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Health care is turning into a consumer product

economist.com

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Re: Health care is turning into a consumer product

#111

Post by dqpb »

dgb23 wrote: post #76
pjc50 wrote: post #54

Earlier quoted context omitted.

The problem is that "market" is a really bad fit for meeting healthcare needs, and doubly so when it's intermediated by insurers. People get the amount of healthcare they can afford from their discretionary budget and work their insurers for - not the amount they need. So they may get "more" (or at least more expensive) care than they need, or less. Note that many of the European systems are semi-private, so you reta…

I agree. The "everything is a market" ideology had a good run of almost half a century, but it should be heavily criticized in hindsight. Institutions like healthcare, education, public transport, prisons(!) and so on are more efficient, less corrupt and of higher quality when they are in large parts collectively and democratically organized and funded. The "in large parts" is important here: A community should agree…

> The "everything is a market" ideology had a good run of almost half a century

But that never actually happened. Externalities were never part of the market.

Re: Health care is turning into a consumer product

#112

Post by cntainer »

ErikVandeWater wrote: post #51
cntainer wrote: post #44

It's interesting to see that "Health care consumes 18% of GDP in America" compared to ~10% in most developed countries. In my (non-american) opinion part of that difference comes from the fact that healthcare is already a consumer product in the US. Maybe not entirely, but much more than in Europe, where universal healthcare sponsored by the state is the norm. Another point is that US healthcare is considered the mos…

> So you basically get the worst performing being also the most expensive. Which doesn't really fit the view that less government involvement results in a more efficient system. The US healthcare is an example of the government being massively over-involved and creating massive inefficiencies.

I guess my initial phrase is a bit superficial, from my European-centric point of view the US government seems less interested/involved in the health of their healthcare system compared to what I'm seeing in europe.

The point I was trying to make is that government involvement is needed to make sure that the right incentives are in place at all times for all involved actors (public or private). And if the system becomes dysfunctional or is abused it's the government's job to fix it.

Most of the countries that have universal healthcare in Europe have their own take on how it should be done: - France has state funded insurance and (mostly) state funded services - Switzerland private insurance and private/public services

Two totally different takes with arguably very similar (good) results.

The goal of government involvement should be to make sure everyone has access to basic healthcare and avoid double standards and abuse.

Re: Health care is turning into a consumer product

#113

Post by papito »

Which is an anti-pattern. Healthcare is not a product with supply and demand dynamics of, say, cars. Capitalism does not help with its delivery. Biotech, equipment manufacturing, yes, but not delivery.

"I am just not going to get sick" is not a strategy. No one can control the inherent risk of life. Slipped, swiped by a car, and since we are talking about the United States, let's just go there - caught in a crossfire.

Re: Health care is turning into a consumer product

#114

Post by analog31 »

kzzzznot wrote: post #78
cpursley wrote: post #40

Earlier quoted context omitted.

You missed maybe the most important thing: Allow cities for humans to be built. The American suburbia model is unhealthy on so many different levels. This only became apparent to me on my trips back stateside after living in Europe for a while.

Can you expand on that or provide an article please? Sounds interesting

This is an interesting series of videos:

https://www.youtube.com/channel/UC0intLFzLaudFG-xAvUEO-A

Clearly, they mainly focus on cycling being the solution, but still, the overall analysis seems quite good.

Re: Health care is turning into a consumer product

#115

Post by papito »

Ensorceled wrote: post #109
causi wrote: post #50

Earlier quoted context omitted.

Another point is that US healthcare is considered the most expensive and worst-performing in terms of outcomes compared to the other developed countries. Not that your thesis isn't correct but be careful there. You're combining the cost of care for the people who get care with an average outcome that includes people who don't get care. The quality of care for Americans who can afford care is excellent.

> The quality of care for Americans who can afford care is excellent. As a Canadian who knows many Americans, works for a US company and has extended US family, this is not quite true. Most Americans "who can afford care", maximum 70%, have access to medical care that is on par with Canadian health care, but is fraught with peril; "booby traps" such as out of network costs, high co-pay fees that can bankrupt, surpris…

Also, this idea that Elon Musk is going to wait in line to get a checkup is ridiculous. Those who can afford it will always be able to buy premium care. But we have millions of people who are waiting to be financially ruined by an act of God.

Re: Health care is turning into a consumer product

#116

Post by UglyToad »

mrsuprawsm wrote: post #35

This seems more like a symptom of the wildly broken American health-care system than anything else. In countries with a more functioning healthcare system, disruption of the status quo (especially by VC-funded private companies seeking a large payday) is neither necessary or desirable, slow iterative improvements are the name of the game. Furthermore, the US spends far more per capita than every other country on heal…

To add to this, the absurdity of the 'healthcare' system in the US is made even more apparent as a non-US citizen buying health insurance for (long-term) international travel.

Firstly (loosely regulated) insurance is an absolutely stupid way to provide healthcare. Pre-existing conditions? Maybe you just don't deserve to live, either way we're witholding life-saving care from you because our tables say so. Need to claim near the start of your cover? You must be lying about pre-existing conditions. Need to fix something that wasn't acute enough to seek care about previously? Nope, no cover for you. And on and on and on. Anyone who thinks an insurance market is a solution for healthcare is just an idiot, there's no way around that. (I realise some universal systems run on a private insurance basis but they're a lot more regulated)

But then, even in that entirely messed up system, designed to cut you off from urgently needed medical care, all policies are divided into 'regions'. There's not much cost difference between regions until you get to any region "including the US". It's even named, the only country in the world they do that for. That's how badly those guys have messed up their healthcare system. And if you select that? It's at least double the cost, for no extra cover in terms of policy limits.

That for me clarified that, no, I wasn't missing anything. Anyone who supports the current US system is so far removed from the commonly inhabited reality that none of their opinions are worth listening to.

Re: Health care is turning into a consumer product

#117

Post by Ensorceled »

papito wrote: post #115
Ensorceled wrote: post #109

Earlier quoted context omitted.

> The quality of care for Americans who can afford care is excellent. As a Canadian who knows many Americans, works for a US company and has extended US family, this is not quite true. Most Americans "who can afford care", maximum 70%, have access to medical care that is on par with Canadian health care, but is fraught with peril; "booby traps" such as out of network costs, high co-pay fees that can bankrupt, surpris…

Also, this idea that Elon Musk is going to wait in line to get a checkup is ridiculous. Those who can afford it will always be able to buy premium care. But we have millions of people who are waiting to be financially ruined by an act of God.

The very rich in Canada mostly go to the US for extraordinary health care (surgeries etc.), the very rich will always find a way to skip the line.

Re: Health care is turning into a consumer product

#118

Post by virgilp »

netizen-936824 wrote: post #86
virgilp wrote: post #84

Earlier quoted context omitted.

But how is that not "expected"? Feels like the argument that "communism is good, it just wasn't implemented well anywhere so far". Well, sorry, but by this point I chose to believe that a full state-run system is vulnerable to under-funding in the long term.

So we should just expect people to be greedy and try to ruin systems for their own benefit. That raises the question of how to make these systems more robust to defend against that sort of attack.

Exactly. Expecting people to be generous and collaborative and selfless and whatnot is just asking for trouble.

Note that I'm not saying that people are not/ cannot be generous, selfless etc. I'm saying that relying on them being so is a crappy strategy. You need a system that continues to work in the presence of greedy people.

Re: Health care is turning into a consumer product

#119

Post by omosubi »

dgb23 wrote: post #76
pjc50 wrote: post #54

Earlier quoted context omitted.

The problem is that "market" is a really bad fit for meeting healthcare needs, and doubly so when it's intermediated by insurers. People get the amount of healthcare they can afford from their discretionary budget and work their insurers for - not the amount they need. So they may get "more" (or at least more expensive) care than they need, or less. Note that many of the European systems are semi-private, so you reta…

I agree. The "everything is a market" ideology had a good run of almost half a century, but it should be heavily criticized in hindsight. Institutions like healthcare, education, public transport, prisons(!) and so on are more efficient, less corrupt and of higher quality when they are in large parts collectively and democratically organized and funded. The "in large parts" is important here: A community should agree…

Re: prisons - This isn't necessarily the case. Florida's private prisons have air conditioning and the public ones don't in part because of democratic control and the private ones have fewer deaths from heat stroke as a result.

Re: Health care is turning into a consumer product

#120

Post by onlyrealcuzzo »

toolz wrote: post #97
cntainer wrote: post #44

It's interesting to see that "Health care consumes 18% of GDP in America" compared to ~10% in most developed countries. In my (non-american) opinion part of that difference comes from the fact that healthcare is already a consumer product in the US. Maybe not entirely, but much more than in Europe, where universal healthcare sponsored by the state is the norm. Another point is that US healthcare is considered the mos…

I'm curious how you can suggest the US government spends the most money in the world, by far, on healthcare and the simultaneously suggest there's less government involvement. The government is involved in every step of American healthcare. As you can imagine of a system that gets all of its funding thru companies completely overseen by regulatory bodies or thru social programs.

Compared to a single-payer socialized system, this is less involvement - even if it is a lot of involvent.
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