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I write about America’s health care system, and I got caught up in it

nakedcapitalism.com

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Re: I write about America’s health care system, and I got caught up in it

#141
post #125

Earlier quoted context omitted.

> This account, or at least should account, for a very small minority of interactions with healthcare facilities. sadly its not. you're in pain? you need to visit a medical facility to figure out whats wrong. without knowing how serious it is it can lead to a life long issue. again you don't really have choices here. pay the healthcare tax or risk long term issues. there is a reason preventative medicine is cheaper (…

> sadly its not. you're in pain? you need to visit a medical facility to figure out whats wrong. without knowing how serious it is it can lead to a life long issue. again you don't really have choices here. pay the healthcare tax or risk long term issues. I don't see how that is a congruent thought. The 'sadly it's not' doesn't follow from your statement after. If you are in pain without knowing how serious it is, yo…

> If you are in pain without knowing how serious it is, you would likely get opinions from several doctors.

> You're not going to walk into the first hospital you find and say "I'll pay anything you ask just fix me."

these two statements are functionally equivalent. by running around paying every hospital for opinions you're literally saying 'I'll pay anything you ask just fix me'. It also tracks with my statement that medical pricing isn't influenced by rational markets which are what is required for a capitalist free market to 'work'. people need to be able to say 'this is unnecessary' which never happens in health care.

In healthcare you have two modes: 1. I can afford the care, price is fairly immaterial make me better. 2. I can't afford the care, doesn't matter what the price is.

> that backs my point, right? Those hospitals aren't funded by emergency care either, which means the point about costs being a one sided negotiation while the other party is dying is still inaccurate.

not sure how you get to this idea. the point is you're hung up on the dying aspect which is basically immaterial. I can torture you and get you to say anything I want. medical care is basically the same thought process for those who need care. The only thing that prevents people from paying any price is literally not being able to afford it. Otherwise people will 100% bankrupt themselves to make pain go away.

Given that the majority of bankruptcies in the US are due to health care just proves this point.

There is no way to make this kind of market work in a 'free' market system.

> I don't see any reason why taxpayers should pay so a small mountain town

we already do. you can argue whatever you want but as a society we've already mandated this level of access. for the same reason we've mandate fire and police coverage. its a public safety issue and a tax payer in bum fuck no where have the same right to have their taxes ensure they're covered as joe shmoe in NYC.

There are MANY reasons why this is economically a good thing via 2nd/3rd order effects that more than pays for itself.

> I don't think recognizing the limits of a given resource is cruel or immoral, it's reality.

every country with universal coverage disagrees with you. I'm not going to belabor this point further. Reality has proven otherwise. The US system is just completely dysfunctional. and thinking otherwise DOES make you cruel and immoral. If you want to discuss how to make a healthcare system that works, fine, but I'm not going to moralize with you on a clearly disgusting world view.

Re: I write about America’s health care system, and I got caught up in it

#142
post #141

Earlier quoted context omitted.

> sadly its not. you're in pain? you need to visit a medical facility to figure out whats wrong. without knowing how serious it is it can lead to a life long issue. again you don't really have choices here. pay the healthcare tax or risk long term issues. I don't see how that is a congruent thought. The 'sadly it's not' doesn't follow from your statement after. If you are in pain without knowing how serious it is, yo…

> If you are in pain without knowing how serious it is, you would likely get opinions from several doctors. > You're not going to walk into the first hospital you find and say "I'll pay anything you ask just fix me." these two statements are functionally equivalent. by running around paying every hospital for opinions you're literally saying 'I'll pay anything you ask just fix me'. It also tracks with my statement th…

> by running around paying every hospital for opinions you're literally saying 'I'll pay anything you ask just fix me'

No you're not. You can choose which hospitals you're getting opinions from.

> In healthcare you have two modes: 1. I can afford the care, price is fairly immaterial make me better. 2. I can't afford the care, doesn't matter what the price is.

No it doesn't. I've shopped around for PCP. It wasn't like that at all. Do you think every doctor works in an inner city ICU or something? I'm not sure where you're pulling this view from.

> Given that the majority of bankruptcies in the US are due to health care just proves this point.

What point does it prove? I don't really see what point you're making. Is it the US system has major problems? If so, I agree. Is it that nationalized healthcare is the best choice? I haven't seen you make an argument for that at all other than conjuring your own personal ethical code.

> these two statements are functionally equivalent

I'm trying to make a coherent point, so that makes sense.

> not sure how you get to this idea. the point is you're hung up on the dying aspect which is basically immaterial...

So you agree with me now? Emergency care doesn't play a major role in the market?

> we already do. you can argue whatever you want but as a society we've already mandated this level of access

I'd like to see the mandate you're referencing. Sounds like you actually agree with codifying qualifying circumstances for care ;)

> every country with universal coverage disagrees with you

No they don't. Countries with nationalized healthcare routinely ration care. They recognize limited resources same as us, just through a bureaucratic system a oppose to a market system. Just because it's a man with an office deciding if you get to see the doctor rather than your bank account doesn't make it morally superior.

> If you want to discuss how to make a healthcare system that works, fine

This is the discussion I've been getting at the whole time. You're the one constantly conjuring some vague sense of morality as opposed to discussing which models may work better than others.

Re: I write about America’s health care system, and I got caught up in it

#143
post #141

Earlier quoted context omitted.

> If you are in pain without knowing how serious it is, you would likely get opinions from several doctors. > You're not going to walk into the first hospital you find and say "I'll pay anything you ask just fix me." these two statements are functionally equivalent. by running around paying every hospital for opinions you're literally saying 'I'll pay anything you ask just fix me'. It also tracks with my statement th…

> by running around paying every hospital for opinions you're literally saying 'I'll pay anything you ask just fix me' No you're not. You can choose which hospitals you're getting opinions from. > In healthcare you have two modes: 1. I can afford the care, price is fairly immaterial make me better. 2. I can't afford the care, doesn't matter what the price is. No it doesn't. I've shopped around for PCP. It wasn't like…

> No you're not. You can choose which hospitals you're getting opinions from.

you clearly don't understand how hospitals work. getting opinions costs money. just visiting and taking their time costs money.

you can get a hospital to quote you the cost of a procedure. but to actually get a doctor to diagnose you takes time, resources, and tests. this costs money. and without doing said work you have no idea what procedures to get a quote for.

and frankly the only reason to get multiple opinions is if the current doctor has failed to resolve your problem.

no one jumps doctor to doctor unless there is something wrong with the current one like a lack of progress on resolving the issue.

> You're the one constantly conjuring some vague sense of morality as opposed to discussing which models may work better than others.

without understanding the moral outcomes of an economic system makes any such discussion meaningless. You should checkout Albert Hirschman https://www.ias.edu/press-releases/albert-o-hirschman-1915%E...

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