Why does the United States not have mandated paid maternity

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I wish I could be an indigenous Canadian. It must be sooooooo nice...

We're the wealthiest country on Earth--yet we are neither the largest nor most populous. Bigger, more populous countries than us have universal healthcare, and I don't hear them demanding the 'efficiency' of privatized medicine. I think we can manage it. If anything, the private healthcare system is much less efficient. So much money wasted on overhead and advertising.

So then do it like Canada. Socialized medicine is clear across the country, yes, but each Province & Territory administers it's own.

@AngelRho I'll yield to your political understanding of the U.S. on this matter hehe.



There are two. China and India. China does not have fully public healthcare, but is working towards it. India does. They are both pretty shoddy for regular citizens that can't afford expensive private hospitals - no sane person would trade the private U.S. system, whatever its troubles for the state of healthcare in either of those countries.

I can speak more about the NHS - the UK's attempt at this. While it's better than China or India - it still isn't great. Despite what you may have heard from advocates - people can and do die due to poor healthcare provision, especially in poorer areas, often old people left rotting in beds in understaffed hospitals lacking the equipment they need and this was the case long before Brexit exacerbated the staffing problem. We often hear of people travelling to other countries for expensive treatments that the NHS simply can't fund. The trusts that run the NHS have to be brutal when it comes to choosing cost effective medicines. If you think insurance companies are bad when they prioritise money over life... It's been in perpetual crisis for decades, no matter how much money is thrown at it - it is a black hole of government spending. We cannot really afford it as is.



Not a good comparison. Canada's population is tiny compared to the U.S. It's significantly smaller than even the UK.

I tell you what is an interesting system though. Japan. Population about a 1/3 of the US. Not socialised, but heavily regulated, standardised, subsidised and price controlled. Hospitals run by doctors instead of bean counters and by law - not for profit. Insurance is mandatory, but there is state assistance for exceptional cases. Not free at the point of use - but very reasonable service fees. It solves so many of the problems of the NHS and the overall standard of care is very high, but because the NHS is a borderline religion here - we're stuck with this s**t.

You undermine your argument with such a cop-out of a deflection. You think life is a picnic for native Americans here in the US?

Check your privilege. Besides, it's relevant. You can't pick on the US about "depriving...of the basics of modern life" when your country does exactly that and not expect someone to hit back. goldfish21 knows good and well that I'm right.

How is it not comparable?

If anything, Canada's systems should prove to America that universal systems can be deployed over incredibly vast geographic regions in a cost effective manner for such a "low," population of only ~38 Million people. And despite the huge size of our country AND low population, we're able to administer universal healthcare at a fraction of the cost per person as the American system costs them.

Just like with every other industry in the USA and volume/quantity discounts/economies of scale - USA should be able to do what we do, only better, for less money.

Instead, they do less, get less, and pay significantly more - because they're lining the pockets of layers of insurance companies and private hospitals and a smattering of publicly held corporations all in it for the earnings per share.

With 330 Million people and many more large densely populated cities, the USA should be able to have a far better single payer universal healthcare system than we could ever dream of here in Canada. But instead I read about Americans going bankrupt over simple medical expenses, or crowdfunding campaigns for surgeries no Canadian ever needs to even know the cost of.

Canada's historic (and present) mistreatment of Indigenous people, which the USA has approximately the exact same track record of, is somehow a relevant justification to American citizens not deserving the same basic public services as the rest of the developed world? Make it make sense.

I'm not defending crap United States policies. I just don't believe adding more crap policies to existing ones is the answer. I also don't have any illusions that the existing system in my country is somehow superior. You're the one crowing about how amazing Canada is. While we're on that topic, how easily do young black people find getting access to mental health care in Canada? I bet it's SO NICE being a visible minority in Canada.

Just like with every other industry in the USA and volume/quantity discounts/economies of scale - USA should be able to do what we do, only better, for less money.

That's not how governments work. Send out the government to buy a cake, they'll come back two days late with a piece of stale bread and no change. That is not to say everything should be privatised, the piece of stale bread is often preferable to whatever dystopia the private sector can cook up. But the inefficiencies, the bureaucracy, the short term thinking, the political point scoring are real and they scale exponentially with the population. Again I think Japan would be a better model for the US to try.

American health care system costs four times more than Canada's single-payer system
Average Americans pay $2,497 a year for insurance overhead and admin costs, while Canadians pay just $551
By IGOR DERYSH
FEBRUARY 15, 2020 3:00PM (UTC)

The cost of administering health care in the United States costs four times as much as it does in Canada, which has had a single-payer system for nearly 60 years, according to a new study.

The average American pays a whopping $2,497 per year in administrative costs — which fund insurer overhead and salaries of administrative workers as well as executive pay packages and growing profits — compared to $551 per person per year in Canada, according to a study published in the Annals of Internal Medicine last month. The study estimated that cutting administrative costs to Canadian levels could save more than $600 billion per year.

The data contradicts claims by opponents of single-payer health care systems, who have argued that private programs are more efficient than government-run health care. The debate over the feasibility of a single-payer health care has dominated the Democratic presidential race, where candidates like Sen. Bernie Sanders, I-Vt., and Sen. Elizabeth Warren, D-Mass., advocate for a system similar to Canada's while moderates like former Vice President Joe Biden and former South Bend, Indiana Mayor Pete Buttigieg have warned against scrapping private health care plans entirely.

Canada had administrative costs similar to those in the United States before it switched to a single-payer system in 1962, according to the study's authors, who are researchers at Harvard Medical School, the City University of New York at Hunter College, and the University of Ottawa. But by 1999, administrative costs accounted for 31% of American health care expenses, compared to less than 17% in Canada.

The costs have continued to increase since 1999. The study found that American insurers and care providers spent a total of $812 billion on administrative costs in 2017, more than 34% of all health care costs that year. The largest contributor to the massive price tag was insurance overhead costs, which totaled more than $275 billion in 2017.

"The U.S.-Canada disparity in administration is clearly large and growing," the study's authors wrote. "Discussions of health reform in the United States should consider whether $812 billion devoted annually to health administration is money well spent."

The increase in costs was driven in large part due to private insurers' growing role in administering publicly-funded Medicare and Medicaid programs. More than 50% of private insurers' revenue comes from Medicare and Medicaid recipients, according to the study. Roughly 12% of premiums for private Medicare Advantage plans are spent on overhead, compared to just 2% in traditional Medicare programs. Medicaid programs also showed a wide disparity in costs in states that shifted many of their Medicaid recipients into private managed care, where administrative costs are twice as high. There was little increase in states that have full control over their Medicaid programs.

As a result, Americans pay far more for the same care.

The average American spent $933 in hospital administration costs, compared to $196 in Canada, according to the research. Americans paid an average of $844 on insurance companies' overhead, compared to $146 in Canada. Americans spent an average of $465 for physicians' insurance-related costs, compared to $87 in Canada.

"The gap in health administrative spending between the United States and Canada is large and widening, and it apparently reflects the inefficiencies of the U.S. private insurance-based, multipayer system," the authors wrote. "The prices that U.S. medical providers charge incorporate a hidden surcharge to cover their costly administrative burden."

Despite the massive difference in administrative costs, a 2007 study by the Centers for Disease Control and Canada's health authority found that the overall health of residents in both countries is very similar, though the US actually trails in life expectancy, infant mortality, and fitness.

Many of the additional administrative costs in the US go toward compensation packages for insurance executives, some of whom pocket more than $20 million per year, and billions in profits collected by insurers.

"Americans spend twice as much per person as Canadians on health care. But instead of buying better care, that extra spending buys us sky-high profits and useless paperwork," said Dr. David Himmelstein, the study's lead author and a distinguished professor at Hunter College. "Before their single-payer reform, Canadians died younger than Americans, and their infant mortality rate was higher than ours. Now Canadians live three years longer and their infant mortality rate is 22% lower than ours. Under Medicare for All, Americans could cut out the red tape and afford a Rolls Royce version of Canada's system."

Himmelstein later told Time that the difference in administrative costs between the two countries would "not only cover all the uninsured but also eliminate all the copayments and deductibles."

"And, frankly, have money left over," he added.

Democrats like Biden and Buttigieg have argued that it would be a mistake to switch to a single-payer system because many people have private insurance plans they like. Both have proposed a public option, which would allow people to buy into a government-run health care program but would not do away with private plans.

But study senior author Dr. Steffie Woolhandler, at Hunter College and lecturer at Harvard Medical School, argued that a public option would make things worse, not better, because they would leave profit-seeking private insurance in place.

"Medicare for All could save more than $600 billion each year on bureaucracy, and repurpose that money to cover America's 30 million uninsured and eliminate copayments and deductibles for everyone," she said. "Reforms like a public option that leave private insurers in place can't deliver big administrative savings. As a result, public option reform would cost much more and cover much less than Medicare for All."


IGOR DERYSH
Igor Derysh is a staff writer at Salon. His work has also appeared in the Los Angeles Times, Chicago Tribune, Boston Herald and Baltimore Sun.

Tips/Email: [email protected] Twitter: @IgorDerysh

MORE FROM IGOR DERYSH

Then fire them & elect someone else that will do the job that everyone knows can be done. If "lowly Canadians," can figure it out than surely with all the "American might and ingenuity," or whatever south of the border they can figure it out, too.. no?

https://www.salon.com/2020/02/15/americ ... n%20Canada.

Excuses excuses.. sounds an awful lot like "..but he only beats me on days that end in Y."

Like I said, I can't speak for or about the black community in Canada - because I'm not black And we don't Have a significant black community here. I do wonder what the causes of what you posted, are, though. Cultural hesitation and sitgma preventing people from seeking mental health services? Or bias of healthcare professionals not allowing access to care? Some other factor or combination? I have no idea - for the reasons stated.. I'm not black and there are very few black people around me.