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'A full-blown crisis': Americans brace for a surge in healthcare costs

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Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#141

Post by silexia »

nradov wrote: post #139
silexia wrote: post #131

We desperately need to vastly increase the number of physicians in this country to decrease costs. The AMA is the most powerful trade union in history and has locked the number of new doctors a year for many years now. Restricting supply for a service with inelastic demand skyrockets prices and lines their pockets.

Bullshit. The AMA is a voluntary membership organization, not a trade union. They have no power to set prices or engage in collective bargaining. The immediate bottleneck on producing more physicians is limited Medicare funding for residency slots. Every year some students graduate from medical school with an MD but are unable to practice medicine because they don't get matched to a residency program (some do get mat…

Who lobbies for the regulations that limit funding for residency and have these ridiculous regulations to start with?

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#142

Post by almosthere »

harmmonica wrote: post #126
protocolture wrote: post #108

I find the US healthcare "system" to be an interesting topic. More nuanced than people think. It honestly seems like the worst way to run anything. Like I honestly cant see who its for, other than maybe US Corporations on the list of approved medical vendors. Like, putting on my "Lives in a free(ish) healthcare country" hat, it looks bonkers from that angle. But even from a more libertarian mode, the whole thing look…

The US, today, is set up very well for wealthy people. The health care system works great for them. Their doctors are amongst the best in the world. Same with the hospitals they use. The costs are manageable if not reasonable for all of those people. And you can actually go beyond health care and find that almost everything in the US is pretty high quality for wealthy people. Housing, their neighborhoods, their schoo…

> Housing, their neighborhoods, their schools

All of these can be great, but the class of people that make a neighborhood in "the heights" won't have dog barking, basketballs, drugs and gunshots. The people that don't live in "the heights" could decide tomorrow to no longer have those 4 things either - but they don't because - it's a different class of people.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#143

Post by JumpCrisscross »

ChicagoDave wrote: post #44
almosthere wrote: post #18

Earlier quoted context omitted.

when the gov foots the bill, there's no reason to have competition.

Before 1985, there was no for-profit healthcare. Worked pretty good.

> Before 1985, there was no for-profit healthcare

Wait, what changed in 1985?

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#144

Post by tirant »

vunderba wrote: post #134
johnnienaked wrote: post #117

Earlier quoted context omitted.

Health care is fine here if you have a decent job. Health care is not that great in public systems and you still pay for it with higher taxes

And naturally you make this absolute claim because you've undoubtably lived in more countries than just the United States, right? As point of reference, I lived in Taiwan for years - they have a national health insurance system, and taxes are comparable if not lower in some situations to the United States.

I have lived in 3 countries with socialized health care system and the public systems were just average to poor, and costing me a lot.

In Germany if you’re mid to high earner, a private insurance can cost you less than half than the public healthcare system and you get much better service. Starting with appointments with specialists, who always give preference to privately insured people.

In this day and age public healthcare system are not efficient and bill the wrong people.

They are mostly payed by young population, between 18 and 65 years old. Specially the highest earners.

However most of the usage comes from 65+ citizens, which are starting to become majority. And also tend to be the ones concentrating the wealth of the country.

These public systems work great when most of the population is young and is paying into the system. But modern western societies are not like that anymore. Wealth is not owned mostly by older people while they barely pay into the system.

Private systems work better because each citizen pays into his old age health coverage during his young years.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#145

Post by nradov »

silexia wrote: post #141
nradov wrote: post #139

Earlier quoted context omitted.

Bullshit. The AMA is a voluntary membership organization, not a trade union. They have no power to set prices or engage in collective bargaining. The immediate bottleneck on producing more physicians is limited Medicare funding for residency slots. Every year some students graduate from medical school with an MD but are unable to practice medicine because they don't get matched to a residency program (some do get mat…

Who lobbies for the regulations that limit funding for residency and have these ridiculous regulations to start with?

Which ridiculous regulations? Can you give us a specific CFR reference? I don't understand your question.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#146

Post by docdeek »

tirant wrote: post #64
Avicebron wrote: post #9

Earlier quoted context omitted.

Excuse me, but how in the world were you able to afford 1200/month, you know that's like cheap rent right?

That’s absolutely not an exception. I’m in Germany, and for a family of four, the public healthcare system, covering my wife and my two kids costs us around 2,200€ per month. The company pays half. A switch to a private insurance would lower the costs around half.

I was under the impression that German healthcare was essentially free (government funded) at the point of delivery, with additional top-insurance carried by most people similar to how it is in here in France.

Here I am self-employed and pay about 100 euros a month in top-up insurance (mutuelle) for myself and a couple of kids. Of course, the healthcare costs more, that’s why my taxes are high; but the insurance cost is about €1200 a year, not €2200 a month.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#147

Post by ArtemZ »

beej71 wrote: post #137
johnnienaked wrote: post #120

Earlier quoted context omitted.

Your taxes would double, and don't even bother trying to say they wouldn't literally every country with public health care pays twice as much as we do in tax

We pay more tax for healthcare in the US than virtually anyone else. Last I looked, only Norway had us beat in terms of taxes for healthcare.

Then how our taxes are lower on average than most other developed countries?

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#148

Post by ArtemZ »

nradov wrote: post #111
runako wrote: post #92

Earlier quoted context omitted.

There's a third piece too, which is that insurers are ramping price much faster than inflation. Our (unsubsidized) premiums increased 20% year-over-year, after also increasing faster than the rate of inflation the last few years. Since premiums never decrease, one can pretty easily plot out that in the next ~decade we will see family premiums larger than the median salary. The economics of all this are going to get v…

That's all true, but insurers are ramping up premiums faster than inflation largely because providers have raised their prices, and utilization has greatly increased due to an aging sicker population. The ACA minimum medical loss ratio means that health plans profits aren't increasing much.

But isn't it insurers actually set how much a service is going to cost you and then make "a discount" on that figure?

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#149

Post by simianwords »

silexia wrote: post #135
choeger wrote: post #47

Where does all that money go to, though? Is there a rich caste of doctors or pharmaceutical shareholders that don't need to work and live off these dividends? Or is the system so inefficient that most people in it aren't contributing to actual health care?

Doctors are by far the highest paid professional occupation in America. The AMA is the most powerful trade union in history and restricts the number of new doctors, pushing up prices.

I have changed my mind on this after looking at the data. Not much cost can be attributed to the doctors.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#150

Post by simianwords »

ETH_start wrote: post #105

The root cause: https://www.researchgate.net/figure/Healthcare-administrator... "Healthcare administrator's growth in the US. Healthcare administrator's growth by 3200% between 1975 and 2010 compared to 150% Physician growth according to Athena Health analysis of data from Bureau of Labor Statistics, the National Center of Health Statistics, and the United States Census Bureau's Current Population survey in accordanc…

What value addition do the administrators provide? It might be helpful to understand why competing hospitals still find it useful to employ these people even if the cost is so high.

If a competing hospital can provide equivalent service while also not spending so much on an administrator, why didn't they already do it?

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