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And if you look at rates of visits, while ignoring cost/content of the visits it seems like you're missing a big part of the analysis. Sure, letting people suf

• AnthonyMouse 9y ago
  > And if you look at rates of visits, while ignoring cost/content of the visits it seems like you're missing a big part of the analysis. Not so much, because of the way emergency rooms work. What costs is the capacity, not what you use it for. You have to pay the going rate for a surgeon who can do open heart surgery, even if that doctor is only administering aspirin for a headache. That's why a $.25 band-aid costs $100 at an ER. > Sure, letting people suffer and die is cheaper on the medical systems books - but people dying earlier than they need to is a negative cost on our society and larger economys side ... let alone the ethical questions there. But the original problem was that people can't afford healthcare, either individually out of pocket or collectively as insurance premiums or taxes. If covering more people under government insurance doesn't reduce costs then it doesn't solve the problem -- people still won't be able to afford healthcare. It doesn't help anything to make it mandatory as taxes so that they end up not being able to afford rent or food instead of health insurance. We need to figure out how to actually reduce costs so that the amount of healthcare people need costs less than the amount of money they have, so that it's possible for people to get healthcare without going bankrupt. That probably means people paying for more things out of pocket, because out of pocket payments shouldn't have triple the expense due to insurance paperwork, and people only compare prices when it's their own money.
  • dv_dt 9y ago
    > But the original problem was that people can't afford healthcare, either individually out of pocket or collectively as insurance premiums or taxes. If covering more people under government insurance doesn't reduce costs then it doesn't solve the problem -- people still won't be able to afford healthcare. There is a wealth of data that shows that the problem with health costs is in fact solved by strong government involvement in health care in systems where people don't pay out of pocket at all ... ignoring that data is willful ignorance. http://www.pbs.org/newshour/rundown/health-costs-how-the-us-compares-with-other-countries/ http://www.pbs.org/newshour/rundown/health-costs-how-the-us-... Proposing alternatives government involvement are interesting, but not very constructive if we can't even get to the point of agreement of how well real world health systems perform in other nations vs the US.
    • AnthonyMouse 9y ago
      > There is a wealth of data that shows that the problem with health costs is in fact solved by strong government involvement in health care in systems where people don't pay out of pocket at all Just comparing costs doesn't work when there are so many asymmetries. The US has far lower density than those countries, which increases costs because it makes it necessary to have a lot more idle capacity in order to maintain a reasonable emergency response time. And a big part of the cost that the US system pays and nationalized systems don't is actually legitimate -- it pays for medical R&D. If we just regulated prices like other countries then that money disappears -- which is fairer, but that doesn't mean it wouldn't cost lives. Other countries have lower costs because they're ripping us off by not paying an equal share. Unless you can convince them to pay more, we can't eliminate that cost without eliminating the research it pays for. Moreover, there is no question that parts of the US system are terrible -- especially the insurance companies and the amount of overhead and inefficiency that comes from using "insurance" to pay for non-catastrophic care. But it should be possible (politics and corruption notwithstanding) to change that part of the system without nationalizing the whole thing. Because national healthcare has its own problems. From your link: > In Japan, if spending in a specific area seems to be growing faster than projected, they lower fees for that area. That's the bureaucratic solution. It absolutely works to keep prices down. As long as you don't mind that it implies responding to demand by spreading the existing resources thinner without regard to how that affects outcomes. There is a reason the US has a worse average but a better median. There have to be ways to reduce costs and help the bottom 20% without hurting the middle -- and that's the only thing that will pass anyway, because you can't get 50% of the votes with something that will reduce the quality of care for the other 80% of people.
      • ryandrake 9y ago
        > The US has far lower density than those countries, which increases costs because it makes it necessary to have a lot more idle capacity in order to maintain a reasonable emergency response time. The density argument doesn't make sense. If that were true, New Jersey would have cheap healthcare on par with "those countries" that have similar population densities. New Jersey would also have cheap, super-fast broadband and a robust statewide public transportation system, other things that people claim the U.S. simply can't do because population density.