Both in rich and poor countries, universal health care brings huge benefits • Hacker News Board

Re: Both in rich and poor countries, universal health care brings huge benefits

#261

Post by dv_dt » Wed, May 02, 2018, 3:58 PM UTC

sykh wrote: post #6

When a person gets a life threatening disease they ought not worry about whether or not their treatment will leave their family in penury. This is especially so in a nation as wealthy as the U.S. The American healthcare system is immoral and I hope it drastically changes. Americans need to change their underlying notions of what it means to be a society. An author was once made fun of for suggesting that it takes a v…

Not only is universal healthcare more moral, it has been demonstrated as more economically efficient many times over. You only need to start by comparing the per-capita costs paid for healthcare in the US vs every other modern nation in the world. The US pays more than double the average of the other nations and we get much less performance for it. There are no modern nations that pay as much as the US in absolute terms, nor as high a percentage of our GDP.

https://www.pbs.org/newshour/health/health-costs-how-the-us-...

The other nation's systems have mixes of full nationalized care to administrative combinations of private insurance, so there is some leeway there. But all of them contain public controls on the cost of drugs and procedures. And that demonstrably works with both better prices, and better outcomes in total measures like life expectancy.

Edit: Btw the PBS article is from 2012, with data up to 2010. In later years, US life expectancy has had years which it has dropped, and even when growing, it lags the nations modern peers (while approaching nations such a Mexico..). There are some forces there that aren't all healthcare, but healthcare is central to life expectancy...

https://www.cnbc.com/2017/02/22/us-life-expectancy-is-low-an...

Re: Both in rich and poor countries, universal health care brings huge benefits

#262

Post by kalleboo » Wed, May 02, 2018, 3:58 PM UTC

Frondo wrote: post #250

fbunau wrote: post #60

In my country we do have single payer health care, but I wouldn't step foot into a state hospital unless I would have a terminal disease. The infrastructure is old and crumbling, people get infections during operations and walk out more sick than they entered. Sometimes you are asked to bring your own medicine, and basic medical supplies because hospitals don't provide you with anything. The system is overcrowded and…

What country is that?

Presumably not one that spends twice the world average per capita on healthcare like the US.

Re: Both in rich and poor countries, universal health care brings huge benefits

#263

Post by programmarchy » Wed, May 02, 2018, 3:58 PM UTC

tremon wrote: post #78

programmarchy wrote: post #22

If you get cancer, would you rather be treated in the US or Europe? Survival rates are significantly higher in the US, so I know what I'd choose. And yeah, I'll pay more, too, because I want high quality doctors.

Yes, let's turn a multifaceted, fairly objective article into a narrowminded, single-issue catchphrase, and introduce a false dichotomy that isn't even close to the content of the article. It seems like a lot of work just so you can keep beating your chest, or do you have an actual point to make?

Looks like you worked harder than I did to just come here and whine.

Re: Both in rich and poor countries, universal health care brings huge benefits

#264

Post by [deleted] » Wed, May 02, 2018, 3:59 PM UTC

fastball wrote: post #226

sykh wrote: post #121

Earlier quoted context omitted.

Our spending on healthcare is grossly and immorally inefficient. A change is needed. One reason for the ineffiency is that public welfare is subordinate to special interests. All universal healthcare systems in the world are cheaper on a per capita basis than the American system. A change is needed. I’m not advocating for more money. I’m advocating for a change in perspective by our leaders.

Just because something has worked for other countries does not mean it will work for the US.

[deleted]

Re: Both in rich and poor countries, universal health care brings huge benefits

#265

Post by curtis » Wed, May 02, 2018, 3:59 PM UTC

patrickg_zill wrote: post #246

Skeptic's questions: 1. How many are aware that Britain's NHS, if run as well as Spain's healthcare system, would kill 10,000 fewer patients each year due to better treatment? https://www.independent.co.uk/news/health/nhs-world-ranking-... and http://www.cityam.com/270171/nhs-world-class-if-you-ignore-i... (3rd to last paragraph) 2. I can get an MRI in the USA within 3-5 days (sometimes next day), virtually anywhere…

> If you were diagnosed with a possible brain tumor/cancer requiring an MRI to confirm, would the 50 to 90-day difference in MRI and diagnosis result in a measurable difference in outcome, if you did in fact have a tumor?

I would assume in a case like this that they'd move you to the front of the MRI line.

Re: Both in rich and poor countries, universal health care brings huge benefits

#266

Post by SamReidHughes » Wed, May 02, 2018, 3:59 PM UTC

rogerb wrote: post #225

SamReidHughes wrote: post #194

Earlier quoted context omitted.

Okay, but what about people in other countries? Why don't we have an obligation to help them, to?

That's a different question which is outside of the scope of healthcare in the US IMO.

So let's talk about healthcare in the US. Don't Britons have a moral obligation to get taxed and that money get sent to the US to pay for the US healthcare system?

Re: Both in rich and poor countries, universal health care brings huge benefits

#267

Post by mikeash » Wed, May 02, 2018, 3:59 PM UTC

pitaj wrote: post #199

mikeash wrote: post #133

Earlier quoted context omitted.

Many people would also lose access to health care. Remember when a pre-existing condition meant you were fucked for life? It wasn’t that long ago. Fully privatized, deregulated systems can work out great for people who are lucky enough to avoid financial hardships, bad planning, or being born into bad circumstances. I’d rather not just screw everybody else.

You're operating under the assumption that insurance companies would continue acting as they do now, even if there is much more competition. Insurance companies shouldn't want to deny you coverage just because you have a pre-existing condition. They most likely would just charge you more, because you're at a higher risk of costing them money.

Of course they’ll just charge you more. That’s how it was before, too. But when the premiums are so high that you can’t possibly pay them, there’s no real difference between that and being denied.

Re: Both in rich and poor countries, universal health care brings huge benefits

#268

Post by aninhumer » Wed, May 02, 2018, 3:59 PM UTC

fastball wrote: post #249

arcticbull wrote: post #136

Earlier quoted context omitted.

Sure, my bad, in re-reading I can see how this wasn't clear. I meant along the lines of: I can't see how allowing medicare to negotiate drug prices, letting nurses do more of what doctors do and publishing prices gets the US medical system anywhere close to a 50% reduction in per capita spend, or gets the US any closer to covering 100% of the population. The US should do each of these. Each would make a difference. W…

Centralized systems are more efficient when they're smaller. The bigger a centralized system becomes, the more you need to spend on intermediary layers of bureaucracy that don't actually help achieve whatever goal it is you're going for (in this case, medical care). The US has ~330 million people. The US has ~13 million undocumented immigrants. The US is the size of Europe. You're not going to magically get the effic…

If only the United States had some kind of system of geographic administrative divisions similar to the countries that make up Europe...

Re: Both in rich and poor countries, universal health care brings huge benefits

#269

Post by mmirate » Wed, May 02, 2018, 4:00 PM UTC

monocasa wrote: post #86

conanbatt wrote: post #74

Earlier quoted context omitted.

> When a person gets a life threatening disease they ought not worry about whether or not their treatment will leave their family in penury. You can't start any economic argument by saying that paying any cost is a must. You will get fleeced. It is not true that universal healthcare pays for everything. The most expensive and experimental treatments will not be covered ever by the system, and it shouldnt.

> You can't start any economic argument by saying that paying any cost is a must. You will get fleeced. ... in an open market.

Or in any realm of scarce resources. (Also known as "reality".)

Re: Both in rich and poor countries, universal health care brings huge benefits

#270

Post by chimeracoder » Wed, May 02, 2018, 4:00 PM UTC

sykh wrote: post #223

chimeracoder wrote: post #189

Earlier quoted context omitted.

> No, because it's free, but 1/3 of Medicare recipients opt to receive their coverage through private insurers that typically add on additional coverage They don't simply add on coverage; they replace it. Most people on Medicare Advantage don't opt for coverage above what Medicare itself can provide - they simply receive their benefits from a private entity instead of Medicare, because Medicare provides such a bad ex…

Private entities contract with Medicare to provide insurance that covers what Medicare covers (and perhaps more). Would said insurers cover everyone that Medicare covers in the absence of Medicare? The answer is no. How many of these people on private Medicare plans pay for Medigap? Everyone who get kicked off a private plan can go back to the original Medicare. Your point is disingenuous. Medicare is the universal i…

> Medicare is the universal insurer of last resort for elderly. Their lives would be much worse without this last resort insurer

That's a far cry from "people don't seek to leave Medicare", which is literally the original claim. By and large, people do seek to leave it, to the extent that they can, both legally and financially.

Yes, for people who can't access anything better, having Medicare is better than literally nothing, but nobody's arguing that. That doesn't mean that Medicare provides a good model of what would best suit everyone else, and that's the relevant question when talking about a single-payer system.

If you want to talk about a single-payer system and use Medicare as an example in support of it, you have to address the fact that privately managed plans consistently outperform Medicare on the top three performance indicators, and that patients themselves prefer all the alternatives to Medicare except "no coverage at all".