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I do question the morality of the US system, and the sustainability of inflated prices it creates. Its also important to remember that in for - profit healthca

by cortic 10y ago

I do question the morality of the US system, and the sustainability of inflated prices it creates. Its also important to remember that in for - profit healthcare, its operated as a profit center and thus has profit margins that are corporately mandated and not determined by need, at least not directly. This leads to a massive inflation of price and decrease of quality of service, medicine, machines etc. Not saying the EU system is better, but then that depends whether you are a shareholder or a patient.

ThomPete 10y ago
I am unconvinced any of the systems are sustainable. The US system isn't better it's different. The inflated prices aren't due to it being more privately driven but because of lobbying which can be dealt with.
- cortic 10y ago
  EU systems get much better outcomes for a fraction of the cost, and you think that's 'unsustainable'? 'lobbying' can be dealt with a either side of the pond, the only thing you are arguing for is making profit from the poor and sick.
  - ThomPete 10y ago
    Better outcomes doesn't shield you from in-sustainability if your cost still is bigger than the money you can afford to put into it. The problem with healthcare is that you can never spend enough money on it. There are always methods, never and better machines. In a singlepayer system the taxpayers pay for that which means there need to be political mandate behind the budgetting. You can only spend money in a singlepayer system. In a system more driven by market you can actually make money. It's finding the right balance between those two I consider the most interesting part of this discussion. Unfortunately it's impossible to have this discussion because people either see you as a singlepayer proponent or a 100% marketdriven proponent.
    - cortic 10y ago
      "cost still is bigger than the money you can afford to put into it." - so spending even more would be super sustainable, so long as it enriches the wealthy shareholders? "you can never spend enough money on it" - i say again, 'enough' is defined differently, a 'socialist enough' is enough to please the people; where a 'capitalist enough' is the smallest number that can sustain profit. these 'enough's are radically different. "In a system more driven by market you can actually make money." - only by denying treatment. this is the cornerstone of the market model, those who can't pay don't matter. "It's finding the right balance between those two" - In the UK, we are bringing private companies into contracts within the NHS, its always been a disaster, costing much more money that the services needed to cost, the inefficiency inherent in private companies (from bloated wages of CEOs to dividends) drag the whole system into financial crisis. The people who pay for the profits at the top are always the poor users of the service.
      - ThomPete 10y ago
        Spending even more is whats unsustainable you can't keep spending more and more money in a single payer system as it will either affect other areas or you will have to tax the citizens even more. There is a limit to that. If you get more and more treatments available and what people consider being part of healthcare and you are running a cost center then your system gets more and more expensive. No enough here is meant as there will always be things you can spend to make your system better than it is. It's not a matter of opinion it's a matter of what kind of treatments are available compared to how many you can offer. The single payer system is also denying treatment exactly because it can't pay if everyone used it. It's just another way to say some people don't matter enough. In the UK system is also deciding which drugs it will prioritize and which it wont. You are mixing two things together. Yes there are plenty of issues with the US system but the single payer system have issues too and they are not the same.
        cortic 10y ago
        "Spending even more is whats unsustainable" - nationalized healthcare spends less for the same or better outcome, if your problem is price, then your problem is private healthcare. 'cost center' Vs 'profit center' <why would the profit center be cheaper? its the same as a 'cost center' with an added money drain and incentive to inflate prices.. '[denying treatment] because it can't pay if everyone used it' - This is just false, moneys going into a countries nationalized health system is high return (due to taxes), its also cheaper (due to group union prices). So long as its a healthy part of a healthy GDP (12%) it should have capacity for everyone in the country. compared to the US system which costs over 40% of your GDP and still does not have capacity for all your citizens. 'which drugs it will prioritize' - true, but this is done mostly on evidence of usefulness, not price. I largely agree with your last statement, but whatever problems a socialist system has, they pale in comparison to the misery caused by Laissez-faire in our health system.
alphonsegaston 10y ago
There's no question about it morality - it's immoral. Creating a system where whether you live or die is premised on your income is immoral. Even more so when single-payer systems demonstrably achieve better health outcomes at lower prices. The reality is that that so many people in this country have bought into some kind of Capitalist Calvinism, where the suffering is not only pre-ordained by "market forces," but considered salutary itself, that it's sickened our culture beyond the capacity for reason. We'd really rather watch our friends, families, and neighbors die in sickness and poverty, than admit the failure of the grotesque just-world fallacy that is our economic ideology.
- ThomPete 10y ago
  It's not that simple. Single payer systems also decide who to treat and for what sicknesses, what machines to buy etc. The reason why the US system is so expensive is because of perverse incentives given to the industry. As long as you can afford it I would rather be treated in the US system than the French or Danish system.
  - alphonsegaston 10y ago
    >It's not that simple. Single payer systems also decide who to treat and for what sicknesses, what machines to buy etc. So does the US, they just use one's wealth as a proxy to arrive at demonstrably worse results for everyone overall. If you want to have a system where one's income determines their ability to survive because you have enough money and that works for you right now, go ahead. But at least drop the pretense that it's in any way just or moral.
    - ThomPete 10y ago
      Thats a different discussion though. You can be of the opinion that everyone should get access to the same treatment or you can be of the opinion that they shouldn't and that people who can afford better treatment should be able to. All I was doing was point out that a single payer system has it's own issues as well. Whether you are a fan of one or the other is more a political discussion.

by cortic 10y ago

ThomPete 10y ago

I am unconvinced any of the systems are sustainable. The US system isn't better it's different. The inflated prices aren't due to it being more privately driven but because of lobbying which can be dealt with.

cortic 10y ago
EU systems get much better outcomes for a fraction of the cost, and you think that's 'unsustainable'? 'lobbying' can be dealt with a either side of the pond, the only thing you are arguing for is making profit from the poor and sick.
- ThomPete 10y ago
  Better outcomes doesn't shield you from in-sustainability if your cost still is bigger than the money you can afford to put into it. The problem with healthcare is that you can never spend enough money on it. There are always methods, never and better machines. In a singlepayer system the taxpayers pay for that which means there need to be political mandate behind the budgetting. You can only spend money in a singlepayer system. In a system more driven by market you can actually make money. It's finding the right balance between those two I consider the most interesting part of this discussion. Unfortunately it's impossible to have this discussion because people either see you as a singlepayer proponent or a 100% marketdriven proponent.
  - cortic 10y ago
    "cost still is bigger than the money you can afford to put into it." - so spending even more would be super sustainable, so long as it enriches the wealthy shareholders? "you can never spend enough money on it" - i say again, 'enough' is defined differently, a 'socialist enough' is enough to please the people; where a 'capitalist enough' is the smallest number that can sustain profit. these 'enough's are radically different. "In a system more driven by market you can actually make money." - only by denying treatment. this is the cornerstone of the market model, those who can't pay don't matter. "It's finding the right balance between those two" - In the UK, we are bringing private companies into contracts within the NHS, its always been a disaster, costing much more money that the services needed to cost, the inefficiency inherent in private companies (from bloated wages of CEOs to dividends) drag the whole system into financial crisis. The people who pay for the profits at the top are always the poor users of the service.
    - ThomPete 10y ago
      Spending even more is whats unsustainable you can't keep spending more and more money in a single payer system as it will either affect other areas or you will have to tax the citizens even more. There is a limit to that. If you get more and more treatments available and what people consider being part of healthcare and you are running a cost center then your system gets more and more expensive. No enough here is meant as there will always be things you can spend to make your system better than it is. It's not a matter of opinion it's a matter of what kind of treatments are available compared to how many you can offer. The single payer system is also denying treatment exactly because it can't pay if everyone used it. It's just another way to say some people don't matter enough. In the UK system is also deciding which drugs it will prioritize and which it wont. You are mixing two things together. Yes there are plenty of issues with the US system but the single payer system have issues too and they are not the same.
      - cortic 10y ago
        "Spending even more is whats unsustainable" - nationalized healthcare spends less for the same or better outcome, if your problem is price, then your problem is private healthcare. 'cost center' Vs 'profit center' <why would the profit center be cheaper? its the same as a 'cost center' with an added money drain and incentive to inflate prices.. '[denying treatment] because it can't pay if everyone used it' - This is just false, moneys going into a countries nationalized health system is high return (due to taxes), its also cheaper (due to group union prices). So long as its a healthy part of a healthy GDP (12%) it should have capacity for everyone in the country. compared to the US system which costs over 40% of your GDP and still does not have capacity for all your citizens. 'which drugs it will prioritize' - true, but this is done mostly on evidence of usefulness, not price. I largely agree with your last statement, but whatever problems a socialist system has, they pale in comparison to the misery caused by Laissez-faire in our health system.

alphonsegaston 10y ago

There's no question about it morality - it's immoral. Creating a system where whether you live or die is premised on your income is immoral. Even more so when single-payer systems demonstrably achieve better health outcomes at lower prices. The reality is that that so many people in this country have bought into some kind of Capitalist Calvinism, where the suffering is not only pre-ordained by "market forces," but considered salutary itself, that it's sickened our culture beyond the capacity for reason. We'd really rather watch our friends, families, and neighbors die in sickness and poverty, than admit the failure of the grotesque just-world fallacy that is our economic ideology.

ThomPete 10y ago
It's not that simple. Single payer systems also decide who to treat and for what sicknesses, what machines to buy etc. The reason why the US system is so expensive is because of perverse incentives given to the industry. As long as you can afford it I would rather be treated in the US system than the French or Danish system.
- alphonsegaston 10y ago
  >It's not that simple. Single payer systems also decide who to treat and for what sicknesses, what machines to buy etc. So does the US, they just use one's wealth as a proxy to arrive at demonstrably worse results for everyone overall. If you want to have a system where one's income determines their ability to survive because you have enough money and that works for you right now, go ahead. But at least drop the pretense that it's in any way just or moral.
  - ThomPete 10y ago
    Thats a different discussion though. You can be of the opinion that everyone should get access to the same treatment or you can be of the opinion that they shouldn't and that people who can afford better treatment should be able to. All I was doing was point out that a single payer system has it's own issues as well. Whether you are a fan of one or the other is more a political discussion.