLS) to rewrite their projections for medical personnel jobs, in very much an upward trajectory. After all, middle- and upper-class people that already had decent won’t somehow need more healthcare just because it’s free, but people who have never seen a doctor in their adult life would suddenly have access to a physician. More total patients means more medical staff needed, both short-term and long-term. The latter is because the barrier to annual checkups is all but eliminated, which should also yield better outcomes through early detection of problems and development of working rapports with one’s physician.
If, however, the baseline situation is a functional but private-payer healthcare system in a place with a low Gini coefficient – meaning income is not concentrated in a few people – then it’s more likely that healthcare is accessible to most people. Thus, the jump in patients caused by free healthcare may be minimal or even non-existent. It may, however, be that different segments of this population would benefit by access to a higher standard of quality care under a universal healthcare system, if removing private-payer results in dismantling of legacies caused by racism, colonialism, or whatever else.
After all, that’s one of the tenants of a universal healthcare system: people get the treatment they need, with no regard for who they are or what wealth they have (or not).
Munkisquisher@lemmy.nz 2 weeks ago
Think about all the people involved in health care that aren’t involved in actually providing healthcare. Billing, debt collection, assessing insurance claims, denying claims, legal fighting over denied claims, advertising etc.
All that money is better spent providing healthcare.
PP_BOY_@lemmy.world 2 weeks ago
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jeffw@lemmy.world 2 weeks ago
Eh, this is like “how to lie with data 101”. You want YOY growth, not cumulative since 1970. All this says is we had very few, if any, managers in 1970. Also, we need that green line to move more
Rhynoplaz@lemmy.world 2 weeks ago
You bring up a counter point that I’ve heard often, and my usual response is that most could probably find admin positions in the government’s system, and the rest can figure it out like the rest of us.
The last part doesn’t make for a great sales pitch, so what about those people who don’t have a job anymore?
Munkisquisher@lemmy.nz 2 weeks ago
Keeping people in unproductive jobs isn’t an excuse to keep a drain on the the system and bloating costs of health care.
What do they do in other countries that don’t have those roles? They find jobs elsewhere or train in something else. Of course you wouldn’t be able to reform healthcare overnight, it would take a decade or a generation.
Cevilia@lemmy.blahaj.zone 2 weeks ago
In the UK, hospital administration still goes on. There’s no shortage of jobs for skilled administrators. There are people to assess whether you’re eligible for free treatment, people to assess what treatment you’re eligible for, people to bill patients who choose to go private and chase their debts, etc.
Plus there’s the extra layers of administration at local, regional, and national levels.
Plus there’s people moving money around to ensure bills get paid, facilities are maintained, and staff are fed. Money still moves around even when the patient isn’t the one paying it.