So I am currently halfway through a 14 day trip to Italy. I am here with my wife who is working with 15 colleges students from TTU. They are working in two hospitals located in and around Bologna.

It’s been quite eye opening. The level of care here is actually comparable to the US and in some ways better and some ways worse. However, what has been the most educational for me is learning that they pay over 40% in taxes and the wages are very low.

Some of the people we are working with have a net pay of $2200 a month with very similar living expenses as we have. Similar careers in the US would have salaries more than double that. Even paying $1000 for health insurance they would come out better in the US.

We talk a lot about the fact universal health care isn’t “free” from the conservative view point, just interesting to see it first hand.

High tax rates for sure, but I think the 40% range is the top end for the highest incomes and it's more like low 20s at the bottom end of the spectrum.

This is for someone who is making only $2200 a month. He said they take over 40% out of his check. His net pay is only $2200 after they take everything out.

Sure he has a little lower expenses but he’s making 60% less than what he would make in the US doing the same job.

The sad truth is the govt has made it very difficult to have good health care in the US these days. I was just talking about this a little in the OR yesterday with my staff. The one thing that could make health care so much better in the US is the ability to balance bill insurance. This would allow a stratification of skill set and service that the market would bear out.

I have long said "free healthcare" is great when you can get access and don't have to pay out the ear for it. Show me anywhere that is the case. Most of the model examples of universal "free" healthcare come from very small populated countries that are largely homogenous ethnically, or from very very rich countries that have exorbitant excess and have nothing else better to spend money on.

Taking an example like the US where we have such diverse ethnicity with its various medical and cultural concerns, and trying to make a universal "free" system of healthcare that had adequate access and little (will never be zero) rationing of care/services, we would be looking at a similar tax rate with at least a minimum of 40% (possibly could be high as 60%)for EVERYONE. As it stands, the lower 40% of the population pay zero income tax (most in this bracket actually they get money back so its a negative tax rate), the next 20% of earners (those making between 58k-108k) pay a total of 10% of the income tax revenue, the next 20% pay a total of 18% of the income tax revenue, and the top 20% pay 68% of the income tax revenue (based on 2022 numbers). While acknowledging the income tax is not the whole tax revenue for the US federal budget, looking at payroll taxes, again the amounts are very disparate with the bottom 40% of earners only contributing 12% of payroll tax revenue total, the next 20% contribute 14%, the earners in the 60-80% bracket contribute 20% of the payroll tax revenue, and the top 20% of earners contribute 53% of the payroll tax revenue. This is apples to oranges for a comparison, I know, but it shows the US is not even close to some sort of a universal tax code.

That is the forgotten item on the list. EVERYONE has to pay equally. A lot of people clamor on about how terrible our system is and disproportionately it hurts people of lower ses....but no one is willing to shell out the bucks for the programs that would be necessary. All we would have is a two or three tier system that would allow the rich people to pay out of pocket and the poor people would be stuck in terrible situation with poor access/service/quality of care/rationing they would hate.

My brother’s wife fell when they were in Paris. Broke her arm, collarbone, and jaw. They put her in a hospital room and did minimal work, but declared that her injuries were not severe enough to deal with till later. The brother put her on a plane back to the US for treatment. National health service. Make of that what you will.

Im sure with the million African migrants they took in, will make it better.

The healthcare system isn’t just burdened by the government. People go to the doctor, especially the emergency room, for things that people used to just deal with. People regularly visit the ER with a mild fever, minor strains and sprains, minor cuts and scrapes, etc. Everybody thinks they are entitled to see a doctor for every little thing and it is burdensome.

Doctors work more hours and spend less time with patients, emergency rooms filled with people that don’t have an emergency. And they will sit and wait 8 or 12 hours to be seen. If you wait that long, it’s a clue that you are probably ok, you are last in triage.

The most expensive thing I ever got was free.

And this is why my comment about access in a "free system" is so critical. People will do one of two things, use it without any concern for the lack of need or wait to use it till its too late.

In the military system I routinely saw patients who did not need a single thing other than a conversation for a lonely person. They took appt slots away from people who may have actually needed them. For things available over the counter, most retirees were not willing to pay for that as they were "told they would be covered for everything for life" and stuff like ibuprofen or artificial tears were just expected to be stocked at the pharmacy and not paid for.

The other end of the spectrum would be the people who abuse their bodies for so long by the time they get care they would have to spend an enormous amount of time and resources to "fix" the problems and there would be essentially whole hospitals set up as extended rehab centers and transitional care facilities because someone would say that person was not safe to return home in the condition they would be. Think about the liability that would be taken on if healthcare were "free and govt sponsored"....you think people would stop suing and attorneys would stop attacking?

So many aspects of this problem that we americans do not even want to go down that road with....

Givers and takers...way too many takers...free health care in the US is and would be a huge disaster.

Wife spent 15 years in the ER and is now an NP at an urgent care that accepts Medicaid in a small and relatively poor community. Welfare recipients make an appointment at the urgent care for a headache so they can get meds and care for free rather than to go to Walmart and buy store brand Tylenol for $3.

Way too many takers...

They also call ambulances for home visit health care and blood pressure checks.

I can tell so many of today's members of society didn't grow up with a Dad like I have...he instilled in me from a very young age. There isn't anything free in this world. What I've yet to figure out is if folks don't know this key fact or they are just so self centered they don't care.

There is very little positive that will come from universal HC or Free HC as you call it. I cannot think of a single thing the government has gotten their hands in that was privatized that they have actually made better...one thing is for certain, it will be more expensive int he long run at minimum.

I spoke with a priest that was visiting from the Vatican, about health care. I asked how it worked over there. He said, “if you mean the public system, I don’t use it I pay to see a doctor. Other wise I could almost never get an appointment “.

We already have free healthcare. Just go to a county hospital and tell them your name if Juan Hernandez. You will get treated and everyone else will pay for it with their property taxes.

I need a fake Venezuelan ID.

Yep and it has been this way for a very long time. It is one of the lies told by Obama, there has always been healthcare for the indigent. It is against the law for a hospital to deny "emergency" health care based on a person's ability to pay. .

I watched it play out night after night at JPS.

Plain & simple, if you can pay for it, you should have access to it. If not, then no. That be the only way to bring a competitive edge to that marketplace.

And Parkland, Dallas County.

That hospital had a year that there were close to 16,000 babies delivered in one year. It is very common for a person that doesn't speak English to sneak into this country a few weeks before delivery and walk into the ER at the onset of labor. Also common for this to be their first time with a DR. during the pregnancy. If all goes well they're out of there in a few days. If it's a complicated delivery, you tell me how much the bill could be for a mother that needs surgery, and an infant with a serious complication?

Free health care has been around long before F Joe Biden said to Barry, "This is a big F-n' deal" on a hot mike. What the Socialists want is for us all to have the same level of care as those that want if free. I have insurance and pay my own way and get great care when I need it. I paid cash for a $400.00 inhaler when I had pneumonia, worth every penny, if you like to breath.

You don’t even have to tell them a name. You can call 911 and get emergency services, or walk into almost any hospital and receive care. I explained this to the people we were working with and they thought anyone who couldn’t pay out of pocket or afford insurance went completely without healthcare…

They also said that while their system worked well with regard to emergency needs and emergency surgeries, anything that was chronic you would have a hard time getting care for. You could still use private healthcare for those issues though.

We have several plants in Canada. None of them has anything good to say about their healthcare.

The problem with that is it increases costs for the people who pay anyways.

You'll have a much unhealthier community using the resources regardless of the ability to pay because of legislation around emergency care etc.

Take legislation out of it. Where is freedom to enjoy good health written in the Constitution? Maybe if people had to suffer from the consequences of their chosen bad actions, they could live in such a manner as to be more healthy. If not, it is their choice after all, why should we pay for it? If they didn’t, it could save on social security benefits.

The Injuns had it right.

The biggest take-away from countries like Italy, is that the treatment received may not be the best every time, but you will never have to worry about going bankrupt. Still, Italians have much better outcomes than Americans. Their system is ranked among the highest performers such as France and Norway, while ours is towards the bottom with Mexico and Algeria.

The "free" healthcare people still use ER for regular stuff and still don't pay any of their bills, which unpaid bills was one of the driving points of passing the Affordable Healthcare Act. Why is it legislation does the opposite of what it's name implies? All Obummercare did was make it more expensive for those that pay for healthcare.