I wonder if there is anyone here who can chime in with their experience in the Ausie healthcare system. That basic fact is all I know about it.
@bewildered I can chime in about Aussie healthcare. At it's core, it's Medicare if you are poor and private insurance if you have a decent income. It's a tiered system of taxes, so the richer you are, the more you contribute to the total pool, while also getting tax rebates depending on your age and income. They have caps on a lot of their medical treatments/drug costs which is a big contributor to keeping overall costs down. They do charge for specialists, but I believe they have a tax or a work contribution that helps pay for/caps how much out of pocket charges you can incur per year. Public hospitals are free, but you can pay for private hospital care as well with either private insurance or out of pocket. One of the big advantages is the federal government negotiates rates for most of the healthcare products/pharmaceuticals they offer. This is a big sticking point which will almost never work in the US. This idea is where the thoughts of "death panels" comes from, the government deciding which procedures and medicines are necessary. The Australian people as a whole are WAY more trusting of their government as a whole then people in the US are so when the government buys a stockpile of medicine to offer at super cheap rates, you don't have every person with a Twitter account calling out for reforms or claiming corruption or questioning why they are being forced to take medicine A vs medicine B. *Edit Although with COVID, apparently there was some major discrepancies between who got the Astra vaccine vs who got the Pfizer one. There was a big outcry because there were some really rich people who jumped the line and got a "better" vaccine because they either paid for it or knew someone who "gave them the wrong vaccine by mistake". There was also the fact the government spent a giant amount of money on the Astra vaccine and they have had an incredibly slow rollout of it. Overall, Australia has a lot of very good programs which take advantage of using tax money way more efficiently then the US does, with the trade off being the government is in control of a lot more then in the US. This hasn't become a problem yet because of the ranked choice voting they have for their legislature so one party doesn't fully control any branch of government. It also forces the government to be WAYYYYYYYYYYYYYY more cooperative with other parties, otherwise your party gets completely wiped. This leads to the government focusing more on things like "How can we help affect climate change" as opposed to one party denying climate change even exists and nothing happening towards that goal when they are the majority.
Let me offer a counterpoint. There are systems that are like that in some points, but this is not what universal healthcare looks like in my country. I live in Germany and I'm also a hospital worker. We have two types of insurance, public and private. You can only go private above a certain income threshold. While in the public system, your monthly is tied to your paycheck, with private your income doesn't matter. It's usually cheaper when you're younger and gets gradually more expensive. There's a cutoff age at which you can't switch from private to public anymore, to prevent people from gaming the system. Private in general gives you more stuff, but can be extremely costly when you're old and stuck with it. The public system still has different companies, but the rate is pretty similar while they have slight differences in their catalogue. I'm in the public system, although I could go private if I wanted to. -I can go to a different GP every time. No one's gonna bother me about it. Or call me. Most GPs have a certain amount of walk-in hours anyways. -if I need to see a specialist, I can see any specialist I want. To be fair, it takes a while to get an appointment. But if you really have an acute problem, they'll see you. Might have to wait a bit for them to squeeze you in, but I've never been turned away. There's a hotline you can call to get you a specialist appointment as soon as possible. -for non-emergency surgery, you might wait a bit. But not years. Don't know the average waiting time. Best guess, maybe 3-4 months. Not years. -Out-of-hospital medicine is covered if it's prescribed by an MD. Sometimes you pay a marginal fee. Ambulance rides are covered. Dental is covered up to a point. If you want the more sophisticated treatment, you might have to pay or get dental insurance. But I don't pay to go to the dentist for check-ups. I can go to the eye doctor for free. Glasses you pretty much have to pay on your own.
I am Australian. Popped Cherries description is pretty accurate. We have universal free public healthcare (dental is not included), but you can choose to get private health insurance. In general, it's a good system with lots of flexibility, but it can also be very complicated in practice to try and navigate the system to get the ideal care for your needs. Public Hospitals The quality of care in public hospitals is excellent in Australia and care is provided quickly for urgent or serious matters. For example when my partner had a tumour in her chest, she was biopsied and screened for cancer the day we discovered it (negative) and in surgery to have it removed within a week. Even if you have private health insurance you often end up having to go through the public system, because the private hospitals don't provide a lot of treatments. Cancer treatments for example are often done entirely in the public system, because it's too expensive for the private system to afford all the up to date and high tech cancer gear. Similarly, years ago, I randomly started experiencing visual problems after contracting a virus and I went to a private hospital (I was insured), but they sent me over the road to the public hospital to use the high tech retina scanning machines for free. You can choose to go to your preferred specialist in the public system in theory, but in practice you'd just take whichever specialist will see you first (for most people that will be whoever is on shift the day you turn up to hospital). You also can't choose a specialist who only works in the private system. In my experience the waiting times have always been reasonable in the public system, for example, once when I fractured my toe I had to wait about 2 hours before seeing a doctor and getting x-rayed. Of course if you turn up to the ER with some minor non-emergency issue then you can expect to wait a long time. For non-emergency procedures you often end up waiting a few months or longer. But they usually consider being in pain as a reason to make the procedure urgent. Also if you were advised that the wait time was going to be any longer than 1 year you could always just sign up for private health insurance as in Australia health insurance companies can't exclude care for pre-exisiting conditions after 1 year of membership. If you're admitted, then you rarely get a private room in a public hospital and are usually required to sleep in a shared ward. The food is also terrible and they are usually dingy and old buildings, so it can feel pretty depressing being in one for any extended time. But it's all free. Private Hospitals If you have insurance you can go to a private hospital (technically you can go to a private hospital without insurance and pay out of pocket, but no one does and many private hospitals will insist you go to the free public option if you try). Most people have an initial out of pocket deductible of $250-1000 depending on their health insurance plans. We pay $300 a month all up for top level comprehensive private health insurance for my wife and our baby son with a $750 deductible. I am uninsured and just rely on the public system. The private hospitals are usually associated with a religion. The care is very good and the hospitals are often quite swish. You can expect a private room and decent food. You can get in very quickly for procedures/surgeries for non-urgent issues. You can choose your preferred specialist. However, many specialists in the private system charge extra fees on top of what your health insurance covers, so you can end up spending a bit of money out of pocket even with insurance. For example, a pregnant woman who goes through the private system can expect to pay between $2000 - $10000AUD over the course of the pregnancy/birth depending on how much their chosen obstetrician charges. The obstetrician has to charge you their fee in advance, so there are no nasty surprises or huge bills. A woman in the private system will see their obstetrician about every 2 weeks for regular check ups during the entire pregnancy. In contrast, in the public system you'll mostly see midwives unless it's a complicated pregnancy and you'll only see your obstetrician once or twice before the delivery. GPs and primary care You can choose to go to any GP you want that is within the public system and it's totally free. However, if you want to make a booking to see a GP in the public system you usually need to book a week or two in advance. In practice most people end up just going to a walk in GP super clinic with about 10-20 doctors on staff and seeing whoever you can first. In my experience you usually have to wait a couple of hours at one of these mega clinics to see a doctor. The care at public GP clinics is good, but quite rushed - you can only expect to see the doctor for 15 minutes maximum for 90% of issues and the clinics usually feel pretty dingy. In smaller cities though, it can be quite hard to find public GP clinics so you may end up having to go to a private GP depending on where you live. You can go to a private GP which usually costs around $40-90AUD per session. Health insurance does not cover GPs. You can usually make bookings to see a doctor on the same day or within a day or two at a private clinic (although really respected doctors might not be taking on new patients). The quality of care is thorough and you don't feel as rushed and the clinics are usually a more glamorous experience. It's definitely worth spending on the private clinic if you want to talk out your health care issues/treatment options in detail. Other issues Popped Cherries is right that a major reason that our health care is affordable is because of the Pharmaceutical Benefits Scheme - a program where the Federal Government negotiates purchsing medicines with pharmaceutical companies on behalf of all of Australia and then regulates the maximum price they can be sold for within the country. Cherries is also right that we totally screwed up the Covid-19 vaccine response in this country, but that was a product of our current government being cheapskates and not purchasing enough different types of vaccines. Doesn't really have anything to do with the broader health system.
The biggest challenge, as I said, is getting the people in the US to agree on the government getting control of a large portion of their medical care. People are fucking stupid and constantly do/vote against their best interests. It's really that simple.
So there's an Afghan resistance that's holding ground in Northern Afghanistan, and some reports indicate is even gaining ground. This would seem to indicate that the Afghan army was so corrupt that a significant number of people would rather fight the Taliban on their own than work with all the advantages that the Afghan army would have given them.
Speaking of powerful pictures, here's one that's been making the rounds. Before you interpret the obvious, word on the street is that picture's been online since August 2nd. They planned ahead. 20 years is long enough to find some good social media interns. https://youtu.be/C6WTa1QmaF8
Every time I see one of these clips it’s a handful of guys on each side, outnumbered by reporters/media/folks videoing the nonsense. It isn’t massive crowds rioting or making their voices heard. Why is anyone even paying attention anymore? If we all just turned our backs and refused to acknowledge them they would go away.
this guy's actually a really good streamer, really good at finding the action. However, currently he has lost his rental car keys and needs to find them. Though he did pass a bunch of rednecks with guns, both real and of the paintball variety, jumping into pickup truck beds.
It’s hard to believe how much of a shitshow Afghanistan has become. I’ve spent the last week trying to figure out how Biden could’ve fucked it up this badly. Everyone wanted it to end, but how do you manage to be so inept? The past week has prompted me to reminisce about the old days. I never saw any combat, but 10 years ago I was in the Marine Corps. Thinking back over the last weeks, I remembered I had an account on this site. I was in 8th grade when September 11th happened. The social studies teacher turned on the TV and told us that moment would define our lives. Years later, I enlisted. The first 3 Marines I met were my recruiter, the J-Hat (Drill Instructor), and my first rack-mate. They’ve all been dead for a long time. Twenty-two a day finds you quickly, I learned. It’s the start of a long list, and in one way or another, the wars in Afghanistan and Iraq played a role in all of them. Marriages ruined, limbs lost. How are we right back to where we started? The Taliban back in charge, and the terrorists getting a huge propaganda win? One of the first Marines I met in the fleet was having some trouble at the time. He no longer met the height-weight standards. He was the same 180 pounds he’d always been, but he was 3 inches shorter after the IED blast crushed his spine and killed everyone else in the vehicle. He no longer made the height-weight standards of the Marine Corps. How big are your problems by the way? I think about all the suicides, guys I was close to. For some reason, the people I think about the most were a couple young boots, I didn’t actually know them well at all. They invited me to hang out with them a couple times, pretty common around the barracks. I remember Christian telling me he was going to buy a car, he was real excited as a young kid. A couple beers, and wind-swept roads with a film of sand was enough. Christian Mogrovejo and Jeffrey Kendall took off. Christian lost control at 100 MPH just off of highway 62, they skidded through a park and impacted on the passenger side. Jeff’s head smacked the window and he was unconscious. Christian was awake but disoriented as the fire started. They didn’t make it out. So new to the fleet they were, their dental records had been lost and hadn’t arrived. They had a roommate go to the morgue to identify one of the bodies, by the unburnt portion of flesh, a tattoo he’d had gotten after bootcamp….on his ass. Weeks later they flew the families out for the memorial service. I sat a couple rows behind them as the services began. A roll call ceremony was to be held, and I had the honor of participating. With the entire battalion looking at you, do you speak with a strong voice, or do you offer a glint of support and compassion to the families? The Sergeant Major began… “PFC Kendall.” Silence. “Private First Class Kendall!” Silence. “Private. First Class. Jeffrey. N. Kendall.” Silence. Jeff’s sister let out a sob, and it pushed his mother over the edge. His father leaned in to comfort them, I realized he only had one arm. I learned later he’d lost his other in a car accident. He comforted them as best as he could, but didn’t have a hand to wipe the tears from his own face. “Lance Corporal Ryan Milliron.” I popped to attention and shouted “Present!” Was it too curt? Too rough? Echoing through the theater? Did I hide the emotion I was feeling? I was reading the memorial write up as the Sergeant Major continued. “Lance Corporal Christian Mogrovejo!” Silence. I had talked to Jeff a couple times briefly. As I read the write up, I realized he was a lot like me as a young kid. A jock, an athlete, an idealist who’d watched the September 11 attacks and wanted to serve. He wasn’t killed in combat. But the wars killed him. Absent the attacks and the wars, he probably would’ve went to some state university, joined a frat and partied like dumb kids do. I’ve had closer friends die, I’m always confused on why I return to Jeff and Christian so often. I think part of it is that they died younger than I was when I enlisted. I walk around and I take notice of all the soft targets. The “hardening” from 2001 is gone. The complacency is back. People were tired of reading about a military they don’t understand, in a place they know nothing about. I get it. We didn’t want to leave a residual force. We’ll have nothing to show for it, and we’re no safer than we were before. I get it. But why in the hell do we have to hear the Biden administration pound their chest over the success of the evacuations? Why do we have to watch them stage-manage a senile man who has no business calling the shots? Does anyone have faith in the Department of Homeland Security? Figured I would ask some strangers.
Well. Well, well. This I did not see coming. As someone who was in the thick of things, how do you view how this was handled? After multiple presidents completely fucked it up, I mean.
Not sure I would say I was really in the thick of things. From a pure optics standpoint, we could've left on May 1 before the fighting season and while the Taliban didn't have much momentum or control, and then we could've avoided the optics of this disaster. We could've left a force at Bagram through the withdrawal or permanently, and it would've been a game-changer. Biden has no excuse for not keeping holding that base through the duration of any withdrawal at minimum. He has no excuse for not getting on the ball as things started falling apart. I'm concerned they are going to hit the Kabul airport over the next few days. That was my concern even before the reports about ISIS. The propaganda win of chasing us out by force and on video, would be too powerful for them to pass up (distinction between Taliban/ISIS/AL Qaeda is overblown IMO). Their recruiting is going to explode as it is.