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

#391

Post by Consultant32452 » Wed, May 02, 2018, 5:26 PM UTC

ska wrote: post #230

Consultant32452 wrote: post #173

Earlier quoted context omitted.

The most economically efficient way to pay for B is to allow the free market to drive the cost of care so low that the person is either able to pay for it, or the cost through charity is trivial. This has the double benefit of not attempting to rectify one moral wrong (person does not receive care) by committing another (violent coercion by the state).

The most economically efficient way to pay for B is to allow the free market to drive the cost of care so low that... Talking about free market efficiencies is a bit like talking about the effect of Newtonian forces on a spherical cow. Very useful to learn from in an undergrad setting but rarely sufficient to capture real world systems. What you actually want from policy is something like a trajectory toward the best…

>What you actually want from policy is something like a trajectory toward the best expected result in existing markets over reasonable times.

What I don't want from policy is you* deciding for me what results should be aimed for and then forcing me to maximize your personal pet project. If you have good arguments that something should be funded, you don't need to force me to do it.

*: The you here is proverbial. Feel free to insert Donald Trump as an example of the type of person who would have a say in my healthcare options.

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

#392

Post by skrause » Wed, May 02, 2018, 5:27 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…

> 2. I can get an MRI in the USA within 3-5 days (sometimes next day), virtually anywhere in the country.

You can get that in Germany as well and don't even have to pay anything for it. And I'm speaking out of experience because my girlfriend was diagnosed with a brain tumor: If you have sudden symptoms (like a seizure in her case) or a threating disease you basically get all appointments within 2-3 days.

So far her total co-payment for 18 months of treatment, 3 hospital stays with surgeries, about 10 MRIs, radiation and chemo therapy and daily medicacion is about $300.

And since she can't work at the moment because of her illness she gets a monthly payment ("Krankengeld") by the public health insurance which is about 90% of her last after-tax salary and lasts for 78 weeks. Since you already have to worry enough about your illness you shouldn't have to worry about money as well.

I'm so glad that we don't live in the USA.

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

#393

Post by moorhosj » Wed, May 02, 2018, 5:27 PM UTC

Consultant32452 wrote: post #274

throwawayjava wrote: post #216

Earlier quoted context omitted.

The point of this report is that the empirical evidence contradicts your hypothesis. These sorts of broad-strokes, ultra-rationalist arguments should be set aside whenever data is available.

Data is available on rapid price inflation that coincides with central planning initiatives in the US. Data also exists showing the systemic risks to nations created by these systems, such as the looming global demographic crisis created by the combination of social welfare systems and the baby boom.

We aren't talking about those abstract ideas, we are talking about health care and it's associated access and cost. As such, the data shows us the United States fares worse than similar countries on the measures of access and cost (both to the individual and the state)[1]. The United States also has the most "free market-like" system of comparable countries. How can it be that costs are so high and outcomes are no better if we are closer to a free market than others?

[1] https://thumbor.forbes.com/thumbor/960x0/https%3A%2F%2Fblogs...

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

#394

Post by patrickg_zill » Wed, May 02, 2018, 5:28 PM UTC

guitarbill wrote: post #331

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…

> 2. I can get an MRI in the USA within 3-5 days (sometimes next day), virtually anywhere in the country. Not if you don't have insurance, like a few million Americans. But fuck those guys, right? At least my MRI is fast!

(this is 2009 timeframe)

When I had an abdominal CT scan in the USA, I paid cash for it. $262 on my VISA card, paid at time of service.

If I'd had insurance with 90% paid, I would have ended up paying about 10% of $2K, because that is the "retail" price and a typical policy at that time covered 80-90% of the "costs". Plus I would have had to pay into the insurance scam for several months to have had coverage.

I'm not really sure that you know what you are talking about...

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

#395

Post by DanBC » Wed, May 02, 2018, 5:28 PM UTC

judah wrote: post #192

oldcynic wrote: post #135

Earlier quoted context omitted.

> The government has final say over healthcare decisions No, the medical professionals, i.e. doctors do. "the unanimous opinion of the doctors who have examined him and the scans of his brain is that almost all of his brain has been destroyed". What happens in a non state run healthcare system when a parent refuses to accept someone's death in the ICU?

>> No, the medical professionals, i.e. doctors do. The UK doctors punted, agreed. But Italian doctors believed different treatments were warranted. The Italian government gave the boy citizenship. In a private healthcare system, the parents would be free to pursue that. But in the state-run system of the UK, there was no such freedom. Alfie Evans died last Monday.

The Italian doctors agreed treatment was futile. They were only offering end of life care.

https://www.judiciary.gov.uk/judgments/thomas-evans-v-alder-...

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

#396

Post by Andre_Wanglin » Wed, May 02, 2018, 5:28 PM UTC

fastball wrote: post #229

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…

It's immoral for people to pay for the time and work of others?

Apparently doctors should only work for the public good and accept (relatively) piddling wages but startup tech bros and VCs are absolutely entitled to their billions.

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

#397

Post by PurpleBoxDragon » Wed, May 02, 2018, 5:28 PM UTC

ordinaryperson wrote: post #138

skywhopper wrote: post #49

Earlier quoted context omitted.

You make lots of bad assumptions. But if you are going to get all nihilist about it, go all in. Your wealth is predicated on the government that ensures it’s value. Nothing you “own”, including money, is “yours” except by virtue of the laws and under threat of force from whatever relevant powers exist in your locality be they corporate, military, or organized crime. You benefit greatly from the “power transfer” that…

My wealth? Didn't I just say above I'm not wealthy? Just because the state provides benefits (self-defense, rule of law, etc) doesn't preclude you from ownership rights, not really following your argument there. Taxing one group and providing the benefits to another is a wealth transfer, however unappealing the idea sounds to you. How is not favoring selective taxation "nihilist"? If I were a nihilist I'd believe in…

>Just because the state provides benefits (self-defense, rule of law, etc) doesn't preclude you from ownership rights, not really following your argument there.

Its a fundamental different view of reality and especially society. We are animals, we have no rights and not duties. We do what we want. Things like ownership are derived not from some concept of rights, but from power. We combine our power through government, and in doing so grant the ability to own things. Theft is wrong, not for a moral reason, but because we decided to punish those who steal.

This view doesn't completely reject the notion of rights and duties, because we can still use the concept of such to determine how we run our combinations of power. But it does do away with the assumption they inherently exist. It becomes something of a more philosophical question, much like asking does math exist outside of humanity (or any other intelligence that is able to understand the concept of math).

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

#398

Post by speby » Wed, May 02, 2018, 5:30 PM UTC

narrator wrote: post #287

The big riddle is how do you get the health care costs in the U.S back in line with the rest of the world, which doesn't necessarily have single payer. I'm a big fan of Singapore's public/private hybrid which delivers excellent results for a very low percent of GDP. We spend double as a percent of our GDP on health care vs all other developed nations.

Me too. Then of course you get into the nitty-gritty (https://www.vox.com/policy-and-politics/2017/4/25/15356118/s...):

"More than 80 percent of the hospital beds in Singapore are in public hospitals, and those hospitals are cut into different “wards” with different levels of amenities: A-class wards provide unsubsidized care but have single rooms and air conditioning, while C-class wards are overwhelmingly subsidized but are set up like shared dormitories with common toilets. There are a number of ward levels in between, too, all with a sliding scale of comfort and subsidization. So both A-ward patients and C-ward patients are paying for their own care, but the prices they’re paying are very, very different, because the government is absorbing the direct cost of care in the C-wards."

Not saying common toilets are unacceptable but it's things like that which would be a big adjustment/shock to the American system of being used to mostly individual rooms with meal service, etc.

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

#399

Post by DanBC » Wed, May 02, 2018, 5:31 PM UTC

judah wrote: post #90

theBobBob wrote: post #47

Earlier quoted context omitted.

The fact that the healthcare was paid for by the Government had absolutely nothing to do with that case. A healthcare decision had to be made for a patient that was not able to make the decision themselves. When the doctors thought that the decision that the parents were making on behalf of the child was against the best interests of the patient they asked the courts to make a judgement of what should be done. The sa…

>> A healthcare decision had to be made for a patient that was not able to make the decision themselves Yes - it was made for the patient against the patient's legal guardians - his own mother and father. The government-run system overruled the patient's legal guardians. This is precisely the issue at hand: a loss of freedom resulting from a healthcare system ultimately ruled by the government itself. The government…

So, you might not know this but the doctors were not allowed to carry out their plan without a court order. The hospital needed to get the agreement of the court in order to turn off life support.

Contrast this with the US, where the hospital can announce the plan, and the parents have to sue to stop it happening.

That feels substantially worse.

Especially because in the UK the parents will have legal aid available to pay for their legal representation (Alfie's parents went through seven firms of solicitors) and because the child will have their own independent legal representation.

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

#400

Post by pygy_ » Wed, May 02, 2018, 5:32 PM UTC

SamReidHughes wrote: post #146

rogerb wrote: post #131

Earlier quoted context omitted.

There's a simple thought experiment that helps: - an american citizen break his leg, he is not insured. Do you A: let him die B: take care of him ? if your answer is A - you are a terrible person, but you hold a consistent position. if your answer is B - the only question that remains is what is the most economic, efficient way to take care of this person ? b is universal health care. if you think you can do A with e…

What if they're not an American citizen? What if they're also in a different country?

I'm a Belgian national, living in France (under the French health care regime). If I need medical assistance while I'm in in Spain or Germany, the care will be reimbursed per the local rules, by the French health care system.

Quoting Wikipedia:

The European Health Insurance Card (or EHIC) is issued free of charge and allows anyone who is insured by or covered by a statutory social security scheme of the EEA countries and Switzerland to receive medical treatment in another member state free or at a reduced cost, if that treatment becomes necessary during their visit (for example, due to illness or an accident), or if they have a chronic pre-existing condition which requires care such as kidney dialysis. The term of validity of the card varies according to the issuing country.

The intention of the scheme is to allow people to continue their stay in a country without having to return home for medical care; as such, it does not cover people who have visited a country for the purpose of obtaining medical care, nor does it cover care, such as many types of dental treatment, which can be delayed until the individual returns to his or her home country. The costs not covered by self-liability fees are paid by the issuing country, which is usually the country of residence but may also be the country where one receives the most pension from.[1]

It only covers healthcare which is normally covered by a statutory health care system in the visited country, so it does not render travel insurance obsolete.

https://en.wikipedia.org/wiki/European_Health_Insurance_Card