David Pakman | Health Care

well there's a very well-funded effort to make it really muddy in the United States in order to prevent people from realizing that almost any system would be better than the system we have now you mentioned a few different arguments we've got to really unpack them one by one yeah it's and because the systems are so different in each country there's no single criticism that is going to apply to all of the countries that are out there that have different systems so Canada for example has a province based system of care that is administered by each province so they're all they're different well it's their they they're administered at the provincial level they're very similar programs but they're administered in that way and the relationship between the care providers and the provincial government is one sort of relationship in other countries you actually have governments that run the health facilities or that are administering the health facilities which are still privately run but the health insurance piece for example might be funded through taxation so in order to really think about this we have to have more narrow critiques so like even when we say cancer survival rates are better in the US than in other countries for example we've got to talk about which country and what type of cancer because there is no one answer to that often times cancer survival rates can depend on how sick are the patients at the point of diagnosis how much early screening is there just because a survival rate is higher doesn't necessarily mean that it's because the health care system is better it can be that for whatever reason people are having a less severe form of that cancer for example so as you can see it's super complicated and nuanced and there's no sort of net that we can throw and say here's ten issues that I've heard and let's kind of discuss it we've really got to break them down one by one do you think the fact that America is so diverse and so populated changes our conversation with specifically health care actually probably even education to a lot of these issues the fact that we're so diverse do you think that that like changes anything for us that that maybe other countries don't have to think about as much in what way would diversity affect it um well don't um you know when it comes to health like genes genealogy when it comes to education you know you know I was having probably probably so many more pockets of different subcultures different states cities within those states well let's think about healthcare first so genetics mmm the idea I want to make sure I understand the idea the idea is that healthcare in the u.s. is different than in some other countries in some way because of genetic diversity in the United States oh I'm just posing the question I honestly I honestly have no idea of I don't know yeah I can't think of a way and reference yeah yeah I don't I'm not aware of any way in which that would make a difference I mean certainly having a larger population lets you spread the risk over more people and the more the larger your risk pool when it comes to uneven outcomes I mean that's that's the thing about health care which is that different people will have different health care needs throughout their life a lot of people will have relatively small health care needs until very very late in life other people will have acute health care needs at individual points due to injury for example or certain conditions and then some people will have sort of very expensive chronic care for chronic conditions and the more people you have across whom you can spread that risk the better you can sort of anticipate what your total health care need will be so that's one way in which having a bigger population would be good for transitioning to some kind of universe or single-payer system and can you talk about like the the state of Obamacare and I'm asking from someone who genuinely genuinely knows very very little about it the successes and the failures of it I think it's in a hard place because it's I think it was it's like trying to be a competitor right it's a competitor to what to all the other options out there for everyone but I feel like all I hear is that everyone's just like unhappy with it please right well so let's see Obamacare is does not provide health insurance Obamacare mandated that everybody needed to have for-profit health insurance so it's coming from all the same for-profit companies so or pay a fine if you opted not to have health care at all that was called the individual mandate which the Trump administration has done away with in that sense Obamacare was interestingly Obamacare was really conceived by the Heritage Foundation a very conservative organization in the 90s because it mandates tens of millions of new customers for for-profit insurance companies so the opposite of socialism the opposite of left-wing is their incentive was purely monetary whose incentive the Heritage Foundation well they're the incentive of the of the for-profit health insurance companies is that the government will say everybody has to go and get a for-profit insurance plan from these for-profit insurers right so their incentive was was just monetary the right the insurance companies were standing to get tens of millions of new customers from that so the complaints about Obamacare there's there's different complaints about Obamacare one is that the premiums of the healthcare.gov plans increased from one year to the next now the reason that's not particularly interesting or unique kritis criticism is that health care premiums inside of obamacare exchanges and outside of obamacare exchanges have been rising for decades in the united states like that's the problem the problem is that it continues to get more and more expensive every year for mediocre coverage and people ending up having to pay more and more out-of-pocket so it's true that premiums went up within the obamacare exchanges but they also went up outside of the Obamacare exchanges even more quickly so that's not a very good criticism the criticisms about the finance viability of Obamacare are not unfair but they are significantly influenced by the fact that you need that individual mandate in order to make the system financially viable and what Donald Trump came in and did was he said well you don't have to you don't have to pay that fine if you don't get one of those programs that's how actuarial calculations work which is you have to have everybody needs to be in the pool so to speak everybody needs to be in the risk pool and if you're not there needs to be some financial compensation otherwise the numbers don't work so that would be a criticism but that would be one that we should really be looking at Donald Trump for because he's the one who ended that individual mandate so it's again to say everybody's basically unhappy with Obamacare Republicans had two plans that were so unpopular which would have gotten rid of the Obamacare that supposedly everybody is unhappy with and they were such obvious political dead ends that with a Republican president a Republican house and a Republican Senate they weren't able to get it done because they didn't have enough Republican support because Republicans realized this is way worse than what we have right now and tens of millions of people are going to end up losing insurance hey everyone thanks so much for watching the episode if you're interested in contributing to the conversation and supporting the show there's two easy things you can do one click subscribe and to visit our patreon page where you get exclusive access to the exploring minds community


  1. I only lament that people don't talk about the huge benefits of universal healthcare for small business and the working class that has literally nothing to go with actual heathcare… and nobody that is for universal healthcare even brings them up!! what am I talking about?… millions of Americans are locked into jobs they hate for fear of losing healthcare, that goes away. This means it's easier to try more beneficial jobs… this means employers have to try harder and be more honest about compensating people they would otherwise be locking in. It's easier to start a business and hire people which at the moment is a massive hurdle. When employers are more honestly working to keep their staff, things get better, wages go up, people get happier, can get healthier… all this is worth literally investing in, but the fact is, universal healthcare can be cheaper than the system is currently. How do I know all this? I'm an Australian that moved to the US and saw first hand the poop-show that is healthcare in this country, it was literally the biggest culture shock of the move: Americans actively don't want to help themselves and their fellow Americans get a better system by all measures.

  2. This man is a moron. If I was there i would have wrecked him intellectually.

  3. Hes ignorant on this issue & He doesnt work in the field. Not someone to learn from about anything

  4. He doesn't ever want to give broad analyses of certain topics. Some of that may be justified because it's good to go into detail about what you're talking about.
    But if you actually know what you're talking about why not give your broad overview first and then justify it?

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