The United States is the only wealthy, industrialized nation without universal health care.
Why do you think this is?
Universal healthcare in all other industrialized, wealthy nations has been working well for decades compared to the US healthcare system.
Let´s focus on statistics Pre Covid please.
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Because the majority of the population who identify as " christian " think decent healthcare should only be available to well heeled middle and upper class Americans as the lower paid Americans do not desrve such, they will even claim that this is just as Jesus recommended.
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@just_sayin
Explanations for the current crisis “have to start with a consideration of Covid-19,” Ben Zaranko, an economist at the Institute for Fiscal Studies (IFS) whose work focuses on Britain’s health care system, told CNN. “There’s the simple fact that there are beds in hospitals occupied by Covid patients, which means those beds can’t be used for other things.”
https://www.cnn.com/2023/01/23/uk/uk-nhs-crisis-falling-apart-gbr-intl/index.html
This information was taken January 2023 citing Covid-19 as a consideration in the wait times. Covid hospitalizations have skewed the nuimbers along with other complications of Covid such as lack of health care workers, etc.
Let´s compare the health care systems pre-Covid so as to get a more fair analysis letś say pre 2019.
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Well it is definitely a for-profit business. Let´s explore further.
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@Factfinder
Our healthcare system is a for-profit system. Yes, money is key. But I´m interested in your assertion that if we had universal healthcare like all other WICs (made up acronym for wealth, industrialized countries) then the bureaucrats would have more control over our healthcare than the doctors?
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@just_sayin
In December, 54,000 people in England had to wait more than 12 hours for an emergency admission. The figure was virtually zero before the pandemic, according to data from NHS England. The average wait time for an ambulance to attend a “category 2” condition – like a stroke or heart attack – exceeded 90 minutes. The target is 18 minutes. There were 1,474 (20%) more excess deaths in the week ending December 30 than the 5-year average...
Can you post a link to the above information. I cannot find it.
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Even Marxist propaganda sites like CNN are admitting the utter failure of the socialized medicine system in the UK. :
I don't care about Marxism or Maxist sites , nor do I care about CNN , why are Americans so obsessed with Marxism?
Also what has the UK situation got to with what I said.?
You would have to hate Americans to want to do to them what happened to UK.
I don't want them or expect them to do anything as my observations are entirely accurate.
You cannot deny that the US identifies as a christian nation and you cannot deny that the majority detest the idea of Universal healthcare , what part of that thinking is " christian" in your opinion?
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That was a bit snarky @Joeseph.
How so? The comment I made is entirely accurate.Please explain what is " snarky" about it?
Money is of course a driving factor
Yes, should the poor and lower paid not recieve healthcare because of a lack of money?
. But more over it's the idea that bureaucracies would be deciding what proceedures can be done and who can have them done, instead of physicians
Thats not true at all , what do you base that assertion on?
. We already experience a taste of that with hmo's. And it leaves a bitter taste at that.
I know what HMO's are. It's remarkable the way Americans totally support a rip off healthcare system which can leave one medically bankrupt.
How can the lower paid access decent healthcare without assistance?
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Not where I live. Healthcare can be both public and private.
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But whats your solutions? How do those with lack of money get decent healthcare.
Why are you citing other systems in other countries what has it got to do with the US?
The failings in any system can be exposed , its remarkable to me that Americans take pride in a medical set up that fleeces them and they instead of criticising such robustly defend it.
Here is how easy to attack any countries medical system , its just deflection and goes no where to addressing the underlying issues
What are the biggest problems with U.S. healthcare? Below are eight of the top issues.
.
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NHS faces 'humanitarian crisis' as demand rises, British Red Cross warns
“Figures cannot account for untold patient misery,” he said. “Overcrowded departments, overflowing with patients, can result in avoidable deaths.” Hassan and Holland blamed the government’s underfunding of the NHS and social care systems for contributing to hospitals becoming worryingly full...
“The emergency care system is on its knees, despite the huge efforts of staff who are struggling to cope with the intense demands being put upon them. The situation is intolerable for both staff and patients, who are all too often left in the undignified position of waiting on a trolley in a corridor for a bed to become free,” said Hassan, who is an A&E consultant at two hospitals in Leeds...
So, are you brain damaged? If so, know that it will take at least 3 months, and maybe even 1 year before you can see a doctor in Canada.
What about the wait times Canada isn’t tracking?
Why do you think that 2/3rds of Canadians have private health insurance when health care is free in Canada? And why do you think the country of Canada is trying to ban private health care insurance? Please respond to those questions. If you get the answers right, you'll be on your way to understanding why socialized medicine is a bad idea.
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@just_sayin
Can you please submit links to the quotes you use? I´d like the verify your sources. It seems you cherry pick pieces here and there.
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NHS faces 'humanitarian crisis' as demand rises, British Red Cross warns and What about the wait times Canada isn’t tracking?
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@just_sayin
It does appear that England´s NHS is broken although this article was 2017.
Let´s compare other wealthy, industrialized nations healthcare systems also to the United States. This is what I find interesting. It appears that the US spends more per patients per year per capita than countries with universal health care. Could it be the for-profit benefits in the US?
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The implications of this difference is profound. Private entities are incentivized to improve the quality of their product, as well as their negotiating skills (e.g. advertisement, convenience, reaction to customer feedback), since otherwise they cannot increase their profit. Public entities are incentivized to increase the cost of the product without improving its quality (which is costly) so they can obtain more funding, hire more bureaucrats and strengthen their standing: their profit is independent of the quality of the product for it comes directly from taxes which the population has to pay no matter how much they dislike the product.
Naturally, in practice private and public entities intermingle, so private entities enter politics in order to stifle the competition and increase their profit without improving the quality of the product, and public entities start meddling in private affairs and claim a chunk of the privately earned profit.
The central issue here is that the inferiority of the quality of public services is hidden behind walls of bureaucratic abstraction. When you go to a private doctor, you see the bill you have to pay first hand: "Here, sir, is how much you owe us for our services" - so you immediately know what you are getting for what price and whether you should keep using the services of this doctor or go elsewhere. But when you go to a public doctor, you do not see anything: "It is free for you, sir". All the inefficiencies are covered not by you paying a bill directly, but by the taxes you and millions of other people pay - and the tax system is too complicated for anyone to be able to say how much exactly the healthcare services costed them. Suffice to say, they have to pay for everyone's healthcare even if they themselves have not used any healthcare services - just like me, someone who has not been to a doctor in 15 years because I have a very healthy style, yet I have to sponsor surgeries for people who eat at McDonalds 3 times a day and lay on their couch and watch Netflix the rest of the day.
However, one can get a rough estimate of this effect by comparing other metrics, such as the median net income. For example, we can compare Sweden with its universal healthcare against the US with its semi-universal healthcare (thanks Obama). The median household income in Sweden is roughly the same as in the US (between $70k and $75k) - however, Sweden imposes a punishing 25% VAT, 32% local tax on everything but the lowest of the lowest salaries, 30% capital gains tax, and 20% national tax on over ~$50k income. In other words, if you are making a median salary, you get less than 50% of it in cash, and any investment or purchases cost you 25-30% extra.
In comparison, in the US in most states $70k a year will have you pay no more than 20% overall tax, and the sales tax is typically going to be below 10%.
There are many other variables to consider, but roughly, it would seem, a median American can buy about twice as much in most goods as a median Swedish person, despite their nominal incomes being similar. Where does half of the wealth of the entire country go then? Well, you guessed it: towards the universal healthcare and other universal things. And are those universal things that good? Any wealthy Swede who has a serious illness will go for a treatment to Switzerland, the US, Singapore or the Emirates: the Swedish system turns out to be incapable of modernizing as quickly as the semi-private systems in those countries. And why would it be otherwise? Have you ever heard of a government leading the spear of modernization anywhere? Ever thought of buying a government-developed smartphone? The idea that healthcare is somehow fundamentally different because people need it much more than they need smartphones is a myth: different people have different needs, and when push comes to shove, having a functional smartphone at hand can often be much more important than having access to healthcare. Get lost in the Mojave wilderness, and you would kill for having a smartphone you can use to call 911, while a healthcare clinic 100 miles away would do you no good for you will expire long before reaching it.
I have lived in many different countries, and I continue to be amazed just how much poorer most other developed countries are than the US. Some of the things that are mandatory here, such as a functional AC at apartments, are not offered in most cases in other developed countries. Almost every domestic undergraduate student here has his own car, which is not the case virtually anywhere else. If you have a sudden toothache, then, unless you live in the middle of nowhere, you will be able to find a dental clinic that will take you in within a couple of hours - in most other places you will have to wait for days to get treated. Amazon now delivers a large array of goodies country-wide within 6 hours - that is unheard of outside of the US period.
Logic works. Wishful thinking does not. A dream of a nice centralized system that takes care of everyone without anyone needing to do anything is like a child's dream of the lalaland in which unlimited amounts of ice-cream are provided upon request and no negative health consequences follow from consuming it. In reality, it is humans exchanging goods and services between themselves - and if you think that humans empowered to take anything they want from you and provide or not provide any services they want for you will magically become more caring and benevolent than your neighbor who told you to F off last time you asked him to watch your dog while you are away on a business trip, then you are deeply mistaken, and human history has a lot to teach you about it.
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Sure. @Joeseph.Your statement made the false claim that Christians' " lower paid Americans do not desrve such, they will even claim that this is just as Jesus recommended." Can you cite where in the tenets of Christianity this is taught and claimed?
No. Not ideally.
Factual data gleaned from models of universal health care systems in place from around the world.
This is the governments definition: https://www.healthcare.gov/glossary/health-maintenance-organization-hmo/ If you have no understanding of this basic component of health care in the United States, how can you possibly have any well formed opinions of it? And we do not "totally" support it as this debate demonstrates.
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Sure. @Joeseph.Your statement made the false claim that Christians' " lower paid Americans do not desrve such, they will even claim that this is just as Jesus recommended." Can you cite where in the tenets of Christianity this is taught and claimed?
But I never said its in the tenets of Christianity, where did I say that?
No. Not ideally.
Your use of " ideally" means what exactly.?
Factual data gleaned from models of universal health care systems in place from around the world.
"All around the world" , seriously? How did you dec8de it was " factual"?
This is the governments definition: https://www.healthcare.gov/glossary/health-maintenance-organization-hmo/ ; If you have no understanding of this basic component of health care in the United States, how can you possibly have any well formed opinions of it?
The question is related to Universal healthcare and the adoption of such, you seem to think one failed attempt at such means its not worth the effort.
And we do not "totally" support it as this debate demonstrates.
Stop being so pedantic about the term totally , you know exactly what I mean .
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I cite other models of universal health care because it's logical to study other models when considering adopting one like them. And the OP cites them as "in all other industrialized, wealthy nations has been working well for decades compared to the US healthcare system." which is unsubstantiated.
That meme could represent any health care system around the world.
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I do not have a solution. I'm just trying to answer the questions stated in the OP. Putting it 100% under government control will not work any better and would likely be worse
I'm not suggesting putting it totally under government control so that's a strawman
. Perhaps you should start a thread?
On what? Why the snarkiness?
So you found no workable solutions in all your endeavours?
. And the OP cites them as "in all other industrialized, wealthy nations has been working well for decades compared to the US healthcare system." which is unsubstantiated.
OK then tell me are all Americans entitled to affordable healthcare from the richest to the poorest?
No , it couldn't, it may apply to some but not all. You have a habit of making claims without backing them up.
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Yes, by means of assessment and verification.
I know what the question is. How so? I haven't seen anything that convinces me we should spend what it would cost to totally convert to a centralized universal system. Nor have I heard from you a valid argument why we should. I haven't based any opinions on one single factor. And you didn't answer my question. Since you admit complete ignorance as to what hmo's are, how can you possibly feel qualified to have an informed opinion while having no understanding of this major element of our health care system?
You chose your words and put them in context. Don't blame me for your inadequate articulation.
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What snarkiness? Seriously, if you want to know how we can give people free healthcare and it be worth a dam then pose the question as a post.
No we are not. We are only entitled to what's made available to us and what we can pay for. We are not all entitled to the most expensive cars or houses either. It is the same in countries with universal health too, as far as I can tell. Everyone is entitled to what those countries have, but what they have isn't near enough so the poor still don't get what's not available to them. Their governments lack nothing are remain entrenched in power however.
Oh, you've found the perfect system? Do tell in detail. Please?
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Your statement surely does imply it as you know. "they will even claim that this is just as Jesus recommended." That's you implying Jesus taught them " lower paid Americans do not desrve such". If it is not then clarify, what did you want people to infer by your broad based judgmental remarks?
Dear oh dear , the comment is in reference to the countless times on here and other forums whereas those who identify as American christians will indeed claim they are following chritian tenats as set down by Jesus.
Yes, by means of assessment and verification.
So I have to take your word for it
I know what the question is. How so? I haven't seen anything that convinces me we should spend what it would cost to totally convert to a centralized universal system. Nor have I heard from you a valid argument why we should. I haven't based any opinions on one single factor
Well then stick to your opinions based on a single factor it will save you having to spend any efforts thinking of perhaps a better way.
. And you didn't answer my question. Since you admit complete ignorance as to what hmo's are, how can you possibly feel qualified to have an informed opinion while having no understanding of this major element of our health care system?
Nice swerve , I looked up hmos and addressed such , so what's your solution?
You chose your words and put them in context. Don't blame me for your inadequate articulation.
I blame you for only one thing your total failure to comprehend simple terms put simply, sorry I cannot dumb it down any more for you.
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In what reality can we have government offered, or supplied, or guaranteed, or, mandated, or declared, or in any other way, decreed without direct government oversight?
Read again what I actually said and perhaps try again.
What snarkiness?
Really?
Seriously, if you want to know how we can give people free healthcare and it be worth a dam then pose the question as a post.
I've done so in the past.
No we are not. We are only entitled to what's made available to us and what we can pay for.
No YOU'RE not I certainly am , you don't speak for others..
We are not all entitled to the most expensive cars or houses either.
Who's saying we are?
It is the same in countries with universal health too
What's the same?
Everyone is entitled to what those countries have, but what they have isn't near enough so the poor still don't get what's not available to them. Their governments lack nothing are remain entrenched in power however.
What you're saying is only certain Americans should be entitled affordable medical care right?
Oh, you've found the perfect system?
Where did i say that?
Do tell in detail. Please?
Tell what? Oh tell you i dont pay high medical costs or dont need paid medical insurance ?
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@Factfinder @Joeseph
Is it really unsubstantiated that other countries enjoy a better healthcare system (not a perfect system, but a better system)? All other wealthy, industrialized countries have adopted a universal health care plan for their citizens. And while they are imperfect as anything complex is, America´s health care is by far the most expensive and least efficient and least equitable than these other countries. I have found much information to support this.
Statistica quotes:
Administrative efficiency and costs
Generally, in countries like Norway, Australia, and New Zealand, where a single-payer health system is in place, there is higher administrative efficiency and lower health administrative costs. The U.S. with its multi-payer system, on the other hand, generates extra bureaucratic tasks for both health care providers and the patients. In the U.S. an estimated 256 million U.S. dollars are wasted per year due to administrative complexity.
Equity
The United States, without universal health coverage, has expectedly large disparities in health care affordability based on income, as individuals with low income are often uninsured and must pay for all their health care out-of-pocket. These results are in line with the equity rankings of this report where the U.S. also came last. With the performance category equity, it is important to point out that the report focuses on income-related disparities. Other disparities based on ethnicity, gender, geography, and more have not been taken into consideration.¨
¨The US spends $2,500 per person on administrative costs.¨
jamanetwork quote:
¨A variety of studies over the last 2 decades have found that administrative expenses account for approximately 15% to 25% of total national health care expenditures, an amount that represents an estimated $600 billion to $1 trillion per year of the total national health expenditures of $3.8 trillion in 2019.1¨
I believe because of our free market capitalism structure, that America´s healthcare system is clearly a For Profit system that´s failed its citizens and continues to get worse.
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Nope. I would like you to do your own research and purpose a valid argument for a change.
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Intellectual dishonesty abounds.
I know , you keep doing it as in making claim after claim without even backing your claims up.
Either you meant to infer Christians' are taught that the poor don't deserve access to health care
Well ask the majority of Americans do they believe in universal healthcare and what do you think the answer might be?
, or you meant that you had past conversations with Christians' and they told you it was a tenet of Christianity;
That's happened on here more than once.
either way you're obvious intention was to slam Christians
My intention was to state a truism I see I hit the mark as your emotional outburst confirms.
and add nothing to the debate.
I've asked you to defend several claims you made your response is to duck , dodge and deflect.
And whether or not you stick to your original response or stay with this back peddled version, you still fail to substantiate your claim.
My claim is founded , the only one back peddling is you as you haven't eventhe balls to admit that you think the poor are unworthy of affordable hehealthcare.
Nope. I would like you to do your own research and purpose a valid argument for a change.
What a cowardly cop out but not untypical of you,. I'm the only one making valid arguments all you're doing is whining and engaging in whataboutism. .
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I've tried to respond twice now, one time at length because your post deserved it. Using the last source you provided on your post. I thought my screened timed out but the last time it popped up with it needs to be approved and then it will appear. Anyway it demonstrated how our costs were coming back down and the other wealthy nations were on the rise. Of course a lot of other things are involved but I don't feel like trying again when obviously something happening out of my control.
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"Nice swerve , I looked up hmos and addressed such , so what's your solution?"
Prove it.
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ARGUMENT TOPIC : FACT FALSIFER FLYS INTO A SULK AS HE CANNOT JUSTIFY WHY ONLY CERTAIN AMERICANS SHOULD RECIEVE AFFORDABLE HEALTHCARE
Please lay out your view on how we can do as the the OP says we can but has failed to support the claim
Please lay out your view as to why you cannot , seeing as your contention is that no other nation has working universal healthcare.
@Joeseph Might I suggest you learn what an hmo is first since you admitted your stupidity where they're concerned.
But I know perfectly well what an HMO is because I read up on it , you don't as you just copy and pasted a one line response on HMO's not knowing a thing about them.
Give us all a brief synopsis of what you think HMO's are and why they failed , I will make corrections where necessary.
You' re that st-pid you babble on about other countries by attempting to bluff and lie to deflect your ignorance regards your own country.
Then maybe your failure won't be as completely void of reality based reason as they have been.
The only failures have been yours as I've caught you out on lie after lie , you "best" response has been to launch personal attacks and babble on about HMO's in an attempt to deflect.
Or you can post more one liners in your humiliation.
But I'm actually having fun exposing your ignorance on your own country.
I think they're kinda funny considering the ignorance you're attempting to mask for yourself.
Says you a clot who believes only certain Americans are entitled to affordable healthcare and cannot even explain what HMO's are.
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You answer what's your solution ? With " prove it" , seriously?
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That seems to be your thing make up a convienient lie when you cannot defend your nonsense.
American healthcare costs are coming down that's what you're saying, seriously?
Why do you keep making stuff up?
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@Factfinder
Here is the curiosity though. All other wealthy, industrialized countries with Universal Health Care, have had this system in place for many, many years and decades. If it is such a losing system, then why have these countries maintained this system for decades?
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The red cross declared the NHS a 'humanitarian crisis' and the Canadian Supreme court said that just because people have a right to healthcare, doesn't mean they actually have access to it in Canada. Both Canada and the UK are experiencing a rapidly growing number of people getting private health insurance so they can actually see a doctor when they are sick.
No doubt you'll be bragging about Cuba's free healthcare. As someone who has been treated in Cuba I can tell you, vet hospitals in the US provide better care. In Cuba you will be in a room with 5 other people. The toilet will not have a seat, and often the floors are mopped with water out of the toilet. You have to bring your own sheets and toilet paper. Surgery rooms look like slaughter houses. And if you get outside of the tourist districts, the pharmacy is literally the size of a card table - because all medicines fit on a card table. If you want something fancy like baby cough syrup or eye drops, well if you can't get it on the Black market, you are SOL. Cuba doesn't spend a lot on its healthcare system. Wait times are 6 months to see a doctor for many basic concerns.
And you appeal to these systems like they are successes?
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The red cross declared the NHS a 'humanitarian crisis' and the Canadian Supreme court said that just because people have a right to healthcare, doesn't mean they actually have access to it in Canada. Both Canada and the UK are experiencing a rapidly growing number of people getting private health insurance so they can actually see a doctor when they are sick.
No doubt you'll be bragging about Cuba's free healthcare. As someone who has been treated in Cuba I can tell you, vet hospitals in the US provide better care. In Cuba you will be in a room with 5 other people. The toilet will not have a seat, and often the floors are mopped with water out of the toilet. You have to bring your own sheets and toilet paper. Surgery rooms look like slaughter houses. And if you get outside of the tourist districts, the pharmacy is literally the size of a card table - because all medicines fit on a card table. If you want something fancy like baby cough syrup or eye drops, well if you can't get it on the Black market, you are SOL. Cuba doesn't spend a lot on its healthcare system. Wait times are 6 months to see a doctor for many basic concerns.
And you appeal to these systems like they are successes?
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I do not think they are "losing systems". As you point out they've had them a while. But that in no way means their poor is getting the same health care access as their wealthy. Do you think upper level government employees say, suffer the same wait times as the poorest of the poor in those countries? I don't. We went through a major overhaul back in the seventies and we're still paying for that. The left did that and now they say "oops" we need more money to be like Europe! The introduction of hmo's. is what I'm referring to. So no, I just don't think it's good to go through it again. There is no firm plan of transition in place and we can't afford another "flipping of a switch" mentality. Look what Biden's ev fiasco has done.
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Yes to the above though not sure how much we pick up the tab of other countries - maybe in the sense only that companies are greedy? I believe our healthcare system is so uniquely complex BECAUSE it is employer-based and not a single payer system. It is much more efficient and inexpensive for single-payer systems to negotiate prices as they´re dealing with one entity. The US has no centralized system for negotiating drug prices which is why we pay higher costs. Our multi-payer system involves many private insurers, government programs (Medicare/Medicaid) which contributes to extremely high administrative overhead costs and incentivizes a company´s ability to profit. Also contributing to higher healthcare in the US is the higher costs of medical education and technology.
With employer-based insurance, employers may not see the full costs directly imposed on them as its hidden and ambiguous which gives one the false impression that their healthcare is inexpensive and efficient. Although we do have health savings accounts which can help, it still doesn´t fix the high healthcare costs we have and merely a placebo effect.
The US has the most dysfunctional, inefficient and expensive healthcare system in the industrialized world. We spend over 4 trilliion a year or about 17% of our GDP on healthcare - twice as much as the average of all other wealthy nations. Yet, our life spans are shorter and infant mortality rates are higher.
This is due to our complex system of using a multi-payer vs. single-payer system. America has the most expensive healthcare of industrialized countries but yields the lowest quality healthcare.
While Obamacare was extremely unpopular in the US, and the government forcing all its citizens to pay into it, it is often misunderstood in its intentions. It was implemented to ensure ALL American citizens have health care not just those who can afford it. It was also implemented to combat unnecessary in inhumane deaths as a result of the ¨prexisting condition¨ that disqualified those to receive health care.
Our system is broken and something needs to be done. While we hear stories of the wait times of other countries, I believe this is way over sensationalized to rationalize America´s dysfunctional, for-profit system.
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When looking at healthcare theres really 3 main variables to look at: Universality, Quality, and Cost.
I could agree the U.S. definetly has inefficiencies but Id argue a lot of that is due to bureacracy and government regulation. Other than medicines with potential monopolies on markets free market is the best way to lower cost and create the best product.
I believe this question has been previously posed. Have you ever heard of a government leading the spear of efficiency or modernization anywhere?
Regarding health outcomes you need to be careful due to differences in definitions and reporting. For example, nations have different defintions of what falls under infant mortality. The U.S. reports deaths occuring in prenatal low survival outcomes that other nations do not.
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No I answered 'prove it' to your claim you know what an hmo is after it was exposed and you admitted, you had no clue
But I do know what a HMO is as I researched it, just because you're American doesn't mean you know more on HMO's I'd say I know more at this stage
. Until you establish that you now have at least some clue there is no point to responding to your gish gallop
But I just told you I know what a HMO is your response was well they failed once so that's that.
You asked one question and you accuse me of gish gallop, you really should stop using terms you don't understand.
. I will not offer a solution because that is not what the op asked for.
Great swerve as usual I know you have no solution.
t ask: should the united states adopt a universal health care system? Then suggested like others. My response is No.
Yes know as you like most Americans on here think the lowly paid aren't worthy of affordable healthcare.
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Great swerve as usual I know you have no solution.
It's called an honest response in a debate where it's also not necessary. Not surprising you can't recognize that reality. What's an hmo?
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Slightly off topic but I'll bite. If person A out produces person B by double, do you @dreamer, have the right to tell the employer of an establishment which is no business of yours, they must pay person B the same wage as person A?
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It's called an honest response in a debate where it's also not necessary
No, it's called avoidance , debate is an exchange maybe you're embarrassed that the US is so far behind other countries regards its care or even attempts for care for the weakest in society.
. Not surprising you can't recognize that reality
Not surprising you can't recognise that reality
. What's an hmo?
What's an hmo?
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