this post was submitted on 11 Apr 2026
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[–] merc@sh.itjust.works 3 points 2 days ago (2 children)

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.

[–] T156@lemmy.world 2 points 2 days ago (1 children)

Nobody would pay to use the private system if they could get their needs met for free in the public system.

They might, if they thought there was an advantage to it. Like being seen more quickly, or getting a discount for something else.

[–] merc@sh.itjust.works 2 points 1 day ago

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.

[–] Kommeavsted@lemmy.dbzer0.com 1 points 2 days ago* (last edited 2 days ago)

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.