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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

#161

Post by Wytwwww »

wh0knows wrote: post #154
Wytwwww wrote: post #127

Earlier quoted context omitted.

> 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.

> Profit can be manipulated

You mean costs can be inflated? Yes, the American healthcare system is extremely inefficient but that doesn't help the shareholders of those insurance companies at all.

Re: Post-apocalyptic life in American health care

#162

Post by jmye »

burnerburnito wrote: post #151
jmye wrote: post #123

Earlier quoted context omitted.

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 plan…

> If you choose to live on an obscure island or corner of alaska unreachable by land

This is a sort of disingenuous way to talk about rural America. Pine Ridge is two hours from Rapid City, not the middle of nowhere, Alaska, and the discussion isn’t about specialty care, but normal primary care, hospital and Ob/Gyn services.

Saying “suck it you stupid rubes, move to a city” is going to make it difficult to get anyone to agree with your version of healthcare reform, assuming it was even going to work.

Re: Post-apocalyptic life in American health care

#163

Post by jmye »

op00to wrote: post #149
jmye wrote: post #123

Earlier quoted context omitted.

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.

That’s not what I said at all.

Then perhaps you should use your words and explain what you actually mean, lest it be assumed to be ill-informed snark.

Re: Post-apocalyptic life in American health care

#164

Post by cyberax »

AnthonyMouse wrote: post #95
colechristensen wrote: post #65

Earlier quoted context omitted.

>when compared to commercial HMOs, Medicaid HMOs and Medicare HMOs. That's not all private insurance, just some of it. That's also talking about the average. >although there is high variation in quality across individual VA facilities ... >It's the usual "review effect", you only see negatives about the VA, not positives. You're saying in rebuttal to a negative review of private insurance, which isn't even what's at…

> That's also talking about the average. It's worse than that. The VA can't be compared to the average insurer because all of their patients are people who could at some point in their adult life satisfy the military's physical fitness requirements, which is not the case for the population at large.

> all of their patients are people who could at some point in their adult life satisfy the military's physical fitness requirements

TriCare covers military spouses and children.

Re: Post-apocalyptic life in American health care

#165

Post by nothercastle »

x86x87 wrote: post #159
nothercastle wrote: post #148

Earlier quoted context omitted.

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 :(

It can get worse but yes… Concierge medicine will only grow as a chuck of the sector. Right now we have a 2 tier system and a very small high end 3rd tier and eventually the premium tier will expand and the 2nd tier will collapse

Re: Post-apocalyptic life in American health care

#166

Post by op00to »

jmye wrote: post #163
op00to wrote: post #149

Earlier quoted context omitted.

That’s not what I said at all.

Then perhaps you should use your words and explain what you actually mean, lest it be assumed to be ill-informed snark.

Why would I bother arguing with someone who misconstrues what I say?

Re: Post-apocalyptic life in American health care

#168

Post by smsm42 »

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…

> The USA spends more GDP on healthcare than any country on earth and the insurance companies are immensely profitable.

Yes, from the recent report of 2020 [1]:

The health insurance industry continued its tremendous growth trend as it experienced a significant increase in net earnings to $31 billion and an increase in the profit margin to 3.8% in 2020 compared to net earnings of $22 billion and a profit margin of 3% in 2019.

These humongous profit margins of 3.8% can no longer... Wait, what? Three point frickin eight percent? That's what passes for "immensely profitable", really? Maybe there's some other place we should look for greedy capitalists that stole our money than in 3.8% profit margins?

[1] https://content.naic.org/sites/default/files/inline-files/20...

Re: Post-apocalyptic life in American health care

#169

Post by BeefDinnerPurge »

Wytwwww wrote: post #158
BeefDinnerPurge wrote: post #143

Earlier quoted context omitted.

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…

>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)?

My marginal rate in California is 53+%. That IMO is ludicrous given the horrendous condition of California and its budgetary planning. But...

I don't think the marginal rates are the real problem here. I think they're just peachy. The problem is we have an effectively ~20 page tax code with 4,980+ pages of bespoke deductions for individuals, corporations, and economic segments. Lose them all and start over with alt-min with far fewer exceptions (if any). I'm already taxed higher than most of the world* including most European Socialist Democracies without any of the perks and returns. It's not about the marginal rates. Which is to say we don't need new taxes, we need fewer loopholes to escape the existing tax rates. And we're not going to get that either. It's way too nuanced and esoteric a platform to gain traction with the sorts that think anyone making $100K in 2023+ is a plutocrat, so once again, I... give... up...

Also, California just loves multiple agencies competing for the same table scraps of tax money, but that's a different thread because all those redundant bureaucrats are getting paid on our dime.

*https://nomadcapitalist.com/finance/countries-with-the-highe...

Re: Post-apocalyptic life in American health care

#170

Post by nine_zeros »

ufocia wrote: post #120
nine_zeros wrote: post #15

American healthcare is truly apocalyptic. It is the worst of all systems in the world. Even developing Asian countries have figured out better systems. There is no one single root cause to fix here. The entire system needs to be uprooted - entire companies and shareholders will need to get wiped out. Unfortunately, ain't happening in ultra capitalist America. For other countries, there is still hope.

America is not ultra-capitalist. American capitalism is hobbled by regulatory capture. Here and there it manages to briefly escape, e.g. Uber and Lyft, only to be recaptured again by redesigned regulation/enforcement to preserve, among others, the tax base (rents) and thus support the bureaucracies.

You are not wrong. But a more accurate assessment is that it is capitalism for the regular people but socialism for businesses.
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