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

#501

Post by conanbatt » Wed, May 02, 2018, 9:31 PM UTC

rogerb wrote: post #131

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…

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…

Unfortunately this simplistic model plays out like insurance doesn't exist.

Any tragedy works like this: a fire, a life lost to chance, etc. The point of insurace is to pay beforehand to reserve a fund and to distribute the chances in a pool.

One more argument: normally its spoken as is government is the solution to this problem, but the government does not prevent the legs from breaking in this analogy. It just decides B for you and everyone else.

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

#502

Post by conanbatt » Wed, May 02, 2018, 9:31 PM UTC

RandomCSGeek wrote: post #314

dv_dt wrote: post #295

Earlier quoted context omitted.

For small stuff almost certainly, but if you get medical "tourists" explicitly travelling for say cancer treatment?

Keep treatment free only for accidental injuries or harm caused by third parties. If a country has cheap treatment though, they could earn a lot through medical tourism.

What about organ donation, can foreigners get on the donor list?

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

#503

Post by conanbatt » Wed, May 02, 2018, 9:33 PM UTC

kitd wrote: post #296

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).

I assume you are also pushing for multiple roads between 2 towns, all competing on toll price.

The competition is before the road is built..

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

#504

Post by conanbatt » Wed, May 02, 2018, 9:37 PM UTC

Daishiman wrote: post #127

austincheney wrote: post #114

Earlier quoted context omitted.

Doesn't that suggest health care in America is too expensive? Increasing funding to an inefficient system doesn't sound like a sustainable or extensible solution.

The inefficiency is in the private sector.

Medicare is just as expensive, and the government is what makes drugs, doctors, malpractice and opening facilities so expensive. So no.

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

#505

Post by conanbatt » Wed, May 02, 2018, 9:39 PM UTC

slantedview wrote: post #479

SilasX wrote: post #387

Earlier quoted context omitted.

How do you know that that, rather than something else, accounts for the high costs? Edit: for example, Scott Alexander's point about US providers feeling they have to provide expensive treatment just to cover the possibility of a lawsuit: http://slatestarcodex.com/2017/02/09/considerations-on-cost-... Edit2: Also, Germany, the Netherlands, Singapore, and several others have typical cost savings but aren't single paye…

Costs are high for many reasons, but having for profit companies whose own overheads far exceed those of public options (such as Medicare) are the the most obvious contributor.

If private insurace cost as much as medicare you wouldnt still have rising cost of healthcare. Medicare has less admin cost but also they pay the least to providers.

I would not adovcate for public health in the us before the government fixes medicare.

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

#506

Post by moorhosj » Wed, May 02, 2018, 9:39 PM UTC

Consultant32452 wrote: post #418

moorhosj wrote: post #393

Earlier quoted context omitted.

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 be…

Causes of price inflation and the looming demographic crisis are not "abstract ideas." For literally decades the US did not open a single medical school due to lobbying from the medical industry. Even though we've tried to reverse the trend since the 90s, there are still fewer medical schools today than there were 100 years ago. When the government decides how many doctors there will be, it may get the number right o…

== And it's a major part of the explanation why US doctors make 2x+ what their counterparts in countries like Germany make.==

That is a nice thought, fortunately NPR has done the actual reporting on this. It seems like the answer is government interference [1]:

"But the biggest reason German health costs are so much lower, experts say, is that doctors are paid less. This largely reflects Germany's concerted efforts to keep costs down over the past two decades."

On administrative costs it seems like government mandates on benefits and payment rates keep those costs 50% lower. Also, they have an employer-based system:

"On top of that, administrative costs are almost 50 percent lower. That's not because the German health system is simple and streamlined. With its employer-based system, multiple insurers and ever-changing rules, German health care is as complicated in many ways as the U.S. system. But administration is much simpler because nearly everybody gets the same benefits, payment rates are uniform and virtually everybody is covered."

==Most of the differences in outcomes between us and other wealthy nations amount to lifestyle/culture much more-so than affordability and availability.==

You have provided no evidence to back up this claim. What makes you so certain that it's true?

==Not having to pay a copay to visit the doctor is not going to change that.==

Might this encourage more people to visit health providers more frequently? This might lead to earlier detection/treatment and lower long-term costs. Why have you dismissed this potential outcome?

[1] https://www.npr.org/templates/story/story.php?storyId=919310...

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

#507

Post by DanBC » Wed, May 02, 2018, 9:43 PM UTC

fortythirteen wrote: post #480

DanBC wrote: post #456

Earlier quoted context omitted.

> Look again and you'll see that, as far as compulsory spending goes the US and UK spend roughly the same percentage of GDP on "healthcare" Yes, that's the point. The US government spends more on healthcare, but that huge spend doesn't cover the whole population. > "The United States does a better job of assisting it's poorer citizens into the highest quality healthcare in the world, Why does the US have such poor mo…

> But also Alfie had his own legal representation. What?! How does an infant/toddler receive legal representation arguing for the plug to be pulled, outside of the wishes of his parents?! That is the very definition of authoritarianism. > He wouldn't have got anything like this in the US. Absolute nonsense spread by someone who has no knowledge of the American system. A child like Alfie is given free medical care fro…

> How does an infant/toddler receive legal representation arguing for the plug to be pulled, outside of the wishes of his parents?!

The child is not property. The child is a human, and has human rights. Those rights are protected. The child has his own independent legal representation to look after its best interests.

This system has been tested by international courts -in Europe- and they've found it works to protect the rights of the child.

> You know, like the Vatican offered,

No. The vatican offered the same end of life care he was getting, with the additional burden of a long difficult journey.

> A child like Alfie is given free medical care from one of many charity hospitals

I've already linked a page in this thread that shows this to be false.

You keep saying "government", but the UK government wasn't involved in any of the cases (apart from the EU ones).

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

#508

Post by mistermann » Wed, May 02, 2018, 9:56 PM UTC

rogerb wrote: post #358

mistermann wrote: post #253

Earlier quoted context omitted.

The underlying reasoning for universal healthcare is based on a principle, does this principle end at the US border, which I'm told is just some arbitrary, meaningless line right? If it's not clear, my tongue is firmly in my cheek as I say that, but where it isn't in my cheek is when I'm telling you some people don't just buy your simple pro-universal-healthcare argument wholesale, especially when you refuse to defen…

I live in the US and I pay taxes in the US, so yes - healthcare for US citizens/residents paid for by US/citizens residents ends at the borders. If there is a better, more efficient system that is morally right (i.e. provides basic healthcare for it's citizens) than universal healthcare I would like someone to propose it ?

Why is it morally right for me to contribute to healthcare for someone who lives in America but doesn't pay taxes, but not morally right to pay for someone who lives in a different country and doesn't pay taxes?

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

#509

Post by JoeAltmaier » Wed, May 02, 2018, 10:08 PM UTC

edanm wrote: post #126

JoeAltmaier wrote: post #91

Earlier quoted context omitted.

Well, he spouts whatever makes a youtube video gets hits. Without research or background. He is an entertainer after all. What he actually believes is probably unknown.

That's a fairer criticism, although I disagree. You could say "what he actually believes is unknown" about anyone, really. He makes his views quite well known, at least from what I've followed him. Still, I think replying to someone's quoting Penn with the equivalent of "well he denies climate change, so why would we listen to him ?" is pretty pointless for a debate, especially when what you say is wrong ! We might a…

Ok maybe he's saying what he thinks when he posts those rant videos on whatever subject. But in them he appears shallow and sophomoric. I think he's smarter than that, so I disbelieve they really reflect his opinions.

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

#510

Post by Tomminn » Wed, May 02, 2018, 10:45 PM UTC

Ah yet another time to remind US citizens they are needlessly dying at worst or massively overpaying for health at best.

The health care of system of the US is insane and has malignant cost disease. If they scrapped everything and adopted a universal health care system where the government simply pays for health care of everyone up to a standard of care above which there is quickly diminishing returns, they could do so without increasing current federal levels of health spending, since US government health spending is already large by the standards of other countries that take the single payer approach. If you want more health care than this, you can buy private insurance, except now because all consumers are weighing up whether it's actually worth it given they have most of their health care covered by the government, the insurance/health system has much less cost disease.

This is how health care works in sane countries. Countries where rational policy discussions cannot get totally derailed by the magical word "socialism".