Jim Fedako ( who wrote this piece; send him email) is a business analyst and homeschooling father of seven who lives in Lewis Center, OH.
Some 27 years ago, I spent two weeks in Yugoslavia, the supposed workers’ paradise cobbled together by the strong arm of Marshal Tito. And, if my memory serves, the country was an overflowing candy store—a middle schooler’s sweet-toothed delight. Socialism as a candy store? Sure. But you have to consider the question and its answer in context.
We know apodictically that socialism cannot efficiently allocate resources. Yet, we also know that socialism can and does produce. This is true whether the society is structured along the lines of German, Soviet, or democratic socialism. In all three forms, goods are produced for consumption by the masses. And some of those goods are sweet, indeed.
My stay in Yugoslavia was centered around the northern steel town of Ravne na Koroškem, in what is now Slovenia. We boarded with a family who had some ground-level apartments for rent, with all apartments sharing a small common kitchen and bath. The conditions were—to be kind to the family—basic at best. The kitchen had several small chairs, a table, and sparse silverware and settings. The little bedrooms had nothing save a too-soft bed, mirror, dresser, and chair. The floors throughout were tiled and cold. And the yellowed-into-opaque windows were outlined by frayed curtains. Outside of the Party, this was good living in Tito’s paradise. And it was livable, barely.
A short walk from the house was the local Nama grocery store—or should I say candy store. The outside was clean and white, but the inside was dark and dingy, with one exception, the sugar-laden aisle. Hard, tasteless bread was sold by the centimeter and the few slabs of meat on the unclean butchers table behind the empty cooler looked gray and inedible. Eggs? Toilet paper? Fresh fruit? Not to be found. But who was looking for that stuff? Especially when you are 13 years old and in front of shelves overflowing with bright boxes of cookies, candy, and over-sweetened juice—and it was all delicious. And the price? Very inexpensive.
Of course, kids are not the only ones who like sweet deals. Every now and again, I hear adults tell their versions of the candy store called socialism. However, for them, it is not sugary treats being referenced. Instead, it’s healthcare.
The tales are all very similar, about trips to European emergency rooms where the waits were short and the doctors and nurses plentiful. And the price? Who can complain about free or nearly free? Well, free or nearly free to them, anyway.
And given these real experiences, is it any wonder that folks return championing socialized medicine? Is it any wonder that a kid from the hills north of Pittsburgh still remembers juice so deliciously sweet and thick and cookies so delectably fruity and fresh?
But the folks championing socialized medicine are always repeating tales of visits for simple cases of the flu or other travel-related illnesses. What is seen is the overflowing abundance of care at that level. This is the sugar, so to speak. Unseen are other types of care. The meat, eggs, etc. And this is where the failures of socialized medicine are as obvious as the lack of nutritious food in a Yugoslavian store.1
The stories from travelers paint a different picture from those told by people living in countries with socialized medicine. Many of these folks—those looking for meat—complain about either the unavailability of care or wait times that exceed the life expectancy of those suffering from the disease.
So we end up hearing contrasting stories: ones from visitors who are amazed by the candy, and others from residents who complain about no meat. And both are right.
Can a society (or a sector of the economy) organized under socialism efficiently allocate resources? No. Can it produce overflowing shelves of sugar in dingy stores barren of essentials? Absolutely. And can it overstaff emergency rooms as a means to satisfy short-term cravings for healthcare even while essential long-term needs go wanting. Certainly, with real examples all around. Can it ever balance the two? And can it balance the two along with all other goods and services desired? Not in this world of scarcity. So not in this world at all.
Bastiat and Hazlitt pushed the idea of the unseen front and center for important reasons. It is essential that the unseen is included in any consideration of a situation. And that is true even when, like me at 13, you want to overlook barren, dirty shelves in order to focus on the oasis of sugar.
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1Our host family was able to produce a nice spread when they invited us to dinner. But that food was not purchased through legal means.
Yet I see Brits and Canadians online Boasting of reasonable health care resources. Bear in mind that the best in American heath care is out of reach for large numbers of Americans so , Apples to Apples, comparing the average American heath care policy to the average heath care in a first world nation with socialized care. I’m confident there is some flim flam hiding the cost of socialized medicine but I haven’t seen it.
Yet I see Brits and Canadians online Boasting of reasonable health care resources. Bear in mind that the best in American heath care is out of reach for large numbers of Americans so , Apples to Apples, comparing the average American heath care policy to the average heath care in a first world nation with socialized care. I’m confident there is some flim flam hiding the cost of socialized medicine but I haven’t seen it.
Duplicate post?
Jim,
You’re not looking at this right.
Of course the money in socialized medicine is allocated sensibly. It’s just not the way you expect. It’s like owning a car. Minor dents and problems are readily fixed but when major and catastrophic detrimental changes arise one starts looking for a replacement. Why throw good money after bad?
Socialized medicine is doing just that. If a worker is so broken then the worker is not carrying his/her/its fair share and a replacement is needed. Why throw good money after bad? Think of the ROI!
Besides, meat and eggs are bad for you, donchyaknow?
OTOH, some people don’t have access to adequate health care so the basic premise that no one should is simply to be fair.
From a doctor’s point of view, taking care of flu symptoms is great. You get paid full price to do absolutely nothing beyond doling out a prescription. Of course, they’re in the candy business. People are willing to give exorbitant salaries for minuscule services because they have insurance (OPM). It’s one of the reasons waiting rooms are so clogged. If there were no access to OPM, these people wouldn’t be there to treat head colds. So now we have Obamacare to further clog waiting rooms
Briggs:
I spent one night in Belgrade before the wall came down. What I remember most was the feeling I got upon seeing military guards at the airport entrances armed with AK-47s. I would not and do not want to live in that sort of state.
History has proven that centrally-planned economies do not work. An economy where the bulk of trade is done via free markets has proven to be the most successful system. This is where you and I probably best agree.
The ACA is not socialized medicine in its current incarnation. It is a free market system that is both regulated and subsidized by the government. In that respect, it’s not a significant change from before the bill passed. The main difference now is the mandate for universal coverage. This applies to both insurance providers and individual citizens. No insurance company can deny coverage, and no citizen can avoid paying for it.
There is no pat scary label for the ACA except possibly Obamacare. It is a system that has never been tried. Applying old scare labels to something entirely new and different does not address any of the actual issues that might otherwise be reasonably critiqued and debated.
My problem with the ACA is not that it smacks of socialism. My problem is that it lacks the necessary aspects of socialized care — which is a far different animal than a centrally planned economy. What’s necessary about socialized care? Among them, a hybrid socialized/free-market system would have the tendency to control rising cost of care.
As cost of care was well before the ACA and continues to rise at a comparable or perhaps even faster rate, this should at the very least be a big hint to you that it is the commonality of the free-market component both before and after is the most likely mechanism for increasing costs.
That does NOT mean that I advocate abolshing free-market captialism as the major component of our economy.
Anecdotal appeals to scare stories of long bread lines are unconvincing arguments. The United States has, and has had for a very long time, the highest per capita cost of care in the world.
Countries that have much lower per capita costs, universal coverage and comparable health outcomes have largely done it by legislating socialized health systems as the major if not only component.
STATISTICS indicate this. Not scary anecdotes. Up your game.
Brandon –
If you think we have a free-market healthcare system right now, I’d like to sell you a bridge.
Brandon,
If you want an example of how badly socialized medicine would be just look at the military system. My ex qualified because her father was a colonel in NATO. All I can say is the waiting lines were long — much longer than at the local hospital ER — and, without providing details, rather uniformly poor diagnostic skills. Look at the problems at VA hospitals today.
So, if the US “has had for a very long time, the highest per capita cost of care in the world” would it be fair to say it came about because of a free market and people were quite willing to pay those costs?
After this state and others mandated car insurance coverage, the cost of collision care went up at a furious rate. ACA is not going to lower health costs and for the same reason.
Emergency health care for life threatening illnesses and accidents was rarely denied to anyone. If necessary, the state picked up the tab, ACA doesn’t fix that and those who couldn’t afford even emergency insurance before still won’t be able to afford it. It will be given to them now instead of waiting until it becomes necessary. What exactly has been solved?
When I originally commented I clicked the “Notify me when new comments are added” checkbox and now
each time a comment is added I get several e-mails with the same comment.
Is there any way you can remove me from that service?
Bless you!
Bottom of the email. Unsubscribe.
Eric: You’re gonna have to give me a little more than that to make it stick.
DAV: I have a pretty good idea of how bad socialized medicine isn’t. The 30,000 ft. view is that we spend $8,500 per head a year, next highest is Norway at $5,700. The Canucks spend $4,500 a year. Germany $4,500. We have comparable life expectancy with all of those countries. Get that? We don’t live appreciably longer than they do, and some of them are spending just over a half of what we are.
Are you seriously trying to tell me that waiting in line a little bit longer isn’t worth $4,000 dollars of your time?
That not having any insurance at all under our previous system is worth being DEAD or bankrupt so that we don’t turn into a puppet state of the now-defunct Soviet Russia?
You want to trade anecdotes about line waits? Ok, ever been a member of Kaiser Permanente?
The VA you say? Ok, well maybe, just maybe, the reason it sucks so bad is due to our fiscal policies of the past 10 years. That the VA is flooded with wounded Iraqi vets from a war that we probably should not have started in the first place. You know, the war that was supposed to pay for itself. Hmmmm ….
We’re Americans, man. We used to know how to do things. When something else works, and works well in other countries, I don’t want to hear, “We can’t do that because it’s Communism.” Give us as a people some credit for being smart enough to be able to choose things that work in countries that are democracies and remain true to our principles of our freedom.
DAV: I guess I wasn’t done.
Emergency health care is the most expensive type there is. Of course I understand that the uninsured received life threatening care for trauma, appendicits, etc. But when an uninsured person can’t afford to get an illness treated until it becomes acute to the point of being life threatening, we need to ask ourselves two questions:
What are the moral implications of letting the generally poor and/or unemployed get ill and possibly die?
If there’s any possiblity that preventative care is more cost-effective over the long run than insurance by ER, isn’t it worth a try?
The current ACA is still mainly a free-market system. By design. Who do you think lobbied Congress for such a juicy deal? Why do you think that the Public Option was blocked?
I don’t demonize the Republicans for doing it because I recognize that the insurance corporations were behind the whole thing. Once they locked in Republic support to block the public option, they turned right around to negotiate the best deal they could with the Democrats and Obama.
And I think it’s obvious that they got exactly what they wanted. I blame both parties for creating the mess that is the current ACA, but it’s at least a move in the right direction. There needs to be more. Going back to the good old days isn’t an option. We already know how that worked, and it stunk on ice.
I don’t want full socialized medicine tomorrow. It’s too abrupt a culture change, and it would create tremendous economic upheaval to simply erase insurance companies — I care for their employees’ jobs, and for their stockholders and corporate officers right to earn money. I care about the doctors, nurses and other healthcare workers that very well might have to take pay cuts. I wouldn’t like that, I don’t think I’d support it either.
But I do object, strenuously, to the argument that moving toward that kind system is a Bad Idea just on principle because we don’t want to turn into Russkies.
Brandon,
Since I’ve retired, I have been self-insured. I have been paying about $1200/yr in health costs and I have a pre-existing condition. I went to the ACA site last fall and found:
1) although devilishly difficult to nail down, my annual costs will be $6000/yr for the same level of care. That’s an increase by a factor of 5x ;
2) even if I can get a subsidy (which I doubt), it will be $3600/yr a factor of 3x what it has been;
3) there will still be out-of-pocket costs;
4) and it looks like it will have to be something like Kaiser Permanente
Yes, a long time ago I was forced into Kaiser Permanente. Fortunately, for only one year and also fortunately I only had to go there twice. HMO’s are little better than the experience my ex had at military hospitals. I don’t see any reason to go back — except that now I will be again forced to. How is this better?
Part of the problem the VA that the doctors are from the bottom of the barrel. The same with many HMOs. A joke: what do you call someone who barely passed the medical practice exams? Answer: doctor.
Without the insurance I was always able to negotiate my costs to the same level that insurance companies pay. It’s surprising low. The insurance companies don’t pay list. Under ACA I will no longer be able to do this. And under an HMO, I no longer will have limited choice of doctors. Sure, I could buy the insurance AND pay to not use it but either way, my costs will sky rocket. And it will get even harder to negotiate.
All around ACA sucks. And it isn’t even (yet) socialized medicine. The way I see it, my access to health care under ACA will deteriorated. It’s a boondoggle for insurance companies.
Are you seriously trying to tell me that waiting in line a little bit longer isn’t worth $4,000 dollars of your time?
Simply put: no.
I should have said: And under an HMO, I will have limited choice of doctors.
So the former Yugoslavia countries produced lots of sweets; how very bourgeois of them: in the communistic Poland (where I I was born and raised) there was always shortage of candy, bar mint ones which are not usually the most desirable/delectable ones.
But, Freakonomics-style, there is yet another link between sweet snacks and healthcare: tooth decay. In the communistic Poland, the dentists were completely ‘free’ (with some small amount charged for oh so hip now gold fillings). Of course, the very same doctors who offered those ‘free’ services had their own private practices where they actually did most of, still shoddy, their work. In neither case the customer had any influence on a quality of the work, because in neither case the doctor had any incentive to perform well/above the minimum.
In the end, it boils down to lowering patients’ expectations., where they are just happy someone did take care of an issue, not because the solution is most elegant or comfortable. In the capitalistic systems, a patient (a consumer of the service) can (and does) expect XYZ in exchange for his/her money. If it is not received (or is different from the desirable outcome), a lawsuit is not out of place, just like it would in case of a mislabeled coffee cup or malfunctioning car breaks.
In the centralized health systems, to go to hospital is not to except much, but the lack of a bill; because of the old ACA adage: “beggars..ekhm..free patients cannot be choosers,”
So take the mint candy, and be happy with it. And that’s a sweet thought to take with you.
DAV: Ok, that’s bad for you. I get it now. I’m on the other side of the situation: I’m the one who was unemployed in 2009-2010 with pre-existing conditions, no insurance, and COBRA well out of my price range. I was denied unemployment because I formed a startup which was going to be years from any hope of any revenue, much less a living wage. This made me not a happy camper.
The current ACA sucks for both of us. If I were Obama, I would be ashamed to have the thing bearing my name. It kind of figures to me that he lied about being able to “keep your plan” because in my mind, he’s lying constantly about the thing being any good at all. Not to defend Obama, or any politician from any party, the insurance industry is the reason behind the way that it was written. It may be that they’re coming out ahead despite having to cover high-risk patients.
That’s not to blame the insurance industry either. Businesses have a fiduciary duty to their shareholders. They act accordingly. Free-markets are a good thing overall, but this is one case where profit motive appears to have come at the cost of us getting screwed out of something that our health and even our lives depend on.
My argument here is: this is NOT socialized medicine, which you agree with. It’s subsidized, mandated private health insurance. So why are some people still pushing the idea that the current form of the ACA in any way resembles socialized medicine? I’m serious, think about it. Why would they be making such patently false argument?
I love the doctor joke, so true. I’ve heard it said that once a med school accepts a student, they do everything in their power to keep students from dropping out. But I’d like you to think again about your statemet re: the VA. The VA is under-funded and overworked, so of course they tend to get the bottom of the barrel medical staff. The private sector is more lucrative. Read that last sentence again and ponder where you would prefer to work if you were a recent med school grad.
“All around ACA sucks. And it isn’t even (yet) socialized medicine. The way I see it, my access to health care under ACA will deteriorated. It’s a boondoggle for insurance companies.”
Did you mean it’s a “boon” for insurance companies?
“And under an HMO, I will have limited choice of doctors.”
Yeah, no kidding. HMOs are still private enterprise. You and I both may have gotten screwed that the ACA didn’t make it through the Senate with the public option intact. We’ll never know for sure until it’s actually tried. Until that happens, if it ever does in my lifetime or yours, we never will. What we’re stuck with until then is a version of the same crap we had before, only flipped over in the pan and sprinkled with powdered crap and called something different. A pig wearing lipstick is still a pig.
And so long as we don’t have some sort of public option, we’re going to be reading scary stories about candy stores in Yugoslavia, as if a former pawn of a former failed Communist state in any way shape or form resembles the strength and greatness of our country, present day, warts and all. That’s a disgusting insult to my patriotism and my intelligence.
To be very clear, I am not at all directing my above ire at you. And make no mistake, I am hopping mad about it for both you and me.
The anxiety over the fear of death is the root of the problem. Medicine, socialized or otherwise, can do nothing about death except perhaps (but only perhaps) postpone it for a little while. Free yourself of anxiety and the problem goes away. I live in a country where there is both socialized medicine and soldiers with loaded AK-47’s standing about. I thank God for both and also for letting me live as long as I have already and bringing me to live in a fairly civilized land.
Brandon Gates ,
A boondoggle is a project that is considered a useless waste of both time and money, ACA is a boondoggle that is a boon for the insurance companies. Boondoggles rarely occur unless someone profits. However, I should have used ‘boon’ instead in my previous post. Think of my typos, grammar mistakes and malapropisms as beauty marks like the one on Marilyn Monroe’s cheek.
I share Jim’s fear of socializing medicine. Just as I resent the loss of control over the cost of my health care I would resent the total loss of control over it. It’s bad enough when someone I’m paying acts as if they are in control. It will be worse when someone else is paying.
I pointed to military and VA hospitals as omens of what to expect under socialized medicine. They are likely best case scenarios. Yes the VA suffers from lack of money and poor management. Why would socialized medicine be any better? Over time our government raided Social Security funds to pay for other things to the point that “full retirement age” is an ever moving goal. Why do you think socialized medicine won’t be equally treated to similar raids and cost cutting measures?
You may have seen positive examples of socialized medicine and may even yearn for it but you should go listen to the travails of John Brignell at numberwatch. I also have heard stories of Canadians coming to the US for surgery that has been delayed or even denied to them. If the US were to have socialized medicine where would we go when we become irrelevant to it?
We seem to be living in a State Nanny era that assumes the State knows better about one’s health care than the individual. Imagine how oppressive that will be when the State is actually paying for the care. The argument will be the costs to support one’s lifestyle therefore they can control the choice of lifestyles.
ACA is one step very uncomfortably closer to socialized medicine than I would wish. It’s the crack under the lid of Pandora’s box.
Jim, I grew up and live in a country with a health system that I think is a long way from what you would ahve found in and yet you would probably still call “socialized medicine”. I’ve also lived in another country with a system which also fits that description, and yet was definitely different. The small details do matter, at least to some extent.
In any case, I haven’t had any trouble with your “meat and eggs” here, and the American habit of bothering to see a doctor for “candy” like treating a flu or even less signficant virus has always seemed absurd.
Stuart Browning’s 25-minute look at the Canadian healthcare system:
Dead Meat
He has three other shorter videos on related topics. Click on his channel link on the youtube page to see them.
DAV,
It’s a boodoggle for us, a boon for the insurance industry. I often think two things at once and then mash them together in such ways. I’m actually smiling right now. Elsewhere on the ‘net today, we were comparing Monroe to Lewinsky … do you have ESP?
I have a bevy of fears about the future of the US. The question of choice is a hard one for me to answer. The loss of choice of doctors/providers is of concern. I don’t have a good answer, nor time to come up with one at the moment.
Back to the VA. Why I think socialized medicine *might* work for us is that it works in other places. Why I think it might utterly fail is because I have a very low amount of faith in our political system right now.
If the argument is, “we can’t do socialized medicine because our government can’t even run the VA properly” then I’m sitting at my keyboard screaming, “THEN LET’S FIX THE GOVERNMENT!”
Your Social Security examples, etc. only reinforce this point, our shared concern it seems.
I have heard the same stories about Canadians crossing the border. It troubled me at first. That was in, when, 1995 or so during Hillary’s (failed) healthcare reform push. I think you can thank Newt for killing it, but I was a political innocent back then so I can’t quite remember.
I have British and Canadian friends here and there on the web, and I’ve asked them about it. They kind of laugh at me when I ask. “Yeah we’ve heard you’ve heard those stories. Yes, we sometimes need to wait a few weeks for a procedure, but don’t you guys have to do that too? I’ve never felt a pressing need to fly to America for healthcare. Maybe across the Channel to France occasionally.” Etc.
They are just stories though. That does not mean it doesn’t happen that foreigners come here to see a doctor, and it in fact does. Just not for the oft-cited reasons of “the line was too long in Toronto, so I went to Cleveland for my ingrown toenail surgery”. It’s usually for things like highly specialized care for rare diseases, particulary hairy cardiac or brain surgeries, etc. We do have very excellent doctors and technologies here, no doubt about it. This is one of the plusses to free-market, for-profit medicine.
Earlier this year, I went and did some more digging. TONS of people come to the US from everywhere for medical care, but it’s the very well-off who want the most excellent care. Of course those with means are not going to settle for humdrum local medicine when their life is on the line. I’m not advocating for the top 10% here, they’re going to be fine either way we go. I’m thinking about me in the upper part of the 90% where its a queeze, not to mention our fellows not nearly as fortunate.
So then the illuminating fact: nearly as many, if not more US citizens travel outside the US for medical attention. Much of that is cosmetic surgery and liposuctions, but a lot of it is perfectly “routine” gall bladder removals, cardiac bypasses, dental work, the lot. Why? Because it’s affordable. These are average middle-class citizens who have no or little health insurance. It’s cheaper to buy a plane ticket and get a hotel plus the procedure outside the US than to pay out of pocket here.
The kicker? The number one medical destination from the US is Mexico. MEXICO. Granted, many are Hispanics visiting relatives (some illegals maybe, the figures didn’t say) but plenty of American Americans go get their teeth pulled across our southern border because they can afford it without busting their savings account. Or their credit limit, as the case may be.
I’ve no love for Democrats at the moment. The nanny state exists, not just with the Dems though. In either case, it’s kind of sound-bitey in a way that gives me a case of teeth grinding. It probably deserves its own topic … I have ideas for welfare reform that I hashed out with a conservative friend of mine once. Another time.
Dav,
1) in a previous thread a few month ago you said you didn’t have health insurance
2) If you are retired, shouldn’t you have access to medicare!
3) Shouldn’t you have access to the tax credit!
The number of people who have to pay more because of the ACA is much lower than the number of people who have to pay less.
Brandon.
I’m not so sure about the Canadian system. See the Dead Meat link posted by Lynn Clark. You can skip the pointless and non-informational first two minutes.
Also there are a number of John Stossel segments on health care that are worth watching such as this 6 parter (1 hour) 20/20 segment. Part 5 has interesting coverage on Health Savings Accounts (HSAs). He also points out that many who can, come hear from countries with national health care and names names.
https://www.youtube.com/watch?v=kf3MtjMBWx4
Part 5 if you just want to skip to it:
https://www.youtube.com/watch?v=PlNtWy8TX_Y
This is specifically about the Canadian system with some duplication from the 6 parter:
https://www.youtube.com/watch?v=l9u2UU6-wlk
The dentist I go to is rather pricey but he was once named in the Washington Post as the Number One Dentist in the DC area. Even so, what he charges for an extraction wouldn’t even buy cab fare to get to a plane to carry me to Mexico. Getting a new muffler for my car would cost more.
Hopefully those won’t embed.
Sylvain,
1) in a previous thread a few month ago you said you didn’t have health insurance
And I don’t.
2) If you are retired, shouldn’t you have access to medicare!
No. The eligibility for Medicare is an age minimum and has nothing to do with retirement status. I’m not looking forward to it but may have to accept it if my costs are going to be forced so high by ACA.
3) Shouldn’t you have access to the tax credit!
Maybe but I doubt it. It depends on income and financial status. It would be part of the subsidy that I referred to above.
The number of people who have to pay more because of the ACA is much lower than the number of people who have to pay less.
LOL! That’s a good one.
Oh yeah! I feel much better now. Glad you pointed that out. Always good to know your carrying everyone else’s weight.
Jim,
Mixing socialism with totalitarianism and communism show your misunderstanding of these ideologies.
Socialist countries don’t have any central planning and favor equality of right between individual, not equality of living condition.
Communist countries did have central planning that tried to micro-manage all production which was a big bust for Russia’s ability to succeed. Communism favor a very small elite who live live kings under a totalitarian state, which is not very different than what was happening in the US in the late 1800s when true capitalism died. Since then even the US are a socialist state.
As for health care, socialize health care is not perfect and no one claim it ever has been, Yet for all its flaws socialized medicine is able to provide health care to the entire population of the countries. Waiting time usually are reasonable. Though sometimes things happens that can cause longer delays like higher number of people suffering of a particular health problem, not having enough doctor, nurse and other specialist because of competition within developed countries, or people fall sick, etc.
You realize that our actual bureaucracy is actually less important than that seen in the US. No one is denied any care or diagnosis tool (which can be seen in the US) The decision of our care are in the hands of the doctors not the government.
The bureaucracy could even be less important if we removed the regional centers to the benefit of local hospital administration. This way each hospital could select how to spent their budget.
Another thing that could be corrected would be to allow doctor to work both in the private and the public system, which is not allowed at the moment.
It’s interesting that a high deductible ACA policy is essentially catastrophic insurance. Which of course is no longer available…well at least the inexpensive version is no longer available.