Mexico’s 120 million citizens will begin to enjoy free, universal access to healthcare from next year, following a decree by socialist president Claudia Sheinbaum.
Every person has the right to health protection. The law shall determine the bases and terms to access health services and shall establish the competence of the Federation and the Local Governments in regard to sanitation according to the item XVI in Article 73 of this Constitution.
In practice, this has meant a bare minimum level of health care is theoretically available to everyone, but most working people have private insurance on top of that, or see private doctors. For the poorest people it has often been very difficult to get the care they need, even if it’s theoretically available and constitutionally guaranteed. It’s also different from American / Canadian / European hospitals in that family is expected to play a major role doing things that in richer countries are done by nurses or orderlies.
IMO, universal healthcare only really works if the middle class / upper middle class and the poor are all in the same system. If the people can pay more and get better care, they’ll do it, and the system used by the poor will be underfunded. You can’t do much about the truly rich. They’ll always just fly to other countries. If this is just filling the gaps between the various reasons people can use the state system, it’s not going to help that much, even if that kind of fix is necessary.
Any public service only works when there’s no privatization or outsourcing.
Public services, by definition, run at a loss; it’s not possible to profit from them monetarily. All benefits are intangible and derived from their social impact.
More innovation, more wealth production, higher productivity, less crime, better quality of life…
The moment you start privatizing, they stop working, as the only ways to increase profits from a public service are by lowering salaries and giving worse service.
When a public utility or something is sold off, then yes, as soon as the privatization happens the service has to get shittier.
But, I don’t think it’s true that the moment there’s a private alternative the public version stops working. I think it’s often just that the public version starts to decay because it doesn’t get the investment it needs.
For example, if you sell the postal service to a private company, it’s going to get either more expensive, or not work as well, or both.
But, if you allow a private parcel delivery service to compete with the post office, for a while you can have both working fairly well. The private service might offer much faster delivery that you can track, while the post office offers slower delivery for a much lower price. For a while the two services can coexist, and people can choose which one they want based on their needs. But, over time you’ll get underinvestment in the public postal option. People will demand that it be run as a business and won’t take into account that it acts as a public service and does things that are unprofitable but good for society.
Yes but if taxes are paying for the system then preventing tax exemption and building a competitive standard of care system heavily disincentivizes use of the private system.
If the private system is allowed to exist, it will always exist. Someone will find something that isn’t done quite as efficiently as the public medical system and charge privately for doing it. Anywhere the private system exists will be better than the public system by definition. Nobody would pay to use the private system if they could get their needs met for free in the public system.
Because of that, if there is a private system, some people will use it. Those same people will vote to try to limit the taxes they pay for the public system, because they’re not using that system. People who can pay for the private system are going to be the richer people, and so their decisions about where their tax money goes has more of an impact. So, eventually, the public system starts to crumble. When that happens, more people use the private system, and the problem gets worse.
Sorry if I wasn’t clear, I meant to say that if the public system and private system were equal but you had to pay for the private system, nobody would use it. Sure, if the private system is faster then people will use it even if the public system is free.
In places that allow a mix of private and public, the private system basically finds some flaw in the public system and allows people to pay to bypass that flaw. Things like wait times are one of the main issues. But, it’s sometimes something like certain expensive tests being hard to get in the public system (CAT scans or something). In the public system they might only order those when they’re obviously needed. The private system can let you have one whenever you want, so if your doctor says “well… it could help, but it doesn’t meet the threshold the public system sets” some people will pay for it out of pocket. Or it can be more privacy, or more luxurious hospital rooms. Even if the treatment is otherwise identical, some people will pay for that.
Well you’d need a strategy to defeat that mechanism to develop a high standard universal care in the first place. On one hand, that makes the entire argument moot, but on the other hand the same or similar strategy aught to function both for development and maintenance of the system.
Maybe that strategy is widely nuanced in finding an answer to each of the thousands of concerns and organizing for change through protocol. Alternatively there’s revolution and reboot.
Mexico already has a constitutionally guaranteed right to healthcare:
In practice, this has meant a bare minimum level of health care is theoretically available to everyone, but most working people have private insurance on top of that, or see private doctors. For the poorest people it has often been very difficult to get the care they need, even if it’s theoretically available and constitutionally guaranteed. It’s also different from American / Canadian / European hospitals in that family is expected to play a major role doing things that in richer countries are done by nurses or orderlies.
IMO, universal healthcare only really works if the middle class / upper middle class and the poor are all in the same system. If the people can pay more and get better care, they’ll do it, and the system used by the poor will be underfunded. You can’t do much about the truly rich. They’ll always just fly to other countries. If this is just filling the gaps between the various reasons people can use the state system, it’s not going to help that much, even if that kind of fix is necessary.
Any public service only works when there’s no privatization or outsourcing.
Public services, by definition, run at a loss; it’s not possible to profit from them monetarily. All benefits are intangible and derived from their social impact.
More innovation, more wealth production, higher productivity, less crime, better quality of life…
The moment you start privatizing, they stop working, as the only ways to increase profits from a public service are by lowering salaries and giving worse service.
When a public utility or something is sold off, then yes, as soon as the privatization happens the service has to get shittier.
But, I don’t think it’s true that the moment there’s a private alternative the public version stops working. I think it’s often just that the public version starts to decay because it doesn’t get the investment it needs.
For example, if you sell the postal service to a private company, it’s going to get either more expensive, or not work as well, or both.
But, if you allow a private parcel delivery service to compete with the post office, for a while you can have both working fairly well. The private service might offer much faster delivery that you can track, while the post office offers slower delivery for a much lower price. For a while the two services can coexist, and people can choose which one they want based on their needs. But, over time you’ll get underinvestment in the public postal option. People will demand that it be run as a business and won’t take into account that it acts as a public service and does things that are unprofitable but good for society.
Yes but if taxes are paying for the system then preventing tax exemption and building a competitive standard of care system heavily disincentivizes use of the private system.
If the private system is allowed to exist, it will always exist. Someone will find something that isn’t done quite as efficiently as the public medical system and charge privately for doing it. Anywhere the private system exists will be better than the public system by definition. Nobody would pay to use the private system if they could get their needs met for free in the public system.
Because of that, if there is a private system, some people will use it. Those same people will vote to try to limit the taxes they pay for the public system, because they’re not using that system. People who can pay for the private system are going to be the richer people, and so their decisions about where their tax money goes has more of an impact. So, eventually, the public system starts to crumble. When that happens, more people use the private system, and the problem gets worse.
They might, if they thought there was an advantage to it. Like being seen more quickly, or getting a discount for something else.
Sorry if I wasn’t clear, I meant to say that if the public system and private system were equal but you had to pay for the private system, nobody would use it. Sure, if the private system is faster then people will use it even if the public system is free.
In places that allow a mix of private and public, the private system basically finds some flaw in the public system and allows people to pay to bypass that flaw. Things like wait times are one of the main issues. But, it’s sometimes something like certain expensive tests being hard to get in the public system (CAT scans or something). In the public system they might only order those when they’re obviously needed. The private system can let you have one whenever you want, so if your doctor says “well… it could help, but it doesn’t meet the threshold the public system sets” some people will pay for it out of pocket. Or it can be more privacy, or more luxurious hospital rooms. Even if the treatment is otherwise identical, some people will pay for that.
Well you’d need a strategy to defeat that mechanism to develop a high standard universal care in the first place. On one hand, that makes the entire argument moot, but on the other hand the same or similar strategy aught to function both for development and maintenance of the system.
Maybe that strategy is widely nuanced in finding an answer to each of the thousands of concerns and organizing for change through protocol. Alternatively there’s revolution and reboot.