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The Amish health care system

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Re: The Amish health care system

#221

Post by fock »

jacobush wrote: post #217
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.

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.

yeah, I reckon that. But compared to the old caste systems the people on top tend to show even less regard for the ones down (because they are so great and all selfmade!)

Re: The Amish health care system

#222

Post by lippel82 »

AzzieElbab wrote: post #158
ineedasername wrote: post #90

Earlier quoted context omitted.

The biggest administrative costs in health care are the insurance companies' costs. [0] To the tune of more than $200 billion dollars/year. [0] https://time.com/5759972/health-care-administrative-costs/

You have to be able to see that the numbers do not add up, right? 200b is how much out of 3+ trillions? Also, just because Canadian adminstrative costs are hidden, does not mean they are proportionally lower than in the US

What do you mean, the numbers don't add up? From the article: "Insurers’ overhead, the largest category, totaled $275.4 billion in the U.S. in 2017, or 7.9% of all national health expenditures, compared with $5.36 billion in Canada, or 2.8% of national health expenditures."

Re: The Amish health care system

#223

Post by asdkjh345fd »

specialist wrote: post #73
pmiller2 wrote: post #4

Earlier quoted context omitted.

That inequality is still present, except that now, the system is: * Poor people either get hit with huge bills because they're uninsured, or, if they know how to navigate the system, sometimes get these bills written off through "financial aid." * Middle class people frequently have insurance, but get hammered by deductibles and out of pocket maximums, rarely qualifying for "financial aid." This can be ruinous. * The…

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.

Canada has single payer and rising administrative overhead is a major problem here too. Looking at spending on medical staff vs spending on administrative staff, the former has barely gone up at all while the later has gone up over 500%. Plus we deal with the serious problems of lack of care. I know several people who have waited over 2 years for important surgeries like hip replacements. My mother died because they didn't want to keep her alive, and we get no say in the matter. Single payer doesn't magically make health care work well.

Re: The Amish health care system

#224

Post by asdkjh345fd »

JordanFarmer wrote: post #165
_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…

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…

>I am pretty sure that everyone knows that Amish eat healthier

By what definition? According to mainstream health organizations and even still government guidelines, they eat very poorly. Their diet is very high in saturated fat, which although healthy in reality, is not healthy according to the government. They also eat plenty of sugar, the other common scapegoat for dietary problems.

>don't drink or smoke,

They drink and smoke at lower rates, but they absolutely do drink and smoke.

Re: The Amish health care system

#225

Post by Amezarak »

akiselev wrote: post #43
daenz wrote: post #14

>How do the Amish keep costs so low? R&D (plus a few other sources) identify some key strategies. >...the Amish are honorable customers. This separates them from insurance companies, who are constantly trying to scam providers however they can. Much of the increase in health care costs is “administrative expenses”, and much of these administrative expenses is hiring an army of lawyers, clerks, and billing professiona…

> Imagine how many social problems would disappear if people had more integrity and stronger morals. Literally every aspect of life would improve. But instead, we have to bulletproof everything (largely without success) from people who scheme and scam their way through life. We sink enormous costs into this, and it slows the progress and complicates life for everyone else. What bulletproofing? Humanity has operated o…

The modern problem is in large part, scale. Trust works better in smaller communities and at smaller scales - people are more likely to be willing to fleece someone they don't know and will never see than their family, neighbors, or the person standing behind them in line. When there are immediate and permanent social consequences for violating trust, it's much less likely. The community (or tribe, if you prefer) scale is the scale that comes naturally to us.

A lot of 'social technology' exists, in part, to help increase our ability to scale trust up. This includes things such as nations and religions. As people become more irreligious and nationalism declines (including into an us vs them mentality within the nation - simple cheerleading of your country is not what I mean by nationalism), trust declines, and people are more likely to scam, grift, and fleece others. And once it is gone, it is very hard to get back.

Re: The Amish health care system

#226

Post by knolax »

daenz wrote: post #14

>How do the Amish keep costs so low? R&D (plus a few other sources) identify some key strategies. >...the Amish are honorable customers. This separates them from insurance companies, who are constantly trying to scam providers however they can. Much of the increase in health care costs is “administrative expenses”, and much of these administrative expenses is hiring an army of lawyers, clerks, and billing professiona…

> I'm not a religious person, but the thing that the anti-religion movements have failed spectacularly at is providing a universal, teachable framework for basic morality.

Given the numerous genocides committed in the name of religion, I would reckon that religion has failed to do so as well.

Re: The Amish health care system

#227

Post by kwhitefoot »

barry-cotter wrote: post #199
kwhitefoot wrote: post #197

One of the most striking things in this article for me was the remark about Amish women having five to ten children. If this is the case and if all women have children then the Amish population should be increasing rapidly. Is it? This page: https://amishamerica.com/how-fast-are-the-amish-growing/ says that the doubling time is about 19 years. How do they find enough suitable land to practice their way of life?

Agricultural land is cheap and plentiful if you don’t want to live within commuting distance of a major city. The US is really big and comparatively empty. Wyoming is bigger than the United Kingdom and has less than 600,000 people and there are plenty of other states with an abundance of farm land.

But that doesn't seem to be motivating the Amish to move to such areas. According to https://en.wikipedia.org/wiki/List_of_U.S._states_by_Amish_p... the Amish population of Wyoming was 130 last year. Mind you that appears to be 130 more than before.

It seems that, at least until very recently, they prefer to be where there are already substantial numbers of Amish people already (quite sensible of course). The biggest increase in absolute numbers 2010-2019 was Pennsylvania which is also the state with the highest Amish population.

Re: The Amish health care system

#228

Post by bookofjoe »

I just read every word of the 220 comments on this post and not once did I encounter the word "rationing" when it came to debating the merits and negatives of single payer. It is the elephant in the room: people pretend it's not there by saying things like "there's a long wait, sometimes over two years for such things as elective hip replacement."

Re: The Amish health care system

#229

Post by karatestomp »

missedthecue wrote: post #91
kevin_thibedeau wrote: post #87

Earlier quoted context omitted.

As opposed to one where everyone avoids medical care at all costs to avoid extortionate bills?

I don't think there is any system like that in first world countries. The US isn't like that if that's what you're insinuating

It absofuckinglutely is. If you don’t see that you may want to check whether your perspective is informed entirely by a (quite rich) bubble.

Re: The Amish health care system

#230

Post by jdub »

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 inequality that creates philanthropy shouldn't exist. Bill Gates did not himself earn his fortune.
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