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The Amish health care system

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201–210 of 327 posts

Re: The Amish health care system

#201

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…

"Do you want the best medical care?"

"Of course" says everyone because it seems like an easy answer.

"Then you're sprained ancle will need a team of 20 super MDs, an MRI, CAT scan, sterile isolation ward and a helicopter to get you there. That will be 100 million dollars please!" says the greedy fuck maximising profit, and he's giving you what you said you wanted...

This is basically the US system in a nutshell. Other nations have an approach with more focus on affordability, but the US system (from hospitals, to doctors themselves, to insurers, to drug makers, to the courts) is entirely focused on maximum quality. That's what makes it unaffordable. That's also why you don't have teired treatment like you say: an MD is 0.5% better than a trained nurse at setting a bone. They cost 100 times more. But you decide purely based on the 0.5%

Re: The Amish health care system

#202
We have universal healthcare in most parts of Europe, either founded from taxes, either partly funded by mandatory low cost state owned medical insurance and partly by taxes.

I think Spain has one of the world's best health care systems. https://en.wikipedia.org/wiki/Health_care_in_Spain

I guess US can apply the same principles. Some things might be more important than making money.

Re: The Amish health care system

#203

Earlier quoted context omitted.

The past is not a useful guide, because until recently, there was relatively little that could be done medically, and costs were commensurably low. The elephant in the room is that medical technology has advanced to the point where any person's needs can potentially greatly exceed their lifetime's ability to produce. When there are relatively few who find themselves in this state, insurance (and what is described in…

Big agree with this. Also there's no all-encompassing definition of 'healthcare' that will cover all categories, the way there is for groceries or cars or servers. As people get more disposable income to spend, they'll gravitate towards what is not so much medicine as improving their bodies (speaking as an older athlete who's spent significant money to repair shoulder, hip injuries & stay relatively young- my grandpa…

Right, this difference of scale is enormous. Back when hospitals couldn't do that much, and were not far from being hotels with better hygiene & worse food, then how to pay for them wasn't such a hard problem. But now US healthcare is 17% of GDP (if I recall correctly) and this proportion rises with GPD, unsurprisingly, as more other needs are already met. It isn't going to go down.

Pensions are in a way similar. When steelworkers retiring at 65 could expect on average a few golden years, then deciding how to pay for that wasn't such a huge deal. When they can expect a third of their lifetime to be in retirement, then it's very different.

Re: The Amish health care system

#204
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…

The past is not a useful guide, because until recently, there was relatively little that could be done medically, and costs were commensurably low. The elephant in the room is that medical technology has advanced to the point where any person's needs can potentially greatly exceed their lifetime's ability to produce. When there are relatively few who find themselves in this state, insurance (and what is described in…

also we've thankfully left behind the age of caste systems, where you just were poor, because well, peasants be peasants. Today I don't see any rich people engaging in that kind of (really screw up, if you think about it) "philantrophy" anymore... Especially in America (with Amazon and Walmart-slavery) the attitude is more like: you're poor, because you are not putting enough effort in.

Re: The Amish health care system

#205

We have universal healthcare in most parts of Europe, either founded from taxes, either partly funded by mandatory low cost state owned medical insurance and partly by taxes. I think Spain has one of the world's best health care systems. https://en.wikipedia.org/wiki/Health_care_in_Spain I guess US can apply the same principles. Some things might be more important than making money.

> Some things might be more important than making money.

Not to the people that run the US it isn't. They are pushing to fix the pandemic problem by just letting a couple of percent of the population die.

Re: The Amish health care system

#206

Earlier quoted context omitted.

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?

oxy? gimme some oxy, I've paaain, soo much pain.

Re: The Amish health care system

#207
> Amish people spend only a fifth as much as you do on health care, and their health is fine. What can we learn from them?

Given this opener, it seems bizarre that the article doesn't use the word "diet" even once. The comment there by "Scoop" seems right on.

Google tells me the USA is estimated to have around 300,000 obesity-related deaths per year. Apparently [0] obesity is around 10% as common in Amish communities as in the USA as a whole.

Aside: this is compared to around 35,000 gun-related deaths, around 40,000 traffic-related deaths, and around 50,000 opioid-overdose deaths. Presumably the Amish are spared these too.

[0] https://time.com/5159857/amish-people-stay-healthy-in-old-ag...

Re: The Amish health care system

#208
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…

Medicine was much cheaper then, mostly because if you had any of the sicknesses that require 100 000 USD drugs now - you just died.

Part of it is patent law, part of it is dysfunctional American healthcare system that drives prices up, but big part of that is that medicine just got much better and much more inherently expansive.

Re: The Amish health care system

#209

Earlier quoted context omitted.

I currently believe rising administrative overhead accounts for most of the cost increase. Single payer is a straightforward proven solution. Switching from fee-for-service to prevention (capitation) would give us another 25% savings. But I'm newly interested in notions related to cost disease. Am keen to hear anything anyone has to say about mitigation.

Public healthcare in general, not necessarily single payer. Most of Europe is not on single payer, but they are doing fine on costs.

USA has a problem with 3 scams - student debt, dumb lawsuits, and health insurance.

All 3 are connected and make healthcare absurdly expansive.

Re: The Amish health care system

#210
post #148
post #143

Earlier quoted context omitted.

There isn’t a legal requirement to have gone to programming school before one can practice software development. (And a good thing too!) If someone wants to hire someone who can kinda program a little, because they charge less, and are likely able to accomplish the task the person has in mind, then they should be free to do that. (Of course, if the task is one where failure causes a big problem, then one should get s…

> There isn’t a legal requirement to have gone to programming school before one can practice software development. (And a good thing too!) The vast majority of developers cannot kill you if they screw up. In the cases where that isn't true, e.g. software for medical equipment, I'd expect to find some significantly higher hurdles to get past before you can release that software. We don't generally require developers t…

> their output can be measured in other standardised ways nonetheless.

What are these standardised ways to measure developer output? I've never seen any, beyond "burndown charts" and "LOC", which I don't believe pass the sniff test.

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