It’s not up to you.
You made a claim, in Great Debates, which you’ve failed to back up, whereas I provided a government cite to the contrary.
It’s not a hijack to point that out.
Despite your statement that you’re the opposite of me, I feel like you said the same thing as me. I’m not sure if I’m misreading you or you’re misreading me.
I’m loathe to get involved in yet another pointless health care debate with the usual zealots, but this is such total unmitigated bullshit that I just have to point it out.
The first part (minus the last sentence in parentheses) is a repetition of the tired old right-wing trope that the high costs of health care are due to the prolific spending of insured patients because it’s not their own money. It’s as if a couple might sit around and say things like, “What do you think, Martha? A week at a Caribbean resort this winter? A cruise? Or should we fake an illness and enjoy a relaxing free week in the hospital instead?”. No, people don’t seek unnecessary medical treatment for fun. If they did, they’d be flooding doctors’ offices and hospitals in countries where it’s really absolutely free, with no deductibles and no co-pays. But they’re not. What keeps costs down everywhere in the world is a systematic mechanism of uniform cost regulation, and the elimination of what only an outsider in America for the first time would recognize as the incredibly appalling amount of paperwork and bureaucracy associated with every single health care event.
The last sentence in parenthesis is equally unmitigated bullshit of a different kind. “Rationing”? Rationing is when an insurance company roars in and adjudicates every claim to see if they can reduce it or get out of paying it altogether. In single-payer systems, every claim is simply submitted and automatically paid. If you need health care in such a system you know you’ll get it, as a basic human right. It doesn’t achieve cost control by meddling between the doctor and the patient.
Hey I’m sorry if the title and OP were confusing to you. This thread wasn’t meant to be a discussion about why I thought the American healthcare system sucks and needs reforming, but rather a discussion on why Jeff Bezos and Warren Buffet think American healthcare sucks and needs reforming, and why they were doing something about it, per the story I linked to. I’d honestly love to hear your thoughts on the idea of private enterprise taking the healthcare reform bull by the horns, and what, if anything, they could do.
I’m also sorry I gave you two examples of how it sucks for me personally, I should’ve just kept on topic myself. If you care to 'splain further the specific details of my health plan, why they only cover flu shots made by specific companies, or why five corporate pharmacies refused to give my family a flu shot for anything less than $128, feel free to PM me.
I wanted to get a flu shot. It was covered by insurance, but my doctor’s office didn’t stock the vaccine. I went to my pharmacy, which did flu shots cheaply, but my insurance company did not cover them even though they did accept them for prescriptions. I found another doctor’s office, but it was only open during my working hours. I would have had to miss a half day of work and have them bill my insurance for more than the pharmacy would have charged. I said fuck it.
Our system is madness
This plan seems like a great idea to me. Although it still fails in that health care will be tied to employment, which is never a good thing, but it will serve one purpose - that of removing the profit-taking step of outside insurance. If health insurance is part of your salary package and part of that goes into the pockets of private insurance companies, you lose. Much better if the company you work for handles it, because they are not (hopefully) planning to make a profit on their healthcare provision. So, all in all, one step in the right direction.
I don’t understand why big employers like Walmart, GM, GE, etc aren’t pushing for healthcare reform. They are at a competitive disadvantage with companies in other countries. This column from 2005 days that it costs GM over $1,500 per-car in health insurance: more than the cost of steel.
I wish the Demand had pushed healthcare reform as pro-business rather than as a moral issue. Spend less, get more.
And here is the link :http://www.washingtonpost.com/wp-dyn/content/article/2005/04/29/AR2005042901385.html
The graph says that countries with citizens that live longer (more healthy) spend less on healthcare. It does not demonstrate the causal relationship you think it does.
The United States has citizens who make poor health choices. Americans use more illegal and prescription drugs recreationally. They have higher rates of obesity and poorer diets. America also has higher rates of violent crime than other countries. It is not surprising that they use health services more frequently (which drives prices up) and die sooner.
Unfortunately for your post, ignorance doesn’t become valid just because you can toss around the term “bullshit” a lot.
What drives up the cost of care in the US is not healthy people visiting the doctor. It’s sick people opting for extremely expensive care, tests, procedures etc. In most (or all) countries with socialized medicine, there are very long lines for expensive procedures for non-life threatening conditions, which is a form of rationing and keeps down the overall costs. In the US, the doctors have an incentive to recommend these procedures (partially profit, mostly fear of lawsuits, and a bit of “you may as well” thrown into the mix), the patients have little incentive to turn it down because they’re not the primary payers, and there’s really no other brake.
It’s interesting in this context that part of the ACA was intended to address this very dynamic. The tax on high cost plans (aka the “Cadillac tax”) was specifically intended to (besides for bringing in additional revenue) deter employers from offering high cost plans with low cost-sharing, and promote instead cheaper plans with higher cost sharing, which would deter patients from overusing care. However, that tax is extremely unpopular (including with unions, a core Democratic constituency) has now been deferred twice for 4 years, and there’s a pretty good chance that it never comes into being.
Since I live in one of those countries, it’s always amusing to be informed that there are “very long” lines for all this stuff! :rolleyes:
No. Just no. There are no queues for time-critical or life-threatening treatments, and few if any for patients already hospitalized. Where waitlist queues exist for outpatient treatments, well, you know what a queue is, right? It’s not a denial of treatment, it’s a load-leveling system that provides for optimum use and prioritization of limited resources. Unless you want to peddle some of the other right-wing nonsense like people die waiting, in which case you have to explain graphs like the one in the above posts (and there are many others) showing that people live longer and have generally better health care outcomes in these other countries than they do in the US.
In fact, given that there are tens of millions of uninsured in the US who can’t afford and are therefore denied most of these expensive treatments, or whose insurance plans won’t pay for them, you’d think medical costs would actually be lower than in countries with universal coverage. They have historically been some 44 to 45 million uninsured Americans until the ACA and the mandate brought those numbers down to a low of about 28 million a few years ago. Nor do most of the costs arise from the kinds of things that doctors tend to have an “incentive” to prescribe out of a profit motive or fear of lawsuits, which mostly tend to center around unnecessary testing.
You’re grasping at straws to try to explain the high costs with the standard right-wing talking points when the answer is staring you in the face if you just look at comparisons of medical costs in the US versus other countries. Where there is a comparable economy and similar standard of living, such as comparisons between the US and Canada, US health care costs can be many multiples of what they are in Canada – not just a few percent more, but 3, 4, or 5 times as much or more. And that’s for a variety of reasons: the profit motive, lack of cost controls, and the high cost of doing business under the enormously complex and administratively burdened insurance system. And that’s your answer, like it or not.
That may be your fanciful and baseless opinion, but according to the factual article associated with that graph, it says exactly what he claimed it does:
The Commonwealth Fund, in its annual survey, “Mirror, Mirror on the Wall”, compares the performance of the health systems in Australia, New Zealand, the United Kingdom, Germany, Canada and the United States Its 2007 study found that, although the United States system is the most expensive, it consistently underperforms compared to the other countries. A major difference between the United States and the other countries in the study is that the United States is the only country without universal health care.
Exactly.
So I write that “there are very long lines for expensive procedures for non-life threatening conditions” and your rebuttal is that “There are no queues for time-critical or life-threatening treatments”.
So it sounds like you agree with me, even if you yourself don’t realize it.
OK.
“load-leveling system that provides for optimum use and prioritization of limited resources” is just a fancy way of saying “rationing”. I prefer “rationing” because it’s more to the point and clearer in context, and I’m not trying to obscure things with convoluted language. But do your thing.
We disagree about whether companies deciding to “actually start looking at the actuarials and value of different procedures and drugs on longevity and quality of life metrics, and limit their health care spending on that basis” (emphasis added) would make them more attractive to employees. You claim it will, and I say it will do the opposite.
Many people might in theory favor of “actuarials and value of different procedures and drugs on longevity and quality of life metrics” but as a practical matter are not going to want their health care spending limited on that (or any other) basis.
Citation needed.
Generally, we would assume this to be obviously incorrect, since the cost is even more removed from the healthcare recipient in every other system, and they are all cheaper and more efficient. As far as I remember the economic theory behind health care economics, it is rife with externalities and generally unsuited for market delivery, but the biggest issue is the lack of price elasticity.
While third-party payer is an externality in health care, it is generally a right-wing blog phenomenon to single it out as the biggest or main culprit.
Ok, first off “socialized medicine”? What is that?
In my time working in health care and my studies on the subject, its not a term I’ve ever come across professionally. We normally separate systems into Beveridge, Bismarck, National Insurance and out-of-pocket. Once again, this is a term from a certain section of the US political debate.
Citation needed. Along with a definition of “very long lines”. With uninsured and underinsured included. Also, I don’t see how this would keep down costs. As long as the same number of procedures are done, it would not affect the cost how long the wait was before they were done. Although shorter waits mean that the fraction of patients who are working would return to being taxpayers faster, and represent an overall saving.
This calculation was actually part of why we decided to finance flights for patients who want to be treated at hospitals not local to them.
This is also a right-wing blog opinion, however it is not totally without merit. As far as I know, access for non-urgent conditions is an area where the US actually does well, but it still lags a number of nations.
Still, it is strange to see someone from the US refer to other nations systems as “rationing”, given that the US system rations far more harshly.
Generally the amount of money wasted in US healthcare is very, very large. Where it goes has been looed at very, very seriously. Unsurprisingly, third-payer hasn’t come up as one of the big drivers. The big drivers are commonly found to be excessive bureaucracy and medical inefficiency. A few studies do list pricing transparency as a potential area of saving, but its not the big issues.
Cites:
NCBI:Waste in the U.S. Health Care System: A Conceptual Framework
[NCBI: Waste, Economists and American Healthcare](Waste, Economists and American Healthcare)
No, my rebuttal was in two parts, the first part being to clarify that time-critical issues are handled without delay, and the second part to address the incorrect statement about “rationing”.
Wrong. Completely and exactly wrong. “Rationing” according to the dictionary is where you’re allocated only a limited, fixed amount of a commodity – presumably even if you are in dire need of more. This nasty implication of being denied a necessity is why the right-wing crowd loves to throw that word around in the context of single-payer or universal health care. It isn’t “rationing” when expensive resources are managed in a way that prevents wasted idle time by buffering demand in a queue so that when one request has been serviced the next one is immediately available. It’s no more “rationing” than doctors or any other professional scheduling appointments. But tell me, what do you call it in your system when an insurance company denies a claim? Or how about when an uninsured patient is denied treatment? In either situation, the patient never gets treatment at all. What do you call that?
As I said, they address this via rationing.
Government pays the bills.
That’s the whole point. The long lines means that the same number of procedures won’t be done. People are deterred from “overutilization” by the length of the lines.
Your second link doesn’t work, but your first cite defines “waste” as the type of overutilization of medical services that I’ve been describing.
I’m not going to revisit this, but you were very confusing at best.
Rationing via long lines is the same as other rationing for purposes of this matter.
The “presumably even if you are in dire need of more” is just you skewing things to make your point, and is not legitimately implied by the term “rationing” or by anything I’ve said here.
This does not seem correct. The UK is fairly close to the US among developed countries in obesity rankings. And smoke and drink more heavily. Yet they have vastly cheaper healthcare, longer lives and more years in good health. Other developed nations with high rates of obesity include Canada and New Zealand as I can see.
There does not seem to be much of a correlation between obesity rates and lifespan or healthcare costs.
As for violent crime… how many 18-year olds would have to die each year to lower the US average lifespan by 1 year?
You mean because people on the list die or give up?