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Cost of universal health care in California bigger than state's budget

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Re: Cost of universal health care in California bigger than state's budget

#71

Post by DanBC »

dogma1138 wrote: post #52
laurencerowe wrote: post #43

Earlier quoted context omitted.

Single payer would be a great improvement on the current nightmare of American healthcare, but let's not kid ourselves that this is an incredible deal. The UK spent 8.5% of GDP on healthcare in 2013 (life expectancy in the UK is marginally higher than in California.) Most European countries spend around 11%.

Single payer != universal health care. Single payer is likely no not work in the US, but there are plenty of other solutions out there. Europe has universal health care, not every country has single payer the UK and France do, NL and Germany do not. Also in all honesty unless you have cancer or something else which completely degenerative the NHS is garbage that no one outside of the low income brackets wants to deal…

> the NHS is garbage that no one outside of the low income brackets wants to deal with.

The various patient surveys and patient satisfaction scores disagree with you.

The fact that almost no-one uses private insurance is also proof that most people like and will use the NHS, even with all the problems it has. And the numbers of people with private health insurance has reduced, not increased, since 2011.

Re: Cost of universal health care in California bigger than state's budget

#72

Post by DanBC »

brownbat wrote: post #65
curun1r wrote: post #57

Earlier quoted context omitted.

One aspect that makes care in the US cost more is our culture of being highly litigious. We seem to believe that if doctors make honest mistakes, it entitles the patient or their heirs to a large settlement. So doctors/hospitals need expensive malpractice insurance and that cost gets bundled in with the cost of care. To add to that, settlements encompass both medical costs and compensation for pain and suffering, whi…

Allow me to play devil's advocate... Medical negligence is the third leading cause of death in the United States. We have an epidemic of "honest mistakes" like scalpels left in patients after surgeries,[0] often leading to deaths, or amputations of the wrong limb[1] leading to enormous harms to the patient. Something as innocent as 'forgetting to wash your hands' has outsized consequences in this industry, forgiving…

> We have an epidemic of "honest mistakes" like scalpels left in patients after surgeries,[0] often leading to deaths, or amputations of the wrong limb[1] leading to enormous harms to the patient.

I thought "wrong site surgery" was rare.

https://www.ecri.org/components/HRCAlerts/Pages/HRCAlerts111...

> Wrong-site, wrong-patient, and wrong-procedure surgery continues to be the sentinel event most frequently reported to the Joint Commission, with 1,196 such events reported through September 30, 2015, according to recently updated statistics provided by the accreditor. The next most frequently reported events include unintended retention of a foreign object (1,072), delays in treatment (1,035), suicide (932), and operative or postoperative complications (904).

That's way too many, but in 2009 there were 48 million inpatient surgical procedures carried out in the US.

https://stanfordhealthcare.org/medical-clinics/surgery-clini...

I don't think you can call 0.007% an "epidemic".

Re: Cost of universal health care in California bigger than state's budget

#73

Post by euyyn »

Turing_Machine wrote: post #66
euyyn wrote: post #56

Earlier quoted context omitted.

You misunderstand: the overall trend of deaths around the globe due to armed conflict. About Europe, I said I wouldn't argue because I don't have the knowledge to assess those claims. Just saying what is usually acknowledged by historians as the main cause.

"You misunderstand: the overall trend of deaths around the globe due to armed conflict." WWI killed 38 million. WWII killed 60 million. That doesn't look like a downward trend to me.

This is where I got it from: https://ourworldindata.org/war-and-peace/

The downward trend since the middle ages is actually in wars between the major powers. War mortality seems more or less the same over the long term. The number of smaller conflicts goes up, though.

The decreasing long-term trend in all violence, not just war, is stronger: https://ourworldindata.org/slides/war-and-violence/#/title-s...

Re: Cost of universal health care in California bigger than state's budget

#74

Post by curun1r »

brownbat wrote: post #65
curun1r wrote: post #57

Earlier quoted context omitted.

One aspect that makes care in the US cost more is our culture of being highly litigious. We seem to believe that if doctors make honest mistakes, it entitles the patient or their heirs to a large settlement. So doctors/hospitals need expensive malpractice insurance and that cost gets bundled in with the cost of care. To add to that, settlements encompass both medical costs and compensation for pain and suffering, whi…

Allow me to play devil's advocate... Medical negligence is the third leading cause of death in the United States. We have an epidemic of "honest mistakes" like scalpels left in patients after surgeries,[0] often leading to deaths, or amputations of the wrong limb[1] leading to enormous harms to the patient. Something as innocent as 'forgetting to wash your hands' has outsized consequences in this industry, forgiving…

These sorts of incidents are terrible and we should do everything to avoid them going forward. But, given their prevalence, it would seem that the medical industry hasn't done a particularly good job of dealing with them. The current system, which is more interested in assigning blame and providing restitution, is the free market approach that believes that capital incentives are the only ones needed and seem, to me, to be a failure. If you contrast the way that the medical industry handles incidents with the way that the aviation industry handles incidents, you'll see that pilot incidents are handled through a process that is much more interested in preventing future problems than it is in assigning blame. This leads to less defensiveness and more cooperation in finding processes and equipment that prevent future problems.

Also, if you want to make the case that malpractice settlements don't significantly contribute to the cost of health care, it's probably good to cite a source that isn't an association of trial lawyers. Among their failures in logic...arguing that insurance premiums are more tied to market performance than payouts completely disregards the fact that premiums wouldn't be necessary at all without the kind of payouts we currently have. There's an entire insurance industry making billions of dollars per year that is essentially unnecessary overhead that could be eliminated. And the trial lawyers themselves are making significant amounts of money off our broken health care system too.

These types of overhead can be eliminated in a single-payer system. Malpractice can be handled by panels of doctors who's sole goals are to push out habitually negligent doctors and reduce the incidence of mistakes for the vast majority who are quality doctors. And, since single-payer covers all future medical costs, there's no need to compensate patients for future costs that result from malpractice. Such a system completely eliminates all the inefficiency of dealing with medical incidents using the judicial system.

Re: Cost of universal health care in California bigger than state's budget

#75

Post by sctb »

wtbob wrote: post #21
jlarocco wrote: post #17

Earlier quoted context omitted.

Like it or not, it's already done with cigarettes, alcohol, marijuana, gasoline, and a ton of other stuff. These type of taxes are the only way I'm in favor of government healthcare programs. Cigarettes, alcohol, and junk food directly increase medical costs, and people who indulge (and over indulge) in those things should be partly responsible for those increased costs.

> Cigarettes, alcohol, and junk food directly increase medical costs, and people who indulge (and over indulge) in those things should be partly responsible for those increased costs. They also, of course, decrease other costs due to the deaths of the beneficiaries. Is that a net win or a net loss, financially speaking? And are you so sure of your analysis that you would use violence to take your fellow citizens' mon…

We've asked you countless times not to post these ideological talking points here. We ban accounts that continue, so please stop.

Re: Cost of universal health care in California bigger than state's budget

#76

Post by flukus »

Turing_Machine wrote: post #64
flukus wrote: post #60

Earlier quoted context omitted.

> America defeated japan essentially by itself while providing enough food and supplied to keep the russian army alive while also providing the majority of the military strength to the western front, essentially being the primary factor in the defeat of fascism. Where to start? The US did most of the work in beating Japan but they also got a lot of help from Russia toward the end. Once Japan had lost Manchuria to the…

"Once Japan had lost Manchuria to the Russians they gave up on a conditional surrender, they had nothing to bargain for." Most people think that nuking Hiroshima and Nagasaki was what made Japan surrender unconditionally, not the loss of Manchuria. "But more importantly on the Eastern front, the tide had already turned before lend lease to Russia made any difference." I'm sorry, that is simply not correct. The Lend-L…

> Most people think that nuking Hiroshima and Nagasaki was what made Japan surrender unconditionally, not the loss of Manchuria.

Most people have never even heard of the battle of Manchuria. Japan were already putting out feelers for a peace before either, they new they couldn't win by then. They'd already had cities destroyed by conventional weapons, the nukes weren't that big a deal.

> I'm sorry, that is simply not correct. The Lend-Lease pipeline was in full operation by early 1942, well before the tide turned at the Battle of Stalingrad in early 1943. In fact, the Germans moved on Stalingrad specifically to disrupt the Persian Corridor portion of the Lend Lease operation.

First of all, much of the early contribution was british and Canadian rather than American (http://www.historynet.com/did-russia-really-go-it-alone-how-...).

Lend lease was under way but no where near the total contributions (https://www.ibiblio.org/hyperwar/USA/BigL/BigL-5.html), chart 6 has a yearly breakdown. The biggest effect was that it allowed the USSR to counter attack after Stalingrad because they didn't have to throw everything into defending the city.

Re: Cost of universal health care in California bigger than state's budget

#77

Post by wtbob »

sctb wrote: post #75
wtbob wrote: post #21

Earlier quoted context omitted.

> Cigarettes, alcohol, and junk food directly increase medical costs, and people who indulge (and over indulge) in those things should be partly responsible for those increased costs. They also, of course, decrease other costs due to the deaths of the beneficiaries. Is that a net win or a net loss, financially speaking? And are you so sure of your analysis that you would use violence to take your fellow citizens' mon…

We've asked you countless times not to post these ideological talking points here. We ban accounts that continue, so please stop.

sctb, I honestly don't understand why you are threatening to ban me.

It's not an ideological talking point that people who die earlier due to health problems don't cost extra in pension funds. It's just a fact: if someone dies at 55, he won't cost a pension system which starts paying out at 65 a penny. fpgaminer posted much the same thing.

Nor, I think, was my aside about taxes being enforced with violence an ideological talking point: it's a fact that any law is ultimately enforced with violence. I honestly don't see how mentioning a social cost in the context of cost-benefit analyses could be considered a violation of any of the HN guidelines.

I'm not trying to derail or be argumentative; I'm honestly trying to understand how a fair moderator could threaten me with a ban for my comment.

Re: Cost of universal health care in California bigger than state's budget

#78

Post by readams »

a3n wrote: post #11

Separate from the cost debate, the bill is labeled a "job killer," I assume because of all the insurance and related jobs lost. Which would be bad for the people losing their jobs, but they're only employed because they work for an arguably unnecessary middle-man industry. There's no "right" to those jobs, and if we can find a way to deliver health care , as opposed to health insurance , to close to everyone, we shou…

They call it a job killer because of all the extra taxes needed. More than doubling taxes in a state that already has very high taxes will have an impact.

Re: Cost of universal health care in California bigger than state's budget

#79

Post by tuxracer »

threeseed wrote: post #31
tuxracer wrote: post #14

Earlier quoted context omitted.

> A big enough tax on fast food could probably cover it Exactly this kind of statement is what worries some about universal healthcare. I highly support single payer, universal healthcare. But statements like this undermine the cause by feeding fuel to the idea universal healthcare will inherently lead to more government intrusion into your personal decisions.

> inherently lead to more government intrusion into your personal decisions People wouldn't care except that your "personal" decision affects them. (1) Everyone pays for the public health care system e.g. hospitals. So if you're increased risk of serious disease results in increased visits or treatments then that's my problem as well. (2) Everyone pays for insurance. So if you're making premiums more expensive then t…

> People wouldn't care except that your "personal" decision affects them.

Yes it's perfectly logical under a single payer, universal healthcare system. So the reaction by some is: this is exactly why we should not have universal healthcare.

> Everyone pays for insurance. So if you're making premiums more expensive then that affects me too.

It muddies the water quite a bit by having a marketplace of different private insurance companies. If you see me doing something risky you have no clue whether or not I'm even covered under the same insurance company as you. So maybe I am, maybe I'm not affecting your premiums. Single payer universal healthcare removes all doubt.

Re: Cost of universal health care in California bigger than state's budget

#80

Post by brownbat »

DanBC wrote: post #72
brownbat wrote: post #65

Earlier quoted context omitted.

Allow me to play devil's advocate... Medical negligence is the third leading cause of death in the United States. We have an epidemic of "honest mistakes" like scalpels left in patients after surgeries,[0] often leading to deaths, or amputations of the wrong limb[1] leading to enormous harms to the patient. Something as innocent as 'forgetting to wash your hands' has outsized consequences in this industry, forgiving…

> We have an epidemic of "honest mistakes" like scalpels left in patients after surgeries,[0] often leading to deaths, or amputations of the wrong limb[1] leading to enormous harms to the patient. I thought "wrong site surgery" was rare. https://www.ecri.org/components/HRCAlerts/Pages/HRCAlerts111... > Wrong-site, wrong-patient, and wrong-procedure surgery continues to be the sentinel event most frequently reported t…

> I thought "wrong site surgery" was rare.

It is, but that wasn't the entire sentence, nor really representative of the total harm from medical errors.

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