4 ms·

I'm not posing it as a problem. I'm simply pointing out the real reason things work in the UK is that people pay less for the same thing. Tangentially, if anyo

I'm not posing it as a problem. I'm simply pointing out the real reason things work in the UK is that people pay less for the same thing. Tangentially, if anyone proposes UK-style solutions to health care problems in the US without proposing 50-66% wage cuts for doctors/nurses, they are lying to you.

andreasklinger 10y ago
as said above - almost all jobs are Nx paid in the US. Doesnt necessary mean you have more money NET in the end
arethuza 10y ago
Well, the NHS is socialism so as far as I can see an approach like that wouldn't be ideologically acceptable in the US. NB Regarding the "socialism" part, from NHS founder Aneurin Bevan: "A free health service is pure Socialism and as such it is opposed to the hedonism of capitalist society." I always think it is worth noting that the title of Bevan's book on the NHS was "In Place of Fear" - which I think sums it up nicely. https://en.wikipedia.org/wiki/Aneurin_Bevan https://en.wikipedia.org/wiki/Aneurin_Bevan
- yummyfajitas 10y ago
  I have no problem, in theory, with socialized medicine that we drastically underfund. It's probably a great way to waste fewer resources on medicine. In practice that's just not politically feasible in the US. An illustrative example: a few years ago, a major study found that mammograms before age 50 are financially wasteful and medically harmful. Congress passed a law requiring insurance companies to pay for them anyway. https://www.bloomberg.com/view/articles/2012-07-31/in-mammogram-debate-politics-trounces-science https://www.bloomberg.com/view/articles/2012-07-31/in-mammog... http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/breast-cancer-screening http://www.uspreventiveservicestaskforce.org/Page/Document/U...
  - maxerickson 10y ago
    Medicare, Medicaid and the must stabilize mandate for ERs are underfunded. It's one of the reasons that out of pocket costs are so high.
    - chimeracoder 10y ago
      > Medicare, Medicaid and the must stabilize mandate for ERs are underfunded. It's one of the reasons that out of pocket costs are so high. Exactly. This is the hidden secret about US healthcare that very few people are aware of. Even providers usually don't see this anymore, because they're so removed from the billing process (especially now that most providers are salaried and not running their own practices). Medicare and Medicaid are the reasons that sticker prices for treatment in the US are absurdly high. Incidentally - and most people don't know this - if you're uninsured and self-paying, you almost never have to pay the sticker price. Hospitals really don't care, and if you just tell them that you're self-paying and can only afford (say) 10% of what they billed you for, they'll almost always immediately agree to a 90% discount. The only reason they're showing you that bill is that they need to present high bills to private insurers (to make up for the loss on Medicare/Medicaid reimbursements) and they're not legally allowed to present differently-priced initial bills to patients based on their insurance status.
    - yummyfajitas 10y ago
      No, they aren't underfunding. US government health care spending was $4,034/person. UK total health expenditures per person was $3,935. http://data.worldbank.org/indicator/SH.XPD.PCAP http://data.worldbank.org/indicator/SH.XPD.PCAP http://www.usgovernmentspending.com/year_spending_2014USbn_17bs2n_10#usgs302 http://www.usgovernmentspending.com/year_spending_2014USbn_1... For us to underfund it to UK levels, we'd have to expand medicare or medicaid to every single person while simultaneously cutting the total government budget for health care by 2.5%.
      - maxerickson 10y ago
        The UK system isn't competing with private US consumers for a limited pool of services. The comparison perhaps illustrates the poor value/dollar achieved in the US, it isn't instructive as to whether US government funded healthcare meets the costs of providing the services it mandates (a perfectly reasonable definition of underfunded).
throwaway-hn123 10y ago
Except that the per-capita spend on health in the US is approximately three times what it is in the UK, which seems to corresponds quite nicely to what you're saying is the difference in salaries. So, actually, yeah, you probably could move to a UK style solution, with the same per-capita spend as in the US while still preserving the seemingly very high wages for doctors and nurses.

andreasklinger 10y ago

as said above - almost all jobs are Nx paid in the US. Doesnt necessary mean you have more money NET in the end

arethuza 10y ago

Well, the NHS is socialism so as far as I can see an approach like that wouldn't be ideologically acceptable in the US. NB Regarding the "socialism" part, from NHS founder Aneurin Bevan: "A free health service is pure Socialism and as such it is opposed to the hedonism of capitalist society." I always think it is worth noting that the title of Bevan's book on the NHS was "In Place of Fear" - which I think sums it up nicely. https://en.wikipedia.org/wiki/Aneurin_Bevan https://en.wikipedia.org/wiki/Aneurin_Bevan

yummyfajitas 10y ago
I have no problem, in theory, with socialized medicine that we drastically underfund. It's probably a great way to waste fewer resources on medicine. In practice that's just not politically feasible in the US. An illustrative example: a few years ago, a major study found that mammograms before age 50 are financially wasteful and medically harmful. Congress passed a law requiring insurance companies to pay for them anyway. https://www.bloomberg.com/view/articles/2012-07-31/in-mammogram-debate-politics-trounces-science https://www.bloomberg.com/view/articles/2012-07-31/in-mammog... http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/breast-cancer-screening http://www.uspreventiveservicestaskforce.org/Page/Document/U...
- maxerickson 10y ago
  Medicare, Medicaid and the must stabilize mandate for ERs are underfunded. It's one of the reasons that out of pocket costs are so high.
  - chimeracoder 10y ago
    > Medicare, Medicaid and the must stabilize mandate for ERs are underfunded. It's one of the reasons that out of pocket costs are so high. Exactly. This is the hidden secret about US healthcare that very few people are aware of. Even providers usually don't see this anymore, because they're so removed from the billing process (especially now that most providers are salaried and not running their own practices). Medicare and Medicaid are the reasons that sticker prices for treatment in the US are absurdly high. Incidentally - and most people don't know this - if you're uninsured and self-paying, you almost never have to pay the sticker price. Hospitals really don't care, and if you just tell them that you're self-paying and can only afford (say) 10% of what they billed you for, they'll almost always immediately agree to a 90% discount. The only reason they're showing you that bill is that they need to present high bills to private insurers (to make up for the loss on Medicare/Medicaid reimbursements) and they're not legally allowed to present differently-priced initial bills to patients based on their insurance status.
  - yummyfajitas 10y ago
    No, they aren't underfunding. US government health care spending was $4,034/person. UK total health expenditures per person was $3,935. http://data.worldbank.org/indicator/SH.XPD.PCAP http://data.worldbank.org/indicator/SH.XPD.PCAP http://www.usgovernmentspending.com/year_spending_2014USbn_17bs2n_10#usgs302 http://www.usgovernmentspending.com/year_spending_2014USbn_1... For us to underfund it to UK levels, we'd have to expand medicare or medicaid to every single person while simultaneously cutting the total government budget for health care by 2.5%.
    - maxerickson 10y ago
      The UK system isn't competing with private US consumers for a limited pool of services. The comparison perhaps illustrates the poor value/dollar achieved in the US, it isn't instructive as to whether US government funded healthcare meets the costs of providing the services it mandates (a perfectly reasonable definition of underfunded).

throwaway-hn123 10y ago

Except that the per-capita spend on health in the US is approximately three times what it is in the UK, which seems to corresponds quite nicely to what you're saying is the difference in salaries. So, actually, yeah, you probably could move to a UK style solution, with the same per-capita spend as in the US while still preserving the seemingly very high wages for doctors and nurses.