5 ms·

Does this not show that there is something inherently wrong with society?

not_a_cop75 7y ago
Or possibly that we inherently struggle with the limits of our own mortality?
ddingus 7y ago
Yup. The US system is expensive and increasingly cruel. I do not expect that state of affairs to endure too much longer.
- toomuchtodo 7y ago
  A majority of Americans support Medicare For All, it’s just a matter of getting politicians who will vote for it into office.
  - rsj_hn 7y ago
    A majority of Americans do not support medicare for all, they support a public option and believe (mistakenly) that this is what medicare for all means. Moreover 40% of adults have no opinion (sources: https://www.pbs.org/newshour/health/americans-need-more-convincing-on-medicare-for-all-poll-says https://www.pbs.org/newshour/health/americans-need-more-conv... ). This polling is very soft. (https://www.marketwatch.com/story/poll-finds-medicare-for-all-support-drops-when-details-are-included-2019-01-23 https://www.marketwatch.com/story/poll-finds-medicare-for-al...) When you explain to them that they will lose their existing insurance and be forced to take medicare then support plummets. It's a complete mystery to me why people keep pushing medicare for all when a public option is much more popular, and this is even before the ad blitz that would happen should this ever become a serious possibility (which wont happen without a massive political realignment). The main problem here is that the Republican establishment is led by the plutocrats (the top 0.1%) with a strong economically populist insurgency, while the Democratic establishment is led by professionals (the top 10%) with a a strong leftist insurgency. But while you can have affordable healthcare with overpaid CEOs, you cannot have affordable healthcare with medical professionals earning the salaries they currently earn, and these groups have enormous power over the Democratic party establishment. We are now spending 19% of GDP on healthcare and that number keeps going up, meanwhile the only thing the Democrats can do is advocate for more government subsidies to allow the professional classes to keep extracting even more from working class americans. You simply can't have universal healthcare while median nurse practitioner wages are $50/hr (https://www.bls.gov/oes/current/oes291171.htm https://www.bls.gov/oes/current/oes291171.htm) and no one is willing to take a hammer to medical professional wages in order to make universal healthcare affordable. This is why we got Obamacare/Romneycare when the Democrats controlled all branches of government -- there was no support for anything other than more subsidies being funneled into the pockets of the health care system. It is the exact same situation as with higher education -- completely out of control costs that are bankrupting people as we spend triple what the rest of the world spends, and what is the Democrat policy? More taxpayers subsidies are needed, because they are not going to take a hammer to the professionals working in higher education anymore than they are willing will take a hammer to the professionals working in healthcare. Both of these are key Democratic constituencies. Really some kind of political realignment has to happen because the current economic status of this country is that we are being stripped bare by the professional classes who have failed to provide us with either affordable higher education or affordable healthcare and who can only demand more taxpayer subsidies or else they will refuse to provide these crucial services. But people are fooling themselves if they don't see the enormous wells of anger and resentment against the nations universities and hospitals. There simply isn't the support to shovel more subsidies into these groups, and it doesn't matter how you package it, whether a medicare for all program or something else. You are not going to get European style social benefits until these industries are shrunk to requiring European style spending levels. We are talking 50% cuts in total spending just to start things off and even more in higher education. At least one political party has to be willing to both massively cut costs and provide insurance guarantees to ensure coverage. Those who are convinced that there is popular support for medicare for all as the primary reform are in for a big surprise.
    - deleted 7y ago
      [deleted]
    - toomuchtodo 7y ago
      The polling data I’ve seen disagrees, but of course it’s going to be up to elections and not polling. Cost controls and increased revenue will be necessary, but neither will be excessive to accomplish the goal. I carry around Sander’s Medicare For All bill as well as the accounting breakdown when canvassing (practicing for my own federal office run), so I am familiar with the details.
      - dantheman 7y ago
        Question: Why the focus only at the national level? Why can't a state execute this plan if the costs are reasonable?
        rsj_hn 7y ago
        Correct. The only reason a state can't execute the plan is that the bulk of the heavy lifting has to be done on the cost control side which is interstate commerce. Hell, an individual city or even neighborhood could create an insurance pool if it was affordable. Healthcare is not a financing problem or an insurance/risk pooling problem, it's almost entirely a cost control problem.
      - rsj_hn 7y ago
        None of these things will happen until the power of the professional classes is broken. They will fight it, and you will find that you don't have the votes in congress to do any of this stuff. Seriously people are walking into an oncoming freight train thinking they will reorganize 20% of the economy through the power of sheer idealism and it would be funny if the stakes weren't real. But we will meet again in 20 years when the situation is much worse, and you will be confused as all hell why none of these plans were realized. As long as the professionals are in the drivers seat of the Democratic party, you can push the truck as hard as you want but they will steer it towards an Obamacare style solution, at which point you will say "We must push harder! It will happen!" But it will never happen, not as long as the Neera Tandens of this world are calling the shots in the Democratic Party.
smbowner 7y ago
Well, one group of people in one country.
m463 7y ago
maybe, maybe not? I think health care costs can easily become exponential, no matter what society you live in.
- anthony_doan 7y ago
  https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita#/media/File:Health_care_cost_rise.svg https://en.wikipedia.org/wiki/List_of_countries_by_total_hea... It's actually linear if you compare it by percentage of GDP of country. I'm not entirely sure what metric you are using but with GDP it's linear. The only problem it seem is that USA cost is much higher compare to other country. Exponential would have bankrupt a country.
  - m463 7y ago
    I meant it on a smaller scale. I meant exponential vs "this person stays alive". Yes, maybe treatment in Canada will be free, but would a million dollars (anywhere) have a chance at a complete cure?

Or possibly that we inherently struggle with the limits of our own mortality?

Yup. The US system is expensive and increasingly cruel. I do not expect that state of affairs to endure too much longer.

toomuchtodo 7y ago
A majority of Americans support Medicare For All, it’s just a matter of getting politicians who will vote for it into office.
- rsj_hn 7y ago
  A majority of Americans do not support medicare for all, they support a public option and believe (mistakenly) that this is what medicare for all means. Moreover 40% of adults have no opinion (sources: https://www.pbs.org/newshour/health/americans-need-more-convincing-on-medicare-for-all-poll-says https://www.pbs.org/newshour/health/americans-need-more-conv... ). This polling is very soft. (https://www.marketwatch.com/story/poll-finds-medicare-for-all-support-drops-when-details-are-included-2019-01-23 https://www.marketwatch.com/story/poll-finds-medicare-for-al...) When you explain to them that they will lose their existing insurance and be forced to take medicare then support plummets. It's a complete mystery to me why people keep pushing medicare for all when a public option is much more popular, and this is even before the ad blitz that would happen should this ever become a serious possibility (which wont happen without a massive political realignment). The main problem here is that the Republican establishment is led by the plutocrats (the top 0.1%) with a strong economically populist insurgency, while the Democratic establishment is led by professionals (the top 10%) with a a strong leftist insurgency. But while you can have affordable healthcare with overpaid CEOs, you cannot have affordable healthcare with medical professionals earning the salaries they currently earn, and these groups have enormous power over the Democratic party establishment. We are now spending 19% of GDP on healthcare and that number keeps going up, meanwhile the only thing the Democrats can do is advocate for more government subsidies to allow the professional classes to keep extracting even more from working class americans. You simply can't have universal healthcare while median nurse practitioner wages are $50/hr (https://www.bls.gov/oes/current/oes291171.htm https://www.bls.gov/oes/current/oes291171.htm) and no one is willing to take a hammer to medical professional wages in order to make universal healthcare affordable. This is why we got Obamacare/Romneycare when the Democrats controlled all branches of government -- there was no support for anything other than more subsidies being funneled into the pockets of the health care system. It is the exact same situation as with higher education -- completely out of control costs that are bankrupting people as we spend triple what the rest of the world spends, and what is the Democrat policy? More taxpayers subsidies are needed, because they are not going to take a hammer to the professionals working in higher education anymore than they are willing will take a hammer to the professionals working in healthcare. Both of these are key Democratic constituencies. Really some kind of political realignment has to happen because the current economic status of this country is that we are being stripped bare by the professional classes who have failed to provide us with either affordable higher education or affordable healthcare and who can only demand more taxpayer subsidies or else they will refuse to provide these crucial services. But people are fooling themselves if they don't see the enormous wells of anger and resentment against the nations universities and hospitals. There simply isn't the support to shovel more subsidies into these groups, and it doesn't matter how you package it, whether a medicare for all program or something else. You are not going to get European style social benefits until these industries are shrunk to requiring European style spending levels. We are talking 50% cuts in total spending just to start things off and even more in higher education. At least one political party has to be willing to both massively cut costs and provide insurance guarantees to ensure coverage. Those who are convinced that there is popular support for medicare for all as the primary reform are in for a big surprise.
  - deleted 7y ago
    [deleted]
  - toomuchtodo 7y ago
    The polling data I’ve seen disagrees, but of course it’s going to be up to elections and not polling. Cost controls and increased revenue will be necessary, but neither will be excessive to accomplish the goal. I carry around Sander’s Medicare For All bill as well as the accounting breakdown when canvassing (practicing for my own federal office run), so I am familiar with the details.
    - dantheman 7y ago
      Question: Why the focus only at the national level? Why can't a state execute this plan if the costs are reasonable?
      - rsj_hn 7y ago
        Correct. The only reason a state can't execute the plan is that the bulk of the heavy lifting has to be done on the cost control side which is interstate commerce. Hell, an individual city or even neighborhood could create an insurance pool if it was affordable. Healthcare is not a financing problem or an insurance/risk pooling problem, it's almost entirely a cost control problem.
    - rsj_hn 7y ago
      None of these things will happen until the power of the professional classes is broken. They will fight it, and you will find that you don't have the votes in congress to do any of this stuff. Seriously people are walking into an oncoming freight train thinking they will reorganize 20% of the economy through the power of sheer idealism and it would be funny if the stakes weren't real. But we will meet again in 20 years when the situation is much worse, and you will be confused as all hell why none of these plans were realized. As long as the professionals are in the drivers seat of the Democratic party, you can push the truck as hard as you want but they will steer it towards an Obamacare style solution, at which point you will say "We must push harder! It will happen!" But it will never happen, not as long as the Neera Tandens of this world are calling the shots in the Democratic Party.

smbowner 7y ago

Well, one group of people in one country.

m463 7y ago

maybe, maybe not? I think health care costs can easily become exponential, no matter what society you live in.

anthony_doan 7y ago
https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita#/media/File:Health_care_cost_rise.svg https://en.wikipedia.org/wiki/List_of_countries_by_total_hea... It's actually linear if you compare it by percentage of GDP of country. I'm not entirely sure what metric you are using but with GDP it's linear. The only problem it seem is that USA cost is much higher compare to other country. Exponential would have bankrupt a country.
- m463 7y ago
  I meant it on a smaller scale. I meant exponential vs "this person stays alive". Yes, maybe treatment in Canada will be free, but would a million dollars (anywhere) have a chance at a complete cure?