> US spends most on health care but has worst health outcomes
US does not spend on healthcare. It spends on people making profits from healthcare.
But, Europe is slowly getting there too.
US spends most on health care but has worst health outcomes
111–120 of 134 posts
Re: US spends most on health care but has worst health outcomes
#112This isn't at all surprising, for multiple reasons. The entire insurance industry existing is a big one. That we are all overweight is another. I'm generally a very conservative person. But even I am for government funded healthcare. Who in the hell is against it? I've not met a single person completely against it, mostly just people against people abusing emergency rooms. Certain big media and politicians are agains…
> But even I am for government funded healthcare. Who in the hell is against it? Anybody who has ever had to deal with Medicaid?
Medicaid in Washington state (Apple Health) is fantastic, all things considered.
Re: US spends most on health care but has worst health outcomes
#113Earlier quoted context omitted.
> but less so than brutal waste pulled out of your paycheck or taxes. Are you suggesting that universal systems are more wasteful? Wouldn't that imply that a simple natural experiment of total healthcare spending vs average health outcomes should show a benefit to private over universal/tax funded?
In the US a lot of tax dollars are wasted on healthcare. A lot more would be wasted if we tried some kind of universal health care in the US.
It seems to me that a lot of waste in this area is tax dollars paying for commercial prices. The US has some truly insane baseline costs in healthcare. Having the state pay for them, or having the state provide an insurer, only kicks the ball into someone else's court.
Figure out why a hospital can charge you $25 for an aspirin, and start there. If you just let the state pay that $25, yes your taxes are being wasted.
Re: US spends most on health care but has worst health outcomes
#114Earlier quoted context omitted.
The actual data is closer to 1/3 against than 1/2. Nothing more is usually collected than that vote. I don't believe, even given revised data above, that even 1/3 are against it. I'd estimate less than 1/5 are against it no matter what. The remainder has doubts and conditions, a given considering how awful government projects usually go. If I thought healthcare would be run like the DMV, I'd vote against it too.
How awful which government projects go? Yeah the DMV is a thing, but so is NOAA and NASA.
Those are good orgs, but not really customer facing ones. Of those people interact with, I can't think of one people actually like. Social Security offices come to mind. And apparently the IRS is impossible to get ahold of, though luckily I've never need to.
Re: US spends most on health care but has worst health outcomes
#115Earlier quoted context omitted.
The entire insurance industry, and almost all of the industries who make money from it, are against it, for one. There are many doctors and nurses who would also be incensed if you told them that they had to take less pay EVEN IF you also immediately eliminated all their education debts. Nurses in particular are heavily incentivized to work overtime because they usually work insane 12 hour shifts to begin with. You a…
Is the long-run alternative that future medicines like that are available for $0.50/month worldwide or not available at all? > many doctors and nurses who would also be incensed if you told them that they had to take less pay EVEN IF you also immediately eliminated all their education debts If the reduction in current value of their lifetime pay is greater than the value of their education debts, why wouldn’t they be…
> Is the long-run alternative that future medicines like that are available for $0.50/month worldwide or not available at all?
Not if the government nationalizes the pharmaceutical industry and treats it like NASA, which it should have done a LONG time ago.
> If the reduction in current value of their lifetime pay is greater than the value of their education debts, why wouldn’t they be incensed? I would be as well, as would most people.
Hospitals are overworking medical staff. The average nursing shift is 12 hours long. Most surgeons are putting in 60+ hours a week. The number of medical staff needs to increase and their work hours need to be normalized as much as possible. We've allowed medical associations to artificially gatekeep the populations of staff for no damned good reason.
Re: US spends most on health care but has worst health outcomes
#116Earlier quoted context omitted.
So they can spend a lot of money to convince people that reforms are bad, they can buy influence among powerful politicians, and all the rest of the moves that make it so elite preferences do a lot to dictate policy the world over. Are we being naive here?
I think so, yes. You're basically saying that there are lobbyists and that's an insurmountable obstacle, and throwing your hands up in the air. You're not, for example, trying to learn how the countries that executed reforms successfully did so. EDIT: You could easily find a list online of the top ten health systems. Learning about the reforms carried out by each of those in the past 30 years requires effort, but it'…
Maybe I missed a rhetorical question but would-be reformers of the American health system were defeated by the efforts of moneyed interests (AMA, insurers, etc) in the past. It’s not that nobody thought of it. Argue about the wisdom of it if you want, but Obamacare was structured as it was with the idea of turning the industry into allies rather than implacable opponents.
Re: US spends most on health care but has worst health outcomes
#117Earlier quoted context omitted.
Well, some won’t and I think that exposes another issue: the poor outcomes have a lot to do with a lot of people not getting care or waiting too long due to cost. If money is no object the US healthcare system is as good as any (I bet you would see this if you broke down by socioeconomic status).
> If money is no object the US healthcare system is as good as any I don't think so. The medical personnel are way too stressed. You having money does not change that the people that will see you suffer in an inhuman system. Even apart from money, how on earth is it possible that the people who should know more better than anyone else the effects of stress and lack of sleep let doctors work in far too long shifts? Ho…
Well, as you say, that problem isn’t unique to the US.
Re: US spends most on health care but has worst health outcomes
#118Earlier quoted context omitted.
US health spend is bigger than the GDP of every country on that list. The biggest employer in nearly every congressional district is a healthcare system. It’s politically difficult.
You make it sound as if closing nearly half of a country's hospital beds is politically simple. Was done. Or as if nationalising most of a state's hospitals is politically simple. Was done. (In some people's opinion, not mine, but lots of people described it in those words, so it's a fair way to describe the political controversy of the reform.) It's possible to learn how these things were done, or it's possible to j…
Since Medicare has served as a model for some countries that provided universal care, I don’t think lessons are what we need. The problem is overcoming strong, bipartisan opposition.
Re: US spends most on health care but has worst health outcomes
#119Earlier quoted context omitted.
> But even I am for government funded healthcare. Who in the hell is against it? Anybody who has ever had to deal with Medicaid?
Medicaid in Washington state (Apple Health) is fantastic, all things considered.
The "all things considered" must be doing some heavy lifting in that sentence. Medicaid is almost universally hated by health care professionals. Many places won't take it.
Re: US spends most on health care but has worst health outcomes
#120Earlier quoted context omitted.
That is what I was trying to convey on my second point, but perhaps I didn't do a good enough job at it. Yes as a European I see it as a mere "efficiency" thing. My (admittedly, very simplistic) thinking goes like this: > In a population of 1000 perhaps 10 will get a Really Bad Health Issue that requires Really Expensive Treatment that costs 100. So those 1000 people pool their resources up and each pays 0.1 so that…
A risk pool being split among multiple companies doesn't actually increase the average amount that each group would have to pay. For the group of 100 in your example, only one tenth of a person is going to have to get one tenth of the expensive treatment, so each one still has to pay 0.1. As long as each underwriter has a sufficiently large group to ensure that the average cost incurred by its members is sufficiently…
> For the group of 100 in your example, only one tenth of a person is going to have to get one tenth of the expensive treatment, so each one still has to pay 0.1
That makes no sense. It will be one person. Not a tenth. And also if that was true the private insurance would raise their quota to 1.9. And then deny treatment to that unfortunate person anyway because it’s cheaper to pay a lawyer to litigate the expensive cases than to pay them.
Your last bit makes no sense to me at all. It is clear that health care is desirable, and can’t be provided by a competitive market. The richest country in the world can’t pull it off. You lose much more people per week to health care unavailability than to wars. From the point of view of mere efficiency of capital it makes no sense.
And are talking as if there was no proof that socialized care works in other countries. It’s right there if you’re willing to look for it.
If your state agencies are poorly managed and you go private, that is a self-perpetuating cycle. Fewer people will use them, they will get budget cuts, and get worse. The solution is to revolt, strike, demand better, and help each other, even if they are poor.
Abandoning some aspects of capitalism is completely possible and rational.