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I write about America’s health care system, and I got caught up in it

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Re: I write about America’s health care system, and I got caught up in it

#61

Post by BobbyJo »

syki wrote: post #56
refurb wrote: post #31

Earlier quoted context omitted.

Why is that broken? Even systems with universal healthcare have rules like this. Why use a $1000 per month branded drug unless you know the $5 per month generic drug doesn’t work?

In all healthcare systems some form of rationing occurs since there aren’t enough resources to provide the best care to everyone. A system that rations care based on ability to pay or on wether or not your employer is generous is immoral. It is also immoral to profit off of denying someone care. Tough decisions have to be made and financially rewarding a company by denying care is despicable.

> A system that rations care based on ability to pay... is immoral.

You lost me there. What makes it immoral? Money is an asset allocation tool, so why is it morally wrong to use it for medicine the same way we do for food and housing?

Genuine question. I have a hard time understanding what sets medicine apart from everything else when people think healthcare should be universally free, but not food, water, clothing, housing, etc. especially considering those other things are more directly necessary for survival.

Re: I write about America’s health care system, and I got caught up in it

#62

Post by lotsofpulp »

chousuke wrote: post #32
nceqs3 wrote: post #24

Earlier quoted context omitted.

You are comparing an insured price to a cash list price (most of which does not go to the pharma co and a price which effectively nobody pays). As an insured American, I would pay 0$ for insulin.

That's not really a good counterpoint if the non-insured prices are patently insane. How on Earth is it justifiable for insulin to cost 300 dollars? Here it seems to be around 20-40 euros before the deduction you will get from our national health bureau (which can vary from 0% to 100% depending on your diagnosis and the medication you need.) On top of the national mandatory health insurance, there's also optional pri…

Is it 20 to 40 euros for any and all insulin or specific insulins?

Re: I write about America’s health care system, and I got caught up in it

#63

Post by ______-_-______ »

tsol wrote: post #49
civilized wrote: post #9

Earlier quoted context omitted.

I hear that hijinks ensue when you do that.

Best case scenario, though, you win an Emmy

Then you sell the Emmy, and you'll have enough money for one month worth of insulin.

Re: I write about America’s health care system, and I got caught up in it

#64

Post by throwaway6734 »

tragictrash wrote: post #39
throwaway6734 wrote: post #36

Earlier quoted context omitted.

>those at the top are morally bankrupt. These seniors should vote for and advocate for a more expansive social safety net then.

What twisted fucked up naive world view does this come from. These people are poor, vulnerable and sick. You should be ashamed of yourself. Why don't I throw you in a cage, and then you can try voting for someone to advocate for your release. The point is the seniors need help now, not being told to go organize. The healthcare system is broken, and until you get sucked into it, you don't understand the extent of it.…

This is an overly paternalistic point of view that robs these people of their agency.

They've spent their lives participating and interacting within the current political framework. Blaming all problems at the feet of "morally bankrupt leaders" is hyperbolic populist rhetoric to absolve personal responsibility.

Re: I write about America’s health care system, and I got caught up in it

#65

Post by andi999 »

BobbyJo wrote: post #61
syki wrote: post #56

Earlier quoted context omitted.

In all healthcare systems some form of rationing occurs since there aren’t enough resources to provide the best care to everyone. A system that rations care based on ability to pay or on wether or not your employer is generous is immoral. It is also immoral to profit off of denying someone care. Tough decisions have to be made and financially rewarding a company by denying care is despicable.

> A system that rations care based on ability to pay... is immoral. You lost me there. What makes it immoral? Money is an asset allocation tool, so why is it morally wrong to use it for medicine the same way we do for food and housing? Genuine question. I have a hard time understanding what sets medicine apart from everything else when people think healthcare should be universally free, but not food, water, clothing,…

The demand price curve is different. If housing gets more expensive you could (although) difficult move into a smaller apartment, or different region. (Similiar with food up to a certain amount). This allows the market to find the best/right price by supply and demand. (I think this is called inelastic demand)

If you have cancer though than basicall the market cannot find a price, and it would tend towards to: 'give me all you have'.

Re: I write about America’s health care system, and I got caught up in it

#66

Post by nine_zeros »

agumonkey wrote: post #60
nine_zeros wrote: post #37

Price aside, the biggest problem with American health care system is the administrative black hole at every stage. Wife was on some serious (and expensive) medical treatment. After many months, the medical provider was at the final stages of the treatment. As usual, the provider needs insurance approval for arcane codes that constitute that segment of the treatment. Get this, the medical provider applies for approval…

Some countries have been jumping so far ahead. IIRC Slovakia, Iceland have ultra lean administrative processes in lots of places. Minutes instead of days or more, and non hassle. UK has some of that too. France is starting. Someone in the US should get funding for this. It's a 300M people's "market".

I highly recommend healthcare in Asia. In most asian countries, healthcare is pure market driven. Aka, most people are uninsured so there is no insurance bureaucracy. No contracts, no lawsuits. The reputation of service and doctors matters. Appointments for this afternoon? No problem, you got it.

American healthcare is what I would wish on my enemies.

Re: I write about America’s health care system, and I got caught up in it

#67

Post by the-dude »

lotsofpulp wrote: post #57
lil_dispaches wrote: post #54

Health Insurance is a political scam of epic proportions. There is no indemnity involved. It is not real insurance. You don't use insurance to pay a monthly bill, you have it for black swan events. Nor should insulin be 1000/mo, on paper or otherwise. The whole thing is performance politics to distract from the "insurance" companies running everything from medicine regulations to your kids playgrounds (so they don't…

Health insurance in the US has an in network out of pocket maximum of $8,700 for individual and $17,400 for families: https://www.healthcare.gov/glossary/out-of-pocket-maximum-li... With the recent laws regarding mandatory coverage of emergencies while out of network, it seems to qualify for the definition of “insurance”, as you are protected from expenses above $17.4k per calendar year per family. The fact that most…

For reference, in NL I believe I have about €250 out of pocket maximum. Could be €500 now, not sure.

Re: I write about America’s health care system, and I got caught up in it

#69

Post by lotsofpulp »

the-dude wrote: post #67
lotsofpulp wrote: post #57

Earlier quoted context omitted.

Health insurance in the US has an in network out of pocket maximum of $8,700 for individual and $17,400 for families: https://www.healthcare.gov/glossary/out-of-pocket-maximum-li... With the recent laws regarding mandatory coverage of emergencies while out of network, it seems to qualify for the definition of “insurance”, as you are protected from expenses above $17.4k per calendar year per family. The fact that most…

For reference, in NL I believe I have about €250 out of pocket maximum. Could be €500 now, not sure.

It is a spectrum of course, but a 500 Euro out of pocket maximum is probably better described as taxpayer funded healthcare.

The US is pay $400 to $1,200 per person per month from age 0 to 64, and then pay up to $8,700 individual / $17,400 family per calendar year.

At age 65, the government starts paying for your hospital care assuming you or your spouse paid Medicare taxes for at least 10 years, and you then have to buy a nebulous blend of subsidized care / insurance for other things like medication, doctor visits, etc.

Re: I write about America’s health care system, and I got caught up in it

#70

Post by tryptophan »

andi999 wrote: post #65
BobbyJo wrote: post #61

Earlier quoted context omitted.

> A system that rations care based on ability to pay... is immoral. You lost me there. What makes it immoral? Money is an asset allocation tool, so why is it morally wrong to use it for medicine the same way we do for food and housing? Genuine question. I have a hard time understanding what sets medicine apart from everything else when people think healthcare should be universally free, but not food, water, clothing,…

The demand price curve is different. If housing gets more expensive you could (although) difficult move into a smaller apartment, or different region. (Similiar with food up to a certain amount). This allows the market to find the best/right price by supply and demand. (I think this is called inelastic demand) If you have cancer though than basicall the market cannot find a price, and it would tend towards to: 'give…

> If you have cancer though than basicall the market cannot find a price, and it would tend towards to: 'give me all you have'.

Yes it can... there is more than one oncologist in the world. Competition exists.

As for if youre talking about the chemo drugs, you don't have to use the latest-and-greatest on-patent treatment. There are now decades of drugs that are off patent. They may not be as good, but then again, it is your life so many choose to pay for the new better ones. If it was illegal to pay more for better drugs than they would never exist (and don't talk to me about government funding; not a single socialized medicine country has innovated any drug of value in the past 50 years, and yes, they do steal from us in the USA by taking our IP and not paying for it).

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