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Financial lessons from my family's experience with long-term care insurance

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Re: Financial lessons from my family's experience with long-term care insurance

#161

Post by Ekaros »

Yeul wrote: post #131
silisili wrote: post #74

Earlier quoted context omitted.

Healthcare is little more than a jobs program at this point. I believe it is the largest industry by employment in every single state now. That compounds the problem even further. Really fixing it would put a double digit percentage of people out of work. I'm all for it, but I can see why politicians are hesitant.

That is not exclusively an American thing. In my country currently 17% of the workforce is in healthcare. Probably need to start exporting more old folks to 3rd world countries where they can live out their days in resorts.

Or simply let them die when they are too old to survive without most basic automatable care. Say robot dropping food at the door.

Re: Financial lessons from my family's experience with long-term care insurance

#162

Post by Pooge »

refurb wrote: post #151
joe_the_user wrote: post #143

Earlier quoted context omitted.

Most other advanced nations have nationalized health care which works much better. The US health care system is broken because health care is a natural monopoly that US free-market ideology dictates be run with (fake) "free markets" with result being a variety of companies profiting by abusing the system.

> Most other advanced nations have nationalized health care which works much better. That's not true by the definition of "nationalization" (government ownership) Switzerland and Netherlands are entirely private insurance. Most European countries have a public system and private system. It's very common for people to purchase supplemental insurance on top of what the government provides.

In the case of Switzerland, basic health insurance is provided by private companies but the price is mostly fixed by the Federal government.

Prices do vary between companies but many people just use the official insurance comparison tool and choose the cheapest as the services are completely identical. I'm completely against that system and would prefer a national health insurance like Japan.

Re: Financial lessons from my family's experience with long-term care insurance

#163

Post by lenkite »

bruce511 wrote: post #157
apwell23 wrote: post #147

Earlier quoted context omitted.

other nations get benefits from 1. US subsidizing pharma startups and 2. less people with chronic diseases 3. offer lower quality of care at lower price point 4. import doctors vs solely rely on homegrown USA is very very good at complicated, cutting edge medical care but not efficient at delivering routine care.

It's complicated, yes, but simplifying somewhat the "US" does not subsidize pharma startups. Yes, VCs do put money into pharma, but that's private money very much expecting an (overall) profitable return. (Ironically most of that profit comes from Americans who have little or no way to collectively bargain on pricing.) And yes, for bigger companies, there are tax breaks etc, but most of those are regular tax breaks t…

> It's complicated, yes, but simplifying somewhat the "US" does not subsidize pharma startups.

This is utterly false. Agencies like NIH, BARDA, and NSF fund early-stage biomedical R&D by providing SBIR/STTR grants to biotech and pharma startups. They also fund basic research and clinical trials as well as translational studies.

There is the Orphan Drug Tax Credit and R&D Tax Credit. Also, access to NIH labs, etc.

There is a whole plethora of funding. Moderna’s mRNA platform was heavily backed by NIH and BARDA even before COVID.

Re: Financial lessons from my family's experience with long-term care insurance

#164

Post by apwell23 »

bruce511 wrote: post #157
apwell23 wrote: post #147

Earlier quoted context omitted.

other nations get benefits from 1. US subsidizing pharma startups and 2. less people with chronic diseases 3. offer lower quality of care at lower price point 4. import doctors vs solely rely on homegrown USA is very very good at complicated, cutting edge medical care but not efficient at delivering routine care.

It's complicated, yes, but simplifying somewhat the "US" does not subsidize pharma startups. Yes, VCs do put money into pharma, but that's private money very much expecting an (overall) profitable return. (Ironically most of that profit comes from Americans who have little or no way to collectively bargain on pricing.) And yes, for bigger companies, there are tax breaks etc, but most of those are regular tax breaks t…

> (Ironically most of that profit comes from Americans who have little or no way to collectively bargain on pricing.)

Thats what i meant by US subsidizing pharma for the whole world. I didn't mean the us govt.

Would they continue to exist if every single country in the world is doing "collective bargaining"?

Re: Financial lessons from my family's experience with long-term care insurance

#165

Post by tim333 »

WalterBright wrote: post #155
joe_the_user wrote: post #143

Earlier quoted context omitted.

Most other advanced nations have nationalized health care which works much better. The US health care system is broken because health care is a natural monopoly that US free-market ideology dictates be run with (fake) "free markets" with result being a variety of companies profiting by abusing the system.

If they're fake free markets then free market ideology doesn't apply. > health care is a natural monopoly It obviously isn't, because it wasn't a monopoly before the 1960s when the government got involved in it.

It's actually kind of refreshing to use free market lightly regulated medicine. I live in the UK where it's NHS government funded or related but travelling in Asia without insurance you can actually shop around and buy stuff - how much for a doc, how much for an xray etc. It's mostly quite cheap too. If you remove most of the regulatory barriers things work quite well. Obviously doctors and the like should pass exams for competence but I'm not sure you need to restrict it to only x people through y colleges in z country to restrict the supply. If the US said that to practice medicine and all you needed was a medical qualification from any respectable country it could drop costs like 10x I'd guess.

Re: Financial lessons from my family's experience with long-term care insurance

#166

Post by Yeul »

WalterBright wrote: post #155
joe_the_user wrote: post #143

Earlier quoted context omitted.

Most other advanced nations have nationalized health care which works much better. The US health care system is broken because health care is a natural monopoly that US free-market ideology dictates be run with (fake) "free markets" with result being a variety of companies profiting by abusing the system.

If they're fake free markets then free market ideology doesn't apply. > health care is a natural monopoly It obviously isn't, because it wasn't a monopoly before the 1960s when the government got involved in it.

You cannot free market healthcare because quite frankly there is no real profit in this industry.

Yeah even your high net worth client that pays 50k in premiums every year wipes you out when they get some complicated form of cancer.

Edit this actually came up in a videogame called Cyberpunk. A lot of people here on HN consider themselves code wizards indispensable to their employer. Google will replace your multiple sclerosis ass.

Re: Financial lessons from my family's experience with long-term care insurance

#167

Post by throw-the-towel »

Dilettante_ wrote: post #160
jancsika wrote: post #148

Earlier quoted context omitted.

> Whereas the software industry, with near zero government involvement, has had enormous improvements in function and has pushed the cost to literally zero. What's most frustrating about this-- just take the poultry industry. To bring the cost to zero, all it would take is a single hacker to steal one government-regulated chicken and click "Copy" in its elusive little context menu[1]. Try telling that to a young pers…

Sorry, but I'm completely lost on the chicken point. Would you mind expanding on that just a little more? Is the gov't keeping secret vat-grown super-chickens?

I think they're implying that software is completely unlike healthcare or chickens. One can be multiplied for free but the others cannot, no matter if regulated or not.

Re: Financial lessons from my family's experience with long-term care insurance

#168

Post by satyrun »

gosub100 wrote: post #23
GnarfGnarf wrote: post #4

There are three things a nation needs to accept about universal health care: (1) It’s expensive (2) Everybody has to pay (3) The government’s gotta run it

Computers and software used to be extremely expensive about 30 years ago, yet private industry advanced the state of the art and brought the prices down. There seems to be very little talk about making medical education cheaper and more accessible. Why wouldn't it be cheaper if we had more MDs and nurses? What if we made it easier to become an MD ? The insurance system is a cartel and they are greedy. However the reg…

Health care is so different though because the market doesn't work.

If you are facing death, no one wants the off brand, budget cancer treatment. No one is going to shop around for the best value cancer treatment.

If you have a heart attack, no one is going to call around for the best price on the ambulance.

It is like a luxury market. People shop around for the best doctor/treatment with no regard at all for the price.

So it is like complaining that a luxury service market is expensive.

The only way around this is a completely state run health care system that you have no choice.

Re: Financial lessons from my family's experience with long-term care insurance

#169

Post by b112 »

Avicebron wrote: post #79
silisili wrote: post #74

Earlier quoted context omitted.

Healthcare is little more than a jobs program at this point. I believe it is the largest industry by employment in every single state now. That compounds the problem even further. Really fixing it would put a double digit percentage of people out of work. I'm all for it, but I can see why politicians are hesitant.

> Really fixing it would put a double digit percentage of people out of work. I'm all for it, but I can see why politicians are hesitant. I'd love to hear what you think "really fixing it" is, please share. I can report that all (almost all?) of the hospitals and their networks both big and small in the area I am in have had layoffs this year of admin staff and healthcare professionals (nurses, doctors, etc). They ha…

Beyond it being normally weird, that's a very weird thing to do.

With the aging population, we'll need more and more health care professionals. I'm not just referring to people over 60, even people 40 upwards require more care.

Re: Financial lessons from my family's experience with long-term care insurance

#170

Post by jalapenos »

One thing I don't get, given all the talk that the US healthcare system is like it is "because capitalism" - is why doesn't supply increase given the sky high costs?

You'd think with the insane money the system is gouging out of people, every man and his dog would be trying to get a bite?

Also sounds like buying insurance isn't enough there, you'd have to buy some kind of insurer management service to deal with all the bullshit required to claim

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