Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

We Need to Design Health Care Reform That Puts Patients Before Profits

rooseveltinstitute.org

Post reply on HN
Print view View original

61–70 of 206 posts

Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#61

Post by 4ntonius8lock »

dsfyu404ed wrote: post #44
4ntonius8lock wrote: post #23

I'm really not sure why this isn't mentioned: USA should commission a study of health care systems in other countries. Include costs, challenges, issues of bringing it to scale in US, etc. Then we can implement something based on real world experience and data. It seems that these highly complex topics are dealt at the ideological level only. Which is absurd, as details can make anything from any ideology horrible. I…

>It seems that these highly complex topics are dealt at the ideological level only. Which is absurd If you take the view that the goal is winning instead of solving the problem it ceases to be quite as absurd.

Except it isn't only about winning.

Otherwise, we'd have no objective advancements in medicine.

Saying it's ONLY about winning is just as absurd as thinking it's only about solving the problem. It's about solving problems within the system. That includes winning and a lot of other elements.

Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#62

Post by megiddo »

rayiner wrote: post #34

The U.S. spends $3.5 trillion annually on healthcare. Worldwide profits for the 112 publicly traded healthcare industry companies amount to $50 billion per quarter: https://www.thefiscaltimes.com/2018/11/12/Chart-Day-Big-Phar... . Even if all those profits are allocated to the U.S., that's about 5.7% of healthcare spending. (And completely consistent with most other industries.) Hyper-focusing on profits is misguided…

What a strangely factual response on this forum.

Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#63

Post by DonnyV »

creaghpatr wrote: post #35
aaavl2821 wrote: post #33

Earlier quoted context omitted.

Large hospitals systems have been forming regional monopolies for the last few decades. First they would buy other hospitals to increase negotiating leverage with insurers, then they started buying outpatient clinics to control patient flow. They can also increase the amount they charge at outpatient clinics once the larger hospital system buys them. Hospital spend represents 30% of US healthcare spend, and physician…

Healthcare stocks comprise a not insignificant part of many Americans' 401k portfolios, the downstream economic effects of dismantling healthcare would extend way beyond the hospital/pharma industry.

Less than half of the population have stocks of any kind, so this is not an issue. For the ones that do, re-balance.

Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#64

Post by 4ntonius8lock »

aaavl2821 wrote: post #37
4ntonius8lock wrote: post #23

I'm really not sure why this isn't mentioned: USA should commission a study of health care systems in other countries. Include costs, challenges, issues of bringing it to scale in US, etc. Then we can implement something based on real world experience and data. It seems that these highly complex topics are dealt at the ideological level only. Which is absurd, as details can make anything from any ideology horrible. I…

There is plenty of data on this available. It isn't perfect but it's there. The problem isn't lack of data, its lack of awareness of the data. Most people learn about the healthcare system by reading newspapers and other media, and from what I've seen coverage of healthcare in most US media is very political and seldom data-driven Check out here to start, there are plenty of other resources: https://data.oecd.org/hea…

Raw data there is.

I'm talking about a report that says:

After analyzing the health care systems of X, Y and Z countries, a commission suggest A, B and C changes to the US healthcare system. A major commission organized and created by an organization that has proven capable of developing long term, large scale plans for the greater good of the country (think the army corp of engineers, but it doesn't have to be them, just something that is as objective as possible)

I'm also a bit surprised that the ideological bend is so strong, even on 'hacker' news, that net-net I'm getting down-voted on a what I think is essentially a call to look at data and create cohesive reporting to guide public policy.

Maybe there is such a study. I'd be glad to know about it.

Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#65

Post by TheOtherHobbes »

dgzl wrote: post #59
Merrill wrote: post #52

This can be done by converting "for profit" corporations into "not for profit" corporations and having them finance investments with debt instead of equity.

And what about the rights of the stakeholders of those for-profit corporations?

What about the right of patients not to be bankrupted by a service they have been paying into for their entire working lives?

Stakeholders don't get a magic pass on this. The polite view is that they're profiting from suffering. The less polite view is that the entire industry is a toxic, possibly even criminal, cartel, and needs to be split up and defanged in the same way that other toxic industries - tobacco, opioids - have been defanged.

Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#66

Post by tptacek »

The problem with US health care is that it costs too much.

The elephant in the room in US health care costs is inefficiency on the provider side. Payer-side reforms have limited impact, because contrary to rhetoric from both sides of the debate, we could probably zero out administrative costs entirely and still deliver little more than a grocery store discount to American consumers.

However we structure payment, we're still going to have overprescription of outpatient procedures, a shortage of doctors who as a result make drastically more than their counterparts in Europe, bed vacancies in inefficiently provisioned hospitals, diagnostic procedures that vary wildly between providers just a few miles from each other, and a total lack of price transparency to enable consumers (and their doctors) to collaborate and make decisions about care.

There's not much evidence that our government-run health programs (Medicare in particular) is up to the task of solving these problems; Medicare has a central role in how the current health care system is organized, and some of these problems stem directly from decisions made by Medicare.

Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#67

Post by tptacek »

thaumasiotes wrote: post #48
tptacek wrote: post #47

Earlier quoted context omitted.

Is it obvious? I went to a fancy Japanese dinner last night. It was, obviously, a for-profit venture. At any point during that dinner, was anyone in the restaurant worried about the restaurant putting its "profits" above its patrons?

They weren't worried about it, but it was happening anyway.

Your argument is that a nonprofit Japanese restaurant could have delivered a better experience to me?

Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#68

Post by balls187 »

kerkeslager wrote: post #28
balls187 wrote: post #19

Earlier quoted context omitted.

What if we pay for affordable preventative care, and the government covers the cost of traumatic events?

What about chronic diseases that require frequent treatment?

Good question. Along those lines: care and treatment for developmental disorders.

Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#69

Post by balls187 »

creaghpatr wrote: post #50
balls187 wrote: post #17

Earlier quoted context omitted.

We do need Health Care reform, but I'm not convinced single payer government is going to lead to better outcomes. > No, we need to get rid of private insurance with Medicare for All. That would shift the incentivization from maximizing profits, to instead solely minimizing tax payer dollars. Lobbying would still exist (see defense industry). Denying care wouldn't be based on health reasons (dubious), but shift to cla…

Medicare works because it is subsidized by private insurance payers. The system in its current form would collapse instantly if every American became covered exclusively by Medicare.

Also subsidized by current tax payers.

Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#70

Post by civilian »

kerkeslager wrote: post #32
helpPeople wrote: post #6

Until Americans find Physicians (and Pharmacists) as the enemy, it will never happen. They(AMA and APA) are top lobbyists that entrench themselves using monopolistic practices. Sure school can cost 500k, but with 200 to 300k+ per year salaries, they can kill that debt. (This is their common defense)

With my skillset (software engineer) I can easily pull low six figures. And I'm confident that doctors provide more value than I do. I'm pretty sure I've never saved anyone's life. So I have zero problem paying doctors 2 or 3 times my pay, which is about what you're saying they get paid. Health insurance CEOs make, in some cases, literally hundreds of times my salary, while literally killing people for profit. I'm go…

It's a bit much to say individual doctors are the enemy. (I have friends & family who are doctors!) But their organizations are. The AMA severely restricts the number of doctors trained each year. There are more qualified candidates for medical school than they accept-- which is also why there are so many extra hoops medical school candidates are jumping through in order to get in.

It's a classic licensing scheme to restrict competition. Doctors may not be the enemy, but they are financially benefitting from their monopolistic practices, and it is reducing quality of care for Americans.

Post reply on HN