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The Amish health care system

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171–180 of 327 posts

Re: The Amish health care system

#171

Earlier quoted context omitted.

Everyone with absolutely no knowledge of our healthcare system "look(s) at the medical profession as the racket it is." They then proceed to point at things as the root cause that every health policy expert in the country can tell you is not the root cause, and that doesn't hold up to even slight scrutiny by comparison with other, similar, countries.

So what's up then? Or if you can't say what's up -- fair enough, you're not an oracle -- what slight scrutiny in particular topples this particular root cause hypothesis?

It doesn't cost 3k to have an MD do stitches. That money's going somewhere else (Actual experts may or may not know where).

Re: The Amish health care system

#172
post #2

I thought the most interesting part was the commentary on non-Amish care in the past > I asked my literal grandmother, a 95 year old former nurse, how health care worked in her day. She said it just wasn’t a problem. Hospitals were supported by wealthy philanthropists and religious organizations. Poor people got treated for free. Middle class people paid as much as they could afford, which was often the whole bill, b…

Why do I always see articles like this? I am pretty sure that everyone knows that Amish eat healthier, exercise more (very low obesity - the cause of 60% of Western health problems), don't drink or smoke, ingest and inhale far less plastics and chemicals and a large portion of their health care money isn't wasted on health care system overhead (administration). Oh one more thing, 80% of doctor visits and filled presc…

Other problems are not so simply avoided! https://www.cosmopolitan.com/lifestyle/a30284631/amish-sexua...

Re: The Amish health care system

#173

Why does nobody look at the medical profession as the racket it is? You don't need to be an MD to handle %80 of hospital visits, and you can train trades people to handle most emergencies. Insurance companies are awful, but seriously, we can train field medics to do stitches and set bones, why should it cost $3000 to have an MD do it? Listening the hand wringing about it is infuriating when you realize that the reaso…

This.

This gets so rarely uttered if ever I'm having a hard time believing it hasn't been down voted by hyper-credentialists on HN.

I fully believe the number of doctors allowed to start practicing medicine is heavily controlled using arbitrary rationales and spurious education / training thresholds.

There's no need for so much garbage bureaucracy in medical pedagogy especially when so many doctors are paid insanely lofty salaries.

The whole enterprise of medicine and the way its practiced in the U.S. ( including HIPAA ), needs some heavy de-bloating.

Re: The Amish health care system

#174
post #95
post #64

Earlier quoted context omitted.

That is how health insurance works in New Zealand. If you want private health insurance for say $50 a month[1], then insurance gives access to procedures more quickly and the rooms are much nicer than the public health care system. It may give access to rare but expensive procedures. If you don’t want insurance, then the default is the public healthcare system, which is paid for by taxes. You will usually be in a war…

The most expensive plan for my family (2 parents and a young child) is $367 a month. Equivalent coverage in the US would be thousands of dollars.

I do not know the New Zealand system, but I suspect the base level of care is still covered by public funding and the insurance is only covering optional extras (like private rooms).

Re: The Amish health care system

#175

Earlier quoted context omitted.

We don’t have a free market in healthcare. We have a highly regulated one. Free market healthcare is lasik and boob jobs. Both have come down in price because they are not part of the insurance system. They’ve also gone up in quality due to competition and demand.

Dental care is also a 'free market' and I don't think I need to say how much of a disaster getting any sort of dental work can be in the US. Why haven't dental costs fallen through the floor if it's a free market?

It's covered by most employer health plans, so patients don't see the true cost and don't shop around much. That's not the case for lasik or elective plastic surgery.

Of course since the latter are elective, customers have the luxury of shopping around and taking their time.

Re: The Amish health care system

#176
post #153

Earlier quoted context omitted.

One snare is that that a lot of overhead takes the form of jobs in the insurance industry. Any reasonable plan to reduce that overhead means eliminating all of those jobs.

1. FWIW this is a recognized problem under M4A plans those people would be taken care of. 2. Nobody has a right to earn a living by causing suffering to others.

If they’re being “taken care of”, how is the plan to eliminate their jobs supposed to save money?

Re: The Amish health care system

#177
post #9

Earlier quoted context omitted.

That's what some universal systems already do. I was reading up on Singapore. There is a baseline of insurance for hospital stays, but it's in a ward with 6 other patients in the same room. If you want something better (and there are tiers), you pay more. You can buy insurance policies that pay for the more comfortable stay.

The same in Fiji. We have universal health care, but anyone is of course free to forego that and pay (or use their private insurance) for a private room rather than a ward, or just go to a private hospital instead. I don't understand the debate about this in the US. It's as if the rich assume that things will change for the worse for them if universal health care is enacted.

The big difference between the two camps that I see is that one side recognizes the cost benefit of their position and the other side doesn't.

Price controls on healthcare (socialization) has positive and negative impacts. The positive impact is universality. Everyone gets approximately the same basic level of care. In some countries you might be able to pay for a nicer room, or quicker service, but generally speaking it's all the same. The downside is that price controls stifle innovation. That's just basic mainstream economics and is the case in every industry, not just healthcare. The trick about stifling innovation is you don't feel it immediately. On day 1 of the price controls, the rich are about the same but the poor are better off. On year 50 of the price controls, everyone is worse off because of all of the innovation that never came to fruition.

I never hear advocates of universal healthcare have an adult conversation that they are trading long term benefits for short term gains. I think that's a reasonable position to hold, but if we just pretend that it's all benefits and no cost we're not having an adult discussion. It's not as if one side is right and one side is wrong. Once we accurately discuss the economics, it's easier to understand that this is a very difficult moral decision and not the trivial one that is sometimes portrayed in the political sphere.

My speculation is that the rich people you refer to are more likely to be trained in economics (formally or otherwise) and are more likely to have a long term mindset regarding cost benefit tradeoffs.

Re: The Amish health care system

#178
post #101

Earlier quoted context omitted.

“fully trained” has a different meaning in other countries. In the US the number of doctors that can be “fully trained” is artificially limited. Furthermore, many countries with cheaper healthcare have abbreviated training for doctors.

> abbreviated training for doctors I mean do doctors really need to spend 4 years getting a bachelor's degree in "pre-med"? If you know you're going to be a doctor why not just start off with biology, anatomy, physiology, chemistry in year one and go on to cutting up bodies in year 2? It seems utterly ridiculous to spend 4 years majoring in humanities, or calculus[1] only to seek entrance to med school. The UK doesn'…

You are speaking from a place of ignorance. The prerequisites needed to take the courses that you mention alone are >1 year, yet alone all of the material needed to become a doctor. Where I went to Uni, you didn't take biochem until you were a senior. The reason for this is because before you take biochem you need General Chemistry 1 & 2, Organic Chemistry 1 & 2, and some smattering of Biology. You have to take these courses sequentially, they build on each other. If you don't know what a nucleophile is then you simply can't pass biochem, and that's how it should be.

Granted, you could theoretically shorten the program by removing all the humanities courses; but shouldn't doctors-to-be take ethics courses?

Re: The Amish health care system

#179
post #110

Earlier quoted context omitted.

It's not, though. It takes under an hour to set a bone, so that doctor's time is not driving the expense.

Why do I need to see a doctor to get a mole or skin lesion checked? Why is it necessary for someone to go through 4 years of undergrad, med school, etc etc just to examine a mole and remove it with a scalpel?

Are you trolling? Are you legitimately asking why you need a doctor to check something that might be, amongst the million other possible complications, Cancer?

Re: The Amish health care system

#180
post #2

I thought the most interesting part was the commentary on non-Amish care in the past > I asked my literal grandmother, a 95 year old former nurse, how health care worked in her day. She said it just wasn’t a problem. Hospitals were supported by wealthy philanthropists and religious organizations. Poor people got treated for free. Middle class people paid as much as they could afford, which was often the whole bill, b…

Why do I always see articles like this? I am pretty sure that everyone knows that Amish eat healthier, exercise more (very low obesity - the cause of 60% of Western health problems), don't drink or smoke, ingest and inhale far less plastics and chemicals and a large portion of their health care money isn't wasted on health care system overhead (administration). Oh one more thing, 80% of doctor visits and filled presc…

> 80% of doctor visits and filled prescriptions today are completely unnecessary and unhelpful

Source?

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