Earlier quoted context omitted.
What was your experience like with the VA?
Hearing first or second hand stories of veterans waiting months or years for important care or struggling to get something addressed at all.
No experience then. Okay.
Post-apocalyptic life in American health care
71–80 of 189 posts
Re: Post-apocalyptic life in American health care
#72“Standardizing an interface between health care providers and insurance companies would be a huge win. No matter how badly designed, it would be better than the current mess, and save several percent of US GDP.” A new regulation was actually proposed by the federal government a year ago to do that: https://www.cms.gov/priorities/key-initiatives/burden-reduct... There’s also a new program to reduce fragmentation for d…
None of those issues address the elephant in the room.
If you dismantle the incumbent system and introduce efficiencies that bring US health care spending in line with other developed countries, millions of health insurance workers would be out of their [parasitic] jobs. Which is politically untenable.
The underlying issue is incentive incompatibility. The health insurance industry is a behemoth 10x the size of the automotive industry, for example. You can imagine what kind of lobbying power they have as a result. And they are not interested in anything that destroys their jobs.
Re: Post-apocalyptic life in American health care
#73Earlier quoted context omitted.
> Just look at how the VA is run and complains about it. The VA system has on average delivers better outcomes than private insurance: https://www.rand.org/news/press/2018/04/26.html It's the usual "review effect", you only see negatives about the VA, not positives.
>when compared to commercial HMOs, Medicaid HMOs and Medicare HMOs. That's not all private insurance, just some of it. That's also talking about the average. >although there is high variation in quality across individual VA facilities ... >It's the usual "review effect", you only see negatives about the VA, not positives. You're saying in rebuttal to a negative review of private insurance, which isn't even what's at…
> That's not all private insurance, just some of it.
There are other studies with similar results. Comparisons with HMOs is especially illuminating because of the similar models (vertically-integrated organizations).
> Difficulties getting things covered and being buried in beurocratic nonsense isn't really connected to "health outcomes on average".
Of fucking course it is! WTF you're even talking about? People absolutely get inferior care because they can't wade through bureaucracy.
Re: Post-apocalyptic life in American health care
#74Earlier quoted context omitted.
> Why with single payer would there not still be instances of treatment being denied? The most common failure mode for single-payer is scarcity. You won't be denied, but you'll have to wait many months for an appointment. > Would this not be replaced with faceless automata in government? They are controlled by politicians, who are directly responsible to their electorate. Brexit is a good example, using money sent to…
>They are controlled by politicians, who are directly responsible to their electorate. Brexit is a good example, using money sent to EU for NHS was one of the more influential ads. Of course, the outcome turned out to be... different. Calling out Brexit is an... interesting way to argue here. If you're proposing my options for heath care are going to be taken away and given to the single option controlled by the elec…
> Calling out Brexit is an... interesting way to argue here.
Why? It's an example of directly affecting healthcare via political pressure.
> If you're proposing my options for heath care are going to be taken away and given to the single option controlled by the electorate who are liable to do things like Brexit... no thank you
That's the thing, it can also be fixed by the electorate.
> I'll take marketplace competition where I can "vote out" the idiots by making a different choice for myself.
Except you can't. Go on, read your insurance contract if you don't believe me. You're at the total whim of death panels, who can just tell you to go and die.
Re: Post-apocalyptic life in American health care
#75American healthcare is an easy target, plenty to criticize. There are complicating factors here: We culturally, societally, and philosophically don’t really know how to make decisions about end-of-life care, and death in general. We also lack an agreed upon moral framework for how to care for people with diminished cognitive capacity (the extreme being permanent vegetative state).
A lot of money is spend on end-of-life care, trying to keep someone alive on their deathbed for an extra month or two, and people don't seem to want to talk about the diminishing returns of some of that care, and the opportunity costs - the other people that could have been helped more with those resources. It's a thing, even if ignored. We're paying big premiums for that to insurance companies as part of our wages a…
Forget the costs, there's unnecessary suffering inflicted on patients with some forms end-of-life care. Overwhelmingly doctors - who have witnessed such care - firsthand, sign DNRs to avoid going through that[1].
[1] https://www.saturdayeveningpost.com/2013/03/how-doctors-die/
Re: Post-apocalyptic life in American health care
#76My boyfriend woke up one day to find out they couldn't pee. After a few ER visits and an MRI, they determined he had Stage 2 bladder cancer. However, because they had the audacity to seek immediate medical treatment for a life threatening health issue, they have now been saddled with thousands of dollars in medical debt. I had to personally dip into my earnings from my Big Tech internship to help pay some of it off.…
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Re: Post-apocalyptic life in American health care
#77I'd be interested what one, single change might help. Something intangible like independently curated complete health record in some normative form on a smart card. Or, a legalism of a "first do no harm" nature which demands once a qualified professional determines you have cover and it's just an argument about who pays between competing covers, you get no-worse-off service choices immediately until they decide which…
One simple change - make it illegal to offer medical services if you’re not kaiser or similar structure
Re: Post-apocalyptic life in American health care
#78My boyfriend woke up one day to find out they couldn't pee. After a few ER visits and an MRI, they determined he had Stage 2 bladder cancer. However, because they had the audacity to seek immediate medical treatment for a life threatening health issue, they have now been saddled with thousands of dollars in medical debt. I had to personally dip into my earnings from my Big Tech internship to help pay some of it off.…
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Looks like they used both "he" and "they". My guess was that the boyfriend might use either set of pronouns.
Re: Post-apocalyptic life in American health care
#79I have a different take on the cause: everyone has been eaten by the liability monster.
Re: Post-apocalyptic life in American health care
#80My boyfriend woke up one day to find out they couldn't pee. After a few ER visits and an MRI, they determined he had Stage 2 bladder cancer. However, because they had the audacity to seek immediate medical treatment for a life threatening health issue, they have now been saddled with thousands of dollars in medical debt. I had to personally dip into my earnings from my Big Tech internship to help pay some of it off.…
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They as in he and his bladder.