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GoFundMe CEO: ‘Gigantic Gaps’ in Health System Showing Up in Crowdfunding
221–230 of 291 posts
Re: GoFundMe CEO: ‘Gigantic Gaps’ in Health System Showing Up in Crowdfunding
#222Earlier quoted context omitted.
From my perspective, it shouldn't. Yes, its cold and heartless to say so, but wanting children isn't a health issue.
Not being able to have children is clearly a health issue.
How so? Some percentage of everything on the planet is infertile and cannot reproduce, thats just the nature of genetics - why should humans get a very expensive special exception? its not as if we have a shortage of people having babies, or a shortage of kids needing a home either. I don't think you have a fundamental right propagate your genetic material.
Re: GoFundMe CEO: ‘Gigantic Gaps’ in Health System Showing Up in Crowdfunding
#223Earlier quoted context omitted.
Not being able to have children is clearly a health issue.
How so? Some percentage of everything on the planet is infertile and cannot reproduce, thats just the nature of genetics - why should humans get a very expensive special exception? its not as if we have a shortage of people having babies, or a shortage of kids needing a home either. I don't think you have a fundamental right propagate your genetic material.
This is a ridiculous question and you know it.
Re: GoFundMe CEO: ‘Gigantic Gaps’ in Health System Showing Up in Crowdfunding
#224Earlier quoted context omitted.
If you get private health insurance, do you get your NHS contribution back? Thats what would make it "competing" in the open market. If you have to pay for it no matter what, there is no competition, there is double charging.
There isn’t double charging, because private health insurance universally doesn’t cover the same things as the NHS does, and universally depends on the NHS to work with for anything they think might be too expensive to cover. Given that we spend less money on healthcare than countries that do have healthcare “on the open market” like you suggest, I’d say this is a system that obviously works. If there were an imbalan…
If there are general practicioners in the private market in the UK, that means their patients pay for the NHS and also for the private GP, thus double charging. Particularly with your primary care provider, continuity is important in medical care, not everything is replaceable like a cog.
> Given that we spend less money on healthcare than countries that do have healthcare “on the open market” like you suggest, I’d say this is a system that obviously works.
Sorry but this is a ludicrous claim. Argentina spends 2% less of GDP than the UK, and 70% of its care is private. And not only that, it gives free healthcare services to other countries, including organ transplants.
Re: GoFundMe CEO: ‘Gigantic Gaps’ in Health System Showing Up in Crowdfunding
#225Earlier quoted context omitted.
> We need to get rid of health insurance companies. They are the reason all of our costs are massively inflated This is not correct. Insurance is a very valuable service to prevent high-risk events, and applying insurance is a very hard problem. You need to do economics, operations, fight fraud, etc. What does create price insensitivity (and thus doesnt allow for the competition that drives down prices and increases…
You're misunderstanding the problem. Americans are not being bankrupted by annual checkups. Americans are being bankrupted by cancer and other serious health problems. And this is in spite of being insured. In practice, private insurance turns out not to be, as you put it "a very valuable service." Given a choice between death and bankruptcy, most people will choose bankruptcy. There is no downward pressure on the co…
There are multiple reasons why healthcare is expensive in the US. Life ending or multimillion dollar diseases exist everywhere and the reasonable solution to that is insurance: that doesnt make healthcare expensive or cheap, or care good or bad. If you have a cancer that is estimated cost of care is 5 million dollars, neither private nor public insurance will make it cost less, and someone somewhere still has to decide if its covered or not. You cant have unlimited health care, because it requires human beings to deliver it. (at least today).
> Given a choice between death and bankruptcy, most people will choose bankruptcy. There is no downward pressure on the cost of medical care because there is no alternative
This is a common trope in this debate, but its not an economically sound argument. First of all, people choose this all the time: a european person does not sell their home and get indebted to pay for a trip to the us to get bleeding-edge 1% rate of success medical care for his unique condition. Second, its not medically sound. Medicine is absolutely practiced with economic considerations in mind. Care is not the same in the U.S. than say, an African country with hospital shortages. The doctors recommendation changes based on the patients sensibility to prices (for example, a doctor will not recommend highly expensive vitamins to the unemployed, or wont indulge in expensive out-of-coverage procedures for people who would find great economic suffering for the test alone).
This latter part is a key missing education link that for some reason the public seems to misunderstand. Its strange because in actual education people understand that prices give different qualities, but someone reject the idea that healthcare doesnt behave that way.
I have other counter-arguments to this notion of downward pressure, but fundamentally what makes prices low is competition. Any one would prefer bankrupcy to starvation, but thats not a problem with food isn't it.
Re: GoFundMe CEO: ‘Gigantic Gaps’ in Health System Showing Up in Crowdfunding
#226Earlier quoted context omitted.
They have the incentive to make the ones they use good. This idea has shown to not happen in real life. Public schools, for example, do not deliver a "uniform" service.
No, Government officials in the US are afforded socialized medicine. "The Federal Employees Health Benefits (FEHB) Program is a system of 'managed competition' through which employee health benefits are provided to civilian government employees and annuitants of the United States government."
Strange contradiction: you are show a case on how federal workers have an undue benefit in comparison to the population, which is what my original argument was. This program seems to be about selecting insurances tho, not an actual insurance. It's tangential.
Re: GoFundMe CEO: ‘Gigantic Gaps’ in Health System Showing Up in Crowdfunding
#227Re: GoFundMe CEO: ‘Gigantic Gaps’ in Health System Showing Up in Crowdfunding
#228Earlier quoted context omitted.
I agree, that in a form current insurance companies exists - i.e. perpaid medical discounts plan, they should be removed. People should be getting insurance from insurable events - i.e. accident, heart attack, etc. Not from routine vaccination, annual checkup, seasonal cold. High-deductible plans are a hack to get people to pay for more of routine stuff and I think it moves into the right direction.
> Not from routine vaccination, annual checkup, seasonal cold. I feel like you lump in a lot of preventative care in that statement. If your routine checkups / vaccination prevent necessary emergency care and thus save money down the line, not incentivization people to do so seems stupid to me. The insurance company would have to pay for it regardless, unless they manage to cut those cases from the body of their insu…
Lack of vaccination/etc should be a "pre-existing condition". Otherwise, people who know they will be saved will choose to do stupid things, like https://www.nytimes.com/2019/03/09/well/oregon-child-tetanus...
"When the time came for his second round of DTaP, doctors talked with the family about the need for vaccinations. Surviving tetanus, unlike some other diseases, does not offer immunity in the future.
But despite an “extensive review” of the risks, and the benefits of vaccination, the article said, the family declined the second vaccination — or any other recommended immunization."
Re: GoFundMe CEO: ‘Gigantic Gaps’ in Health System Showing Up in Crowdfunding
#229Earlier quoted context omitted.
That's why I called it a hack and not proper implementation. While what you described is true - patients are hit with "real costs" instead of $10 co-pays and rising premiums. ideally - yes, most minor stuff would be paid out of pocket - market forces would immediately put things in a right place. And for emergencies - leave that to insurances.
Switzerland does this right: there is an annual excess (which patients can choose, typically between $500 and $2500, and which is reflected in reduced premiums if you choose a higher excess) which is paid entirely by the patient, and after that the insurance kicks in for 90% of costs up to another threshold, after which the insurer covers everything. In this way the insurance is actually an insurance like a car insur…
This sounds pretty much what high deductible plans are in the USA. Are there some other differences? Perhaps patients file insurance claims themselves?
Re: GoFundMe CEO: ‘Gigantic Gaps’ in Health System Showing Up in Crowdfunding
#230Earlier quoted context omitted.
My current world view is that socialism implemented via central authority ruling over a very large group (i.e. socialistic government of USSR) is not working, because personal relationships connections are broken when helping each other is outsourced to some abstract entity. It is that entity being praised and hated when someone gets help or someone doesn't. The fact that it is neighbors, other region people, etc act…
This is a very interesting idea. I've been thinking that one of the big problems with government today is that most people do think of it as a 'they' instead of an 'us', but I think the reason is more complex than personal relationships being broken. At the core, whatever the reason for it, government is not, in fact, a 'they'; it is an 'us.' Many of us insist otherwise, and give many, many different reasons for it,…
I totally agree and trying to point it out all the time when I hear "they". But the reality is - when some person sits looooong away in Washington and makes some rules - they are hardly connected to the people they represent. Smaller and more compact governing bodies I think would resolve the problem, where we would still get a benefit of a dedicated person working on organizing life in the region, and yet not too disconnected to be called "they".