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Health Care Is a Business, Not a Right

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Re: Health Care Is a Business, Not a Right

#51

Post by ewzimm »

SilasX wrote: post #27
SmellTheGlove wrote: post #5

The conclusion of the article is a bit ridiculous. tl;dr healthcare isn't a right because we can only spend a finite amount. Yeah, ok, but that dismisses priority entirely. Scarcity is still in play, so you treat the immediate needs first. I think we do have capacity in the healthcare system to do it that way. The author of the article basically bucketed a sprained ankle and a stroke in the same category, and conclud…

I agree the author makes the wrong inferences from the situation, but her points do often go overlooked in the debate: people make a big deal about "omg, someone died because they couldn't afford [more] health care", even though this will always be true, in every system, even the best ones -- you can't save everyone. (Similarly, the rhetoric around "death panels" was toxic made this insight harder to accept.)

I've had the opposite experience. When talking about the problems of the US health care system compared to national health systems, the number one thing I hear is that ours is much more expensive and achieves worse results. One of the primary motivations behind people who want to nationalize health care is to reduce costs. Everyone is thinking about costs.

The comparison to food is misleading. With food, there's an aligned interest. People go to the store and buy your product. If they aren't satisfied, they buy something else. With health care, most people have few choices. They get whatever plan is assigned by their employer or whatever they can afford within their limited market, often one or two possibilities. Then they go to the hospital, often the only one in the area, which in most cases won't tell them how much it will cost to be treated.

There's no free market, no choice, no aligned interests. The interests of the insurance companies are aligned against them. People are paid to deny as many claims as possible. It often takes years of legal battles to get anything paid out, even when it's legitimate.

Because even preventative care is unpredictably expensive, most people wait to be treated until the problem is most expensive to treat.

Re: Health Care Is a Business, Not a Right

#52

Post by clavalle »

exclusiv wrote: post #47
clavalle wrote: post #40

'Right' is probably too strong a word. Does a person have the 'Right' to be rescued from a car accident that would surely kill them without help when it is in other people's power to do so? No. BUT at some point I think it is fair to expect certain behavior from others living in civilized society. A Right? Probably not. But Reasonable Expectation doesn't have the same punch as a slogan.

Agreed. I think it's a little damaging to use that word. If it requires someone else to provide it - it's NOT a right because that would infringe on another's rights. It's that simple. It may be the right thing to do to provide it inexpensively, however. At the same time - so many people don't exercise, eat crap, get obese and diabetes or other preventable diseases and then overload the system with expenses. I'm not…

Me neither, not completely anyway. But there are dozens of things I think might help.

-Make medical debt non-dischargeable if you incur it without insurance. (Encourage everyone to make an accurate accounting of the risk they are putting on themselves and the system without insurance).

-Require price lists of common procedures and tests from providers. (Competition on price).

-Close the medicaid gap.

-Publish insurance standards and require providers to accept all insurance that meet those standards. (This would allow smaller players into the insurance market spurring competition -- it would also be very difficult to pull off -- perhaps tie it to providers that get federal money in some way).

-Incentivise staying healthy by giving rebates for good health.

-Incentivise not using health care by giving rebates for not using it over some period of time.

-Incentivise shopping around by giving rebates based on finding providers/treatments/prescriptions that are below the average. Penalize those that are above some threshold by dinging future rebates.

And on and on. I don't think there is one solution. I think we need to try a bunch of things and keep what works.

Re: Health Care Is a Business, Not a Right

#53

Post by johngalt »

When you have a NHS you are agreeing on a single standard of care as a nation. The problem that the author illustrates is that it is difficult to have an honest dollars and cents conversation about what that standard of care should be. It certainly can't be 'whatever is necessary at any cost' without bankrupting the program. Where the dollars do get spent will be determined by political expediency rather than individual choice. As with most government programs the incentives will be with what's popular rather than what is effective. Politicians will get elected to put more money towards $cause of the day$.

Also consider the moral hazard involved with national healthcare combined with our two party system and electoral process. Who would be surprised if Iowa and New Hampshire end up with more hospitals per capita than other states? What if CA and NY end up with a lions share of the healthcare dollars? What if they don't?

IMHO, the right way to run a NHS for the US would look very different than the UK's NHS. Perhaps something similar to a minimum wage. I.E. A federal minimum standard of care that is uncomfortably low, with state and private coverage able to build on top of that as determined at a local level. But we have to be able to look at something like a "death panel" and say 'yes of course that would be necessary'. Until we can have honest conversations about varying standards of care, we won't see meaningful healthcare reform in the US.

Re: Health Care Is a Business, Not a Right

#54

Post by SilasX »

ewzimm wrote: post #51
SilasX wrote: post #27

Earlier quoted context omitted.

I agree the author makes the wrong inferences from the situation, but her points do often go overlooked in the debate: people make a big deal about "omg, someone died because they couldn't afford [more] health care", even though this will always be true, in every system, even the best ones -- you can't save everyone. (Similarly, the rhetoric around "death panels" was toxic made this insight harder to accept.)

I've had the opposite experience. When talking about the problems of the US health care system compared to national health systems, the number one thing I hear is that ours is much more expensive and achieves worse results. One of the primary motivations behind people who want to nationalize health care is to reduce costs. Everyone is thinking about costs. The comparison to food is misleading. With food, there's an a…

>I've had the opposite experience. When talking about the problems of the US health care system compared to national health systems, the number one thing I hear is that ours is much more expensive and achieves worse results. One of the primary motivations behind people who want to nationalize health care is to reduce costs. Everyone is thinking about costs.

Yes, you can reduce costs and get more per dollar invested; it's still a fallacy to believe that one system will eliminate the problem of people dying because someone refuses to throw further resources at them.

Re: Health Care Is a Business, Not a Right

#55

Post by [deleted] »

johngalt wrote: post #53

When you have a NHS you are agreeing on a single standard of care as a nation. The problem that the author illustrates is that it is difficult to have an honest dollars and cents conversation about what that standard of care should be. It certainly can't be 'whatever is necessary at any cost' without bankrupting the program. Where the dollars do get spent will be determined by political expediency rather than individ…

[deleted]

Re: Health Care Is a Business, Not a Right

#56

Post by seangrogg »

codegeek wrote: post #7

"People need a lot of things. You’ll die without food long before you’ll die without health care, and yet few people say we need to “take the profit motive out of farming”." "Why is health care Special" I tell you why healthcare is special. You cannot buy healthcare at the cost of food. I can buy ramen noodles and survive for cheap. Sure it is not the best but I won't frikin die. But If I get cancer and cannot afford…

The average American can live a relatively healthy lifestyle off of $10/day in food expenses preparing their own meals (unless you live in high-cost regions). The majority of cancer diagnoses occur after 50 years of age.

Assuming you start earning an income at the age of 20, if you stuck $10 under your mattress daily (the same amount that you could for relatively healthy meals) you would have $109,500 by age 50. Switch to health insurance (found a plan in my state for $129 that does provide for cancer coverage - your situation may differ) and throw the rest into a dollar-cost-averaging investment account and the situation is even brighter.

There's a difference between "too expensive and difficult to deal with" and "I have no plans in place to deal with it nor the desire to implement them". And while that makes sense (most humans are hungry at regular intervals and sick at irregular intervals and thus budget accordingly) you shouldn't pretend like the average citizen is ever prepared for anything outside of their routine - with the exception of buying "gifts" for themselves, which they are more than capable of budgeting for.

I think our system is far from perfect, but if you're going to pretend that the cost of food dramatically outweighs the cost of paying for health care I really worry for your health due to lack of nutrition.

Re: Health Care Is a Business, Not a Right

#57

Post by ewzimm »

SilasX wrote: post #54
ewzimm wrote: post #51

Earlier quoted context omitted.

I've had the opposite experience. When talking about the problems of the US health care system compared to national health systems, the number one thing I hear is that ours is much more expensive and achieves worse results. One of the primary motivations behind people who want to nationalize health care is to reduce costs. Everyone is thinking about costs. The comparison to food is misleading. With food, there's an a…

>I've had the opposite experience. When talking about the problems of the US health care system compared to national health systems, the number one thing I hear is that ours is much more expensive and achieves worse results. One of the primary motivations behind people who want to nationalize health care is to reduce costs. Everyone is thinking about costs. Yes, you can reduce costs and get more per dollar invested;…

Basically, the article is a strawman fallacy. It paints national health care supporters as people who think, as you said, that health care as a human right would mean that everybody gets treated no matter how expensive. Nobody thinks that. The goal is to reduce the amount of people who are sick and dying as much as possible. We have data on that in the form of the performance of various systems and their impact on health.

The US is still the world's economic superpower, but it's health care system is rated below Dominica and Costa Rica.

Re: Health Care Is a Business, Not a Right

#58

Post by dragonwriter »

> You’ll die without food long before you’ll die without health care, and yet few people say we need to “take the profit motive out of farming”

Yes, and the reason few people say that -- even while people do argue for regulation to limit certain commercial practices in farming that they view as harmful to food availability, affordability, and/or quality -- is because you don't see monopolies on basic foodstuffs in the developed world being used to drive prices on foods that people rely on so high that many people, even with the safety net provided by government, can't afford essential foodstuffs in a first-world nation like the US.

That is, because, problematic as it is, the combination of private for-profit business and government regulation operating in food markets is working adequately well, such that people are less likely than is the case for healthcare in the US to perceive that the model under which it is provided is broken, inadequate for the needs of society, and essential to fundamentally reform.

History has shown, more than once, that when the systems of delivering food are perceived to be as broken as the US system of delivering healthcare is now perceived to be, people do clamor -- often violently -- for change.

Re: Health Care Is a Business, Not a Right

#59

Post by SilasX »

ewzimm wrote: post #57
SilasX wrote: post #54

Earlier quoted context omitted.

>I've had the opposite experience. When talking about the problems of the US health care system compared to national health systems, the number one thing I hear is that ours is much more expensive and achieves worse results. One of the primary motivations behind people who want to nationalize health care is to reduce costs. Everyone is thinking about costs. Yes, you can reduce costs and get more per dollar invested;…

Basically, the article is a strawman fallacy. It paints national health care supporters as people who think, as you said, that health care as a human right would mean that everybody gets treated no matter how expensive. Nobody thinks that. The goal is to reduce the amount of people who are sick and dying as much as possible. We have data on that in the form of the performance of various systems and their impact on he…

So was I just imagining all the people repeating the line that 'no one should die because they can't afford health care'? Or do you not see how that condition also exists in all the countries that do it right?

>The US is still the world's economic superpower, but it's health care system is rated below Dominica and Costa Rica.

What is this replying to? What did I say that contradicted this or suggested otherwise, or merited a re-run of "everything wrong with health care in the US" as if I disagreed? I was addressing a specific fallacy, not somehow claiming that everything the US is wine and roses.

Re: Health Care Is a Business, Not a Right

#60

Post by ewzimm »

SilasX wrote: post #59
ewzimm wrote: post #57

Earlier quoted context omitted.

Basically, the article is a strawman fallacy. It paints national health care supporters as people who think, as you said, that health care as a human right would mean that everybody gets treated no matter how expensive. Nobody thinks that. The goal is to reduce the amount of people who are sick and dying as much as possible. We have data on that in the form of the performance of various systems and their impact on he…

So was I just imagining all the people repeating the line that 'no one should die because they can't afford health care'? Or do you not see how that condition also exists in all the countries that do it right? >The US is still the world's economic superpower, but it's health care system is rated below Dominica and Costa Rica. What is this replying to? What did I say that contradicted this or suggested otherwise, or m…

That low ranking is related to the first thing you're saying. It's what drives advocates of national health care, not the idea that nobody will die.

When people are talking about deaths of people who can't afford health care, they're talking about people who don't have the resources to ever get care, the people who don't catch things in the early stages when they're easily treatable and find out too late that their condition has become terminal. The point of national health care isn't to eliminate all treatable deaths no matter how expensive, it's to improve care and accessibility so that it's in a place that aligns with the resources society could reasonably support. When we look at much poorer nations being able to provide much better care, we see that there's a problem that needs to be addressed. That's what people are talking about, not eliminating all deaths.

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