22 ms·

Universal healthcare. It works well in the majority of civilized world.

conanbatt 8y ago
In universal care you dont get access to 'clinical trials and research and things like that, where people need access to leading-edge potential treatments' You are also not eliminated the need to get funds, you are changing who you are asking them from. And let me tell you that government officials are seldom generous.
- Judgmentality 8y ago
  So you believe the US healthcare system is better than, say, the United Kingdom?
  - conanbatt 8y ago
    I dont know the UK health intimately to compare confidently. I can tell you what it looks like with Argentina. that has universal care. Normally anyone with a dime goes private. Public is a lower-quality, cheaper service. That system is great for the poor, most expensive to middle class. I can also tell you what I think are reasons why US healthcare is so expensive, and they are not fixed by universal care programs.
    - arcticbull 8y ago
      No, they absolutely are fixed by universal healthcare, as they are everywhere else on earth.
      - conanbatt 8y ago
        How is universal care going to reduce the shortage of primary care doctors? How is universal care going to eliminate patents for pharma? How is universal care going to make non-profit hospitals cheaper? How is universal care going to eliminate fee-for-service, which has the administrative costs that are the woes of care providers? How is universal care going to reduce healthcare spending?
        maxxxxx 8y ago
        Countries with universal care also usually have tight regulations on what can be charged and how. A first step would be to make all prices transparent so people can actually compare. In my view the biggest problem in the US is that the billing aspect of health care is intentionally opaque.
        conanbatt 8y ago
        Medicare is justs as opaque, and also distortive: Medicare costs 11k a year, but retirees pay less than half its cost as it is. The main reason pricing is opaque is because patients dont have freedom to compare between insurance companies, and because insurance companies are not a good model for frequent care. If you had High-deductible plans, you would make a much better system but people hate those plans. You need a big change in popular sentiment to make pricing work well. (i am all for HDPs)
        arcticbull 8y ago
        Most Americans can’t afford $500 in case of an emergency, which is why high deductible plans are a non starter to provide coverage. For them a $5000 deductible is as good as not being covered in the first place.
        conanbatt 8y ago
        Health insurance costs 800$ a month so not having 500$ means you dont have insurance. Thats another level of poverty, for the which there is medicaid and a different set of programs and way to deal with those cases.
        arcticbull 8y ago
        That's not true. First of all $800/month is what you'd expect to pay if you were young and healthy and with moderate deductibles. Good luck being older or sicker. The $500 that I'm referring to is $500 beyond what they budgeted for after their monthly expenditures. No, Medicaid doesn't always apply to these people, you should look into it. It also requires extreme levels of financial hardship. Medicaid takes a lien against your house to recover their costs. Not to mention the donut hole for whom having their house taken isn't even an option. It's brutal. When I said most of America, I meant it. It's fifty seven percent of America. [1] Are you going to put them all on Medicaid and take their houses? I thought you were arguing for private cover :) This is the kind of thinking that pushes up costs. Creating barriers to seeking care early makes everything more expensive as the longer you wait, the more it costs to resolve. Let's be rational about this. The US median individual income is $39,336. [2] Your take-home pay would be approximately $2614 per month after tax assuming you save nothing toward your retirement. Taking out $800 leaves you with $1814. The US median rent is $1500 per month [3]. This leaves you with $314 for food, gas, transportation, electric, water and sewer combined. And this is the best possible case: you're single. Then you want them to handle a $5000 deductible?! [1] https://www.cbsnews.com/news/most-americans-cant-afford-a-500-emergency-expense/ https://www.cbsnews.com/news/most-americans-cant-afford-a-50... [2] https://en.wikipedia.org/wiki/Personal_income_in_the_United_States https://en.wikipedia.org/wiki/Personal_income_in_the_United_... [3] https://www.prnewswire.com/news-releases/us-median-rent-hits-a-new-high-at-1-500-a-month-but-rent-growth-slows-heading-into-fall-300720740.html https://www.prnewswire.com/news-releases/us-median-rent-hits...
- badfrog 8y ago
  > government officials are seldom generous If government officials are using the same healthcare system as everybody else, they have incentive to make it good.
  - conanbatt 8y ago
    They have the incentive to make the ones they use good. This idea has shown to not happen in real life. Public schools, for example, do not deliver a "uniform" service.
    - arcticbull 8y ago
      No, Government officials in the US are afforded socialized medicine. "The Federal Employees Health Benefits (FEHB) Program is a system of 'managed competition' through which employee health benefits are provided to civilian government employees and annuitants of the United States government."
      - conanbatt 8y ago
        Strange contradiction: you are show a case on how federal workers have an undue benefit in comparison to the population, which is what my original argument was. This program seems to be about selecting insurances tho, not an actual insurance. It's tangential.
        arcticbull 8y ago
        No, I'm saying it's strange having the people in charge of the government touting a privatized health program for the entire nation except themselves. If private care was so much better than socialized government care, why are the senators, the house members and everyone in the armed forces so staunchly in favor of keeping their socialized care? Don't you think if socialized medicine was murder and death panels and bad outcomes and high costs, that the senators and house members would be on private plans? Why are they so in favor of staying on the government's program? Is it because socialized medicine is in fact better than private care? Further if they don't want to get off the socialized program because it's better than the private plan, why don't they work towards extending that to the average citizen like every other developed country in the entire world? Political expediency probably.
- bitcurious 8y ago
  Why not? Clinical trials in the US tend to be free from the patient's point of view.
  - conanbatt 8y ago
    Because governments dont spend nearly as much as private investment into the medical field, and have a very different alignment in terms of costs/revenues. The second part of the sentence alludes to something I did not intend to imply.
    - rosser 8y ago
      > Because governments dont spend nearly as much as private investment into the medical field... Are you not aware of how much fundamental drug and medical research is actually conducted on the taxpayer's dime at the university level, and then exclusively licensed to private enterprise for commercial exploitation? I've seen a number of sources make a compelling case that "big pharma"'s number one line item is marketing, not research.
      - conanbatt 8y ago
        At great cost to society. There should be no federal funding on this. This is one of the gravest reasons why healthcare is so expensive in the U.S. It subsidizes big corpo, big hospitals, then subsidizes richest employees, eliminating the most basic price mechanisms for competition. Not only does it do all the subsidizing, but it also makes it expensive by putting extremely costly regulation. But thats a whole topic on its own: government funding of healthcare research is not efficient and does not make it cheaper in any way. Big Pharma's #1 expenditure is always going to be protect its patent monopoly process with the FDA.
        arcticbull 8y ago
        You have a fascinating perspective on medicine and research. Research should be paid for by the people and made available in the public interest. If a private entity does pay for the research they are entitled to protect their inventions for 20 years via the patent program. That doesn't mean buyers or buying organizations shouldn't be allowed to negotiate.
- rosser 8y ago
  > In universal care you dont get access to 'clinical trials and research and things like that... [citation needed]
  - conanbatt 8y ago
    The US has substantial incoming medical tourism. If it really were strictly worse to european alternatives (more expensive or lower quality) europeans would not go to the US.
    - DanBC 8y ago
      That doesn't mean those tourists are getting effective or even safe treatment. It just means the US hospitals are good at marketing to desperate and wealthy people.
      - conanbatt 8y ago
        The funny paradox of argumenting people are stupid is that inevitably you will be put in the same category.
        DanBC 8y ago
        I'm not saying those people are stupid. I'm saying there's an information asymetry that doesn't benefit the patient customer.
    - rosser 8y ago
      > if it were strictly worse... Ohai goalpost. When did you get there? The existence of .eu-to-.us medical tourism is utterly orthogonal to the availability of research in those countries. If you honestly took ten minutes to try, you'd be able to find dozens, if not hundreds of trials in every .eu member state, plenty of which are at least comparable to, if not more advanced than what's available in the US. I could go to .eu or .in or .mx or .th, or any of dozens of other countries, to get access to medical treatments and procedures that are by many, if not most, measures superior to their alternatives available here, but which aren't available here (just one, token example: RISUG), or are vastly more expensive here, but have comparable — or, again, better — outcomes there. Most of those places offer varying degrees of socialized, if not universal, medicine.
- DanBC 8y ago
  > where people need access to leading-edge potential treatments' Those leading edge potential treatments tend to be both very expensive and ineffective, and often cause additional harm on top. That's from the analysis of a leading oncologist in the UK. https://www.bmj.com/content/357/bmj.j2097 https://www.bmj.com/content/357/bmj.j2097
  - conanbatt 8y ago
    I'm not making a judgement on the clinical validity of experimental treatments. That was a direct quote from the article.
- fatbird 8y ago
  Access to leading-edge potential treatments is a minor concern in health care: few need it, fewer qualify, and fewer are helped. Even then, your statement is false: leading edge medical research is carried out in all countries with universal health care. The U.S. has an infant mortality rate worse than 43 other countries because large numbers of pregnant women can't access routine prenatal care. That's but one example of what real health care concerns are like.
  - ams6110 8y ago
    Can't access, or don't? Medicaid will pay for prenatal care, and there are other options as well.
    - fatbird 8y ago
      Can't. The U.S. has well documented problems with the working poor being unable to afford insurance or qualify for medicare; even if they qualify, medicare is not universally accepted (because it doesn't pay market rates) and there's no legal requirement for medical professionals to do so.
  - conanbatt 8y ago
    Its a quote from the article.
- gautamdivgi 8y ago
  Clinical trials are mostly free for the patients who are chosen for them. But I think what you’re saying is government healthcare won’t pay for experimental treatment (currently in a trial stage). However, that is true even for private insurance here in the US. My regular insurance doesn’t cover experimental treatments. I have a separate add on that pays for some experimental treatments.
  - conanbatt 8y ago
    Its a direct quote from the article, not delving deep into clinical trials.
- arcticbull 8y ago
  Absolutely wrong. There's nothing that says people living under a socialized medical system don't have access to clinical trials. Government is an extension of the people. If you want generosity you vote for generosity. In Canada, where I grew up, it works wonderfully. In the rest of the civilized world, it works wonderfully. There's no reason it won't work in America. Moving to America the scariest thing in the world was giving up my OHIP card (my Ontario government socialized medicine card). Still is, honestly.

In universal care you dont get access to 'clinical trials and research and things like that, where people need access to leading-edge potential treatments' You are also not eliminated the need to get funds, you are changing who you are asking them from. And let me tell you that government officials are seldom generous.

Judgmentality 8y ago
So you believe the US healthcare system is better than, say, the United Kingdom?
- conanbatt 8y ago
  I dont know the UK health intimately to compare confidently. I can tell you what it looks like with Argentina. that has universal care. Normally anyone with a dime goes private. Public is a lower-quality, cheaper service. That system is great for the poor, most expensive to middle class. I can also tell you what I think are reasons why US healthcare is so expensive, and they are not fixed by universal care programs.
  - arcticbull 8y ago
    No, they absolutely are fixed by universal healthcare, as they are everywhere else on earth.
    - conanbatt 8y ago
      How is universal care going to reduce the shortage of primary care doctors? How is universal care going to eliminate patents for pharma? How is universal care going to make non-profit hospitals cheaper? How is universal care going to eliminate fee-for-service, which has the administrative costs that are the woes of care providers? How is universal care going to reduce healthcare spending?
      - maxxxxx 8y ago
        Countries with universal care also usually have tight regulations on what can be charged and how. A first step would be to make all prices transparent so people can actually compare. In my view the biggest problem in the US is that the billing aspect of health care is intentionally opaque.
        conanbatt 8y ago
        Medicare is justs as opaque, and also distortive: Medicare costs 11k a year, but retirees pay less than half its cost as it is. The main reason pricing is opaque is because patients dont have freedom to compare between insurance companies, and because insurance companies are not a good model for frequent care. If you had High-deductible plans, you would make a much better system but people hate those plans. You need a big change in popular sentiment to make pricing work well. (i am all for HDPs)
        arcticbull 8y ago
        Most Americans can’t afford $500 in case of an emergency, which is why high deductible plans are a non starter to provide coverage. For them a $5000 deductible is as good as not being covered in the first place.
        conanbatt 8y ago
        Health insurance costs 800$ a month so not having 500$ means you dont have insurance. Thats another level of poverty, for the which there is medicaid and a different set of programs and way to deal with those cases.
        arcticbull 8y ago
        That's not true. First of all $800/month is what you'd expect to pay if you were young and healthy and with moderate deductibles. Good luck being older or sicker. The $500 that I'm referring to is $500 beyond what they budgeted for after their monthly expenditures. No, Medicaid doesn't always apply to these people, you should look into it. It also requires extreme levels of financial hardship. Medicaid takes a lien against your house to recover their costs. Not to mention the donut hole for whom having their house taken isn't even an option. It's brutal. When I said most of America, I meant it. It's fifty seven percent of America. [1] Are you going to put them all on Medicaid and take their houses? I thought you were arguing for private cover :) This is the kind of thinking that pushes up costs. Creating barriers to seeking care early makes everything more expensive as the longer you wait, the more it costs to resolve. Let's be rational about this. The US median individual income is $39,336. [2] Your take-home pay would be approximately $2614 per month after tax assuming you save nothing toward your retirement. Taking out $800 leaves you with $1814. The US median rent is $1500 per month [3]. This leaves you with $314 for food, gas, transportation, electric, water and sewer combined. And this is the best possible case: you're single. Then you want them to handle a $5000 deductible?! [1] https://www.cbsnews.com/news/most-americans-cant-afford-a-500-emergency-expense/ https://www.cbsnews.com/news/most-americans-cant-afford-a-50... [2] https://en.wikipedia.org/wiki/Personal_income_in_the_United_States https://en.wikipedia.org/wiki/Personal_income_in_the_United_... [3] https://www.prnewswire.com/news-releases/us-median-rent-hits-a-new-high-at-1-500-a-month-but-rent-growth-slows-heading-into-fall-300720740.html https://www.prnewswire.com/news-releases/us-median-rent-hits...
badfrog 8y ago
> government officials are seldom generous If government officials are using the same healthcare system as everybody else, they have incentive to make it good.
- conanbatt 8y ago
  They have the incentive to make the ones they use good. This idea has shown to not happen in real life. Public schools, for example, do not deliver a "uniform" service.
  - arcticbull 8y ago
    No, Government officials in the US are afforded socialized medicine. "The Federal Employees Health Benefits (FEHB) Program is a system of 'managed competition' through which employee health benefits are provided to civilian government employees and annuitants of the United States government."
    - conanbatt 8y ago
      Strange contradiction: you are show a case on how federal workers have an undue benefit in comparison to the population, which is what my original argument was. This program seems to be about selecting insurances tho, not an actual insurance. It's tangential.
      - arcticbull 8y ago
        No, I'm saying it's strange having the people in charge of the government touting a privatized health program for the entire nation except themselves. If private care was so much better than socialized government care, why are the senators, the house members and everyone in the armed forces so staunchly in favor of keeping their socialized care? Don't you think if socialized medicine was murder and death panels and bad outcomes and high costs, that the senators and house members would be on private plans? Why are they so in favor of staying on the government's program? Is it because socialized medicine is in fact better than private care? Further if they don't want to get off the socialized program because it's better than the private plan, why don't they work towards extending that to the average citizen like every other developed country in the entire world? Political expediency probably.
bitcurious 8y ago
Why not? Clinical trials in the US tend to be free from the patient's point of view.
- conanbatt 8y ago
  Because governments dont spend nearly as much as private investment into the medical field, and have a very different alignment in terms of costs/revenues. The second part of the sentence alludes to something I did not intend to imply.
  - rosser 8y ago
    > Because governments dont spend nearly as much as private investment into the medical field... Are you not aware of how much fundamental drug and medical research is actually conducted on the taxpayer's dime at the university level, and then exclusively licensed to private enterprise for commercial exploitation? I've seen a number of sources make a compelling case that "big pharma"'s number one line item is marketing, not research.
    - conanbatt 8y ago
      At great cost to society. There should be no federal funding on this. This is one of the gravest reasons why healthcare is so expensive in the U.S. It subsidizes big corpo, big hospitals, then subsidizes richest employees, eliminating the most basic price mechanisms for competition. Not only does it do all the subsidizing, but it also makes it expensive by putting extremely costly regulation. But thats a whole topic on its own: government funding of healthcare research is not efficient and does not make it cheaper in any way. Big Pharma's #1 expenditure is always going to be protect its patent monopoly process with the FDA.
      - arcticbull 8y ago
        You have a fascinating perspective on medicine and research. Research should be paid for by the people and made available in the public interest. If a private entity does pay for the research they are entitled to protect their inventions for 20 years via the patent program. That doesn't mean buyers or buying organizations shouldn't be allowed to negotiate.
rosser 8y ago
> In universal care you dont get access to 'clinical trials and research and things like that... [citation needed]
- conanbatt 8y ago
  The US has substantial incoming medical tourism. If it really were strictly worse to european alternatives (more expensive or lower quality) europeans would not go to the US.
  - DanBC 8y ago
    That doesn't mean those tourists are getting effective or even safe treatment. It just means the US hospitals are good at marketing to desperate and wealthy people.
    - conanbatt 8y ago
      The funny paradox of argumenting people are stupid is that inevitably you will be put in the same category.
      - DanBC 8y ago
        I'm not saying those people are stupid. I'm saying there's an information asymetry that doesn't benefit the patient customer.
  - rosser 8y ago
    > if it were strictly worse... Ohai goalpost. When did you get there? The existence of .eu-to-.us medical tourism is utterly orthogonal to the availability of research in those countries. If you honestly took ten minutes to try, you'd be able to find dozens, if not hundreds of trials in every .eu member state, plenty of which are at least comparable to, if not more advanced than what's available in the US. I could go to .eu or .in or .mx or .th, or any of dozens of other countries, to get access to medical treatments and procedures that are by many, if not most, measures superior to their alternatives available here, but which aren't available here (just one, token example: RISUG), or are vastly more expensive here, but have comparable — or, again, better — outcomes there. Most of those places offer varying degrees of socialized, if not universal, medicine.
DanBC 8y ago
> where people need access to leading-edge potential treatments' Those leading edge potential treatments tend to be both very expensive and ineffective, and often cause additional harm on top. That's from the analysis of a leading oncologist in the UK. https://www.bmj.com/content/357/bmj.j2097 https://www.bmj.com/content/357/bmj.j2097
- conanbatt 8y ago
  I'm not making a judgement on the clinical validity of experimental treatments. That was a direct quote from the article.
fatbird 8y ago
Access to leading-edge potential treatments is a minor concern in health care: few need it, fewer qualify, and fewer are helped. Even then, your statement is false: leading edge medical research is carried out in all countries with universal health care. The U.S. has an infant mortality rate worse than 43 other countries because large numbers of pregnant women can't access routine prenatal care. That's but one example of what real health care concerns are like.
- ams6110 8y ago
  Can't access, or don't? Medicaid will pay for prenatal care, and there are other options as well.
  - fatbird 8y ago
    Can't. The U.S. has well documented problems with the working poor being unable to afford insurance or qualify for medicare; even if they qualify, medicare is not universally accepted (because it doesn't pay market rates) and there's no legal requirement for medical professionals to do so.
- conanbatt 8y ago
  Its a quote from the article.
gautamdivgi 8y ago
Clinical trials are mostly free for the patients who are chosen for them. But I think what you’re saying is government healthcare won’t pay for experimental treatment (currently in a trial stage). However, that is true even for private insurance here in the US. My regular insurance doesn’t cover experimental treatments. I have a separate add on that pays for some experimental treatments.
- conanbatt 8y ago
  Its a direct quote from the article, not delving deep into clinical trials.
arcticbull 8y ago
Absolutely wrong. There's nothing that says people living under a socialized medical system don't have access to clinical trials. Government is an extension of the people. If you want generosity you vote for generosity. In Canada, where I grew up, it works wonderfully. In the rest of the civilized world, it works wonderfully. There's no reason it won't work in America. Moving to America the scariest thing in the world was giving up my OHIP card (my Ontario government socialized medicine card). Still is, honestly.