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Health care is turning into a consumer product

economist.com

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Re: Health care is turning into a consumer product

#301

Post by rscho »

Broken_Hippo wrote: post #252
rscho wrote: post #26

Earlier quoted context omitted.

The big difference up to now has been that US hospitals have been run by a huge layer cake of administrators for a long time, while in other western countries healthcare workers have had much more direct control over how things are run. This is changing fast though, and Europe is migrating to the US model at a rapid pace, with growing administrative layer and loss of control over prices. Interestingly, european polit…

I have so many issues with this: Europe is a big place and the countries do not exactly work in unison on these things. I only have experience in Norway - and that's only for the last 8 or 9 years. The prices have always been pretty standard - the doctors office doesn't set the rates, at least not in the public system (there is a private system, but the majority of doctors are in the public system). There hasn't been…

Nope, that's just experience from daily life. I'm a doc in a public hospital in Switzerland, and also worked in the US.

Europe is still a bit behind in terms of admin, but getting there. And yes, american influence is felt all over Europe, with varying degrees of implementation among countries, as you noted.

I can understand that outsiders don't believe what we have to say when political propanganda is so strong. But for us insiders, it's really crystal clear what is happening. It used to be that problems arising in clinical management was solved by asking frontline workers what they needed. Healthcare workers had a lot of control over their working environment. Nowadays, admins are taking all decisions from above. European hospitals are now in competition with the private sector due to changes in the billing and insurance system coming from the US. As a result, european hospitals are now managed much more like your usual run-of-the-mill company than they used to. This is a terrible result for anyone but upper management.

Re: Health care is turning into a consumer product

#302

Post by terr-dav »

virgilp wrote: post #282
terr-dav wrote: post #268

Earlier quoted context omitted.

I would rephrase that argument as, "communism is good, it has just been ruthlessly sabotaged by capitalist interests every time an ideologically communist regime forms". In the case of the NHS, my understanding is that neoliberal politicians have been pushing to privatize it, and have underfunded it to make it look like it's not working in order to make privatization more appealing. The same is true for many programs…

Nah, Stalin and the communist leadership were perfectly capable saboteurs, didn't need help from capitalist interests. In a system where "the state" has the capability to enforce "public good" policies above anything else, it's only natural that the following will happen: - individual freedom will be suppressed (because "public good"; can't have greedy people doing greedy things, them weeds need to be killed early).…

The Bolshevik revolution was carried out under the assumption that world revolution would follow, particularly in Germany. This assumption did not hold, and Russia did not have the needed technological developments to sustain themselves.

Cuba is the best example of a successful communist-ish state. Most if its struggles are due to sanctions imposed by the US and enforced via its allies across the world.

Re: Health care is turning into a consumer product

#303

Post by waynesonfire »

mumblemumble wrote: post #189
dgb23 wrote: post #76

Earlier quoted context omitted.

I agree. The "everything is a market" ideology had a good run of almost half a century, but it should be heavily criticized in hindsight. Institutions like healthcare, education, public transport, prisons(!) and so on are more efficient, less corrupt and of higher quality when they are in large parts collectively and democratically organized and funded. The "in large parts" is important here: A community should agree…

One thing to note about US healthcare is that it seems almost deliberately engineered to not be a market. I've never received significant health care in another country, so I can't say how the US system differs from others with any expertise. But I can say how US health care differs from just about anything else I spend money on: 1. I don't really get to shop for health insurance providers. My employer picks one, may…

Another sleazy behavior I've noticed is that when I receive care, and state that I'm uninsured, the provide chargers me a different rate then had I handed over my insurance card.

The way this plays out is that if I hand over my insurance card, the provider will attempt to extract as much money as possible and bill an outrageous amount. The insurance provider has maximum limits it's willing to cover for each billing code and so only covers some lesser amount. You pay the difference.

This is such scumbag behavior.

Re: Health care is turning into a consumer product

#304

Post by rscho »

dontreact wrote: post #299
hitpointdrew wrote: post #276

Earlier quoted context omitted.

> the fact that healthcare is already a consumer product in the US I would strongly disagree with this. Healthcare in the US is currently a cartel system, not a consumer product/market system. If healthcare were a consumer product then: 1. It wouldn't be tied to or dependent on my employment. 2. Prices for medical treatment wouldn't be hidden/obfuscated by medical providers. 3. Insurance providers wouldn't be restric…

The Japanese system is not a single payer healthcare system and in terms of outcomes vs. cost is one of the best in the world, so I am not so sure that single-payer is the most reasonable solution. Particularly in the US where voters are averse to giving up their private insurance. Japanese system does have a public option and much tighter price controls, which we are missing here.

What the US is missing to achieve that is japanese culture. It can't work the same or even similar.

Re: Health care is turning into a consumer product

#305

Post by virgilp »

terr-dav wrote: post #302
virgilp wrote: post #282

Earlier quoted context omitted.

Nah, Stalin and the communist leadership were perfectly capable saboteurs, didn't need help from capitalist interests. In a system where "the state" has the capability to enforce "public good" policies above anything else, it's only natural that the following will happen: - individual freedom will be suppressed (because "public good"; can't have greedy people doing greedy things, them weeds need to be killed early).…

The Bolshevik revolution was carried out under the assumption that world revolution would follow, particularly in Germany. This assumption did not hold, and Russia did not have the needed technological developments to sustain themselves. Cuba is the best example of a successful communist-ish state. Most if its struggles are due to sanctions imposed by the US and enforced via its allies across the world.

> This assumption did not hold

"if the entire world is a sh*thole, nobody will be able to tell it's due to communism"?

I fail to see what "needed technological developments" would West Germany give them.

> Cuba is the best example of a successful communist-ish state

Successful as in "not completely failed, unlike all the others". Look, I sympathize with their struggles being so close to the US & all, but the fact that this is the best-case for you have should give you a bit of pause, because Cuba is by no means close to being a paradise.

To put things in context, both the largest & most populated countries in the world used to be communist. They both had to abandon it & switched to a form of crony capitalism, which, as bad as it is, seems to actually work better for them than the alternative.

Re: Health care is turning into a consumer product

#306

Post by tablespoon »

dqpb wrote: post #270
tablespoon wrote: post #171

Earlier quoted context omitted.

>> The "everything is a market" ideology had a good run of almost half a century > But that never actually happened. Externalities were never part of the market. But isn't the essence of an externality that it's a social cost not factored into the market price?

It becomes a social cost because it was not accounted for as a market cost. It may be that some of these cannot in principle be accounted for, and even more which cannot in practice be accounted for. But I imagine the majority of externalities could be accounted for if we tried.

> But I imagine the majority of externalities could be accounted for if we tried.

The irony is if you actually came close to achieving that (e.g. accounting for all externalities in the market price), you'd have something like central planning. That's why externalities are usually managed through other mechanisms.

Also, externalities are only one kind of market failure.

Re: Health care is turning into a consumer product

#307

Post by neuro_image2 »

analog31 wrote: post #98
neuro_image2 wrote: post #15

Earlier quoted context omitted.

I guess it depends on your comparison - that article didn't include Australia, NZ or Canada. Also if you factor in earnings and expenses over a lifetime (including cost of studying and the fact that many of the countries mentioned have free healthcare and education and far lower insurance requirements) it evens out substantially. More importantly, even the highest physician salaries are orders of magnitude less than…

Indeed, I think the deal should be: You go to medical school for free, then you work for the government for a nice professional salary. Malpractice insurance can be a government function. An interesting side effect might be to change the demographics of who can become a doctor, maybe attracting more people from middle class or blue collar backgrounds.

Not sure the opportunity to work for the federal government is a great way to incentivize the best and the brightest.

Doctors already come from a variety of different backgrounds.

Re: Health care is turning into a consumer product

#308

Post by neuro_image2 »

ryan93 wrote: post #110
neuro_image2 wrote: post #58

Earlier quoted context omitted.

I encourage you to rethink this stance. https://worldbeyondwar.org/ - is an organization dedicated to the abolition of war. I encourage you and anyone reading this to take a look. Also take a look at possible alternatives. (A global security system that doesn't require violence) - there's an ebook discussing this system in full. https://worldbeyondwar.org/alternative/ Continuing to head in the direction of militarism…

Posts about permanently ending war are basically spam

Says the guy commenting with no explanation or reference.

Stick to watching fox news.

Re: Health care is turning into a consumer product

#310

Post by ryan93 »

neuro_image2 wrote: post #308
ryan93 wrote: post #110

Earlier quoted context omitted.

Posts about permanently ending war are basically spam

Says the guy commenting with no explanation or reference. Stick to watching fox news.

A reference for why war can’t be stopped? Lol. https://en.m.wikipedia.org/wiki/History
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