3 ms·

>This isn't about being "cost effective," it's about doing what is right. There are a finite number of resources in this world and an infinite number of wants

>This isn't about being "cost effective," it's about doing what is right. There are a finite number of resources in this world and an infinite number of wants and needs. It is ALWAYS about being "cost effective". Money used on health care cannot be used on other things, such as education, transportation, or investment in a company that provides jobs and useful services. How much medical care should everybody get? Should we be willing to spend $1 million to extend an elderly citizen's life for a year? Should EVERYONE have access to that quality of medical care? These are important questions. Cost and benefit must be weighed in health care, just like anywhere else. Life is more complex than leftist soundbites, my friend. If spending $1 trillion extra on medicine would save a thousand lives, I would contest that it would not be worth it. The question is, how much of a reduction in the quality of life in America are you willing to accept for an improvement in the average quality of health care?

Retric 18y ago
From a resource perspective basic medical care is cheep and effective. EX: The cost benefit ratio of free vaccinations is varying positive. We can efficiently have basic universal healthcare without spending huge piles of cash on every patent. The problem is we obligate institutions to treat everyone without funding them to do so which destroys the free market. We don't have huge efficient hospital chains because it's not profitable to create them. I say we use the Japanese approach of basic universal insurance and private medical system for the best of both worlds. PS: Would you rather the government pay ~50$ per MRI in Japan or your private insurance pay ~1500$ in the US for the same procedure?
- gunderson 18y ago
  Are you saying that people in the US don't get vaccinated already with or without "health insurance"? BTW, the reason that someone can't sell a $20/month insurance policy that gets you the kind of basics you're talking about is b/c it's illegal. By law health insurance plans have to abide by all kinds of rules, one of which is that they must insure against the possibility that you develop a drug problem and all kinds of improbable things. The end result is that even the cheapest health insurance is quite expensive. The problem is that government is already regulating the private market significantly. Add to that the tax loophole that lets employer-provided plan fees be taken from pre-tax income, and you have a set of incentives that have resulted in the mess we're in. Also, top notch care at a level that was very elite in 1990 is now significantly cheaper than it was in 1990. The problem is that the average person wants cutting edge 2007 medicine, which is a lot more expensive. Think about it this way, the more effective healthcare is, the more people will spend on it (not less). As procedures have a higher chance of succeeding, more people will decide to get them (who in the past would have gone to hospice).
  - Retric 18y ago
    Yes, some people don't get vaccinated due to cost issues. (It's a small group for many diseases but they are out there.) What I am saying is the real cost of treating a broken leg is less than what people with or without insurance pay in the US. When you seek treatment the hospital / doctors office does a quick "what are my chances of being paid back" and then they charge you Total Cost of Treatment * Profit / (pay back%). So someone with insurance might pay 500$ * 1.2 / .8 = 750$. But someone without insurance might pay 500$ * 1.2 / .5 = 1200$. Now if relative to the rest of the world our system was cheaper or more effective then I would say stick with it but it's not. At the most basic level Insurance does not lower costs because it does not prevent coverage.
deathbyzen 18y ago
I understand that there are limits and finite resources. If you're asking where to get the money from how about a little less on weapons development and a little more on medical research. "How much medical care should everybody get?" Well -any at all- would be a start for the millions without it. A lot of the questions you posed (who gets what and how much) have been answered in one way or another by the dozens of countries who already employ a universal health care system. We should be looking to them as a template and applying their to a new system. Sorry, but I get a bit heated about UHC. People tend to say things like "Where is the money going to come from?" or "The government is too incompetent to manage such a system" which are cop-outs, imo. "The question is, how much of a reduction in the quality of life in America are you willing to accept for an improvement in the average quality of health care?" I'm willing to give up a lot more of my money for health care than for weapons and war funding.
- yummyfajitas 18y ago
  >I understand that there are limits and finite resources. If you're asking where to get the money from how about a little less on weapons development and a little more on medical research. Sounds great. Only one problem: money is an illusion. The issue isn't money, it is supply of medical care as measured in units of doctor-hours. The only way you can get doctor-hours for person X is to take them from person Y. Doctors already work far more than full time and are unlikey to work more. Getting more doctors will be tough, since medical schools are all full. The issue is that medical care is a very scarce commodity. And you can't legislate scarcity away. Any proposed solution that doesn't create new doctor-hours (or find a substitute good for doctor-hours, such as nurse-hours) is a fraud.
  - mlinsey 18y ago
    "The issue isn't money, it is supply of medical care as measured in units of doctor-hours" Except it isn't. The cost of the supplies necessary for treatment (drugs, medical equipment) is at least as big of an issue. Also, wages for doctors are trending downwards thanks to HMO's. I'm not saying that's an inherently bad thing, but it's definitely not what you would expect if doctor-hours were the scarcest resource in the system.
tx 18y ago
"If spending $1 trillion extra on medicine would save a thousand lives" "Medicine" is too vague of a term. You'll be spending your trillion dollars on Ducatis and BMWs of drug sales reps and medical equipment middlemen, plus thousand of other parasites that make several times more of what an average engineer can dream of, by milking the system we have in place. I know a little bit about how the "sausage is made" and it makes me sick, what an irony...

Retric 18y ago

From a resource perspective basic medical care is cheep and effective. EX: The cost benefit ratio of free vaccinations is varying positive. We can efficiently have basic universal healthcare without spending huge piles of cash on every patent. The problem is we obligate institutions to treat everyone without funding them to do so which destroys the free market. We don't have huge efficient hospital chains because it's not profitable to create them. I say we use the Japanese approach of basic universal insurance and private medical system for the best of both worlds. PS: Would you rather the government pay ~50$ per MRI in Japan or your private insurance pay ~1500$ in the US for the same procedure?

gunderson 18y ago
Are you saying that people in the US don't get vaccinated already with or without "health insurance"? BTW, the reason that someone can't sell a $20/month insurance policy that gets you the kind of basics you're talking about is b/c it's illegal. By law health insurance plans have to abide by all kinds of rules, one of which is that they must insure against the possibility that you develop a drug problem and all kinds of improbable things. The end result is that even the cheapest health insurance is quite expensive. The problem is that government is already regulating the private market significantly. Add to that the tax loophole that lets employer-provided plan fees be taken from pre-tax income, and you have a set of incentives that have resulted in the mess we're in. Also, top notch care at a level that was very elite in 1990 is now significantly cheaper than it was in 1990. The problem is that the average person wants cutting edge 2007 medicine, which is a lot more expensive. Think about it this way, the more effective healthcare is, the more people will spend on it (not less). As procedures have a higher chance of succeeding, more people will decide to get them (who in the past would have gone to hospice).
- Retric 18y ago
  Yes, some people don't get vaccinated due to cost issues. (It's a small group for many diseases but they are out there.) What I am saying is the real cost of treating a broken leg is less than what people with or without insurance pay in the US. When you seek treatment the hospital / doctors office does a quick "what are my chances of being paid back" and then they charge you Total Cost of Treatment * Profit / (pay back%). So someone with insurance might pay 500$ * 1.2 / .8 = 750$. But someone without insurance might pay 500$ * 1.2 / .5 = 1200$. Now if relative to the rest of the world our system was cheaper or more effective then I would say stick with it but it's not. At the most basic level Insurance does not lower costs because it does not prevent coverage.

deathbyzen 18y ago

I understand that there are limits and finite resources. If you're asking where to get the money from how about a little less on weapons development and a little more on medical research. "How much medical care should everybody get?" Well -any at all- would be a start for the millions without it. A lot of the questions you posed (who gets what and how much) have been answered in one way or another by the dozens of countries who already employ a universal health care system. We should be looking to them as a template and applying their to a new system. Sorry, but I get a bit heated about UHC. People tend to say things like "Where is the money going to come from?" or "The government is too incompetent to manage such a system" which are cop-outs, imo. "The question is, how much of a reduction in the quality of life in America are you willing to accept for an improvement in the average quality of health care?" I'm willing to give up a lot more of my money for health care than for weapons and war funding.

yummyfajitas 18y ago
>I understand that there are limits and finite resources. If you're asking where to get the money from how about a little less on weapons development and a little more on medical research. Sounds great. Only one problem: money is an illusion. The issue isn't money, it is supply of medical care as measured in units of doctor-hours. The only way you can get doctor-hours for person X is to take them from person Y. Doctors already work far more than full time and are unlikey to work more. Getting more doctors will be tough, since medical schools are all full. The issue is that medical care is a very scarce commodity. And you can't legislate scarcity away. Any proposed solution that doesn't create new doctor-hours (or find a substitute good for doctor-hours, such as nurse-hours) is a fraud.
- mlinsey 18y ago
  "The issue isn't money, it is supply of medical care as measured in units of doctor-hours" Except it isn't. The cost of the supplies necessary for treatment (drugs, medical equipment) is at least as big of an issue. Also, wages for doctors are trending downwards thanks to HMO's. I'm not saying that's an inherently bad thing, but it's definitely not what you would expect if doctor-hours were the scarcest resource in the system.

tx 18y ago

"If spending $1 trillion extra on medicine would save a thousand lives" "Medicine" is too vague of a term. You'll be spending your trillion dollars on Ducatis and BMWs of drug sales reps and medical equipment middlemen, plus thousand of other parasites that make several times more of what an average engineer can dream of, by milking the system we have in place. I know a little bit about how the "sausage is made" and it makes me sick, what an irony...