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> With HDHPs being so common the 'disconnect' between providers and patients is already not a real thing. Long way to go for HDHP to take over the market. But

> With HDHPs being so common the 'disconnect' between providers and patients is already not a real thing. Long way to go for HDHP to take over the market. But its definitely the way to go. It will however attack mostly the primary care market, not the hospitals which are 40% of the national health spending. > At any rate, entrusting laymen to understand when they should and should not seek emergency medical attention means that people will die through entirely preventable causes in an attempt to ration their health care spending. Your cure sounds worse than the disease. Not my "cure" thats the economic reality. Unfettered access to healthcare will give you skyrocketing costs. You cant complain about both at the same time, they are a trade-off. I do think that cost is the single most important thing to attack, and the policies to do so are very easy to enact. They are just very unpopular, because the democratic party wants to increase the state, not make healthcare cheaper, and because republicas have their head up their ass on this topic for reasons I dont understand.

Amezarak 7y ago
According to Kaiser, HDHPs are the second most common health insurance plan and account for 28% of all insurance plans. > Not my "cure" thats the economic reality. Unfettered access to healthcare will give you skyrocketing costs. You cant complain about both at the same time, they are a trade-off. Yes, if the problem is skyrocketing demand. But it isn't. Yes, if we waved a magic wand and provided unlimited free access to medical care, demand would rise somewhat. But demand is not the reason for the current high prices, and it's not the reason costs are outpacing inflation. Medical care in the US is much more expensive than in comparable countries, but demand is not appreciably different. As long as people keep looking at this through a "market" lens, or through a "just make it single payer" lens, the problem will never be solved. The fundamental problem isn't that demand is too high. The problem is cost disease, the root of which consists of dozens of different factors. This is a decent article, albeit one that barely scratches the surface. https://slatestarcodex.com/2017/02/09/considerations-on-cost-disease/ https://slatestarcodex.com/2017/02/09/considerations-on-cost... Look at those graphs! It's mindblowing! Medical costs have increased ten times more than inflation, while doctor and nurse salaries were flat (actually worse, since now their salary goes to paying off educational debt) over the same time period. If there's a demand problem, why aren't salaries of medical professionals rising faster than inflation? Lastly, I think most people would disagree that cutting costs is the most important thing. Going bankrupt is better than dying of pneumonia because you were worried about wasting money on a doctor visit.
- conanbatt 7y ago
  > As long as people keep looking at this through a "market" lens, or through a "just make it single payer" lens, the problem will never be solved There is definitely a sort of impasse on both ideological positions. The forces that be for some reason have not agreed to test out their ideas: a public option and deregulation simultaneously. But neither policy is popular in neither party. I disagree with your diagnosis, but I'm willing to do a policy that satisfies both your ideas and mine. Support a public option that will not have the issues you mention, and let me have my unlicensed, foreign, cash-pay, non-subsidized doctors, non-FDA meds and malpractice waivers.
- mempko 7y ago
  Medicare for All will solve a lot of these issues. Look at the healthcare prices in Japan, which has a single payer system. Insanely cheap, high quality, and more doctors per capita than the USA. The other part that someone like Sanders is pushing is tuition-free colleges. If doctors aren't burdened with half a million in student debt, maybe we can get cheaper care. You combine both programs and you get a real win.
  - Amezarak 7y ago
    Medicare for All would help individuals, but does too little to stop rising costs - you get the benefit of government negotiation and annihilate insurance overhead, but it’s not enough. You help people in the short term, but ultimately you only delay the day of reckoning. I already posted a link showing doctor and nurse compensation have been flat in the same time period that medical costs increased 10x faster than inflation. While free university might be a good idea for other reasons, this isn’t it.
    - conanbatt 7y ago
      > you get the benefit of government negotiation and annihilate insurance overhead You don't have the benefit of government negotiation today and you cant seriously say that the government runs without overhead.

Amezarak 7y ago

According to Kaiser, HDHPs are the second most common health insurance plan and account for 28% of all insurance plans. > Not my "cure" thats the economic reality. Unfettered access to healthcare will give you skyrocketing costs. You cant complain about both at the same time, they are a trade-off. Yes, if the problem is skyrocketing demand. But it isn't. Yes, if we waved a magic wand and provided unlimited free access to medical care, demand would rise somewhat. But demand is not the reason for the current high prices, and it's not the reason costs are outpacing inflation. Medical care in the US is much more expensive than in comparable countries, but demand is not appreciably different. As long as people keep looking at this through a "market" lens, or through a "just make it single payer" lens, the problem will never be solved. The fundamental problem isn't that demand is too high. The problem is cost disease, the root of which consists of dozens of different factors. This is a decent article, albeit one that barely scratches the surface. https://slatestarcodex.com/2017/02/09/considerations-on-cost-disease/ https://slatestarcodex.com/2017/02/09/considerations-on-cost... Look at those graphs! It's mindblowing! Medical costs have increased ten times more than inflation, while doctor and nurse salaries were flat (actually worse, since now their salary goes to paying off educational debt) over the same time period. If there's a demand problem, why aren't salaries of medical professionals rising faster than inflation? Lastly, I think most people would disagree that cutting costs is the most important thing. Going bankrupt is better than dying of pneumonia because you were worried about wasting money on a doctor visit.

conanbatt 7y ago
> As long as people keep looking at this through a "market" lens, or through a "just make it single payer" lens, the problem will never be solved There is definitely a sort of impasse on both ideological positions. The forces that be for some reason have not agreed to test out their ideas: a public option and deregulation simultaneously. But neither policy is popular in neither party. I disagree with your diagnosis, but I'm willing to do a policy that satisfies both your ideas and mine. Support a public option that will not have the issues you mention, and let me have my unlicensed, foreign, cash-pay, non-subsidized doctors, non-FDA meds and malpractice waivers.
mempko 7y ago
Medicare for All will solve a lot of these issues. Look at the healthcare prices in Japan, which has a single payer system. Insanely cheap, high quality, and more doctors per capita than the USA. The other part that someone like Sanders is pushing is tuition-free colleges. If doctors aren't burdened with half a million in student debt, maybe we can get cheaper care. You combine both programs and you get a real win.
- Amezarak 7y ago
  Medicare for All would help individuals, but does too little to stop rising costs - you get the benefit of government negotiation and annihilate insurance overhead, but it’s not enough. You help people in the short term, but ultimately you only delay the day of reckoning. I already posted a link showing doctor and nurse compensation have been flat in the same time period that medical costs increased 10x faster than inflation. While free university might be a good idea for other reasons, this isn’t it.
  - conanbatt 7y ago
    > you get the benefit of government negotiation and annihilate insurance overhead You don't have the benefit of government negotiation today and you cant seriously say that the government runs without overhead.