151–160 of 349 posts
That is certainly a relief for the patients who have huge debts but not so great for the future patients who could have been treated at the centre? "There are no solutions, only trade-offs"
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Exactly. I feel the same way about GoFundMe campaigns for medical bills. On one hand, I'm happy that some of them can get outside help, on the other hand why is a GoFundMe campaign necessary to stay afloat?
What’s so ironic about GoFundMe is that it’s basically a diorama of how socialized medical care would work (minus the cost savings), and yet nobody has any political objections to socialized funding when it happens there. I recall debating with a friend who was against socialized healthcare recently, and then seeing them promote a GoFundMe campaign for a mutual friend’s medical bills on Facebook a few days later. The…
If federal taxes were broken down to, say, defense taxes, infrastructure taxes, health taxes, administrative taxes, and people saw how much of what they pay goes into each fund, it would be much closer to what you describe.
For instance, people would be more aware that twice as much of the tax-derived budget goes into defense and international security than to safety net programs.
And people might also be more wary of actions that grow the federal debt — both spending and high-income-earning tax cuts — if they saw that more of their tax money goes to paying off its interest than toward funding infrastructure, education, and science and medical research combined.
Instead, that information is buried in federal reports and reported with the perception of being policy wonkery. It doesn't have a personal impact. Seeing what you remit to the government broken down by what it's spent on would drive it home much as having Social Security and Medicare as line-items on paystubs does.
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> It's inevitable that medical care in some way is tied to personal wealth. Some treatments are so expensive and/or niche that public programs likely wouldn't cover them. Such treatments will probably always exist. (And if they didn't, then that could he a problem by itself.) Not in a single-payer state, no. It's also not really a problem in and of itself. You'll find that if cancer treatments are actually cheaper an…
This isn't correct in the UK under NHS. There's a set amount NHS is willing to pay for drugs and treatment, and beyond that, it's refused altogether. You'd have to go elsewhere and on your own dime for expensive treatments. Here's a link from the BBC I quickly found but it's widely documented: https://www.bbc.com/news/health-28983924
In the US companies will happily exploit dying people to extract as much money from them, and their families, as possible.
In the UK we recognise that dying people are vulnerable to this form of harm and we put protections in place.
The cancer drugs fund was a way to allow the NHS to use newer cancer drugs by reducing the amount of testing needed, and by increasing the amount of money we were will to pay for these meds.
After several years we realised that these drugs, while being very expensive, provided no meaningful benefit and often caused harm. Sometimes they degraded quality of life and shortened length of life.
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Thing is a good public option decimates the market for advanced private care of the level you have in the US. Here in Norway the private health providers that do exist mostly deal with low-investment, low-asset, high-return cases. They will look into your psoriasis but ain't going to treat your cancer. Fortunately the advanced care in public system is great. Still it's not unheard for patients that can afford it to g…
> decimates the market for advanced private care of the level you have in the US. > Still it's not unheard for patients that can afford it to go to the USA for specific treatments. They're often getting very expensive, but not very good, treatment that do not lengthen life nor improve quality of life. Sometimes these treatments reduce length of life or quality of life.
Sometimes they would work and sometimes they wouldn't, but in Norway your option then is basically arranging your own funerals.
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In rich countries outside of the US it’s called “the government”
Other countries are slipping, though. For example, Germany does not actually have a single-payer system, but instead a "system" of public and private health insurance companies. As an employee you`re usually in the public system, which can be more expensive for higher-earners because the fees are based on your income (although the health taxes are regressive, capped above like 65K income per year). Self-employed peop…
Although I recognize the personal hardship this can cause, I fail to accept this as a general injustice. In the German healthcare system nobody is forced to choose a private insurance instead of the public one. Choosing a private insurance when you're allowed to (which often means because you're in a higher income bracket) is usually only cheaper if you're young and healthy. It's basically a gamble on your own health for wealthy people.
And if the wealthy young and healthy population don't contribute to the public health insurance system which also pays for the not-so-wealthy and not-so-healthy (older) population, the public insurance system isn't sustainable.
The real problem with this system is its division in public and private insurance. Mandatory public insurance would mean lower insurance fees for public insurance and the problem of being stuck in private insurance would no longer exist.
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> This is an absolutely ridiculous assertion. What do you think is a better proxy?
You seem to be assuming that "contribution to society" should be the only factor when portioning out health care, and that there should be only one "best" proxy to measure such a factor. Why?
There are alternatives to rationing things by wealth. All the ones I can think of are arbitrary, unfair, or unworkable (raising interesting and difficult questions too, eg, a fun example would be should highly contentious politicians be first in line for the best healthcare due to their mass popularity or last in line due to mass condemnation?).
I think that people are happy to call me ridiculous but not actually able to say how we should be deciding who gets time from a doctor. I'm very doubtful of the alternatives, I suspect that many of them involve magical thinking that wealthy people are somehow hiding hundreds of doctors in their cellars that will suddenly appear and literally cure everyone's ills if only the government mandates it.
There are a lot of problems with US healthcare. It costs too much, and there are too many restrictions that stop one person trying to help another. But the fundamental "pay money, get service" aspect isn't something that is as easy to improve on as people try to believe. It is reasonable for wealthy people to get a much better standard.
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I don't even understand how the "health care" system and the insurance industry can be both so messed up in the US. It may be just anecdata, but In Hong Kong, my family has an insurance agent whom we work very close with. We're just middle class. E.g. only my dad has a car; my sister is 42 and I'm 38, and we still don't have our own car. Whenever something related to making use of the insurance plan comes up, the ins…
> We don't get this nonsense where the insurer tries to deny us and hope that we don't dispute. It’s also not the case in 99% of US claims. The ones you hear about are typically due to healthcare providers not providing sufficient justification for the healthcare or medications they are prescribing, which can easily cost tens of thousands, if not hundreds of thousands of dollars. The “insurers” are many times not eve…
So is it just sampling bias that we hear constant stories outside the US of everything from broken legs to cancer patients being denied coverage or being covered but having life destroying out of pocket costs? Because it really is constant.
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> Unless there is some really amazing alternative, money is one of the best proxies available for for contribution to society This is an absolutely ridiculous assertion. Many people inherit, luck out, or get wealthy by other means. Personal wealth is a terrible way to determine "societal value". It is deeply disturbing to me that there are people with these types of views. I hate to assume but my impression is that y…
> This is an absolutely ridiculous assertion. What do you think is a better proxy?
Quote (https://en.wikipedia.org/wiki/Disability-adjusted_life_year):
>The methodology is not an economic measure. It measures how much healthy life is lost. It does not assign a monetary value to any person or condition, and it does not measure how much productive work or money is lost as a result of death and disease. However, HALYs, including DALYs and QALYs, are especially useful in guiding the allocation of health resources as they provide a common numerator, allowing for the expression of utility in terms of dollar/DALY, or dollar/QALY.
This is already widely in use btw, it's not exactly a new idea.
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And even if you can contest the denial, it can take days to months to get it back, meanwhile you’re shouldered with the burden of paying full price for your treatment with the _hope_ that they’ll reimburse you later. My fiancée has cancer, and we regularly joke that dealing with insurance companies is worse than the actual stage 3 cancer she has. They constantly deny her coverage for medications she’s been on for yea…
It’s intentional. They save billions using this practice because some people don’t have the time, knowledge or resources to dispute.