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The Amish health care system

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Re: The Amish health care system

#211

Post by otikik »

Consultant32452 wrote: post #177
markdown wrote: post #13

Earlier quoted context omitted.

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 speakin…

> stifle innovation

The most innovation I am seeing coming up from the US health system these days is in finding ways to extract more wealth.

Innovative things like "let's make a cartel, increase the price of insulin by 1000%, and use some of that money to buy politicians so they don't stand in our way".

Re: The Amish health care system

#212

Post by truculent »

drdeca wrote: post #143
mrtksn wrote: post #139

Earlier quoted context omitted.

So does the developers. Anyone can code and do %90 of what a developer can do with a very little training. Yet, these are highly paid jobs because It’s not about being able to do it, it’s about understanding what they are doing. This way, they don’t just know how to do it but why to do it and what are the implications of doings it and how to debug it when the outcome is not the expected one. Any junior can probably d…

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.

It is if you are developing software in some high risk settings!

Re: The Amish health care system

#213

Post by andruby »

iguy wrote: post #203
hash872 wrote: post #105

Earlier quoted context omitted.

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. Whe…

You say it won't come down, but that's because the US is in it's own ballgame. In most other advanced western country healthcare "only" accounts for 7~11% of GDP.

The chart on [0] is incredible. I also shows how much that percentage has grown over the last 45 years.

[0] https://en.wikipedia.org/wiki/List_of_countries_by_total_hea... [1] Source data OECD: https://stats.oecd.org/Index.aspx?DataSetCode=SHA

Re: The Amish health care system

#214

Post by La1n »

bmelton wrote: post #35
floren wrote: post #18

I'm surely hopelessly naive and ill-informed for even asking, but is there a reason a hospital or clinic couldn't operate 100% without dealing with insurance? Do such places exist in the US? We always hear how the hospital sends a bill for $40,000, then the insurance company argues that down to $2000, but woe unto you if you DON'T have insurance because you'll have a hard time getting that same deal yourself. Couldn'…

There are cash-only doctors, or doctors who will accept cash as payment, and for what it's worth, the discounts for not using insurance can be substantial. More importantly to me though was this less-talked-about perk of having a doctor who -- once he knows he's not just going to receive a negotiated rate from an insurer -- will actually take a little bit longer with you and hear out your complaints. Knowing that if…

>Knowing that if you take longer, he can bill you more is actually a net good, IMO.

You can easily flip that around too. The healthcare system would become less efficient because time spend gets valued instead of results.

Re: The Amish health care system

#215

Post by grandinj »

_fq4v wrote: 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…

that hides a lot of detail.

Like just chopping off a leg instead of spending a 12 hour operation and months of physiotherapy to save it.

Letting people die from chronic conditions instead of managing them.

Letting old people die, because the cost of medical treatment was too high.

Not performing operations for heart disease, so people got one heart attack and then died a year later.

Which we could totally go back to, it really is a lot cheaper.

Re: The Amish health care system

#216

Post by zaarn »

int_19h wrote: post #190
robocat wrote: 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…

They still pay taxes, though. Germany allows people to opt out entirely, although there are a bunch of conditions and limitations. Most people don't, so the public system can still pay for itself.

Sadly in germany it's rather difficult to switch between public and private or no insurance. Or rather, it's very difficult to get back on a public insurance once you're private or self-insured. The best you can hope for is pulling it off once, maybe twice.

Re: The Amish health care system

#217

Post by jacobush »

fock wrote: post #204
mannykannot wrote: post #86

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…

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.

Since 1980 or so, the caste system is on a return. Not in rhetoric, but in outcome. "Social mobility" is down, down, down in the US.

Re: The Amish health care system

#219

Post by 0-O-0 »

fock wrote: post #204
mannykannot wrote: post #86

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…

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.

What's screwed up about philantrophy? And it's still here, Bill & Melinda Gates Foundation is a most prominent example.

Re: The Amish health care system

#220

Post by fock »

0-O-0 wrote: post #219
fock wrote: post #204

Earlier quoted context omitted.

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.

What's screwed up about philantrophy? And it's still here, Bill & Melinda Gates Foundation is a most prominent example.

the one where people somehow think, the status quo is god-given and that it's their godly duty to give alms. And no, Bill Gates is not an example for that - I think it's basically limited to the 3rd world, people in the US are still supposed to get their life together ;).
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