351–360 of 569 posts
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If you're renting, your landlord is paying property tax and passing it on to you.
By that logic, no one pays taxes except consumers.
Pass-through taxes exist though, yes.
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Who gets "good" care here? Senators and millionaires definitely do. But, most people don't get good care, many people are missing essential care (dental), and everyone has to wait. Often months. We in the US pay more per capita for worse care than most other developed nations (Canada/UK/Nordic countries). Name your country where the care is worse than the US please and let us know how much they pay for it per capita…
You ever been to a Canadian hospital?
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I have made no statements about how things should be. I have lots of opinions about how things should be, which I don't share on HN. I was making statements about how things actually are , since no discussion about how to make the world we want is likely to be meaningful or useful if there is not a shared view of what is first.
And what you focus on brings about thoughts of a zero sum game which I called out. You can safely assume I don’t agree with what you find most pertinent. I think a country which lets some get rich off of other’s cancer is an abhorrent, indefensible, system.
I’m an MD who trained in NYC. I have also had emergency surgery in the NHS at one of their most prestigious hospitals in London and so I feel like I’ve seen the system a little bit from the inside. It was far cheaper for me than it would have been as a Brit in the USA, but the standard of care was lower. They didn’t have some technical and staffing resources late in the afternoon that would be a baseline in any of th…
> It will likely strain these systems even further, as reimbursements from Medicaid/Medicaid are insufficient to run large health systems which depend on higher rates from private insurers
Time ran an article a few years ago about hospital billing and whatnot. One of the things that they pointed out was that Medicare reimbursement rates were based on the actual cost to provide the service. If the problem is that Medicare doesn't pay enough extra to subsidize indigent care then having medicare-for-all would address that as it would reduce the number of uninsured.
> In NYC even more physicians and group practices will try to go to alternate models such as cash-only. Try being on Medicaid or Medicare and finding an outpatient psychiatrist in NYC now as it is. This will extend to more PCPs, chronic disease specialists, etc.
As opposed to what's already happening? Keep in mind that the southeast part of San Francisco already has relatively poor access to health care. A few years ago Sutter decided to revamp Saint Luke's hospital in Bernal Heights. St. Luke's used to be a community hospital where you'd go for primary and emergency care. Sutter changed that all up and stocked the offices almost exclusively with specialists (because that's where the money is).
> The US healthcare system, if you have private insurance, is the best in the world already in terms of level of service and access to rapid specialty and high-end care.
I'm sorry, what? Back when I had Blue Cross/Shield I had to book an ultrasound something like three months in advance. In San Francisco. At the time I was seeing a fee-for-service GP. If I'd wanted to switch to an in-network GP the wait at UCSF was like nine months. Finding a GP that takes both new patients and insurance was not easy – in fact I didn't as my GP was amazing.
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I have made no statements about how things should be. I have lots of opinions about how things should be, which I don't share on HN. I was making statements about how things actually are , since no discussion about how to make the world we want is likely to be meaningful or useful if there is not a shared view of what is first.
And what you focus on brings about thoughts of a zero sum game which I called out. You can safely assume I don’t agree with what you find most pertinent. I think a country which lets some get rich off of other’s cancer is an abhorrent, indefensible, system.
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>Massachusetts may try it as well: https://masscare.org/ Massachusetts has had 98% health care coverage for more than 15 years. (The only countries in the world with more than that are those, such as the UK, in which no membership card is needed for receiving care.)
Health care coverage with a deductible and copays is not at all similar to taxpayer funded healthcare such as that in the UK.
Neither the UK's monolithic NHS that combines single-payer insurance and (more or less) 100% free on delivery with no membership card, nor Canada's single-payer insurance with no legal private alternative, is the norm internationally. Germany, Austria, Switzerland, and the Netherlands all have Obamacare-like systems with dozens of competing private insurance plans with premiums. 30% copay is the norm in France's three separate government insurance plans. Australia has single-payer insurance but people are heavily incentivized to move to private plans. Etc., etc.
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Where is that? My parents lived in North County and paid 13k+ a year on a $350k house. Their current place in Tampa is about 400k and the taxes are less than half of what they were in NY. Maybe Florida is a special case?
I'm basing this off of apartments in NYC. I often see ~$600k co-cops with $800 monthly co op fees (of which half is maintenance half is taxes). That seems low to me compared with similarly priced homes elsewhere.
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You seem to believe employees wouldn't be able to opt out of their own employer-based insurance. Why is that?
From the summary of the bill: > Private insurance that duplicates benefits offered under New York Health could not be offered to New York residents. --- My interpretation of that is that private insurance (which includes employer-based insurance) would be banned.
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You ever been to a Canadian hospital?
I have, as have members of my family, and have received excellent care for some fairly serious conditions. I think the Canadian system is under funded, and I'm sure there are plenty of true horror stories, but they always get highlighted by people who want to tear down/prevent a public healcare system so I feel I have to bring up that my family have received good and timely care. When I really needed healthcare I was…
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Very broad strokes, doctors in the US are overpaid and conservatives legislated Medicare can't negotiate drug prices. Lots of room to drive down costs. Spending is high because of a dysfunctional system driven by profit instead of care. https://www.npr.org/sections/money/2019/03/12/702500408/are-... https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2010.... https://www.bostonglobe.com/2021/10/25/opinion/let-medi…
Agree with the part about doctors being overpaid in the states. My wife is a 3rd year resident of a fairly well-known hospital system in one of the biggest metro areas of the US. We always feel lucky that she is a doctor because we know that she will make $250K+ (more like $300K/year if she choose a hospital in a rural area) as an internal medicine doctor (hospitalist/attending). My wife might go for oncology fellows…
That being said the system of training is a ridiculous and discriminatory waste of human potential. Eight years of study with giant amount of vacation is just abhorrent. 18 year-olds who want to be doctors need 48 weeks of school per year like a military medic or any normal adult. What a joke college is in the US. And the residencies are flat out nonsensical illegal discrimination. If a woman wants to have a baby every year while she can, there are many types of medicine where there is zero reason to require 24 hour residency shifts, yet they basically coerce it anyway. Similar for a disabled trainee or just anyone whose training need not include such things. Heck, even a trainee with a bit of sleep apnea or a sleep disorder should not be forced to destroy their cardiovascular and mental health unless shift work is a necessary component of training for the respective discipline.