301–310 of 690 posts
Earlier quoted context omitted.
If the Japanese cashier makes half the amount, but spends only 1/3 on healthcare that still seems to favor Japan
Well sure, then you're kinda cherry picking data that could easily be considered within a margin of error to make a rather unconvincing point
Earlier quoted context omitted.
Insurance is really not the issue, it’s provider cost. And just the total cost entirely of the system of insanity. If you look closely into it there is no single (or few even) knobs you can tweak to fix the system. Not even Medicaid for all, at least as it’s currently designed. No argument from me that insurance is not competitive enough. But they are almost all public corporations that are highly regulated so the nu…
Many of the largest health plans are non-profit, not publicly traded corporations. This includes most of the Blue Cross Blue Shield Association licensees as well as some other large payers such as EmblemHealth.
The real players are big corps like United and CVS, who control the whole vertical of provider and payer. They own the doctors, the pharmacies, and the insurance.
Healthcare administrative overhead in the US is pretty huge and has been for a long time. Back in the early 90s I worked on claim processing software and I recall it being discussed as being around a third of healthcare costs. Last year this podcast said that nobody wants to solve this because solving it is going to eliminate (IIRC) hundreds of thousands of jobs. Which is a point to consider. In 2021, the U.S. spent…
That's the reason why a lot of inefficiencies are kept in countries around the world: it keeps people employed and moves money through the economy. If broken things were suddenly to be made efficient overnight, the government wouldn't be able deal with masses of angry people/voters suddenly out of a job.
Americans don't want cheaper healthcare.
We've collectively decided the nightmare of employer based health insurance is a good idea.
Single payer healthcare will never happen.
Imagine if you will an Apple farmer willing to supply an entire town for a set amount per person.
One town, call it NordicTown says this is a great idea. Everyone chips in.
Another town, Jamestown has lively debate on the issue, but half the population believes unworthy people will get apples.
Since it's the policy that if anyone who shows up at the apple market starving they'll always get an apple, the apple farmer figures out they can bill the town for whatever they want.
Jamestown then ends up implementing special taxes to pay for poorer people to have apples. They could actually extend this to cover everyone without raising taxes.
But this will never happen. Someone you consider lazy might get a free apple. So you gladly pay 3 times as much.
Everyone in America is a single expensive illness away from ruin. We like living in a dystopian nightmare where you have to pick between medicine, a car note and rent.
Did I mention Jamestown residents who relay on free apple programs regularly vote against free apples?
Earlier quoted context omitted.
It's such a small market that it's really not competitive. Further, because medicine is so expensive, it means there aren't going to be newcomers to the market who can shake thing up. It requires way too much startup capital to start a new insurance company. The agencies with the most negotiation power don't because it negatively affects their bottom line. This is why there needs to be a real second option. A public…
Insurance is really not the issue, it’s provider cost. And just the total cost entirely of the system of insanity. If you look closely into it there is no single (or few even) knobs you can tweak to fix the system. Not even Medicaid for all, at least as it’s currently designed. No argument from me that insurance is not competitive enough. But they are almost all public corporations that are highly regulated so the nu…
Big players like United just shuffle money around because they own the entire vertical market. Their insurance arm is regulated so they just move the money to to their service provider arms like Optum which are unregulated with uncapped profits.
Earlier quoted context omitted.
Even if it's 10% in aggregate it could be much higher for individuals and families that are screwed over by drug pricing. But anyway we really do need to go after providers and end the racket that is employer provided health insurance.
Wait, I hate employer-provided health insurance and think it's a terrible policy but what does that have to do with providers charging everyone --- including Medicare! --- way too much for services?
Earlier quoted context omitted.
"Obesity costs the US healthcare system almost $173 billion a year." So that's about 6% of the difference? I'm not immediately saying no, but it sounds like that's not the real problem.
Social reasons it would never work. I hate to mention anything race related online but simple truth is America has complicated history and African Americans are 30% more likely to be obese than White Americans and also earn approximately 60% of income that whites earn. A fat tax, especially one that properly allocated the cost burden to the individual, would erode race relations.
Healthcare administrative overhead in the US is pretty huge and has been for a long time. Back in the early 90s I worked on claim processing software and I recall it being discussed as being around a third of healthcare costs. Last year this podcast said that nobody wants to solve this because solving it is going to eliminate (IIRC) hundreds of thousands of jobs. Which is a point to consider. In 2021, the U.S. spent…
>Last year this podcast said that nobody wants to solve this because solving it is going to eliminate (IIRC) hundreds of thousands of jobs. That's the reason why a lot of inefficiencies are kept in countries around the world: it keeps people employed and moves money through the economy. If broken things were suddenly to be made efficient overnight, the government wouldn't be able deal with masses of angry people/vote…
Huge chunk of the costs come from the fact that Doctors pay astronomical malpractice insurance rates in some states with no tort reform. Some have to spend more than 100k on insurance - 1/3 of their total pay. Since some states allows multi-million dollar judgments from juries that raises insurance everywhere, which raises not only prices for everyone but also dramatically contributes to more procedures and tests bei…
Healthcare administrative overhead in the US is pretty huge and has been for a long time. Back in the early 90s I worked on claim processing software and I recall it being discussed as being around a third of healthcare costs. Last year this podcast said that nobody wants to solve this because solving it is going to eliminate (IIRC) hundreds of thousands of jobs. Which is a point to consider. In 2021, the U.S. spent…
>Last year this podcast said that nobody wants to solve this because solving it is going to eliminate (IIRC) hundreds of thousands of jobs. That's the reason why a lot of inefficiencies are kept in countries around the world: it keeps people employed and moves money through the economy. If broken things were suddenly to be made efficient overnight, the government wouldn't be able deal with masses of angry people/vote…
Literal overnight change might be too radical (although, frankly, I'd want to see some academic work on the matter because it sounds like it might work - typically the problem seems to be that the body politic tries every alternative but good policy first then blames the mess on freedom) but people who are scared of rapid improvement because they don't like change are a massive threat to human prosperity and really shouldn't be left in charge of anything important.
Delaying the industrial revolution was never a good choice at any point in human history. The potential gains from efficiency are unbelievably large.