Hacker News new | past | comments | ask | show | jobs | submit login

Singapore and Switzerland both have privatized healthcare, but it is extremely regulated at the same time.

In a way, that's true of the US too; and various (perhaps most?) european systems have most care provided privately - with whatever regulations apply.

The framing of "privatized" vs. government health care is, IMNSHO a holdover from the cold war when everything needed to be as ideologically distinct from USSR as possible. Now, it's just corrosive. This isn't a dichotomy; it's not even really a gradual scale - it's typically a whole host of choices of how to set up those regulations. Presuming in advance that privatization is a good (or bad) thing simply leads to worse outcomes.

US healthcare is absolutely not regulated on the same level as Swiss or Singaporean healthcare.

It is probably regulated in a far more complicated manner.

Singapore has forced savings accounts for basic care (out of pocket spending drives costs down), less barriers to entry into the medical profession (thus more doctors at lower wages than the US), less regulation that results in non-competitive hospital and medical practice like in the US.

It's far more effective at delivering high quality at low cost due to more market forces. They spend 3% GDP for excellent results vs 16-20 in the US which is a regulatory death by a thousand cuts.

Catastrophic care is covered by the government but this is far more efficient than universal systems elsewhere.

If you think US Healthcare is a problem of a lack of regulation you don't understand US Healthcare…


The problem is not how much is regulated, it is what parts are regulated and whether they really matter. Opaque pricing is definitely an issue in the US, as is over-reliance on medications [1] which is correlated to shitty workers rights.

[1] https://www.nytimes.com/2018/01/27/opinion/sunday/surgery-ge...

Yeah, it's a complex issue with many interlocking parts.

Which is why it's a shame when we get hung up on "privatized" vs. not - on that kind of topic people have often already made up their mind, and you're just not going to get anywhere anymore.

At least for Switzerland it's also mandatory to be part of a "Krankenkasse" (health insurer); you cannot be uninsured.

Guidelines | FAQ | Support | API | Security | Lists | Bookmarklet | Legal | Apply to YC | Contact