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Economic Analysis of Medicare for All

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Re: Economic Analysis of Medicare for All

#101

Post by time-domain0 »

Let's say an American has to have a very expensive treatment for stage IV cancer that exceeds their insurance's lifetime limit and they can't work. They can say goodbye to their health insurance, goodbye to their savings and hello to bill collectors will force them into bankruptcy where they have to justify keeping a home, a vehicle and the clothes on their back. Dying and having to pay late fees that a person can't pay. It's criminal.

It really sucks when that person is married with children. It's often better for the spouse to divorce them and take all the assets well ahead of declaring bankruptcy so they can't be liquidated and lose everything.

This is what corporate hospitals, for-profit insurance companies and big pharma has reduced care to: make as much money as possible while screwing over patients, and killing them with substandard care compared to the rest of established economies. Unregulated capitalism is a cannibal.

Re: Economic Analysis of Medicare for All

#102

Post by chrisbennet »

anarchimedes wrote: post #37
aczerepinski wrote: post #17

Earlier quoted context omitted.

High earners were on average raised by high earning parents. Is being born rich fair? Which stages of the game should be fair?

(C'mon downvotes!) I thought the idea of paying your "fair share" was in relation to the services provided by the taxes paid. I can take an extreme example that I've tried to steel man to hold up this point: Bill Gates. Does Bill Gates the man use more taxpayer provided military/healthcare/infrastructure.. than anyone else? Of those things that he does use more of, if he taxed by the volume of those services used (ex…

The wealthy want to believe it was their hard work and not luck that made them successful. (It’s both of course.)

Consider where their wealth comes from: it comes from skimming off some of the income earned by employees or by investment - which again, skims off earnings from productive enterprises.

Neither of those incomes come from their own actual work.

Re: Economic Analysis of Medicare for All

#103

Post by agumonkey »

gmueckl wrote: post #100
monocasa wrote: post #34

Earlier quoted context omitted.

If only. I work in the same town as a big medical device manufacturer, and several co workers over the years had worked there and immediately nope-ed out on moral grounds. Stuff like panics on anything out of the order in a morphine pump that defaults to full on while resetting. Apparently those killed a few people. Meeting the FDA guidelines is more about finding the cheapest way to technically meet the spec rather…

I do get that such a device panics on the smallest error. But then it is supposed to go into a safe mode. "Full on" does not seem safe to me. Full off and emitting an acoustic alarm until it is actively acknowledged would be the right thing to do. Whoever designed this thing to do what it did was frankly a morron. But gaming the certification process is unfortunately also a thing. In the EU the certification is perfo…

Oh yeah EU certifications are sadly super weak. Now to your original point, I think it's quite possible to have an open review system. Linux and the likes have shown great capabilities in finding and fixing issues fast. With a national effort to ensure paid engineers it's not science fiction.

Re: Economic Analysis of Medicare for All

#104

Post by VikingCoder »

beginningguava wrote: post #68
VikingCoder wrote: post #51

Earlier quoted context omitted.

Quick question: What if America's education problem is that the children don't have parents who can nurture them? Because we have stagnant or decreasing real wages? Because the cost of daycare, housing, health, and advanced education have all gone up? Because we're making it harder to declare bankruptcy? Because we're criminalizing activities, and ripping families apart? Maybe it shouldn't be a surprise that our educ…

US education is top notch based on international PISA scores if you break it down by race and compare them to europe, latin america, africa, etc https://nces.ed.gov/surveys/pisa/pisa2015/pisa2015highlights... Singapore almost always takes 1st in international test scores and their long time leader didn't pull punches https://imgur.com/a/a8nCQUO and it's not an income thing, the poorest whites and asians score as high…

Since people were treated separately based on their race (slavery, no right to vote, no civil rights, redlining, segregated schools), it's not a surprise you can still measure the impacts of that decades later, based on race.

It takes a long time to undo damage like that.

Re: Economic Analysis of Medicare for All

#105

Post by VikingCoder »

epicureanideal wrote: post #70
VikingCoder wrote: post #51

Earlier quoted context omitted.

Quick question: What if America's education problem is that the children don't have parents who can nurture them? Because we have stagnant or decreasing real wages? Because the cost of daycare, housing, health, and advanced education have all gone up? Because we're making it harder to declare bankruptcy? Because we're criminalizing activities, and ripping families apart? Maybe it shouldn't be a surprise that our educ…

Something about this seems right to me. I'd be interested to see if there are any studies correlating these issues.

Children from financially unstable families do worse in school. Hungry children do worse in school.

If you want studies, here's discussion of one I just saw the other day:

https://www.bloomberg.com/opinion/articles/2018-12-04/verdic...

Re: Economic Analysis of Medicare for All

#106

Post by s3r3nity »

erentz wrote: post #48
s3r3nity wrote: post #39

Earlier quoted context omitted.

More like the doctor who has dropped six-figures + a crazy amount of years in education and certification to work very long hours seeing a lot of patients, many of whom think you're a quack and trust an online forum over anything you say. Oh and don't forget the high premiums for malpractice insurance, as you're working crazy hours without breaks, and if you make a mistake you're sued up the whazoo. And that's just d…

Doctors aren’t a huge cost issue. Their pay isn’t that outrageous or out of line. It’s the pharmacy costs and administrative costs (and I think also DME costs?) that are seriously out of whack in this country.

Oh I'm not claiming they're out of line - they deserve that pay. My point was that it's not all these evil salesmen / drug capitalists driving high-costs in medicine. Sometimes better quality care just costs more.

Re: Economic Analysis of Medicare for All

#107

Post by candiodari »

epicureanideal wrote: post #77
ams6110 wrote: post #11

Earlier quoted context omitted.

The real cost is not so much in the hardware but in the certification requirements. Medical devices need to be built to and work at a higher standard than consumer electronics, for obvious reasons.

But if the cost becomes so high that people simply go without the devices, is that really a good tradeoff? Maybe a device with 1 in 10,000 failures is better than no device at all, for some subset of illnesses? Also, I suspect this is FUD by some entrenched medical devices companies who know how to play the game of complying with standards. Anyone here ever gone through compliance testing with software? I've seen sys…

That's one thing. But there's other problems:

1) certification that takes 10 years (more like 3, but ...) means you, at the very best, have 10 year old technology

2) Certified at a higher level. That can for various reasons be very different from reliable at a different level. For instance, circumstances change or knowledge advances.

For instance certification tends to take "proof" that something works. Yet the most reliable robots are pretty bad hardware, with the ability for multiple components to do the same job "most" of the time. Such a device, despite being much more reliable, is disqualified a priori in nearly all certification processes I've seen.

(needless to say, every time the things they take as proof tend to be ... less than proof)

Plus we've all been in a company having this discussion. "For the price of this one 'reliable' server we could have 20 normal ones, and they would be a hell of a lot more reliable together. Hell, just give me 3 of the cheap ones and I'll make it more reliable". And we all know what the boss's answer and the resulting reliability was.

3) You assume no regulatory capture (or outright dishonesty on the part of government employees and/or lawmakers)

Re: Economic Analysis of Medicare for All

#108

Post by thatfrenchguy »

ekianjo wrote: post #24
thatfrenchguy wrote: post #6

Earlier quoted context omitted.

And a lot of this is administrative overhead. Coming from a country outside of the US, I was also shocked by the price of medecine, every medecine magically seems to be 5-10x more expensive in the US.

The prices help pay for the huge cost involved in developing drugs. How many drugs were developed in France in the past 10 years compared to how many were developed in the US? You know the answer.

Ever heard of Sanofi ?

Re: Economic Analysis of Medicare for All

#109

Post by ekianjo »

thatfrenchguy wrote: post #108
ekianjo wrote: post #24

Earlier quoted context omitted.

The prices help pay for the huge cost involved in developing drugs. How many drugs were developed in France in the past 10 years compared to how many were developed in the US? You know the answer.

Ever heard of Sanofi ?

Yeah and you know that their main drug market is the US and they target that market when deciding which drugs to develop? Also, ever heard of the concept of multinationals, where companies are spread around the world and not in a single country? same for Sanofi.

Re: Economic Analysis of Medicare for All

#110

Post by naveen99 »

AtlasBarfed wrote: post #45
entee wrote: post #2

One thing that sometimes gets lost in the "health care is inefficient" discussion is that one person's inefficiency is another person's living. The cost controls the paper appears to advocate for literally mean someone is making less money, that someone will advocate strongly against it. I've spent the past 3.5 years in healthcare, everyone is convinced they're not the problem, that they're underpaid or overworked or…

The cost problem in healthcare is exactly that: many pigs at the trough, and everyone points at the other pig for being the problem. Healthcare administrators! Drug companies! Device companies! Trial Lawyers! Insurance companies! Doctors (especially specialists)! They're all the problem, and yes lots of them should make less money. I know cardiologists pulling down 500k+ and that is ridiculous. I can see highly skill…

Cardiologists aren’t pill pushers. They are interventional radiologists of the heart. They do need lots of skill also.
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