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The thing I keep wanting to bring up: >Higher prices aren’t all bad for consumers. They probably lead to some increased innovation, which confers benefits to p

by lsc 9y ago

The thing I keep wanting to bring up: >Higher prices aren’t all bad for consumers. They probably lead to some increased innovation, which confers benefits to patients globally. Though it’s reasonable to push back on high health care prices, there may be a limit to how far we should. Fundamentally speaking, much like education, while I agree that healthcare is unaffordable to many, I point out that this is different from being too expensive. I think the idea that we are spending too much of our wealth on education and healthcare is... wrong. I mean, sure, there are limits on what we want to spend, as a society, on healthcare, and yes, I personally think that a lot of the public money being spent on healthcare (and I think a lot of public money should be spent on healthcare) should be spent on research that benefits all, but overall? as a society? I don't think spending 17% of our GDP on healthcare is a problem (assuming we're receiving good benefits from that, which I think we are) And yeah, maybe there needs to be 'community college' equivalent of healthcare; a system where anyone can show up and get care that is good but not the best for next to nothing. And yes, we do need more and better-funded research for the public good. I certainly don't have a problem with private industry researching new drugs for us, but we have to understand that their incentives are... different, and that there's a place for public-funded work for the public-interest.

intopieces 9y ago
> I think the idea that we are spending too much of our wealth on education and healthcare is... wrong.[...]I don't think spending 17% of our GDP on healthcare is a problem (assuming we're receiving good benefits from that, which I think we are) You're missing a dimension to both of these numbers: Outcome. The U.S. spends more on healthcare than any other country — but not with better health outcomes [0]. "The US stands out as an outlier: it spends far more on health than any other country, yet the life expectancy of the American population is not longer, but actually shorter than in other countries that spend far less." [1] [0]http://beta.latimes.com/nation/la-na-healthcare-comparison-20170715-htmlstory.html http://beta.latimes.com/nation/la-na-healthcare-comparison-2... [1]https://ourworldindata.org/the-link-between-life-expectancy-and-health-spending-us-focus https://ourworldindata.org/the-link-between-life-expectancy-...
- lsc 9y ago
  One explanation of the difference in outcomes, especially your "Number of deaths per 100,000 from preventable diseases or complications had adequate healthcare been available, in 2013" statistic has mostly to do with accessibility. Lack of access. That, and a cultural avoidance of seeking help, but I bet it's mostly the lack of access. If you have bad insurance? there's huge variance in what a procedure will cost, and in my experience, hospitals aren't setup to deal with the "how much is this going to cost me?" question. The ACA may have helped with this. With my yearly out of pocket limits, I have some peace of mind that it won't, at least, go over that. Personally, I think we can continue to compare this to the education system, we need something like 'community colleges' - Sure, you need paperwork and to go through a bunch of hoops if you want to go to Stanford- and you get a better product than at the community college, if you can make it, but anyone can walk into the community college and get half a pretty decent education that is almost completely paid for by the government. I think we need something similar in medicine... a place anyone can walk in where they know they can get care that meets minimal government standards that is next to free. But... my point is just that making the whole system cheaper is not the best way to solve that. We don't want to replace Stanford with the University of Phoenix. To continue my analogy, the private sector does beautifully at the high end, in both schooling and medicine. To bring back the University of Phoenix example, at the low end? I would much rather have the low end government product than the low end private sector product.
  - intopieces 9y ago
    It's precisely about lack of access, hence the conclusion of the quote: ".. had adequate healthcare been available." There is a cultural avoidance of seeking help because the help will bankrupt you. Because it's too expensive. Making it cheaper = better access = better health outcomes. How do we know? Every other industrialized nation does it better than we do for cheaper.
    - lsc 9y ago
      >Making it cheaper = better access = better health outcomes. How do we know? Every other industrialized nation does it better than we do for cheaper. My understanding was that the nations that have better outcomes for the poor tax people and use that money to pay for government supervised medical care, and that it's the government paying for and supervising the care that leads to better access. Private sector solutions, as I said before, seem to work extraordinarily well for the rich, both in medicine and education. If Stanford will let me in, sign me up. But, when I am shopping on the low end? I want some government intervention. Cheap private sector medicine, I suspect, would look a lot like cheap private sector education... ITT tech, Corinthian Colleges, or at best, the university of phoenix.

by lsc 9y ago

intopieces 9y ago

> I think the idea that we are spending too much of our wealth on education and healthcare is... wrong.[...]I don't think spending 17% of our GDP on healthcare is a problem (assuming we're receiving good benefits from that, which I think we are) You're missing a dimension to both of these numbers: Outcome. The U.S. spends more on healthcare than any other country — but not with better health outcomes [0]. "The US stands out as an outlier: it spends far more on health than any other country, yet the life expectancy of the American population is not longer, but actually shorter than in other countries that spend far less." [1] [0]http://beta.latimes.com/nation/la-na-healthcare-comparison-20170715-htmlstory.html http://beta.latimes.com/nation/la-na-healthcare-comparison-2... [1]https://ourworldindata.org/the-link-between-life-expectancy-and-health-spending-us-focus https://ourworldindata.org/the-link-between-life-expectancy-...

lsc 9y ago
One explanation of the difference in outcomes, especially your "Number of deaths per 100,000 from preventable diseases or complications had adequate healthcare been available, in 2013" statistic has mostly to do with accessibility. Lack of access. That, and a cultural avoidance of seeking help, but I bet it's mostly the lack of access. If you have bad insurance? there's huge variance in what a procedure will cost, and in my experience, hospitals aren't setup to deal with the "how much is this going to cost me?" question. The ACA may have helped with this. With my yearly out of pocket limits, I have some peace of mind that it won't, at least, go over that. Personally, I think we can continue to compare this to the education system, we need something like 'community colleges' - Sure, you need paperwork and to go through a bunch of hoops if you want to go to Stanford- and you get a better product than at the community college, if you can make it, but anyone can walk into the community college and get half a pretty decent education that is almost completely paid for by the government. I think we need something similar in medicine... a place anyone can walk in where they know they can get care that meets minimal government standards that is next to free. But... my point is just that making the whole system cheaper is not the best way to solve that. We don't want to replace Stanford with the University of Phoenix. To continue my analogy, the private sector does beautifully at the high end, in both schooling and medicine. To bring back the University of Phoenix example, at the low end? I would much rather have the low end government product than the low end private sector product.
- intopieces 9y ago
  It's precisely about lack of access, hence the conclusion of the quote: ".. had adequate healthcare been available." There is a cultural avoidance of seeking help because the help will bankrupt you. Because it's too expensive. Making it cheaper = better access = better health outcomes. How do we know? Every other industrialized nation does it better than we do for cheaper.
  - lsc 9y ago
    >Making it cheaper = better access = better health outcomes. How do we know? Every other industrialized nation does it better than we do for cheaper. My understanding was that the nations that have better outcomes for the poor tax people and use that money to pay for government supervised medical care, and that it's the government paying for and supervising the care that leads to better access. Private sector solutions, as I said before, seem to work extraordinarily well for the rich, both in medicine and education. If Stanford will let me in, sign me up. But, when I am shopping on the low end? I want some government intervention. Cheap private sector medicine, I suspect, would look a lot like cheap private sector education... ITT tech, Corinthian Colleges, or at best, the university of phoenix.