141–150 of 163 posts
This is "too big to fail" logic applied to hospitals. How do our basic life services always become captured by huge organizations that are poorly run and require bailouts by the government? Or is "too big to fail" just a ploy by those organizations to entrench themselves even further in our lives?
People here seem to go straight to politics on US healthcare, but does anyone ever stop to consider that this really is a complicated problem? I’ll look at two political extremes: - in a pure-market healthcare situation, these hospitals likely wouldn’t exist in the first place. Health services would be worse than they are now in rural areas, to the point that many probably wouldn’t have “real” health services at all…
In a pure-market healthcare situation, we would treat people essentially the way we treat cars. Some would be worth much more than others and they would depreciate to approximately $0 as they age, and we would make repair calculations against that value. It would be considered morally heinous. The basic root of the problem is trying to put an economic value on human dignity and morbidity/mortality, and it will always involve tradeoffs.
It’s really interesting how the US has managed to get a health system that’s extremely expensive, doesn’t cover everybody, is highly bureaucratic and complex, delivers below average outcomes and has overworked hospital staff. And somehow people defend this system because it works fine for the top few percent (especially the people in Congress) and people who have Medicare or VA.
> It’s really interesting how the US has managed to get a health system that’s extremely expensive, doesn’t cover everybody, is highly bureaucratic and complex, delivers below average outcomes and has overworked hospital staff. The healthcare industry (it should not be an "industry") in the US is all about extracting maximum profit for the benefit of middlemen. In a rational system, the only people who should be invo…
It's easy to say that only patients and providers should be involved with healthcare. But what do you propose to do with patients who need expensive treatments and can't afford to pay? Some level of cost and risk sharing is always going to be necessary, and that's where the complexities and politics come in.
Earlier quoted context omitted.
Is there any country with a medical system that people don't complain about? For instance is there anyone in the world that would agree: "Gee, my healthcare is so cheap, it's surprising that it covers everything I want it to without me needing to go out of my way to justify my treatment options and I have so many medical professionals available to me at a moments notice!"
France is #1 in care according to the world health organization for 1/2 the cost per capita. It is all private, well-regulated, and provides universal coverage (your company pays your premium; if you have no employer, the govn't does). We are #37 according to the world health organization and we cost twice as much. I'm sure people in France complain, but they have way less of a reason to. Some reasons for the cost sa…
> We are #37 according to the world health organization and we cost twice as much.
Note that ranks alone are not sufficient to evaluate this comparison. If the top 40 countries for Healthcare outcomes all had near-equivalent mortality rates, e.g., it wouldn't necessarily be a problem to be #37.
That said, they don't have equivalent mortality rates, so the ranks do happen to discriminate quite a bit.
Earlier quoted context omitted.
> It’s really interesting how the US has managed to get a health system that’s extremely expensive, doesn’t cover everybody, is highly bureaucratic and complex, delivers below average outcomes and has overworked hospital staff. The healthcare industry (it should not be an "industry") in the US is all about extracting maximum profit for the benefit of middlemen. In a rational system, the only people who should be invo…
> In a rational system, the only people who should be involved in health care are the patients and the providers (doctors, nurses, technicians, etc) who actually provide health care. Nobody else should be involved, let alone skimming profits from the care. While I agree with the sentiment, hospitals require management to run well. They certainly don't need the amount of overhead they have, but it can't just be doctor…
I don't know how you can realistically look at this without thinking of the "I never thought leopards would eat MY face!!" meme. Politics matters. Voters in rural areas (generally, of course) have consistently voted against policies that would help support health care in these rural locations, such voting in politicians who are staunchly against Obamacare, who refuse any expansion or even adequate support for Medicai…
Except rural hospitals in blue states that expanded Medicaid, etc., are also at risk of closure: https://www.beckershospitalreview.com/finance/631-rural-hosp... . For example, 41% of rural hospitals in New York are at risk of closing, similar to the 38% in Florida, and a lot more than the 18% in Kentucky. Solid blue Washington is at 33%, worse than Iowa or Indians at 24 and 21%. Idaho, which you call out specifically…
Earlier quoted context omitted.
I'm not exactly sure what would drive rural hospitals to be a net drain unless they are "built too large" for the population, or are usually empty. Most of the rural hospitals I know will send you "to the big city" anyway for specialized procedures.
The same reason rural areas are a net drain in other ways. They have no efficiencies of scale and since everything is spread apart, providing services becomes more expensive and difficult. https://www.brookings.edu/research/why-rural-america-needs-c... > "This pattern holds for state government spending, too. Studies in Minnesota, Georgia, and Wisconsin reveal that metropolitan areas contribute more to state coffers…
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> So vote for my party or you don't deserve healthcare? What an enlightened liberal world view. What a silly mischaracterization of my point. That point being that actions have consequences, and sometimes unintended consequences. Since you seem to be taking a "tribal" approach to this, I'll flip things on their head. Voters (again, generally of course) in some urban areas have decided addressing inequalities in crimi…
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I don't know how you can realistically look at this without thinking of the "I never thought leopards would eat MY face!!" meme. Politics matters. Voters in rural areas (generally, of course) have consistently voted against policies that would help support health care in these rural locations, such voting in politicians who are staunchly against Obamacare, who refuse any expansion or even adequate support for Medicai…
Except rural hospitals in blue states that expanded Medicaid, etc., are also at risk of closure: https://www.beckershospitalreview.com/finance/631-rural-hosp... . For example, 41% of rural hospitals in New York are at risk of closing, similar to the 38% in Florida, and a lot more than the 18% in Kentucky. Solid blue Washington is at 33%, worse than Iowa or Indians at 24 and 21%. Idaho, which you call out specifically…
Irving, NY - Chautauqua County - Trump
Fulton, NY - Oswego County - Trump
Ticonderoga, NY - Essex County - Clinton
Amsterdam, NY - Montgomery County - Trump
Sidney, NY - Delaware County - Trump
- https://www.shepscenter.unc.edu/programs-projects/rural-heal...
- https://www.nytimes.com/elections/2016/results/president
Voting against Medicare or Obamacare aren't the only ways to vote against healthcare reform, as OP states:
> Politics matters. Voters in rural areas (generally, of course) have consistently voted against policies that would help support health care in these rural locations
Earlier quoted context omitted.
I'm not exactly sure what would drive rural hospitals to be a net drain unless they are "built too large" for the population, or are usually empty. Most of the rural hospitals I know will send you "to the big city" anyway for specialized procedures.
The same reason rural areas are a net drain in other ways. They have no efficiencies of scale and since everything is spread apart, providing services becomes more expensive and difficult. https://www.brookings.edu/research/why-rural-america-needs-c... > "This pattern holds for state government spending, too. Studies in Minnesota, Georgia, and Wisconsin reveal that metropolitan areas contribute more to state coffers…