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Post-apocalyptic life in American health care

metarationality.com

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Re: Post-apocalyptic life in American health care

#151

Post by burnerburnito »

jmye wrote: post #123
op00to wrote: post #105

Earlier quoted context omitted.

Why is it Medicare’s problem to fix that educated people choose not to live in certain places?

So your solution to healthcare in this country is to light rural America on fire so that you, personally, can have cheaper care? That sounds workable.

I think what he's saying is far more comparable to:

"If you choose to live on an obscure island or corner of alaska unreachable by land, should the government be obligated to keep a doctor living and working nearby you?"

To which I'd then imagine the thought process is more sometimes you'll just have to move to a more urban / developed area if you have a really severe disease, or deal with long drives or getting plane flights.

Re: Post-apocalyptic life in American health care

#152

Post by figassis »

JoshGG wrote: post #43

Great article but the author is missing the fact that this is all designed on purpose. The insurance system is designed around a consistent strategy called “don’t pay out”. The USA spends more GDP on healthcare than any country on earth and the insurance companies are immensely profitable. Every company involved is making money off the status quo and wants to maintain the current system. when a patient comes along wh…

There are entities in the US that have the power to change this, and in the end, it’s congress and senators. But those to not act on something that apparently every soul in the US would benefit from, because politics, lobbying, etc. The power is there, it’s just not being wielded, and it seems that the reason is because these people are more afraid of vested interests than they are of you, the people. I would like to understand why and what would be a solution.

Re: Post-apocalyptic life in American health care

#153

Post by cwmma »

JoshGG wrote: post #43

Great article but the author is missing the fact that this is all designed on purpose. The insurance system is designed around a consistent strategy called “don’t pay out”. The USA spends more GDP on healthcare than any country on earth and the insurance companies are immensely profitable. Every company involved is making money off the status quo and wants to maintain the current system. when a patient comes along wh…

This is surprisingly not really the case a lot of the time, including this case, Anthem would have actually saved money had the mother been transferred out of the hospital.

Instead insurance are allowed to set premiums based on how much they payed last year plus a percentage. So the only way to charge more is to pay out more which sounds insane.

Re: Post-apocalyptic life in American health care

#154

Post by wh0knows »

Wytwwww wrote: post #127
l33t7332273 wrote: post #113

Earlier quoted context omitted.

A quick search shows they made more than 40 billion dollars in profit last year. That seems immense to me.

> That seems immense to me. From an emotional perspective sure. Their revenue is more than 1 trillion, so while less than 4% lower prices would be nice it wouldn't really fundamentally change anything.

Profit can be manipulated. Creating a giant bureaucracy of overpaid administrators and middlemen can siphon off any amount of money while declaring no profit.

Re: Post-apocalyptic life in American health care

#155

Post by BeefDinnerPurge »

jmye wrote: post #150
BeefDinnerPurge wrote: post #145

Earlier quoted context omitted.

So how do places like Hong Kong make this work? Because they do. My out of pocket expenses there uninsured are less than my copayments fully insured here. https://journals.lww.com/jcma/Fulltext/2015/10000/Overview_o... I suspect every reason you will cite is something we could both address as a nation and we will refuse to do so because freedom or some other idiocy. I truly give up. I threw money at family's medical…

Do you think there might be other differences between Hong Kong and the United States that could account for differing challenges in providing healthcare? I’m not clear why you’re giving up - it’s not an intractable problem. Some folks need to give up on “healthcare only for the rich/cities” and some folks need to stop having strong opinions about a very, very complicated industry they don’t understand at even a surf…

I've literally never been about only healthcare for the cities or 100% medicare for all, I literally said it ought to be a baseline on which to build something better. It's much like how we can't even agree as a nation that coal sucks and replace it with renewables/nuclear/natural gas on the way to something better.

So here we are, paralyzed indefinitely, throwing more money at a broken system annually. But also, so many in tech build things from strong opinions about very complicated things, and they are inadequate, but at least they're not doing the same thing over and over and expecting a different result.

I will say this though. I have yet to see private equity do anything besides make an existing problematic situation worse. And if that's what you mean by a difference between America and Hong Kong, yep, I agree.

Re: Post-apocalyptic life in American health care

#157

Post by jmye »

BeefDinnerPurge wrote: post #155
jmye wrote: post #150

Earlier quoted context omitted.

Do you think there might be other differences between Hong Kong and the United States that could account for differing challenges in providing healthcare? I’m not clear why you’re giving up - it’s not an intractable problem. Some folks need to give up on “healthcare only for the rich/cities” and some folks need to stop having strong opinions about a very, very complicated industry they don’t understand at even a surf…

I've literally never been about only healthcare for the cities or 100% medicare for all, I literally said it ought to be a baseline on which to build something better. It's much like how we can't even agree as a nation that coal sucks and replace it with renewables/nuclear/natural gas on the way to something better. So here we are, paralyzed indefinitely, throwing more money at a broken system annually. But also, so…

Neither comment was directed at you and I’m sorry if they read that way - M4A (specifically) discussions usually center on people who live in a big city and are solving only for that. I’ve also agreed in several comments that single payer is a likely component of the right solution, but that current proposals are woefully insufficient, to the point of not even being solutions. I’m all in for incremental improvements (the ACA was certainly one), but not if it just trades my pain point for creating five new ones for you.

The difference between HK and the US starts at the fact that one is 1100km^2, and the other is 9.8 million km^2. Solutions that work well in what’s essentially a really dense city don’t, necessarily, work across a massive country with a distributed, diverse population that faces very different, area-specific challenges.

I’ll add, apropos of nothing, that the fastest way to make healthcare in this country better is to fix education costs. If we dramatically increase the number of people in med school/nursing school, and simultaneously dramatically decrease what they owe upon graduation, you will see far more high quality providers enter the system who will be far more able to practice in places that really need them.

Re: Post-apocalyptic life in American health care

#158

Post by Wytwwww »

BeefDinnerPurge wrote: post #143
Wytwwww wrote: post #129

Earlier quoted context omitted.

So healthcare providers would be fine with significantly lower incomes just because the government tell them to suck it up? Also, it's not like the fact that the private insurance model failed in the US means that it can't work at all. For instance, not all countries in Europe have single payer. In some the health insurance system is privatized to a much higher degree than in the US, no equivalent of Medicaid/Medicar…

The chief problem is here is asserting healthcare must be either entirely Medicare For All or the current inadequate privately funded system when the two can coexist. Just like legalizing drugs won't cure crime and unhappiness on its own, I doubt a baseline (note I said baseline) Medicare For All fixes healthcare on its own, but to assert neither are a step in the right direction seems absolutely absurd. There are cl…

> The chief problem is here is asserting healthcare must be either entirely Medicare For All or the current inadequate privately funded system when the two can coexist

I'm certainly not asserting that. However, first of all, 'Medicare For All' only makes sense if it's mandatory, which means additional taxes. Yes, considering the social, political, and economic reality, the likeliest outcome would be a two-tier system, with those who can afford it getting additional insurance in some way. I'm not sure what's so great about that?

> And sure, a more transparent private system could work, > experiment yet good luck with that in the current media/political environment. Not giving either party a break here

Would passing an extended ACA II with way fewer compromises and more effective regulation than the Obamacare version be really harder than instituting Medicare for All (so either a significant increase in federal income tax or a new tax altogether)?

Re: Post-apocalyptic life in American health care

#159

Post by x86x87 »

nothercastle wrote: post #148
x86x87 wrote: post #139

Earlier quoted context omitted.

I don't think anyone is saying that you cannot get the best healthcare on the planet if you have the required money. Lots of money. The problem is that most people don't have that kind of money and the system as a whole is designed to take advantage of regular folks by not providing the care they need (regular care, not the best care).

I think this is a common theme in all 3rd world medicine. That’s the point we’re moving towards that model

I think the point is that we are already there :(

Re: Post-apocalyptic life in American health care

#160

Post by [deleted] »

ufocia wrote: post #128
andutu wrote: post #19

My boyfriend woke up one day to find out they couldn't pee. After a few ER visits and an MRI, they determined he had Stage 2 bladder cancer. However, because they had the audacity to seek immediate medical treatment for a life threatening health issue, they have now been saddled with thousands of dollars in medical debt. I had to personally dip into my earnings from my Big Tech internship to help pay some of it off.…

Not an ad hominem attack or a microaggression, but hopefully constructive criticism. Your use of the "them" pronoun makes the post confusing. Does it refer to "they," presumably the doctors, the employer (job), the insurance, UT Southwestern, or to the gendered "boyfriend." Since you already decided to use a gendered noun, perhaps use it instead of the "they/them" or use a matching gendered pronoun "he/him" to distin…

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