Giving free healthcare is a good step, but the important question is how good will it be and how much will be covered.
Brazil has 100% of its population (210M people) covered by free, single-payer, universal healthcare, resulting in a life expectancy of 75 years (US is 79, Japan and Switzerland with 83 IIRC).
But your experience can vary dramatically. It all depends on how much money is actually being put on it (in healthcare-costs-PPP-adjusted $/capita).
Not necessarily a counterpoint but Chile's dual system -private and public, both with copay for most- gives them a life expectancy of 81.79 years, surpassing a lot of more developed countries with free universal healthcare.
Brazil's is also dual, everyone gets covered by the public system, but there are plenty of private systems.
And Chile is always a special case, the combination of natural resources, small population and good public systems does wonder for the country. Despite the extreme differences, I tend to compare Chile to the Nordic countries more than with LatAm.
Not sure if that's scalable to larger countries, which is always the big question.
> And Chile is always a special case, the combination of natural resources, small population and good public systems does wonder for the country. Despite the extreme differences, I tend to compare Chile to the Nordic countries more than with LatAm.
You are flat out wrong with this comparison. Chile has one of the lowest tax burdens in the world. It can be accurately compared to either Hong Kong or Singapore.
It's not the taxes that makes everyone like the Scandinavian countries.
If Chile can have government programs with comparable return or results to the Scandinavian countries at a fraction of the cost then they're a hell of a lot more interesting from a policy perspectives.
Comparing governments based on taxes they levy is like comparing modes of transportation based on the amount of fuel they consume.
> Comparing governments based on taxes they levy is like comparing modes of transportation based on the amount of fuel they consume.
I don't think this is a very good analogy. We compare modes of transportation based on the amount of fuel they consume all the time. Unless I'm missing your point? And not everyone likes the Scandinavian countries. They are blessed by very homogeneous populations, in a region unscathed by war the past 70 years, with abundant natural resources, and stable governments. I wouldn't exactly consider them a good model for the rest of the world and I'm not sure what there is to like about them beyond these natural advantages and the fact that most of their people are very nice... Lucky would be more like it.
For example, Norway, the richest per capita of them derives "Export revenues from oil and gas have risen to almost 50% of total exports and constitute more than 20% of the GDP."[0] not exactly something the rest of the world can model.
First your numbers are off "Crude oil and natural gas accounted for 40% of the country's total export value in 2015.[5] As a share of GDP, the export of oil and natural gas is approximately 17%" And this has been steadily shrinking over time.
Also, don't confuse low population density with high natural resources. The US for example get's for more wealth from oil than Norway. Norway just has a tiny population (5.2M).
Further, the US has a much wider range of natural resources including vast coal deposits, gold, diamonds, etc.
Almost every universal healthcare system is has some degree of mix of private and public.
Norway is on the far extreme with it's strict restrictions on private healthcare. Almost every other country has private healthcare insurance as at least an option.
The question tends to be how much you end up contributing towards public healthcare if you take out a private option - ranging from no difference (you pay the same taxes no matter what), to only healthcare for poor/unemployed coming out of general taxation.
Strict restrictions?
I can chose whatever hospital I want and the government will pay for it regardless as long as a GP has referred me to them. If you want you can just pay out of your pocket as well without going through a GP.
There is even a portal where you can search for your ailment and choose hospital (private or public) based on their waiting lists.
The government also buys up a lot of the private spots to reduce public waiting lists. Last time I was in due to sinus infection, I went to a private and a public clinic both paid for in full by the government.
Restrictions aren't just on users, but on providers as well. If you don't see restrictions as an user, it's because most of the restrictions are on the providers.
And nothing wrong with that, I actually support that model, just like in Switzerland, where healthcare is private, but mandated by the government and heavily regulated (with less-regulated private complimentary insurance options).
It allows for innovation and competition between providers, without the harm to users due to the asymmetry of power.
Yeah, the the post I replied to claimed there were restrictions on private clinics specifically, but the public clinics/hospitals have to follow the same rules.
Also: are there any places that charge for births???? That sounds ridiculous and insane to me.
> Also: are there any places that charge for births???? That sounds ridiculous and insane to me.
Then the entire US healthcare system will sound ridiculous and insane to you :)
And, to be honest, it is. I have American friends who had accidents while in developing countries (broke an arm in Costa Rica) and were puzzled that they were treated and didn't have to pay anything, or very little (broke feet in Croatia).
are there any places that charge for births???? That sounds ridiculous and insane to me.
In the U.S., if you have decent insurance, you'll still end up paying a couple thousand or more after insurance payouts. And that's just for the birth and short (1-2 days) hospital stay. Any complications and you're potentially paying much, much more. Especially NICU, it's not unusual to pay hundreds of dollars per day of NICU care after insurance, and non-insured costs can easily end up in the tens or hundreds of thousands, and in rare situations in the millions.
The restrictions in Norway are on which services private providers are licensed to provide.
It's not that many years ago that private providers were unable to offer surgeries that were covered by public healthcare at all. E.g. most private providers in Norway once they started getting licensed at all only offered things like cosmetic surgery. The first private hospital in Norway wasn't started until 1985 (Ring Medisinske Senter, now Volvat) and I remember the controversy it caused, even though it's services originally were very restricted (they were "famous" early on for being the first place in Norway you could get breast enlargements, as they were not covered by public healthcare)
It's been softened up gradually, but you'll note i you click around on the linked provided earlier that for many types of operations the only providers are either non-profits like LHL or government run hospitals - for some this is simply because no private providers have wanted to enter that space yet, but for others it's down to concerns about availability/training making the government hesitant to allow more providers, as described elsewhere.
As I pointed out in my other reply, I'm not criticizing it (at least not as long as it is regularly evaluated for whether or not it continues to offer the best treatment options, as it seems to have been).
Yes, strict regulations. Private providers in Norway have a number restrictions on which services they can provide which tends to be much stricter than most places.
The argument for this has traditionally been that there is a unique scalability problem in medicine: You can't e.g. just educate twice as many heart surgeons, because they need a sufficient number of operations that they can assist in etc. to gain proficiency with real patients, and that pool of patients is limited.
This creates a problem where not restricting which services can be offered has the potential to lower quality of service for all. Something that's a particular concern in countries with smaller populations.
The services that are not restricted are in general areas where there's either a higher volume of patients, or where it requires less training. A sinus infection is a good example of both.
Note that I'm not arguing that this is worse in any way, but used it to delineate one of the most restrictive alternatives when it comes to the availability of private services.
An alternative to life expectancy at birth is looking at the life expectancy at later years. A 40y woman in Brazil actually has about the same expected age at death as an American (~81y).
Expectancies for a 40y man, and for 20y at both ages are somewhat lower in Brazil. This is easy to explain due to deaths by violence and traffic accidents.
Funny to see that despite being chronically underfunded AND spending way less per capita than the US, the end results are similar.
Using life expectancies only gives you a view of healthcare preventing deaths. There is a vast distance between barely alive and a good quality of life.
> It all depends on how much money is actually being put on it
Other hand a lot of public health stuff is really cheap as long as everyone gets it and it's timely. AKA people go to the hospital and get IV fluids and sent home vs going in two days later and spending a week in the ICU (or up and dying).
Brazil has 100% of its population (210M people) covered by free, single-payer, universal healthcare, resulting in a life expectancy of 75 years (US is 79, Japan and Switzerland with 83 IIRC).
But your experience can vary dramatically. It all depends on how much money is actually being put on it (in healthcare-costs-PPP-adjusted $/capita).
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