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

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

#121

Post by rayiner »

claudeganon wrote: post #113
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…

> The public rhetoric frustrates me as someone who favors universal healthcare. Demonizing corporations and rich people is red meat for partisans, but it’s not a solution. How do we pay for this system? How do we cut costs? There are already two pieces of legislation, the Jayapal and Sanders bills, they account for their costs. Tim Faust’s new book likewise walks through all of these concerns in detail: https://www.m…

The Sanders bill plans to pay for Medicare for All with taxes that are much lower than the social insurance taxes in France or Germany. That is pure fantasy. That gives me little comfort that its accurately accounting for costs.

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

#122

Post by leetcrew »

EpicEng wrote: post #101
leetcrew wrote: post #89

Earlier quoted context omitted.

think about the people you care about. would you rather live more years or spend more time with them over a shorter life? what would they prefer? it's an inherently subjective question, and I don't think the answer is obvious. I certainly don't think one of the answers is "insane".

Why are you assuming that I would spend less time with e.g. my wife if she were less efficient in performing some menial task? It would take her longer _to complete_, but that doesn't mean she wouldn't still quit working at 5. Besides, most of the software we write is pretty inconsequential as far as most people are concerned.

> Why are you assuming that I would spend less time with e.g. my wife if she were less efficient in performing some menial task?

because "helping many people allocate their time towards activities they actually value" was an important premise I stated in the post you originally replied to? I deliberately excluded stuff that merely improves productivity at work (although not everyone is fortunate enough to have a job where they can just leave at five if the work isn't done).

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

#123

Post by Scoundreller »

disabled wrote: post #75

As an American with 2 rare immune-mediated neurological diseases, that affect my peripheral nervous system, I can almost guarantee you that decent health care reform will not happen in the foreseeable future. By the way, both of these diseases are in pharmaceutical remission, due to taking a blood product that has immunomodulatory properties. I will have to take it for life. My medical insurance literally pays hundre…

Do be sure to check that any new country will pay for the same thing.

Single-payer/socialized healthcare can mean “Just Saying No” to expensive interventions.

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

#125

Post by EpicEng »

leetcrew wrote: post #122
EpicEng wrote: post #101

Earlier quoted context omitted.

Why are you assuming that I would spend less time with e.g. my wife if she were less efficient in performing some menial task? It would take her longer _to complete_, but that doesn't mean she wouldn't still quit working at 5. Besides, most of the software we write is pretty inconsequential as far as most people are concerned.

> Why are you assuming that I would spend less time with e.g. my wife if she were less efficient in performing some menial task? because "helping many people allocate their time towards activities they actually value" was an important premise I stated in the post you originally replied to? I deliberately excluded stuff that merely improves productivity at work (although not everyone is fortunate enough to have a job…

Then you're going to have to give me some examples. All in all I think doctors and medical scientists are more important to the world than the vast majority of us (since we have to make it an either/or for the sake of argument), so get specific.

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

#126

Post by dragonwriter »

rayiner wrote: post #121
claudeganon wrote: post #113

Earlier quoted context omitted.

> The public rhetoric frustrates me as someone who favors universal healthcare. Demonizing corporations and rich people is red meat for partisans, but it’s not a solution. How do we pay for this system? How do we cut costs? There are already two pieces of legislation, the Jayapal and Sanders bills, they account for their costs. Tim Faust’s new book likewise walks through all of these concerns in detail: https://www.m…

The Sanders bill plans to pay for Medicare for All with taxes that are much lower than the social insurance taxes in France or Germany. That is pure fantasy. That gives me little comfort that its accurately accounting for costs.

> The Sanders bill plans to pay for Medicare for All with taxes that are much lower than the social insurance taxes in France or Germany.

The US has much weaker non-healthcare social insurance than France or Germany, and a much larger per-capita economic activity to tax, so lower social insurance taxes for equivalent healthcare seems to be expected rather than suspicious.

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

#127

Post by maximente »

tptacek wrote: post #120
maximente wrote: post #112

Earlier quoted context omitted.

well said imo. the fact that most jobs in health care are administrative (never see a single patient) is telling that the incentives aren't good: we aren't increasing physicians per capita, we're just ... adding admins, very similar to what's going on in US universities. for example, we know most growth in medical "jobs" are administrative in nature, and thus not helping per-capita physician rate or anything like tha…

Administration on both the provider and payer side of this system accounts for, depending on the estimates I've seen, 12-17% of total health care costs. You can't in reality zero those costs out (even Medicare's much-vaunted 2% administration cost would shoot up if it had to deal with every patient in the country), but even if you could, you wouldn't have made health care in the US affordable.

why estimate? i linked a study you must not have read that says:

> After exclusions, administration accounted for 31.0 percent of health care expenditures in the United States, as compared with 16.7 percent of health care expenditures in Canada.

or did you have a problem with that study or something?

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

#128

Post by shsjxjbsbs »

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…

There are way more doctors than CEOs. If you’re gonna claim that CEO pay is a more significant factor than doctor pay you should do the math on that.

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

#129

Post by mikem170 »

claudeganon wrote: post #43
cmsonger wrote: post #38

It maybe is obvious, or maybe it's controversial, but patients will never be put before profits by for profit corporations.

Agreed, which is why for profit companies should be kept as far away from healthcare as possible.

Are you taking into account that health care is being delivered in most western European countries by for-profit doctors, clinics and hospitals? (the UK being the big exception)

Also the U.K. is not one of the better systems out there. I'd rather have the French system (minimal public + private mix), Sweden (minimal federal mandated controlled by their provinces), or German (similar to Obama-care).

I don't hear any U.S. politicians who are really talking about reforming health care. How about tort reform? Patents? Cost transparency? No, all anyone talks about is how the federal government should get more involved, and everyone knows that lobbyist run the federal government, i.e. remember how the people representatives in congress didn't even have time to read the ACA?

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

#130

Post by tptacek »

claudeganon wrote: post #113
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…

> The public rhetoric frustrates me as someone who favors universal healthcare. Demonizing corporations and rich people is red meat for partisans, but it’s not a solution. How do we pay for this system? How do we cut costs? There are already two pieces of legislation, the Jayapal and Sanders bills, they account for their costs. Tim Faust’s new book likewise walks through all of these concerns in detail: https://www.m…

You're using "account for their costs" in a different sense than I think Rayiner meant. When Sanders "accounts for his costs", he means that they've added up the total projected costs of their plan and then accounted for it with tax revenue.

That's fine, but it doesn't address the fundamental problem of US health care costs, which is --- regardless of "who pays" --- "why does it cost so fucking much". If all we do is move our exorbitant costs off customer bills and invoices and into our tax code, we haven't actually solved anything; in fact, in some sense, we've provided cover to the inefficiencies and incompetencies in the system that are overcharging us.

Single payer or private system or something in between, I don't much care, but I'd like to see a proposal about US health care that is serious about reducing cost, not about accounting for existing costs differently.

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