US spends most on health care but has worst health outcomes • Hacker News Board

Re: US spends most on health care but has worst health outcomes

#131

Post by jrockway » Thu, Feb 09, 2023, 4:47 AM UTC

forgetfreeman wrote: post #99

jrockway wrote: post #68

Earlier quoted context omitted.

Some administrators are going to be necessary to run any sort of healthcare system. Just as an example, someone has to prepare and send each doctor a W-2 every year.

Ok so are we now pretending hospital administration staff doesn't already exist? Or that the simple majority of employees in Dr's offices aren't there solely to process insurance claims? So again, for the cheap seats, insurance companies: 100% overhead, 0% healthcare provided.

Good point. Not sure what I was thinking when I wrote that. No insurance adjusters around, nobody needs to issue them paychecks.

Re: US spends most on health care but has worst health outcomes

#132

Post by Arnt » Mon, Feb 13, 2023, 3:56 PM UTC

emodendroket wrote: post #116

Arnt wrote: post #17

Earlier quoted context omitted.

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.

No, I think the part you miss is that some people succeeded at difficult reforms. Consider a reform where control of parts of each hospital's budget is removed from the owners/management of most hospitals. Might meet with some resistance, wouldn't you say so? You Americans seem to have this idea that your entrenched interests are somehow uniquely skilled at defending the status quo. Something like: "American hospital systems are so much better at defending their budget than that hospital system, so therefore that learning how that reform was executed would be pointless."

Re: US spends most on health care but has worst health outcomes

#133

Post by jujube3 » Mon, Feb 13, 2023, 9:05 PM UTC

forgetfreeman wrote: post #70

jujube3 wrote: post #61

Earlier quoted context omitted.

Actually, Americans are ignorant of the outside world, but not in the way that you're painting. They generally think that Europe has socialized single-payer healthcare, which is mostly not true (a few European countries, like the UK, do, but most have an insurance-based system). They also think that most of the world has access to the quality of care that people do in the US (nope). They also think doctors and nurses…

I literally watched a dude die waiting to be seen in an ER in the US. They are absolutely required to treat but nobody said anything about how they prioritize patients when the ER is busy. Some more news for you, you can't waltz into the hospital with any number of chronic or life threatening conditions and expect to get effective treatment. You'll get the bare minimum required to stabilize your condition in the mome…

I have personally seen the opposite -- a relative came into the hospital with no healthcare (even Obamacare which he was 100% eligible for, but simply forgot to sign up for) and got the best possible healthcare. And eventually got retroactively put on Medicare, so that he didn't have to pay.

In any case, people die waiting for service with single-payer healthcare as well. Before you try to reform the system, try to understand how the system actually works rather than just repeating talking points.

Re: US spends most on health care but has worst health outcomes

#134

Post by forgetfreeman » Wed, Feb 22, 2023, 9:21 PM UTC

jujube3 wrote: post #133

forgetfreeman wrote: post #70

Earlier quoted context omitted.

I literally watched a dude die waiting to be seen in an ER in the US. They are absolutely required to treat but nobody said anything about how they prioritize patients when the ER is busy. Some more news for you, you can't waltz into the hospital with any number of chronic or life threatening conditions and expect to get effective treatment. You'll get the bare minimum required to stabilize your condition in the mome…

I have personally seen the opposite -- a relative came into the hospital with no healthcare (even Obamacare which he was 100% eligible for, but simply forgot to sign up for) and got the best possible healthcare. And eventually got retroactively put on Medicare, so that he didn't have to pay. In any case, people die waiting for service with single-payer healthcare as well. Before you try to reform the system, try to u…

Your anecdote does not disprove the general case. If you walk into a hospital dead broke with no insurance with a chronic but not immediately life-threatening condition you're not getting the same level of care an individual would if they had the ability to pay for ongoing treatment. I've got a couple ER nurses I can rope into the conversation that can confirm that if you'd care to try to continue arguing the point.

As far as healthcare reform goes there's nothing particularly complicated about having a multi-billion dollar industry sieve funds that could be better spent on actual healthcare providers. There is also the minor issue of America's medical bankruptcy rates compared against literally every other industrialized nation on the planet, and the small matter of us having both the most expensive (by a wide margin) and one of the least effective healthcare systems of any 1st world country. Again, what the fuck are you stanning over there?