# What do people actually want from healthcare? **URL:** \ **Category:** Great Debates\ **Created:** [March 24, 2017, 1:08pm UTC](https://boards.straightdope.com/t/what-do-people-actually-want-from-healthcare/782904 "2017-03-24T13:08:00Z")\ **Posts on this page:** 20\ **Page:** 4
**Author:** ![Aspenglow](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/aspenglow/32/76_2.png) [@Aspenglow](https://boards.straightdope.com/u/Aspenglow)\ **Post date:** [March 25, 2017, 4:48pm UTC](https://boards.straightdope.com/t/what-do-people-actually-want-from-healthcare/782904/61 "2017-03-25T16:48:48Z")
> [@Velocity](#): > > This is another reason the ACA (and the ACHA) are and were flawed. You shouldn’t go after insurance companies whose job it is to defray high costs, you should go after the high costs in the first place. > > Trying to get everyone insured is like saying, “Groceries cost the average family $300 per week. How can we get everyone couponed so they can get coupons to lower their cost to $150 a week?” You should instead be going after the high grocery prices so that even the non-couponed can get cheap groceries. I’m afraid you need to do more research on how much health insurance companies are profiting from health care: [Why Big Insurance Adores the ACA](http://www.commondreams.org/views/2017/03/23/why-big-insurance-adores-american-health-care-act) [Health Insurance Industry Rakes in Billions While Blaming Obamacare for Losses](https://www.consumeraffairs.com/news/health-insurance-industry-rakes-in-billions-while-blaming-obamacare-for-losses-110116.html) [Making a Killing Under Obamacare](http://www.salon.com/2016/10/28/making-a-killing-under-obamacare-the-aca-gets-the-blame-for-rising-premiums-while-insurance-companies-are-reaping-massive-profits/) [Health Insurers’ Profits](https://www.nytimes.com/2017/03/18/business/health-insurers-profit.html?_r=0) There are other major profit centers, too. Some of the biggest are “non-profit” hospitals. Great place to hide money and increase wealth. There are few things more profitable than a non-profit hospital. [Nonprofit Hospitals Earn Substantial Profits](http://www.jhsph.edu/news/news-releases/2016/nonprofit-hospitals-earn-substantial-profits.html) [These Hospitals Make the Most Money Off Patients – and they’re Mostly Nonprofits](https://www.washingtonpost.com/news/to-your-health/wp/2016/05/02/these-hospitals-make-the-most-money-off-patients-and-theyre-mostly-nonprofits/?utm_term=.4bbfcf2a3828) The system is rife with profit-making. It’s exactly why our costs are so high in this country. And they’re going to continue fighting hard to keep the profits in place, you can be sure. ---
**Author:** ![up\_the\_junction](https://avatars.discourse-cdn.com/v4/letter/u/f1d935/32.png) [@up\_the\_junction](https://boards.straightdope.com/u/up_the_junction)\ **Post date:** [March 25, 2017, 4:57pm UTC](https://boards.straightdope.com/t/what-do-people-actually-want-from-healthcare/782904/62 "2017-03-25T16:57:39Z")
Indeed, and this after Obamacare …: > [@](#): > > Once again, CEOs of healthcare companies are topping the executive compensation charts, according to the latest annual analysis by the Associated Press and Equilar, released Tuesday. > > Median pay for healthcare and pharmaceutical executives amounted to $14.5 million in 2015, higher than for leaders in any other sector, according to Equilar, a California firm that researches and analyzes executive compensation. Median compensation for all CEOs in the study, which looked at pay packages of 341 executives at S&P 500 companies across multiple sectors in 2015, was $10.8 million. > > The increase in healthcare executive pay from 2014 to 2015 was also greater than in other sectors. Healthcare CEO pay rose 7 percent last year over the amount in 2014, while the comparable median pay increase for all industries was 4.5 percent. > **[CEO Pay Could Be Driving Rising Healthcare Costs](https://www.ibtimes.com/healthcare-pharma-ceos-paid-more-top-execs-any-other-industry-analysis-finds-2374013)** > > Executive compensation is declining in some sectors, but for people like Vertex Pharmaceuticals CEO Jeffrey Leiden and other healthcare industry leaders — it remains robust. ---
**Author:** ![Crane](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/crane/32/3495_2.png) [@Crane](https://boards.straightdope.com/u/Crane)\ **Post date:** [March 25, 2017, 4:59pm UTC](https://boards.straightdope.com/t/what-do-people-actually-want-from-healthcare/782904/63 "2017-03-25T16:59:57Z")
1. On par with the best health care in the world 2. Available to everyone 3. Paid in advance through a lifetime of taxes I have been retired for 20 years and have an annual income of around $65,000. The wife and I pay $9000 a year for Medicare etc. and $1100 a year taxes to support our hospital. The insurance companies are milking us for $$$. They do not add value to the process. Single payer makes sense for a capitalist country, as long as there is strong government oversight. Probably three of the large insurance companies for billing service. The idea of some folks that health care is a free market issue is total bullshit - if you die then change insurance companies. Single payer is not free and it’s not cheap and it’s not socialism - just necessary. Crane ---
**Author:** ![Velocity](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/velocity/32/18006_2.png) [@Velocity](https://boards.straightdope.com/u/Velocity)\ **Post date:** [March 25, 2017, 5:05pm UTC](https://boards.straightdope.com/t/what-do-people-actually-want-from-healthcare/782904/64 "2017-03-25T17:05:20Z")
> [@Shodan](#): > > They want > [ol][li]The best health care in the world[/li][li]Available to everyone, and[/li][li]At a reasonable price.[/ol]They can have, at most, any two of these.[/li] This. Cost, accessibility, and quality are generally at odds with each other. You can get two, but getting all three tends to be mutually contradictory, barring some amazing advance in technology. ---
**Author:** ![Velocity](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/velocity/32/18006_2.png) [@Velocity](https://boards.straightdope.com/u/Velocity)\ **Post date:** [March 25, 2017, 5:06pm UTC](https://boards.straightdope.com/t/what-do-people-actually-want-from-healthcare/782904/65 "2017-03-25T17:06:39Z")
Also, too many Americans get locked into a “We need to be the best in the world” mindset. Being No. 1 out of over 190 countries in the world, in anything, is hard. It would be better for the public and politicians to adopt a “Let’s get into the 90th percentile” mindset; as is, the US health care system isn’t there in the 90th either. ---
**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\ **Post date:** [March 25, 2017, 5:14pm UTC](https://boards.straightdope.com/t/what-do-people-actually-want-from-healthcare/782904/66 "2017-03-25T17:14:22Z")
> [@Aspenglow](#): > > The system is rife with profit-making. It’s exactly why our costs are so high in this country. And they’re going to continue fighting hard to keep the profits in place, you can be sure. It’s one of the reasons, and it has a lot of indirect effects like pressure to have an overabundance of certain types of equipment in order to lure customers, lack of incentive to do preventive medicine or to detect and treat illness early if a person will be another plan’s problem in a year, etc. There are others, too. Some examples: Doctors do not (and likely cannot) reliably know what treatments have the most value to patients because they cannot know the end price and usually do not know the patient’s goals. Our drug costs are extraordinary. We refuse to invest in affordable housing, then pay out the nose when a child is constantly hospitalized for asthma because his family lives in a building with walls made of a putty of mold, roaches, and lead (okay, I know lead doesn’t lead to asthma. It was hyperbole, dammit!) We outsource care coordination or appeal or to the patient or caregiver, which leads to confusion, lack of adherence, failure to catch error, lack of followup care, etc. ---
**Author:** ![Crane](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/crane/32/3495_2.png) [@Crane](https://boards.straightdope.com/u/Crane)\ **Post date:** [March 25, 2017, 5:15pm UTC](https://boards.straightdope.com/t/what-do-people-actually-want-from-healthcare/782904/67 "2017-03-25T17:15:09Z")
V#65, Not the best, just up there in the pack. Crane ---
**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\ **Post date:** [March 25, 2017, 5:16pm UTC](https://boards.straightdope.com/t/what-do-people-actually-want-from-healthcare/782904/68 "2017-03-25T17:16:12Z")
> [@Crane](#): > > V#65, > > Not the best, just up there in the pack. > > Crane If you use the quote function, other people will find it much easier to follow your conversational threads. ---
**Author:** ![igor\_frankensteen](https://avatars.discourse-cdn.com/v4/letter/i/839c29/32.png) [@igor\_frankensteen](https://boards.straightdope.com/u/igor_frankensteen)\ **Post date:** [March 25, 2017, 6:05pm UTC](https://boards.straightdope.com/t/what-do-people-actually-want-from-healthcare/782904/69 "2017-03-25T18:05:15Z")
Some good thoughts above. I want to add that I am finally convinced that the entire current focus on Health INSURANCE, is actually causing a lot of the biggest problems. Insurance is supposed to be about dealing with SURPRISE HIGH COSTS. But in the world of modern health care, we are supposed to buy “insurance” to defray EXPECTED high costs. What makes this even worse, is that a lot of prices that are put on medical procedures and medicines, is set high BECAUSE THE PROVIDERS ANTICIPATE INSURANCE PAYING FOR THE BULK OF IT. Medical providers’ costs are distorted by a host of (ironically) what are best described as “band-aid fixes” that have been slapped over this mess for decades now. Government applies “band-aids” to specific items because constituents complain about them, or because without government intervention, poor people wouldn’t get any care at all, especially when they are injured in public. Insurance companies pile on “band-aids” in the form of demands that providers charge what they think overall market wants, regardless of the providers ACTUAL costs. And the AMA (which provides primary medical guidance to the Insurance companies) add in “band-aids” in the form of recommended tests for all sorts of ills (forcing providers to conduct unnecessary tests to avoid lawsuits), and they limit the ability of providers to decide treatment based on the actual PATIENT, in order to cater to the demands of the Insurance companies, for predictability (which is how the Insurance companies get their profits). It’s collectively insane. It means that medical care in the US isn’t based on helping people to be healthy, it’s based entirely on making sure that anyone involved with medicine, is able to make large profits. Any actual health that results, is an accidental by-product. The point is not that “capitalism and profits are bad.” The point is, that the structure of an enterprise of any kind, should be designed to DO WHAT THE ENTERPRISE IS SUPPOSED TO DO. So when you call something “health care,” but then design it to MAKE MONEY FROM SICK PEOPLE, what you end up with isn’t going to be “health care,” ever. ---
**Author:** ![up\_the\_junction](https://avatars.discourse-cdn.com/v4/letter/u/f1d935/32.png) [@up\_the\_junction](https://boards.straightdope.com/u/up_the_junction)\ **Post date:** [March 25, 2017, 7:59pm UTC](https://boards.straightdope.com/t/what-do-people-actually-want-from-healthcare/782904/70 "2017-03-25T19:59:00Z")
Yep, you don’t seem to include prevention as a primary healthcare policy - clearly a healthy living, healthy eating population is good news for the UK in general and NHS funding in particular. Fwiw, they’ve had significant success with this project and other similar: [Exercise - NHS](http://www.nhs.uk/LiveWell/c25k/Pages/couch-to-5k.aspx) ---
**Author:** ![Grim\_Render](https://avatars.discourse-cdn.com/v4/letter/g/a87d85/32.png) [@Grim\_Render](https://boards.straightdope.com/u/Grim_Render)\ **Post date:** [March 25, 2017, 8:01pm UTC](https://boards.straightdope.com/t/what-do-people-actually-want-from-healthcare/782904/71 "2017-03-25T20:01:07Z")
> [@Shodan](#): > > [Cite](https://epianalysis.wordpress.com/2012/07/18/usversuseurope/). I got to say -I don’t see how that works. I mean I normally see bigger numbers for US healthcare cost increases, but not just that. Everything I’ve ever seen has show the US in 1980 as expensive but not expensive beyond other nations. Today the US is far ahead of all the others. Even your[links graphs](https://epianalysis.files.wordpress.com/2012/07/2012-07-17-03-31-04-pm1.png?w=768&h=460) …I don’t see how that is mathematically possible if the other nations costs grew faster than the US in the period. Look at that, the US is just leaving everyone else in the dust. (How can I insert the graph itself ?) > [@Shodan](#): > > I also addressed the others - the US spends more because of different demographics, different expectations, we spend more on marginal cases, excessive torts, etc. Simply transplanting single-payer into the US is not going to cut costs down to European levels - unless we ration care. This, I believe, is severely misleading. Yes, different demographics, tort etc are contributors to US excessive spending, but none of them are major ones. Well, possibly tort, in that you can blame the spending on defensive medicine on it. However, the boundaries are fuzzy between defensive medicine and other sources of over-provision. The big contributors to US overspending are a) excessive administration, due to the fragmented nature of healthcare in the US with a large number of systems, providers and gatekeepers. B) Over provision due to provision being the main source of profit, defensive medicine, and third-party payer. And C) Excessive drug costs. All of which would be cutting costs in the case of moving to single payer. (Except defensive medicine, but its less than 10 % of the overspending) [Cite](http://www.investopedia.com/articles/personal-finance/080615/6-reasons-healthcare-so-expensive-us.asp). > [@Shagnasty](#): > > Good examples are doctors that specialize in things like elective practice surgery and LASIK eye surgery. Patients generally pay for that themselves. They know how to give reasonable estimates, take personal payments and they compete among similar providers based on the cost and quality of their work. There is little reason that routine care and most surgeries couldn’t work in a similar way. > > Breast augmentation and Lasik surgery each cost about $4000 on average. Good luck getting out of an emergency room with even a simple broken arm for a total cost less than that let alone something that requires actual surgery even though putting a cast on an arm is a relatively old and simple procedure. There is a concept in economics called _price elasticity._ It refers to a customers ability to shop around and refuse a purchase if the price is unduly high. Lack of price elasticity is frequently associate with market failure I am told. You can shop around for Lasik or breast implants. You can refuse prices that are unduly high. This is not the case for a broken leg, shattered hip etc. (There are other confounding factors as well, but price elasticity is a big one) ---
**Author:** ![D\_Anconia](https://avatars.discourse-cdn.com/v4/letter/d/67e7ee/32.png) [@D\_Anconia](https://boards.straightdope.com/u/D_Anconia)\ **Post date:** [March 26, 2017, 1:26am UTC](https://boards.straightdope.com/t/what-do-people-actually-want-from-healthcare/782904/72 "2017-03-26T01:26:04Z")
> [@jsgoddess](#): > > TLDR: Part of our excessive health care cost is our refusal to pay appropriate welfare costs. Who gets to determine “appropriate welfare costs”? You? ---
**Author:** ![Bone](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bone/32/407_2.png) [@Bone](https://boards.straightdope.com/u/Bone)\ **Post date:** [March 26, 2017, 1:58am UTC](https://boards.straightdope.com/t/what-do-people-actually-want-from-healthcare/782904/73 "2017-03-26T01:58:38Z")
> [@Acsenray](#): > > You will never reach a reasonable, realistic discussion on the issue if you repeat blatantly idiotic and dishonest things like this. Please don’t appear to accuse other posters of lying. If you feel you must, the BBQ Pit is right around the corner. [/moderating] ---
**Author:** ![running\_coach](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/running_coach/32/15836_2.png) [@running\_coach](https://boards.straightdope.com/u/running_coach)\ **Post date:** [March 26, 2017, 2:01am UTC](https://boards.straightdope.com/t/what-do-people-actually-want-from-healthcare/782904/74 "2017-03-26T02:01:17Z")
> [@D\_Anconia](#): > > Who gets to determine “appropriate welfare costs”? You? Who gets to determine “appropriate welfare costs”? You? ---
**Author:** ![SuperAbe](https://avatars.discourse-cdn.com/v4/letter/s/f17d59/32.png) [@SuperAbe](https://boards.straightdope.com/u/SuperAbe)\ **Post date:** [March 26, 2017, 2:02am UTC](https://boards.straightdope.com/t/what-do-people-actually-want-from-healthcare/782904/75 "2017-03-26T02:02:36Z")
> [@D\_Anconia](#): > > Who gets to determine “appropriate welfare costs”? We start from “social welfare costs sufficient to avoid direct decline of an individual’s medical condition and thus prevent or reduce the need for expensive medical interventions”. Medically, $100 worth of insulin is a hell of a lot cheaper (on many levels) than dealing with the costs of long term crappy blood sugar control. Making sure the same diabetic isn’t skipping insulin to have enough money for, say, food, is a social welfare problem. When the latter affects the former, we have failed to provide appropriate welfare and burden the healthcare system inappropriately. ---
**Author:** ![D\_Anconia](https://avatars.discourse-cdn.com/v4/letter/d/67e7ee/32.png) [@D\_Anconia](https://boards.straightdope.com/u/D_Anconia)\ **Post date:** [March 26, 2017, 2:24am UTC](https://boards.straightdope.com/t/what-do-people-actually-want-from-healthcare/782904/76 "2017-03-26T02:24:12Z")
> [@running\_coach](#): > > Who gets to determine “appropriate welfare costs”? You? We, the People, in Congress Assembled, do. Not people on message boards. ---
**Author:** ![Leaffan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/leaffan/32/299_2.png) [@Leaffan](https://boards.straightdope.com/u/Leaffan)\ **Post date:** [March 26, 2017, 9:52am UTC](https://boards.straightdope.com/t/what-do-people-actually-want-from-healthcare/782904/77 "2017-03-26T09:52:45Z")
If you truly want UHC, then why can’t you elect a party that promises UHC? In fact l, you just did the opposite; you elected a party promising to reverse the progress towards UHC. If a party in Canada ran on a platform of reducing or eliminating UHC they would get exactly zero votes. Sent from my adequate mobile device using Tapatalk. ---
**Author:** ![up\_the\_junction](https://avatars.discourse-cdn.com/v4/letter/u/f1d935/32.png) [@up\_the\_junction](https://boards.straightdope.com/u/up_the_junction)\ **Post date:** [March 26, 2017, 10:20am UTC](https://boards.straightdope.com/t/what-do-people-actually-want-from-healthcare/782904/78 "2017-03-26T10:20:18Z")
Believe it or not - and I know it’s not easy - but the USA has far bigger problems than healthcare i.e. the entire political class, vested interests and the question of representative democracy. ---
**Author:** ![SamuelA](https://avatars.discourse-cdn.com/v4/letter/s/c77e96/32.png) [@SamuelA](https://boards.straightdope.com/u/SamuelA)\ **Post date:** [March 26, 2017, 10:30am UTC](https://boards.straightdope.com/t/what-do-people-actually-want-from-healthcare/782904/79 "2017-03-26T10:30:36Z")
> [@Leaffan](#): > > If you truly want UHC, then why can’t you elect a party that promises UHC? In fact l, you just did the opposite; you elected a party promising to reverse the progress towards UHC. > If a party in Canada ran on a platform of reducing or eliminating UHC they would get exactly zero votes. A severe part of the problem is that party’s frontrunner made numerous vague promises in public that implied he was for some sort of UHC. When he was in the process of shoving through a bill that would go in the exact opposite direction - from “partial UHC” to “healthcare for only those who can afford to pay a lot for their coverage” - Trump was making it _sound_ like the bill was great. To those who I guess only listen to right wing talk radio or to their friends on facebook, they must have thought the recent bill was an improvement somehow. The political system can’t work if accurate information about the agenda and plans of the politicians you vote for are not available to voters. Think about it. If a political party can do one thing, and then lie and claim they are planning to do something else, and a significant portion of voters buy those lies because there is no actual universal yardstick or trusted media source…well here we are. ---
**Author:** ![Aspenglow](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/aspenglow/32/76_2.png) [@Aspenglow](https://boards.straightdope.com/u/Aspenglow)\ **Post date:** [March 26, 2017, 3:33pm UTC](https://boards.straightdope.com/t/what-do-people-actually-want-from-healthcare/782904/80 "2017-03-26T15:33:01Z")
> [@Leaffan](#): > > If you truly want UHC, then why can’t you elect a party that promises UHC? In fact l, you just did the opposite; you elected a party promising to reverse the progress towards UHC. > If a party in Canada ran on a platform of reducing or eliminating UHC they would get exactly zero votes. > > Sent from my adequate mobile device using Tapatalk. I think it’s hard to express how much damage has been done by alternative news sources – and I absolutely include Fox “News” in this characterization – as well as corporate news sources (CNN, e.g.) in shaping the national discussion on this issue, and hence how many Americans vote. Health care is big, big business in the USA. It constitutes a full fifth of our economy. Corporate players spend staggering amounts of money both to drive their disingenuous message and get their guys into Congress. The message they drive is that health care administered by government is “bad” – and I’m sure for their purposes of continuing to make gobs of money, that’s true! So we hear about phony death panels and how horrible government-run health care will be. We hear about “dingy” hospitals and how people will die while waiting for treatment. A disturbingly large segment of our population succumbs to these fake narratives and they vote accordingly – even against their own best interests. Meantime, those same corporate players are manipulating votes in Congress with their big money sticks. They expect quid pro quo for their financial support of congressional candidates during their elections. Same as the NRA, which is why common sense gun control laws fail repeatedly, despite a significant majority of Americans supporting them. Our Congress is bought and paid for by corporate interests owned and controlled by a very few obscenely wealthy players. They’ve been working toward this showdown for decades and they see this as their moment. I just heard a conservative right-wing pundit characterize Trump/Ryan’s failed health care bill as one issued by “moderate Republicans.” Fuck me. If that’s true (it isn’t), I can’t imagine how hateful a hard right wing Republican plan would be. Actually, yes, I can. “You! Old bitch! Go get on your ice floe!” [Previous page](https://boards.straightdope.com/t/what-do-people-actually-want-from-healthcare/782904.md?page=3) [Next page](https://boards.straightdope.com/t/what-do-people-actually-want-from-healthcare/782904.md?page=5)