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The healthcare market is taxing reproduction out of existence

aaronstannard.com

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Re: The healthcare market is taxing reproduction out of existence

#221

Post by sershe »

waterTanuki wrote: post #196
mattcantstop wrote: post #102

Earlier quoted context omitted.

I have the opposite viewpoint, and I lean heavily progressive in most of my views. Healthcare in the United States isn't a market, and that is why it is so terrible. For instance, there is no reasonable ability to compare prices of services. Prices are entirely hidden. Then there is the "with insurance" price vs cash prices. Healthcare doesn't function as a market, to our detriment.

Nor should it strive to be a market. Healthy markets can only exist where demand is elastic. If the choice is between dying to kidney failure or enduring life-crushing medical debt, you bet I'm going to do anything it takes to get that transplant. And therein lies the problem: You *cannot* have healthy markets in healthcare. Period. Demand for healthcare is fully inelastic. Anyone arguing the opposite is either profi…

I think this is actually an opposite problem. For kidney failure in particular, you can check the insane amount USG spends on end stage care. The demand for healthcare at the limit exceeds any reasonable supply. Healthcare spending across counties goes up pretty much with disposable income. There are massively expensive interventions that could give someone close to death few extra months.

Healthcare has to be rationed. Rationing by market is the least bad kind of we learn anything from history... Too bad healthcare in the US is not a market in any way or form, and in fact the most expensive least DALY efficient interventions (Medicare) are subsidized at the expense of everything else.

Re: The healthcare market is taxing reproduction out of existence

#222

Post by bonsai_spool »

Aaronontheweb wrote: post #174
thatfrenchguy wrote: post #172

Earlier quoted context omitted.

I think OP here is just keeping a completely dominated plan (and his health insurance company knows it). He has less than 50 employees, he is not required to offer health insurance to his employees and he should go on the ACA market. Given he has 3 children, 400% of FPL in 2026 is $150,600 so he's easily eligible for ACA subsidies (which, by the way, in 2021-2026, were available to everyone) by tweaking his income (e…

> Given he has 3 children, 400% of FPL in 2026 is $150,600 so he's easily eligible for ACA subsidies I am absolutely not eligible. I earn more than $150k. And "manipulating your income" is not really feasible with a pass-through entity. > The premiums have nothing to do with the plans. Every single plan on the marketplace has to cover child-birth, that's sort of the point of the ACA. As I mention in the piece, I chec…

> And "manipulating your income" is not really feasible with a pass-through entity.

I don't know if you have a CPA, but this is a sentence my CPA has never uttered.

> but by simply refusing to cover the care those applicants need to survive pregnancy (legal and common.)

Including...? I have never heard of this, and actually have delivered babies and worked with post-partum mothers.

Re: The healthcare market is taxing reproduction out of existence

#223

Post by CommenterPerson »

gishh wrote: post #161
CommenterPerson wrote: post #91

Earlier quoted context omitted.

Had the same reaction when I saw how the 40K was calculated (BTW I strongly believe in Medicare for all to control costs and to pay for civilization. To be paid out of progressive taxes on all income). If Aaronontheweb had the misfortune of getting seriously sick, required surgery .. he would pay $7,150 for something that could easily cost $100K+++. Saying he's paying premiums just for having a baby really feels like…

Which bits cost 100k? The $75 ibproufen? The $47 towel? The $19,563 bed charge? Oh, the $32,925 imaging that NFL players get instantly? Insurance in America is a fucking joke.

The charges you mention are likely all from hospitals. How about Pluvicto for advanced prostate cancer at $42,500 per monthly dose? All the players are in on it.

The sound way to manage costs and avoid these games is via Medicare for all, with premiums paid by progressive rate taxation of income. Maybe even wealth beyond a very large amount.

Re: The healthcare market is taxing reproduction out of existence

#224

Post by orwin »

peter422 wrote: post #112
BeetleB wrote: post #100

Earlier quoted context omitted.

> 15 out of the top 50 and 4/6 top hospitals in the world are in the US Outliers do not say much about the overall quality of healthcare in a country. Rather obvious lesson in statistics. Reminds me of the Russian mathematician who moved to the US after the fall of the Soviet Union. Most of his essays were criticizing American students, but in one essay he was quite frank: Russians who graduate with math degrees are…

Perhaps my language was too imprecise. My argument is that specifically the best care in the US is the best in the world. We have the best doctors and the best technology and the best treatments. This is not completely universal but it is also generally accurate. Whether or not this care is accessible or the median quality is care is good, that is different. I’m just saying we do get something for the money, it’s not…

Can't you just look at life expectancy, and life expectancy in good health? Because the data I found doesn't put the US in the top anything. Even if you're in the top decile of earners.

Re: The healthcare market is taxing reproduction out of existence

#225

Post by sershe »

There are two ways to look at this. Either children are in fact useful for society, and should be subsidized (I weakly hold this view given mass immigration is politically unworkable, and long term that too would run out). That is well and good but cross country data makes the central argument in the title fall apart - US birth rates are/were recently higher than most public healthcare OECD countries. Why blame X if removing X doesn't appear to do much?

The alternative view, that I would hold if it wasn't for the above considerations, is that first world child rearing is currently an expensive hobby, and why should we subsidize it at all? If it wasn't a personal project most would be parents could easily adopt.

Re: The healthcare market is taxing reproduction out of existence

#226

Post by forgetfreeman »

godsinhisheaven wrote: post #76

A lot of this is an issue of insurance no longer being "insurance" in the classical sense. Insurance covers all sorts of things, my HSA pays for all sorts of things that I never would have even considered, and while that sounds great, it helps to drive up costs. It's somewhat counter-intuitive, but if you dropped all government funding of healthcare tomorrow, healthcare plans would get cheaper. It'd also be total cha…

"There's not a single silver bullet that will fix everything" idk, it seems like eliminating the profit motive from healthcare would resolve all kinds of problems.

Re: The healthcare market is taxing reproduction out of existence

#228

Post by AstroBen »

orwin wrote: post #224
peter422 wrote: post #112

Earlier quoted context omitted.

Perhaps my language was too imprecise. My argument is that specifically the best care in the US is the best in the world. We have the best doctors and the best technology and the best treatments. This is not completely universal but it is also generally accurate. Whether or not this care is accessible or the median quality is care is good, that is different. I’m just saying we do get something for the money, it’s not…

Can't you just look at life expectancy, and life expectancy in good health? Because the data I found doesn't put the US in the top anything. Even if you're in the top decile of earners.

How does that account for a population who..

..74% are overweight or obese

..less than 10% meet the fruit and vegetable recommendations

..25% get the recommended amount of exercise

..eat more than 70g added sugar a day

Healthcare really has the deck stacked against it however you look at it

Re: The healthcare market is taxing reproduction out of existence

#229

Post by [deleted] »

Aaronontheweb wrote: post #174
thatfrenchguy wrote: post #172

Earlier quoted context omitted.

I think OP here is just keeping a completely dominated plan (and his health insurance company knows it). He has less than 50 employees, he is not required to offer health insurance to his employees and he should go on the ACA market. Given he has 3 children, 400% of FPL in 2026 is $150,600 so he's easily eligible for ACA subsidies (which, by the way, in 2021-2026, were available to everyone) by tweaking his income (e…

> Given he has 3 children, 400% of FPL in 2026 is $150,600 so he's easily eligible for ACA subsidies I am absolutely not eligible. I earn more than $150k. And "manipulating your income" is not really feasible with a pass-through entity. > The premiums have nothing to do with the plans. Every single plan on the marketplace has to cover child-birth, that's sort of the point of the ACA. As I mention in the piece, I chec…

[deleted]

Re: The healthcare market is taxing reproduction out of existence

#230

Post by outside1234 »

phil21 wrote: post #211
venturecruelty wrote: post #139

Earlier quoted context omitted.

Sorry, this is simply not true. Every 1-3 years, I get a simple diagnostic procedure to make sure I don't get cancer. Without it, I'm at a very real risk of developing cancer that would quickly kill me. There is no universe in which it doesn't cost around $10,000. None. It is simply impossible for me to get out of paying that. My options are: 1. Use insurance, and hopefully it's covered. 2. Pay out of pocket. 3. Skip…

Many of those “simple diagnostic procedures” are a tenth of the cost if done outside of insurance out of pocket. MRIs are one of them. My routine blood work done via my doctor bills something like $1600 to my insurance every other year or so - but it do it on my own outside of the medical system for about $180 every six months. No one should have to do this for necessary care - but once you get into things not typica…

That's what the parent is saying. This is totally insane and should be just handled for us with a system that is something like what almost every other country has put in place.
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