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Some context: Americans pay 2.5x more than the average first-world single-payer system. 2.5x... This funds demonstrably and starkly worse outcomes on the met

Some context: Americans pay 2.5x more than the average first-world single-payer system. 2.5x... This funds demonstrably and starkly worse outcomes on the metrics we should collectively care about: life expectancy. Incidence of chronic disease. Infant morality. The reason we pay much more for much less is simple: for-profit health care optimizes for profits, not outcomes. That is exactly what it has done; exactly what it will do. The public sector already does single-payer in this country with an order of magnitude less overhead cost than the private sector. When I discuss these facts with conservatives and libertarians, I usually discover that most of this is decreed "fine," because we disagree about whether or not health care is a right. For that reason, I've stopped suggesting that it is, and focused on another stark fact: Failure to provide basic health care to all, through straightforward means, merely means that it is provided through partially hidden means (like ER rooms) at vastly greater cost, not least because emergency care cannot perform preventive and chronic care, which in many cases would provide better outcomes for two orders of magnitude less cost. Morality is a matter of instinct and choice. The costs of the existing broken system are however obvious, and render any defense IMO irrational.

refurb 9y ago
The reason we pay much more for much less is simple: for-profit health care optimizes for profits, not outcomes. Over 50% of healthcare in the US is paid for by the gov't and those costs are still higher than other systems that are single payer and non-profit. Doesn't quite align with your theory though.
- notahacker 9y ago
  The healthcare services paid for by the government is (i) provided by profit-motivated companies with all the private sector incentives to overdiagnose and (ii) typically performed at lower rates than those paid by private insurers, and much lower rates than those paid by individuals without the relevant insurance cover.
  - refurb 9y ago
    But even at Medicaid rates, the cost of healthcare in the US is higher than other countries. Are you suggesting that the gov't is swayed by the demands of for-profit companies?
    - creaghpatr 9y ago
      Absolutely, the Healthcare Lobby gets what they want, regardless of which party is in power.
      - refurb 9y ago
        Well plenty of health care providers refused to service Medicaid patients because the rates are so low. That would infer that they aren't getting what they want from the gov't.
- aaroninsf 9y ago
  50% (or whatever...) _subsidy_ is not a proxy for sole management and administration. Funding _source_ notwithstanding, bills are paid to for-profit providers with limited exception (the VA being the main one). Price caps are calculated as a function of the largely unrestrained market gouging of the oligopoly. If you think that's a biased or histrionic description, consider this: https://www.wallstreetdaily.com/charts/0715_HealthcareInsurance.png https://www.wallstreetdaily.com/charts/0715_HealthcareInsura... Stunning growth in profits under Obamacare... The fantastically under-reported reason that the GOP is struggling to find traction or indeed direction viz. undoing Obamacare, is that Obamacare as delivered represented a mostly fulfilled GOP wish list. As a progressive, I would say: concessions to essentially print money were extracted at gun point from Dems willing to sacrifice much to pass a bill achieving specific key planks (namely the removal of 'preexisting conditions' and a strong step towards universal coverage). The GOP walked with a bill they largely wrote. There is little left to want, other than yet more consolidation of wealth... and the roll-back of extremely popular benefits. Watching this break into the open provides very cold comfort.

refurb 9y ago

The reason we pay much more for much less is simple: for-profit health care optimizes for profits, not outcomes. Over 50% of healthcare in the US is paid for by the gov't and those costs are still higher than other systems that are single payer and non-profit. Doesn't quite align with your theory though.

notahacker 9y ago
The healthcare services paid for by the government is (i) provided by profit-motivated companies with all the private sector incentives to overdiagnose and (ii) typically performed at lower rates than those paid by private insurers, and much lower rates than those paid by individuals without the relevant insurance cover.
- refurb 9y ago
  But even at Medicaid rates, the cost of healthcare in the US is higher than other countries. Are you suggesting that the gov't is swayed by the demands of for-profit companies?
  - creaghpatr 9y ago
    Absolutely, the Healthcare Lobby gets what they want, regardless of which party is in power.
    - refurb 9y ago
      Well plenty of health care providers refused to service Medicaid patients because the rates are so low. That would infer that they aren't getting what they want from the gov't.
aaroninsf 9y ago
50% (or whatever...) _subsidy_ is not a proxy for sole management and administration. Funding _source_ notwithstanding, bills are paid to for-profit providers with limited exception (the VA being the main one). Price caps are calculated as a function of the largely unrestrained market gouging of the oligopoly. If you think that's a biased or histrionic description, consider this: https://www.wallstreetdaily.com/charts/0715_HealthcareInsurance.png https://www.wallstreetdaily.com/charts/0715_HealthcareInsura... Stunning growth in profits under Obamacare... The fantastically under-reported reason that the GOP is struggling to find traction or indeed direction viz. undoing Obamacare, is that Obamacare as delivered represented a mostly fulfilled GOP wish list. As a progressive, I would say: concessions to essentially print money were extracted at gun point from Dems willing to sacrifice much to pass a bill achieving specific key planks (namely the removal of 'preexisting conditions' and a strong step towards universal coverage). The GOP walked with a bill they largely wrote. There is little left to want, other than yet more consolidation of wealth... and the roll-back of extremely popular benefits. Watching this break into the open provides very cold comfort.