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The US spends more on healthcare for no gain says new report from Johns Hopkins

jhsph.edu

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Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#511

Earlier quoted context omitted.

No, I reject that equivalency. One party is suppressing the vote and constantly sabotaging the workings of the government to retain power.

Those aren't the equivalencies I'm asserting. My position is that members of both parties expend far too much energy working on re-election fundraising versus working for the people. That's the equivalency I'm asserting.

Both parties, then, are elected (generally. Republicans tend to depend on the electoral college to win).

Both parties eat food.

Both parties drink water.

What's the point of this equivalency? I identify a moved goalpost. Your initial post was "both parties are equal." We are far from there, down here.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#512

Earlier quoted context omitted.

No it doesn't. You can negotiate the price of software before you buy it, and you can shop around and choose between alternatives, or choose not to buy at all. If you need a piece of rebar removed from your chest, then you need a piece of rebar removed from your chest. The price doesn't matter, the choice of provider doesn't matter. The "consumer" is completely at the whim of whatever provider happens to be closest.…

You're engaging in 'all-or-nothing' thinking. The vast majority of medical expenses are not like that. And that's the whole point of insurance--to be covered in case something happens so you don't have to negotiate on the spot. That's like saying we should socialize food distribution because people can't negotiate when they're starving.

Sure, I chose an extreme example, but it's just a fact that healthcare is way less elastic than food.

If the price of beef is too high, I can buy pork instead.

If the price of a hip replacement is too high, what are you supposed to do? Get an appendectomy instead?

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#513

Earlier quoted context omitted.

If you need talents to stay in your country then you need to pay them more.

No, the US needs to stop over-paying their doctors. And doctors need to stop being corrupt by reducing supply of doctors through restrictive medical school entry.

Restrictive medical school admissions aren't the problem. The real bottleneck is in the number of residency slots available for medical school graduates. Every year people graduate with an MD degree but are unable to actually practice medicine because they can't get matched to a residency slot.

Most residency programs are federally funded, although some are also funded directly by teaching hospitals. If you want a larger supply of doctors then lobby the federal government for more residency program funding. And knock off the uniformed conspiracy theories.

https://news.aamc.org/for-the-media/article/gme-funding-doct...

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#514

Earlier quoted context omitted.

I'm not sure (possibly because I read the book years ago). The other two countries handle it differently. Japan's healthcare cost is the lowest of the three though, at 5% GDP, despite an aging population of heavy smokers. So there doesn't seem to be that much overhead.

Despite Japan's aging, heavy-smoking population, Japanese people tend to be very healthy for reasons that aren't necessarily related to their healthcare system.

Due to Japan's "metabo law", adults are required to get their waistlines measured every year and those who exceed the recommended limit have to get treatment.

https://mic.com/articles/84521/japan-has-cut-obesity-to-3-5-...

I don't necessarily agree with that policy, however it does appear to be effective in cutting healthcare causes. In the US a large fraction of our healthcare expenses are due to chronic conditions related to obesity.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#515
post #262
post #236

Earlier quoted context omitted.

Why do you think line-jumping is more immoral than getting worse treatment? In one case you just have to wait in non life-threatening and non-urgent cases (you only have to wait if you actually can wait). In the other case you are actually in a worse physical or mental position.

This is like if the whole town is on fire, but you have enough money to pay the fireman to save your house first. Priority access to universal needs shouldn't be given based on personal wealth. I wonder if the people who wrote this line jumping into law qualified for the public or private insurance.

There actually are private firefighting companies which homeowners or insurers can pay to save their houses first.

https://www.businessinsider.com/california-wildfires-private...

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#516

Earlier quoted context omitted.

Yes, but there are better ways to do it. A natural group to pay R&D for patent-free drugs is health insurance companies, who would benefit from the lower costs, and perhaps even come out ahead. But its hard for those companies to organize such an effort, because they can get the same benefit even if they don't contribute. It's a classic public goods problem. Usually we solve public goods problems with taxes, and we c…

If this was the case in the US than birth control, Plan B, and abortifacient drugs would never have been invented here.

The plan simply provides another funding mechanism. There's nothing in the plan to prevent companies from developing patented drugs. So if you're right, it would just mean that birth control drugs would not be free of patents when introduced, just as under the current system.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#517

Earlier quoted context omitted.

You're engaging in 'all-or-nothing' thinking. The vast majority of medical expenses are not like that. And that's the whole point of insurance--to be covered in case something happens so you don't have to negotiate on the spot. That's like saying we should socialize food distribution because people can't negotiate when they're starving.

Sure, I chose an extreme example, but it's just a fact that healthcare is way less elastic than food. If the price of beef is too high, I can buy pork instead. If the price of a hip replacement is too high, what are you supposed to do? Get an appendectomy instead?

Demand is inelastic? Meh, my brother is living in Brazil and has been using a ton of private healthcare services because it's cheaper. Again, you're engaging in all or nothing thinking. As the price of LASIK goes down, more and more people use it. Americans go to the doctor less because it's more expensive. Healthcare demand is the furthest thing from an 'inelastic'.

Healthcare is bigger than just things that you absolutely need. Obviously, there are those things, but that's what INSURANCE is for. Then, when you are healthy, you can shop around and when insurance is too expensive and has too many items you don't need, you can instead get a barebones plan which would cover the things that you seem to be worried most about.

If a person failed to get insurance, well... that's not good. We shouldn't encourage that as a society. If someone runs out of resources and has to demand it from others, they are a burden and that is bad. If too many people do that, society collapses.

Obviously, there are going to be those people and I'm not saying we shouldn't care for them, but the more we have a socialized system--one that has a shared resource pool everyone takes from--the less efficient it will be because the incentives applying to individual encourage them to use as many resources as possible because they aren't the ones who bear the cost.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#518

Earlier quoted context omitted.

If you get private insurance you pay extra to cover inner London hospitals unless you live there. I haven’t used the NHS for the 6 years that I’ve lived here tried it once when I was looking for some physiotherapy for my knee got told by the GP that it will take 3 months called AXA which was then my provider and got an approval for 3 sessions which was then extended to 12 the same week. I don’t even book GP appointme…

> If you get private insurance you pay extra to cover inner London hospitals unless you live there. That's kind of the opposite of what I was saying anyway. It's fair enough if you are making a decision to go to a more expensive hospital for your own reasons. Yeah, private healthcare in the UK is convenient but far from essential. Physiotherapy was actually exactly what came to mind, I believe it's one of those parts…

It’s also the fact that you can’t register with more than one GP so if you don’t live within say 30min of your work going to doctor appointments is a day off essentially not to mention that if you don’t pretend to be dying when you call them they’ll tell you to get some rest and call again in 3 days.

If you go to A&E sure NHS is good enough, but for preventative care and general appointments however it’s pretty poor same goes for any kind of specialist care unless you are getting it at the hospital.

Don’t get me wrong universal healthcare is important single payer universal isn’t, and the NHS’s trust structure is really poor so if you live in an area where the trust is literarily bankrupt the level of care you get is piss poor at best.

I think the biggest mistake the Brits did is to prevent the NHS from providing premium services at a cost like better rooms or cosmetic surgery.

The best healthcare systems in the world are those in which the healthcare providers are non-profit, are required to maintain a specific subset of services defined by the government, aren’t allowed to deny service but are allowed to make money on the side with things that aren’t covered by the government.

That extra money is key because as non-profits the only thing they can do with it is to reinvest it in either their staff or their services there are no shareholders to give dividends too.

This is something the NHS lacks I would much rather pay the NHS the same money I pay to Bupa and get the same service as I can get now knowing that some of that money is going to go into improving the NHS as a whole.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#519

Earlier quoted context omitted.

> If you get private insurance you pay extra to cover inner London hospitals unless you live there. That's kind of the opposite of what I was saying anyway. It's fair enough if you are making a decision to go to a more expensive hospital for your own reasons. Yeah, private healthcare in the UK is convenient but far from essential. Physiotherapy was actually exactly what came to mind, I believe it's one of those parts…

It’s also the fact that you can’t register with more than one GP so if you don’t live within say 30min of your work going to doctor appointments is a day off essentially not to mention that if you don’t pretend to be dying when you call them they’ll tell you to get some rest and call again in 3 days. If you go to A&E sure NHS is good enough, but for preventative care and general appointments however it’s pretty poor…

The NHS's trust structure is more about forcing a market into somewhere it has no place than about healthcare outcomes.

When we once elected to go private to queue jump we got to see an NHS consultant privately, in an NHS hospital, and all follow on treatment was on the NHS. So it was a simple case of a few hundred pounds for private scan and consultation.

Most hospitals and maternity units have private rooms as an option. As far as I know they're not restricted or limited in any way, unless it's changed since our experiences. We've not needed a hospital for a while.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#520

Earlier quoted context omitted.

It’s also the fact that you can’t register with more than one GP so if you don’t live within say 30min of your work going to doctor appointments is a day off essentially not to mention that if you don’t pretend to be dying when you call them they’ll tell you to get some rest and call again in 3 days. If you go to A&E sure NHS is good enough, but for preventative care and general appointments however it’s pretty poor…

The NHS's trust structure is more about forcing a market into somewhere it has no place than about healthcare outcomes. When we once elected to go private to queue jump we got to see an NHS consultant privately, in an NHS hospital, and all follow on treatment was on the NHS. So it was a simple case of a few hundred pounds for private scan and consultation. Most hospitals and maternity units have private rooms as an o…

Yes but those funds aren’t going to the trust as in the actual public pool.

Most hospitals have private wings, but the NHS doesn’t see any profit from that.

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