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Richard Lynch, an awesome PHP community guy and former colleague needs our help

richardlynch.blogspot.com

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Re: Richard Lynch, an awesome PHP community guy and former colleague needs our help

#291

Post by lotharbot »

mikeash wrote: post #286
lotharbot wrote: post #285

Earlier quoted context omitted.

> ""The best health care system in the world" is a pretty common refrain among American right wingers" In my experience, the right wing perspective is more like "some of the best health care procedures, embedded in a payment/distribution/insurance system that sucks". One of the biggest fears is that the few things American healthcare does well will be sacrificed, and the things that are wrong with the system won't ac…

The two aren't incompatible. I agree with you about the details of the views, but they still generally think it's the best in the world.

Right, but I think "best in the world" is more a negative comment about other systems being terrible than a positive comment about this system being actually good.

Re: Richard Lynch, an awesome PHP community guy and former colleague needs our help

#292

Post by arg01 »

cwaniak wrote: post #284
huherto wrote: post #278

Earlier quoted context omitted.

That is simply not true. Centralized economic solutions work better for some things. Free market soluctions work for other types of things. The USSR was a dictatorship where everything was managed by the State. This is not what it is being proposed.

> Centralized economic solutions work better for some things. I could also say that 2 and 2 not always is 4. Please give concrete examples.

Tragedy of the commons type problems. Concrete example: CFC Regulations.

Prisoners Dilema type problems. Concrete example: Cigarette advertising bans. (I'll clarify that this is better for the companies involved on a competition between company basis and "better" for the public in the form of a shrinking tobacco market)

More to the point a real concrete example is healthcare costs. Per person they are cheaper in comparable countries to the US such as UK, Australia, Canada all countries with public healthcare systems (this is including the tax money spent). I would also point out that if you are going to argue that health outcomes are better in the US than those other systems (Maybe that's true, I couldn't say) you are missing the key point of what these non free market systems can be good at (that is capturing externalities, like in this instance bankruptcy or inability to afford service).

Re: Richard Lynch, an awesome PHP community guy and former colleague needs our help

#293

Post by specialist »

cwaniak wrote: post #284
huherto wrote: post #278

Earlier quoted context omitted.

That is simply not true. Centralized economic solutions work better for some things. Free market soluctions work for other types of things. The USSR was a dictatorship where everything was managed by the State. This is not what it is being proposed.

> Centralized economic solutions work better for some things. I could also say that 2 and 2 not always is 4. Please give concrete examples.

I've got a better idea.

You give concrete examples of decentralized (unregulated) markets working better than open (regulated) markets.

I could also say that 2 and 2 not always is 4.

I don't doubt it.

Re: Richard Lynch, an awesome PHP community guy and former colleague needs our help

#295

Post by mikeash »

lotharbot wrote: post #291
mikeash wrote: post #286

Earlier quoted context omitted.

The two aren't incompatible. I agree with you about the details of the views, but they still generally think it's the best in the world.

Right, but I think "best in the world" is more a negative comment about other systems being terrible than a positive comment about this system being actually good.

My experience is that the system outside of payments and such is seen as superb (when it's actually average), and the rest is seen as OKish (when it's terrifyingly bad).

I was discussing health care reform with one fellow who was under the mistaken impression that outcomes in the US were significantly better. After I explained that people in countries with socialized medicine get care that's just as good as ours, he asked me, "OK, but then why do we need to change anything?" He really thought that the current system, if not great, was still perfectly fine. I've seen that a lot.

There is, no doubt, a wide spectrum of beliefs. But don't underestimate the number of people who think the system is pretty good overall. Really, just look at the total lack of any credible alternative reform put forth by the right wing. They talk big, but they don't seem to come up with anything beyond "leave it alone". They're stuck in kind of a tough position, because they've been advocating government non-interference and free-market solutions for so long, yet they're not in a place where it's acceptable to say that poor people should die in the streets from treatable conditions, even though that's what a free market solution gives you. As a result, there's a huge incentive to convince people that the way things are right now is just fine.

Re: Richard Lynch, an awesome PHP community guy and former colleague needs our help

#296

Post by mikeash »

cwaniak wrote: post #273
specialist wrote: post #270

Earlier quoted context omitted.

massively corrupt The data, comparative experiences, and commons sense, disagrees with you. Single payer is easier to audit. Because it's more simple. Healthcare Fraud: Auditing and Detection Guide [2012] http://www.amazon.com/Healthcare-Fraud-Auditing-Detection-Gu... Healthcare Fraud: Auditing and Detection Guide [2007] http://www.amazon.com/Healthcare-Fraud-Auditing-Detection-Gu... And before you say "tort reform",…

of course! Centralized economic solutions always work the best. The USSR is the best example of that. You people go back to coding and leave economics to economists.

I'll leave economics to economists the moment economists can agree on, well, anything.

Re: Richard Lynch, an awesome PHP community guy and former colleague needs our help

#297

Post by mikeash »

Xdes wrote: post #244
sp332 wrote: post #242

Earlier quoted context omitted.

I'm against public healthcare in the USA because there's no way (in the current political climate) it won't be massively corrupt. Did you know the insurance companies were lobbying in favor of our new system? It's still about corporations making profits.

Public healthcare ought to be implemented at the local level for those that want it (which I don't). I'm quite fine with not seeking treatment when I get a terminal illness. If it ever gets to that point I would prefer euthanasia (illegal in the USA).

What if you get hit by a bus and go into a coma and your treatment costs millions of dollars? If you're not awake, you can't refuse treatment.

Re: Richard Lynch, an awesome PHP community guy and former colleague needs our help

#298

Post by mikeash »

natrius wrote: post #206
secstate wrote: post #201

Earlier quoted context omitted.

But 90% of the world doesn't die from exotic cancers, at least not below the age of 50 (or 60 ... keeps creeping up). The idea that advanced medicine is an justification for for-profit medicine is a straw man argument. The reality is that there are many more nuanced single-payer healthcare systems in the world than the one where the government tells you who gets to live and who gets to die. In the U.K. for example, t…

I don't fear the rest of the world getting better than us at medicine. Money motivates most people. The best doctors will go where they can get the most money. That is here. If I had to pick between the UK's system, where price controls help pay for healthcare for those who can't afford it, and the Affordable Care Act, where wealthy people pay for healthcare for those who can't afford it, I'd choose the Affordable Ca…

Why do you think the reality is completely contrary to what you explain? Care in the UK is just as good, and costs less overall.

Re: Richard Lynch, an awesome PHP community guy and former colleague needs our help

#299

Post by crag »

santosha wrote: post #259
colechristensen wrote: post #250

Earlier quoted context omitted.

The thing that seems to be missing from most people's argument is that the cost doesn't go away if you move to a single-payer healthcare system. You still pay for that $75k in the form of higher taxes and higher prices... it doesn't get erased. Wanting a non-standard treatment and not being approved won't change with single-payer... you'll still have to sell everything you own to pay for it.

Saying the cost doesn't 'go away' is deflecting from the fact that it does reduce overall, because of a number of reasons. Administrative costs are vastly reduced. Employers no longer have to negotiate individual contracts with insurers. Hospitals don't need huge administrative staff for deals with different insurers and paperwork for each one. On the whole, the cost savings from moving to single-payer take a huge bi…

" Administrative costs "

They are HUGE. I work in the field (writing software). Every insurance company has it's own forms and payments requirements. So do governments, local, state and federal. Not to mention reporting requirements. Throw in other insurances such as schools, the VA (and TriCare), Medicare, Medicare Disability (they are different by the way) and Medicaid - and the hundreds of other sources I've missed. This all equals to a administrative nightmare. A cluster-fuck. A huge expense the hospitals and doctors have to deal with. And you'd think moving to electronic medical systems would fix this.

And this is one of the big reasons healtcare.gov failed the first time out.

Re: Richard Lynch, an awesome PHP community guy and former colleague needs our help

#300

Post by JimDabell »

mikeash wrote: post #234
lotharbot wrote: post #180

Earlier quoted context omitted.

> "you can get this public picture that everything is great" I'm not aware of anyone, from any political background, who thinks the US system is anything above "pretty crappy". I've heard some people express positive sentiments regarding small parts of the system -- the quality of certain types of care, for example -- but never for the system as a whole. The primary disagreements I'm aware of concern how to fix the c…

"The best health care system in the world" is a pretty common refrain among American right wingers. Many of them truly think that we are #1 in this area and that the great tragedy of socialization will be destroying that.

The USA has the best health care money can buy. The problem is that some people only see the first half of that sentence and it's the second half that's so damaging to society.
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