House passes "repeal and replace"

[Banquet_Bear]

@Bricker

There can be, in my opinion, little doubt that we as a country do much right with healthcare, and do much wrong. The U.S. has twice as many MRI scanners, per capita, as Canada does. More than twice as many CT scanners, per capita, are in the U.S. than are in the United Kingdom, another oft-presented champion of national medicine.

Those are good metrics.

…these are not “good metrics.” What are you measuring?

Lets put two hospitals side-by-side. Everything is identical, but the hospital on the left has 3 MRI scanners and the hospital on the right has 4 MRI scanners.

Does the hospital on the right have objectively better metrics than the hospital on the left?

Lets bring the analogy closer to your Canada example. The hospital on the right now has 6 MRI scanners. Twice as many as the hospital on the left. How much more objectively better is the hospital on the right now?

Lets bring it to the UK. The hospital on the left has 3 MRI scanners. The hospital on the right now has 10. Is the hospital on the right objectively better?

Now what if I were to tell you that from a medical standpoint, the optimal amount of MRI scanners per hospital to deliver satisfactory outcomes was 1 MRI scanner. Which hospital is doing it better, the one on the left, the one on the right, or the one right behind me that only has one MRI scanner?

America has nearly 3 times the MRI scanners than we have in New Zealand. The first morning I was in hospital (mentioned earlier in the thread) I was scheduled for an MRI. I got wheeled into the MRI waiting room that afternoon. I had maybe a ten minute wait before they wheeled me in. Was my experience objectively worse than what I would have experienced if I were in America?

Without further context your metric is meaningless. I would argue the hospital on the right with 10 MRI scanners is worse off: because it has invested millions of dollars in pointless MRI scanners when that money could have been better deployed somewhere else.

Which really is the tale of the US healthcare system.

But in my opinion, we don’t know what will work best, and even discounting evil conservatives, there is disagreement among liberals as to the wisdom of a single-payer system or a public option or a continuation of the ACA model.

I don’t think that there is much disagreement amongst liberals at all. They nearly all agree that the ACA model is imperfect, and want to move towards fixing it. They would love to see single payer, but American society is just not ready for it yet. So “imperfect” will have to do for now. The ACA was always going to be a compromise between what the “left” could live with, and with what the “right” would concede. The current ACHA has had zero input from the “left”. I don’t think that is wise.

This is the perfect times to realize we have fifty pteri dishes. That’s the strength of the model. We can experiment and see what works.

I don’t think I’ve read anything more horrific on this messageboard in my life.

I read it last night before I went to bed: I hoped that when I woke up and read it with fresh eyes it would have improved. But it hasn’t.

Its horrific for a number of reasons. I think one of the reasons it horrifies me is the thought that you are not the only person who thinks this. That this is mainstream-conservative thinking.

The thing is though is that the year is 2017. UHC has been implemented in a variety of different ways all over the western world for decades. You can quite clearly see what does and doesn’t work. There is no need for 50 individual experiments. You take what works. You tweak it. You implement it. And then you course-correct as required. You do it nationwide because it will be billions of dollars cheaper and easier to implement.

The world is a smaller place now. I can hop onto google maps and virtually drive down a street in suburban America. I can skype with a friend in Los Angeles. I can email a business in Arizona. We can’t turn back the clock. The world is moving towards greater globalization, not less.

Chaos theory predicts that the “fifty petri dish” experiment with health care is doomed to fail. The United States of America is a giant, complex systems of millions of interactions that happens every day. These “50 experiments” won’t work in isolation. They can’t work in isolation. It isn’t 1776 any more. Are you wondering why people are “astounded to learn that there is any difference between federal and state power at all”, this is the reason why. The difference between federal and state power is becoming increasingly irrelevant. Because it makes things harder to do. And more expensive. And as we are discovering during this healthcare debate, it is inherently cruel.

You think that it is unwise for the roles of the Feds and the State to blur. I couldn’t disagree more. If America is going to continue to be a powerhouse in the world it needs to evolve. There are millions of disparate voices in America who are not represented by the people in power right now. Native Americans, people of colour, the LGBT community, women played no part in drafting your founding document, and don’t want to play a part in your grand experiment. They want decent healthcare that is affordable. They want life, liberty, and they want to be happy, not miserable. You concede that “repeal and replace” will probably result in poorer outcomes: but consider that to be an acceptable sacrifice to ensure that there is no increase in the power of the federal government at the expense of the states. I think that is incredibly unwise.

That’s wise.

I couldn’t think of anything less wise to be honest. I think that this slavish devotion to a philosophical principle is the opposite of wise: and your inability to offer a decent argument shows just how unwise it is.