Two problems - one is adverse selection, the other is that uninsured people still get care anyway (showing up at the ER) and somebody has to pay for it. Right now we do it by bankrupting every 20th person that walks through the door, which seems rather unfair.
> uninsured people still get care anyway (showing up at the ER)
This is somewhat of a myth; at least it is nuanced. The care in the ER is to stabilize the patient, not fix them. They provide acute care only.
Even acute care can be quite limited. People are triaged based on how acute their case is. Many languish in an uncomfortable waiting room for hours till they crash or leave.
This rationing is done by limiting the beds so that the ER is almost always over capacity. This is by design. Since ER are cost centers, when a hospital asks for a building permit from the municipality, the number of emergency room beds open to the public is the primary negotiation. It's the bottleneck that limits costs.
Emergency beds equipped to handle trauma, e.g, gunshot wounds or car accidents, is even more limited. To avoid costs, many hospitals simply do not have a trauma center, unless the municipality agrees to have significant subsidy. People die in ambulances while they search for a hospital with an open trauma bed.
It's not complex, it's a great example of poor resource allocation. For how much we collectively spend on healthcare, there should be no perform finding it. The resources are going to the wrong place (profit, insurance, admin).
The uninsured people hold off on getting care for so long that by the time they can finally get care, it's ER time, converting a $20 visit and some antibiotics to a $100k case of amputation, or whatever.
It used to be, and should be again, that the hospital owner or physician would foot the bill if you couldn’t pay. Much more direct charity, a beautiful thing.
Taxing everyone to hell to cover every health expense is immoral.
I wish those advocating universal taxing for crappy care would take the moral high road and not rob his fellow citizen to pay for his bills. Instead, let his fellow citizen give freely in love.
Universal healthcare is such a moral sham, and what we have now in the US is also pretty bad. There is a better way.
If you really mean donations, you are not going to get that many billions of dollars in donations. This specific "better way" does not exist.
If you're trying to get enough hospitals to do this that people don't just go to a cheaper hospital, then almost all hospitals are going to have to raise their prices... and that's effectively the same as a tax. They're "robbing" every patient the same way.
Of course I mean donations, either through your family, church, or beyond. Of course it’s possible, there’s even a network now called Samaritan’s that facilitates this.
The hospital can turn of course offer to foot the bill, but can do so only after you’ve exhausted other options. But none of this is forced.
Not going to defend universal healthcare or healthcare taxes, seeing I'm currently getting fucked by that at this moment, but given the way you wrote that I feel that you need to be pointed out that this results in either:
1) More expensive healthcare, to cover for these cases directly in a fund or via third party insurance.
2) Healthcare scarcity.
You can't draw blood from a stone. Healthcare investors/workers at large don't get in to become a charity so your "solution" comes with explicit downsides you should mention.
It only results in those if you keep the regulation levels high, which we have now. We need a multi-faceted approach which lets the market lower prices. Local control, local solutions. More efficiency, human touch, love.
No solution is perfect, but that’s a world that’s more personal for those helping and being helped. It also is more economically efficient. I’m not saying this is the only solution, but one that starts with robbing your neighbor is the moral low route and we should and can do better.
Force hospital to provide care for indigents -> hospital raises prices for everyone to cover -> same effect as a tax. I'd much rather just be up front about it.
