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The American Healthcare Conundrum

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Re: The American Healthcare Conundrum

#311

Post by bojangleslover »

It's neither capitalist nor socialist. If it were fully socialist you would have long wait lists but it would be free and there would be one payer. It is like this for Medicare and Medicaid which I've heard are a fantastic UX. But this is only the case for about half of Americans (the ones who don't pay for it).

On the other side, if it were fully capitalist you would be able to see the price and walk away if you didn't like it. This is what makes capitalism work. Your margin is my opportunity. Instead, the upper middle class, who pays for everything already, and is unable to use Medicaid, is forced to use a certain "network" of providers and never, ever sees the price upfront. This is the cornerstone of capitalism. Does the buyer like the price? If so, transact. It's completely not there. Instead, it's actively discouraged and banned, and the price is maximized post-hoc by the same entities who negotiate directly with the employee's employer. Ie, a quantitative shakedown.

Re: The American Healthcare Conundrum

#312

Post by ptsneves »

sneak wrote: post #275
dyauspitr wrote: post #273

Earlier quoted context omitted.

It’s what all of Asia does and it’s very effective. Make people’s weight their primary problem until they resolve it. It’s not like it is some unchangeable attribute that can’t be fixed through self control and discipline. The shaming is just unsolicited motivation that works. I feel sad if people are made fun of for attributes they can’t change.

If everyone could control their weight via simply willing themselves to have more self-control, then nobody would be fat. Self-control is, ironically, not usually within one’s self control. Most people don’t contemplate very deeply about the gap between their will and their behavior. I’m extremely focused on self-determination and it’s absolutely astounding (and irritating) to me how little control I have over my act…

> Self-control is, ironically, not usually within one’s self control.

Problem solved. Next!

Re: The American Healthcare Conundrum

#313

Post by TheOtherHobbes »

bojangleslover wrote: post #311

It's neither capitalist nor socialist. If it were fully socialist you would have long wait lists but it would be free and there would be one payer. It is like this for Medicare and Medicaid which I've heard are a fantastic UX. But this is only the case for about half of Americans (the ones who don't pay for it). On the other side, if it were fully capitalist you would be able to see the price and walk away if you did…

Waitlists are a function of funding, not a direct abstract consequence of socialism. Countries with single payer that have adequate funding - with single payments from taxes that are hugely lower per capita than the US system - do not have long wait lists.

As for walking away - it's hard to do that if you're dying or unconscious.

And of course corporate capitalism always collapses to cartels and monopolies.

The idea that a free market optimised for consumer competition is a mythology, not a reality.

Markets compete for shareholder returns, not customer satisfaction. Customers are only ever a convenient source of profit with inconvenient expectations of service quality and cost.

Re: The American Healthcare Conundrum

#314

Post by a_victorp »

legitster wrote: post #91
graemep wrote: post #60

> The US spends ~$14,570 per person on healthcare. Japan spends ~$5,790 and has the highest life expectancy in the OECD. That gap is roughly $3 trillion per year. The difference in life expectancy will be influenced by multiple factors and may have more to do with diet and lifestyle than with healthcare. Japan also spends less per capita than the UK, France or Germany. The US spends a lot more than any of those so th…

The US also has GDP per capita of $90k and Japan has a GDP per capita of ~ $35k. Put another way, in both countries a hip replacement surgery is almost exactly 1/8 of someone's per capita GDP.

The median salary in the US is around $61k a year and in Japan is around $42k a year. Salary-wise the difference is not as big as GDP per capita

Re: The American Healthcare Conundrum

#316

Post by Doable0896 »

bojangleslover wrote: post #311

It's neither capitalist nor socialist. If it were fully socialist you would have long wait lists but it would be free and there would be one payer. It is like this for Medicare and Medicaid which I've heard are a fantastic UX. But this is only the case for about half of Americans (the ones who don't pay for it). On the other side, if it were fully capitalist you would be able to see the price and walk away if you did…

> If it were fully socialist you would have long wait lists but it would be free and there would be one payer.

That is a crazy thing to say. Not saying that it can't be true, but a socialist system doesn't mean automatically long wait lists.

Re: The American Healthcare Conundrum

#317

Post by Ylpertnodi »

bojangleslover wrote: post #311

It's neither capitalist nor socialist. If it were fully socialist you would have long wait lists but it would be free and there would be one payer. It is like this for Medicare and Medicaid which I've heard are a fantastic UX. But this is only the case for about half of Americans (the ones who don't pay for it). On the other side, if it were fully capitalist you would be able to see the price and walk away if you did…

>If it were fully socialist you would have long wait lists but it would be free [....]

No. Wouldn't wait times are dictated by supply (doctors) and demand (patients), not the political system?

Re: The American Healthcare Conundrum

#318

Post by hdgvhicv »

sneak wrote: post #275
dyauspitr wrote: post #273

Earlier quoted context omitted.

It’s what all of Asia does and it’s very effective. Make people’s weight their primary problem until they resolve it. It’s not like it is some unchangeable attribute that can’t be fixed through self control and discipline. The shaming is just unsolicited motivation that works. I feel sad if people are made fun of for attributes they can’t change.

If everyone could control their weight via simply willing themselves to have more self-control, then nobody would be fat. Self-control is, ironically, not usually within one’s self control. Most people don’t contemplate very deeply about the gap between their will and their behavior. I’m extremely focused on self-determination and it’s absolutely astounding (and irritating) to me how little control I have over my act…

Companies make a fortune from creating that lack of “self control”

Re: The American Healthcare Conundrum

#319

Post by kasey_junk »

tptacek wrote: post #271
duped wrote: post #269

Earlier quoted context omitted.

Even if it's 10% in aggregate it could be much higher for individuals and families that are screwed over by drug pricing. But anyway we really do need to go after providers and end the racket that is employer provided health insurance.

Wait, I hate employer-provided health insurance and think it's a terrible policy but what does that have to do with providers charging everyone --- including Medicare! --- way too much for services?

It’s a round about recognition of the agency problem in the medical industry.

If people chose and directly paid for there own medical bills and insurance then extra fees and extra diagnostics would be born directly by the person paying for it, who would have the freedom to make other choices, like picking insurance providers who were better at preventing it.

At least that’s an argument you can reasonably make. I’m not sure it would hold up in practice given how different medicine is from other markets.

Re: The American Healthcare Conundrum

#320

Post by lotsofpulp »

nradov wrote: post #252
lotsofpulp wrote: post #231

Earlier quoted context omitted.

Your claim was > Commercial insurers would be happy to sell plans that pay every claim that comes in at 100% with zero denials. And yet I have never seen one of these after buying insurance in 3 different states. Again, the grandparent claim was that insurance companies can increase profits simply by increasing their expenses. Yet there is no evidence of this, and the fact that everyone has to deal with approval and…

You're really missing the point. Have you ever been in charge of employee benefits for a large group buyer? Obviously such plans aren't available to individual consumers but commercial carriers will absolutely customize products for larger customers.

timtim51251 wrote this:

> The actual reason commercial insurers pay more is that's the only way to can make more profits.

>Because of Obamacare requiring 80% of the money they collect to be spent, the insurance companies just get to keep 20%. So insurance companies spend more so they can collect higher premiums. That's how they make more money.

dmitrgyr wrote this:

> Ding Ding Ding. We have the correct answer. And this was a predicted consequence of that profit cap.

These statements indicate there should exist an insurance plan with a policy to pay for anything and everything. It does not matter what large self insuring employers choose to buy, as there are still significant number of people covered by non employer insured health plans.

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