Yesterday I was reading about a school district on strike in California and the Superintendent of the district said, “We can’t pay teachers any more. The district already spends more than it takes in.”

To which I replied, “Public schools are not a profit making business.” In much of Europe, the same is true for health care.

Americans have gotten so wrapped up in capitalism that they see operating something at a deficit that is to be made up for by the government as a moral failing… But it’s not! The whole point of government is to patch over the holes that capitalism is too myopic to notice.

Social services are there precisely BECAUSE they are needed and unprofitable. If they were profitable, capitalism would be building schools.

It will never cease to amaze me that Americans could decide today to have free healthcare, and we don’t do it.

Capitalism has fucked you people up so badly. Hospitals do not exist to make fucking profit. They exist to provide healthcare. Only in the US are hospitals a business. We don’t need them to generate money, we need them to generate healthy citizens.

These hospitals don’t need to turn a profit, because they are funded by taxpayer dollars. They don’t need to make money, their expenses are already paid, and they don’t need to turn a profit, because healthcare should not be a for-profit business.

Probably the best way to explain this basic concept to an American (cause clearly nobody else would conceive this question) is to rely on something you are somewhat familiar.

In USA you have firefighters and firestations, and from what I understand they are not “for profit” businesses.

They don’t send bills to people they saved from a fire or a flooding or extracted from a car after a car accident (right?)

If I asked

How does a firestations can pay for all those special vehicles, special equipments and firefighters salaries and make profit when they save people for free?

You would (I hope) find my question rather absurd, cause the “fire service” is universally a service not a business for profit. A government organisations at some level(the city, the region, the central government) pays to provide the service to the population taking the needed resources from taxes collected in the same population. (The same goes for Police).

Most countries around the world (and for sure in Europe) do consider hospitals and healthcare in a very similar way (for the most part of what is essential healthcare, not aesthetic surgery for example) as the fire services or police forces. Everybody contribute and everybody gets the service in return.

An added benefit of this attitude is that doctors are not trying to “sell” you as many profitable procedures as possible if they don’t think that’s necessary or helpful for your health, while you can easily understand that, once healthcare is focusing on making profit, the incentives to change the way they would take care of patients to maximize profits is just too tempting, especially if doctors get a % of the profits of those unnecessary procedures.

For example imagine an intervention that would make the hospital a profit of 5000$, image that potentially you could make such intervention on a relatively healthy and relatively young person who doesn’t truly need that intervention, while the other person who truly needs that intervention is older and has other health issues.

The young patient has lower risk of complications and is going to be dismissed in just a couple of days after the intervention while the older patients is more likely to have issues and is going to take maybe 2 weeks.

Choosing to intervene on the older patient is less profitable, more risky and would prevent the hospital from accepting another patient for longer, so the hospital would prefer to not intervene on the patient who really needs surgery and prefer to perform surgery on a more convenient patient even if he doesn’t really need it. (So this “for-profit” mentality is extremely dangerous in healthcare)

You can try to find a firefighting analog for this.

For example if firefighters interventions had profit as their goal they might resort to unnecessary and expensive tools (when there is no need) just to charge more. Or avoiding the more challenging interventions (idk, like chemical industry fires) and prioritize “oil pan fires” in home kitchens cause they know a lid would easily and cheaply solve the problem maximizing profit.

Wouldn’t That be crazy?