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The Amish health care system

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Re: The Amish health care system

#231

Post by AzzieElbab »

lippel82 wrote: post #222
AzzieElbab wrote: post #158

Earlier quoted context omitted.

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."

What I meant is that if insurance costs disappear completely, US healthcare will remain 5 times more expensive than Canadian. It is percentage based markup on already super overpriced system. Therefore, real reasons for why it is so expensive are elsewhere

Re: The Amish health care system

#232

Post by specialist »

asdkjh345fd wrote: post #223
specialist wrote: post #73

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.

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…

Damn. I am very sorry for your loss.

Thanks for tip re Canada's admin overhead. Will research.

Re: The Amish health care system

#233

Post by specialist »

ajuc wrote: post #209
int_19h wrote: post #185

Earlier quoted context omitted.

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.

Am keen to hear your thoughts.

One such common thread is the financialization of consumer debt.

I recently learned (from Michael Lewis' Against The Rules podcast) that removing ban on usury debt (high interest rates) opened the flood gates. Sorry, I forget which episode.

https://atrpodcast.com

Re: The Amish health care system

#234

Post by pnutjam »

fock wrote: post #221
jacobush wrote: post #217

Earlier quoted context omitted.

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!)

Behind the bastards has a good podcast about the lady who mainstreamed adoption. She convinced rich people that they could adopt poor children and they wouldn't be genetically inferior, to be blunt.

She also stole kids and let babies die from lack of care...

Re: The Amish health care system

#235

Post by OrderlyTiamat »

MaxBarraclough wrote: post #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…

Both obesity in the "english" group and the healthier lifestyle of the amish group are discussed by Scott in this article.

Re: The Amish health care system

#236

Post by Moru »

empira wrote: post #196
Consultant32452 wrote: post #177

Earlier quoted context omitted.

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…

On the other hand, right now, only the rich, or those with good enough medical insurance (if your co-pay is more than you make in 6 months, are you really insured ?), have access to the expensive treatments. On a universal heathcase system, whatever the form it may take, more people would have access those expensive options. Is it better to sell your treatment to more people but at a smaller price tag, or to fewer pe…

The peace of mind and knowledge that everyone gets taken care of no matter what is worth the world to me.

Re: The Amish health care system

#237

Post by brazzy »

motohagiography wrote: post #97

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…

> You don't need to be an MD to handle %80 of hospital visits

You do, however, need to be an MD to recognize some of the other 20% as not being part of the 80%.

Re: The Amish health care system

#238

Post by ajuc »

specialist wrote: post #233
ajuc wrote: post #209

Earlier quoted context omitted.

USA has a problem with 3 scams - student debt, dumb lawsuits, and health insurance. All 3 are connected and make healthcare absurdly expansive.

Am keen to hear your thoughts. One such common thread is the financialization of consumer debt. I recently learned (from Michael Lewis' Against The Rules podcast) that removing ban on usury debt (high interest rates) opened the flood gates. Sorry, I forget which episode. https://atrpodcast.com

Well - first you have absurdly expansive universities required to be a doctor.

They can be absurdly expansive because there is an expectation that students will indebt themselves with this one kind of debt you can't default on. So doctors have to earn more to be able to pay it back.

Then you have lawsuits where cost of lawsuit is paid by both sides, no matter who is at fault. So if it takes 2 years and costs 100 000 USD to determine you weren't at fault - you are still going to default (except yo ucan't default on your student's debt). So doctors are expected to be insured against lawsuits. Which is expansive. So they have to earn more.

Then there is a system where one drug company has 100 insurance provider customers who have to buy that drug. Who has more power in that relationship :) ? So you pay absurdly high prices.

Re: The Amish health care system

#239

Post by throwaway894345 »

pmiller2 wrote: post #4
_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 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…

> 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.

How large are these OOP maximums and deductibles on average? I’ve always kept an emergency fund that’s well in excess of my OOP max. Is this unusual? Also, I’m off the impression that you can get onto payment plans if you can’t pay your bills right away? These aren’t rhetorical questions (although that won’t stop people from downvoting as though they are, I’m sure), I’m genuinely curious.

Re: The Amish health care system

#240

Post by pnutjam »

WaylonKenning wrote: post #129
hateMyIdeas wrote: post #116

Earlier quoted context omitted.

Person doesn't have insurance and injured themselves doing a risky activity, and can't afford treatment. If it's really bad, why not use bankruptcy, I can't imagine this person has anything valuable given the history you described. Or use physical therapy, it's cheap.

What is insurance for? To cover risk of something bad happening. The bigger the pool paying for it, the less impact to any one person to cover all the risk. Now imagine that was scaled up to a whole country. That's New Zealand. Check out the Accident Compensation Corporation. All medical costs related to accidents are automatically covered! But who pays the costs! Everyone, via levies. How much? $2000 on a $150K IT i…

I guarantee the average US worker that makes 150k (not an avg salary) pays more then 2k in SSI taxes that cover Medicaid. They pay all over again for private healthcare, probably in the 6k range if they don't have kids.
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