Thread by @davilyra

The rest of the modern world does not have the type of healthcare financing system AOC is proposing. Brazil has, it is crappy as hell with people waiting up to 30 years for an appointment.

https://twitter.com/AOC/status/1069256897251950592

Developed economies usually have a overly regulated system with at least one the following:
- Pay at the point of service (FRA)
- Copayments of services (UK, SWE, ESP)
- Gov subsidizes insurance (GER, SUI, NET)
- Not all-in coverage (CAN, UK, ESP)

We can and definitely should do something to improve the way Americans pay for healthcare -- and this goes a lot through deregulation, by the way. But Medicare for all is not a solution to the problem.

Additionally, if we keep the present levels of financing and just redistribute the money across the board, the likelihood is that lots of patients -- especially elderly and sick -- would see their coverage decreasing, while young and health would have tons of money for nothing.

What she wants is that everyone receives the highest level of care for the lowest price -- or, more precisely, not seeing the bill. This is not achieved through redistribution, but through increment in provision, increasing in supply and innovation. And it takes time!

Lastly, for sure she does not understand other countries systems -- not even the American system in fine detail (nor does Bernie, HRC, Obama, and others). It's politically smart to make blunt (meaningless) claims, but the policy side would come hard when it's time to propose sth.

Increasing supply, prices go down -- usually other developed countries have more healthcare professionals per capita that the US. Changing regulations to force more transparency would also help -- like posting prices. Additionally, reference pricing can help a lot.

Other important factors that affect a lot US outcomes and not European:
- The US is a continental-sized country, each EU country is the size of or smaller than lots of US states -- we have tropical areas like Florida, deserts in Nevada, and permafrost in Alaska

- US population has more genetic backgrounds than average EU country
- US culture is (thanks, God) heavy on freedom and on allowing people make stupid choices, Europeans are totally OK with government overreaches
- Internal movements in the US are more common than within the EU

If we analyze on a state-to-country comparison (something way fairer to the US than US to specific EU country), the perception of American outcomes improve a lot. Also, if we normalize the data for crime differences US results are also much better.

Again, this is not to say that the American healthcare financing system is good -- it is not. It is not to say that we shouldn't reform it -- we definitely should. But it is to state that the "Medicare-for-all" is just a catch phrase backed on bad data and ideas.

It is impossible to have everything free at PoS and with quality for all. Either it is everything, either it is free, either it has quality.

PoS = point of service

Quality and "free": some vaccinations.
Everything and "free": decades long wait and crappy service like Cuba.
Everything and quality: a really expensive healthcare system where you pay with money, not time, like the best care in NYC, CA, Houston.