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> But the original problem was that people can't afford healthcare, either individually out of pocket or collectively as insurance premiums or taxes. If coverin

by 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.
  - AnthonyMouse 9y ago
    Healthcare costs do very significantly from state to state. But density isn't the only factor. For example, one of the strongest indicators of high healthcare costs is having a Democratic majority in the local legislature, which tends to correlate with density and cancel out the benefit. If you look at the red states you can clearly see the effect of density -- the higher density southern red states (Texas/Georgia/Virginia/Carolinas) have lower healthcare costs than the lower density northern red states (Alaska/Wyoming/Nebraska/Dakotas).
- deleted 9y ago
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by dv_dt 9y ago

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.
- AnthonyMouse 9y ago
  Healthcare costs do very significantly from state to state. But density isn't the only factor. For example, one of the strongest indicators of high healthcare costs is having a Democratic majority in the local legislature, which tends to correlate with density and cancel out the benefit. If you look at the red states you can clearly see the effect of density -- the higher density southern red states (Texas/Georgia/Virginia/Carolinas) have lower healthcare costs than the lower density northern red states (Alaska/Wyoming/Nebraska/Dakotas).
deleted 9y ago
[deleted]