Donald Trump had recently finished a familiar riff about banning gender transition surgery for children when the former president, speaking to an audience of Evangelical voters, moved on to something new: a policy that would affect transgender adults.
“I will ban all taxpayer funding for sex or gender transitions at any age,” said Trump, receiving thunderous applause at the Faith & Freedom Coalition conference in Washington last month. The Republican leader, who moments earlier had also pledged to reinstate a ban on transgender men and women serving in the military, paused for several seconds to soak in the crowd’s adulation.
It’s the kind of moment — and the type of policy — increasingly common on the GOP presidential campaign trail this year.
So they want to ban taxpayer funding.
I’m not an American, but how much tax funding goes into regular healthcare, and where the fuck does that money go? Because we hear horror stories over here in Europe that an ambulance callout in the US costs thousands of dollars, giving birth costs thousands of dollars, moderately wealthy people with health insurance have been bankrupted by cancer. In many European countries stuff like that doesn’t really cost you anything. In the UK for example, a visit to your GP is free, as is most medication. In other EU countries a GP is about €65, unless you’re on social welfare, in which case it’s free. And if your GP refers you for a scan or procedure, you generally don’t pay anything. The issue with free healthcare is the waiting time. You can choose to go private to cut the waiting time (in which case you need health insurance, because an MRI + overnight in hospital + procedure + plus drugs might cost €5k). But where a condition is considered an emergency (heart attack, road accident, possible cancer diagnosis) there isn’t a long wait for life-saving treatment. If a car runs you over, an ambulance brings you to the hospital and they treat you - no money change hands. My older sister had terminal cancer, and throughout the entire thing she paid €0 for various operations, scans, drugs and 2 ambulance callouts. She had health insurance, but with cancer, regular healthcare kinda supercedes it. Healthcare gives your more options, but she found that the “best of the best” oncologists and cancer treatment were available for free at the public hospital.
So, a very long run up to my question: WTF healthcare actually gets taxpayer funding in the US, and how are basic things like an ambulance or insulin insanely expensive?
I’ve lived in the US, the UK and the Netherlands, so I have a little info here.
Yes, quite a lot, but not for everyone. There’s a program for people over 65 (Medicare), and a program for low-income people (Medicaid). Then there are several other programs, such as Veteran’s healthcare which comes from the Defence budget, and a crazy number of other programs.
Lack of collective bargaining.
Lets say I’m selling a pill that cures the deadly disease papercutitis, and I want to sell it in the US and the EU. I fill a shipping container with my pills costing me 50 bucks per pill, and I go the USA. I send my representatives to doctors and hospitals, and I find out that I can sell more than I make. So, I simply increase my prices. I end up selling my cure for 5000 bucks a pill, because people are going to die otherwise. Some people have insurance, some people have the government pay, and some people pay it privately, but they all pay.
Now, I go the UK, and take my 5000 dollar papercutitis pill, and the NHS goes “Hahaha, no. We’ll pay 85 quid per pill, take it or leave it.” And well, these pills cost me 50 bucks, and I make 85 quid, and there’s 65 million british people, so I’ll take the 85 GBP per pill. The same in the Netherlands, which had private insurance, but the insurance companies will very happily come together and with the government’s backing say “Your choice, we can either buy asprin form Company X at 5 euros, OR we can a million asprins from you at 4,50, but you have to sell your papercutitis pills at 80 euros”. And since I make a profer there too, I’ll say yes.
So, in why is the US so expensive? Because the healthcare industry can make it so expensive. It’s literally free profit (if you don’t count the dead and bankrupt, but they don’t).