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42 percent of new cancer patients lose their life savings

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Re: 42 percent of new cancer patients lose their life savings

#261

Post by sjg007 »

mythrwy wrote: post #255
existencebox wrote: post #110

Earlier quoted context omitted.

I'm glad this is finally being discussed cogently. For the longest time one would be painted as un-patriotic or some other slur-of-the-moment for even suggesting there were vicious-cycles of pathologies in the current incarnation of this system. (And in how human psychology/game theory plays into it) But as you summarized, all incentives are aligned to maintain the status quo. How do we break out of this? Expansion o…

Congress has a heck of time getting anything done right now. I can't imagine what would happen if it were comprised of 20 times the members with all kinds of minor political parties each with their own narrow agendas. Personally I'm hoping at some point evidence based governance takes over. Which might mean it's not people doing it.

I think it could work. You would get alignment of subgroups and better representation. If say Berkeley wants to be a green party they would be. So the averaging out would take place in Congress vs at the ballot box. This would get more ideas into Congress and blur party lines.

Re: 42 percent of new cancer patients lose their life savings

#262

Post by davvolun »

chimeracoder wrote: post #193
davvolun wrote: post #187

Earlier quoted context omitted.

Did you factor wealth into that? I would hazard a guess that the bottom 20%-40% in the U.S. would have a considerably lower survival rate than the average for the rest of the country.

> Did you factor wealth into that? I would hazard a guess that the bottom 20%-40% in the U.S. would have a considerably lower survival rate than the average for the rest of the country. The population survival rates for cancer in the US are higher than any other OECD country. That already includes people who don't have insurance or otherwise can't afford treatment.

Yes, but let's say in the U.S. the numbers are 100% survival for the richest 50% and 0% survival for the other 50%. Clearly the average survival rate is 50%. Now let's say the Netherlands has a flat survival rate of 50%. If I don't consider wealth, it doesn't matter which country I get care in. If I'm at 49.999% of wealth in the U.S., the difference is 0% survival vs 50%.

We know healthcare quality and healthcare cost are correlated, e.g. http://www.pnhp.org/news/2016/july/wealthy-get-more-health-c... , I think we can intuit that ability to bear cost and wealth are correlated. Outliers aside, I don't think you're going to argue to me that a homeless man in Detroit has a chance of getting the same quality of care as Jeff Bezos.

Simpson's paradox -- how you split up those percentiles matter, the question is how much.

Re: 42 percent of new cancer patients lose their life savings

#263

Post by desertrider12 »

refurb wrote: post #205
desertrider12 wrote: post #72

Earlier quoted context omitted.

I agree with low safety net, but an average income is taxed about as heavily as the UK or Germany.

Source? The highest bracket kicks in a much lower salary in the UK and Germany than it does in the US. My income taxes were much lower in the US coming from Canada.

If your gross income is $80,000, overall federal income tax is 17%. There's also the 12.4% social security tax and the 2.4% Medicare tax, so the overall rate is 32%. State income tax varies (in CA it's 6% on the $80000, in TX it's 0%).

The equivalent UK income is 61200 GBP. Income tax is is 21%, and National Insurance is 8% for 29%. This doesn't include the 20% VAT on most goods and services, but that also doesn't apply to all your income (doesn't apply to savings, housing, utilities).

Sources: https://www.irs.com/articles/2018-federal-tax-rates-personal... https://www.fidelity.com/viewpoints/personal-finance/new-med... https://www.gov.uk/vat-rates https://www.gov.uk/national-insurance/how-much-you-pay https://www.gov.uk/income-tax-rates

Re: 42 percent of new cancer patients lose their life savings

#264

Post by sjg007 »

mythrwy wrote: post #253
Pharmakon wrote: post #4

Sometimes I’m just amazed that people haven’t risen up in bloody revolt yet. Recently my mother had a flare-up up radiation-induced pneumonitis and the PPO insurance she pays $14,000 annually wouldn’t approve a single unit of Advair. It took a week of talking to doctors and insurance drones to figure out that they were pushing her to an alternative that cost them $100 less. If I woke up tomorrow and people were burni…

Maybe the reason people haven't risen up in bloody revolt is a good number of them are also engaged in some sort of rent seeking or useless or parasitic endeavor which pays the bills and which, they tell themselves is needed and noble. After all, nobody wants _their_ gravy train disturbed. The gears of the currently horrible insurance/healthcare fiasco are mostly normal, honest everyday people trying to get through l…

The problem is that the young are less impacted so they don't care to vote. It's only when you have kids, have a health crisis etc.. that you start to take an interest. First understanding why something is the way it is and then advocating for change. Also, most people don't have major health issues (excluding an accident) until they are older (or have kids) .. And the largest consumer of health care are those aged 65+... So basically it's a hidden cost that people don't appreciate.

As an aside, the only good thing about student loans being so egregious is that it will bring out the youth vote.

Re: 42 percent of new cancer patients lose their life savings

#265

Post by davvolun »

jandrewrogers wrote: post #211
davvolun wrote: post #187

Earlier quoted context omitted.

Did you factor wealth into that? I would hazard a guess that the bottom 20%-40% in the U.S. would have a considerably lower survival rate than the average for the rest of the country.

It is for the entire population. I personally know people on welfare that received advanced new treatments and survived "terminal" cancer to this day. The overall cancer survival rate in the US for males is around 67%, which is extremely high even by developed world standards. It wouldn't be possible to have a survival rate that high if a large fraction of the population was excluded from treatment.

I responded to another commenter, Simpson's Paradox -- 67% average doesn't mean that I can expect 67%. Healthcare efficacy is correlated with wealth (i.e. cost of healthcare and ability to bear that cost). To get 67%, let's say the top 67% of Americans have a survival rate of 100% and the bottom 33% have 0% survival rate. The average is 67%, but I really hope I'm not in the bottom 33% and get cancer.

I don't know what you think a "large fraction of the population" equates to, but in this theoretical, 33% of the population being guaranteed to die isn't exactly ideal.

Re: 42 percent of new cancer patients lose their life savings

#266

Post by sjg007 »

toomuchtodo wrote: post #11
Pharmakon wrote: post #4

Sometimes I’m just amazed that people haven’t risen up in bloody revolt yet. Recently my mother had a flare-up up radiation-induced pneumonitis and the PPO insurance she pays $14,000 annually wouldn’t approve a single unit of Advair. It took a week of talking to doctors and insurance drones to figure out that they were pushing her to an alternative that cost them $100 less. If I woke up tomorrow and people were burni…

What would healthcare-centric revolt look like? You would need to apply pressure to specific congressional representatives, who support a specific ideology and don't believe in universal healthcare (A Crowdpac campaign has funded close to $4 million dollars to challenge Susan Collins when she's up for reelection due to her supreme court vote; that most likely won't scale). I could of course see rouge elements of such…

It'll start at the state level with single payer probably through medicaid expansion (medicaid for all). If the Feds aren't on board then you won't get the 50% match from the Feds but the premiums should help offset that. You might then get a few states who band together. What will happen next is that a lot of people will move to those states (as jobs permit) resulting in an economic bonanza for those states.

Re: 42 percent of new cancer patients lose their life savings

#267

Post by davvolun »

jandrewrogers wrote: post #227
Arbitrary4657 wrote: post #217

Earlier quoted context omitted.

Anecdote != data. Do you have a source for that survival rate?

That survival rate came from a study in Lancet Oncology. It is not controversial that the US has exceptionally high cancer survival rates. This is attributed to two factors: much more testing/screening than in most countries, which detects cancer at earlier and more treatable stages (though at high cost), and most new cancer-related treatments are developed and available in the US first so any resulting reductions in…

What study? Did it break down other factors for survival or are you arguing that the 350 million Americans all have exactly the same chance of surviving cancer?

I don't know why you're quoting "anecdote," you gave a textbook example of anecdotal evidence, which is not data. My uncle Bob survived testicular torsion, therefore all uncle Bobs will survive testicular torsion. How many people in the U.S. with that exact same cancer did not receive that particular experimental drug therapy? Did that one person, or even all the people included in the trial, change the survival rates in America during that time period?

Re: 42 percent of new cancer patients lose their life savings

#269

Post by sjg007 »

cabaalis wrote: post #212

I am a moderate conservative. I believe in self-reliance, fiscal responsibility, limited government. But receiving a death sentence like this one, physically and financially, is something I believe society could easily work together to create a parachute for. It seems reasonable to me that not all healthcare should be covered by the government. Individuals need skin in the game for their own care. But catastrophic, l…

>Individuals need skin in the game for their own care.

So smokers who get cancer? People who are obese? A car accident?

How do you decide?

What's the skin? A deductible?

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