10 ms·

> “The whole country is at a health disadvantage compared to other wealthy nations,” the study’s lead author, Dr. Steven Woolf of Virginia Commonwealth Universi

> “The whole country is at a health disadvantage compared to other wealthy nations,” the study’s lead author, Dr. Steven Woolf of Virginia Commonwealth University, said. “We are losing people in the most productive period of their lives. Children are losing parents. Employers have a sicker work force.” For profit healthcare in America is devouring its people and economy, full stop. We can either have a society where half a million people go bankrupt from medical debt each year, thousands die from treatable illnesses and lack of access to medicines, while hospital CEOS and insurance execs walk away with millions. Or, we can have one that excises their parasitism like the rest of the developed world figured out was necessary decades ago.

tenebrisalietum 7y ago
So let's say the worst case scenario happens, and 500,000 people do go bankrupt due to medical expenses every year for a while. Let's say this happens pretty consistently over 10 years. How will that affect the broader political landscape, economy and society?
- claudeganon 7y ago
  I dunno, maybe you would see things like sharp curbs in life expectancy among middle class people. Or a rise of reactionary politics that cynically (but not falsely) targets affluent liberals who turn a blind eye to the suffering of the poor...
- PopeDotNinja 7y ago
  Your healthcare costs more, and the lives of 500k people suck more than they needed to.
  - tenebrisalietum 7y ago
    500k people per year would be bankrupt and basically ineligible for credit, probably unwilling to work if all their wages get garnished to service medical debt, yet ERs still can't turn these financially crushed people away. So I think at some point or threshold there will be more elaborate effects than simply "healthcare costs up, people's lives suck".
    - learc83 7y ago
      Not to diminish the argument that it would cause huge problems. But federal law limits wage garnishment to the lesser of 25% of disposable income or income over 30x the minimum wage.
    - salawat 7y ago
      So, first thing I see is a Public Health crisis. The medical profession is cripplingly dependent on trust. Decreased faith in the goodwill of medical practitioners may lead to people not doing things that have major impacts non overall public health, like getting immunizations. I'd expect a potential rise in suicide rates due to mental problems becoming more prevalent; if not because of escalating paranoia due to "don't get hurt, you can't afford the medical costs", then due to the over-time integration of the assumption of not having any societal value assigned to some injury being fixed. I think this is an oft overlooked aspect of the social experience of having a problem. There are many who look at people with medical issues that are dismissive that it must somehow be all that person's own fault. While the argument can be made in some cases, in the case where you can't afford medical treatment, the message is sent that your (the injured party's) suffering doesn't matter at a social level unless somehow you can demonstrate you can produce X amount of worth where that worth becomes at least strongly correlated to some significant fraction of whatever the Medical Industrial Complex decides. It is funny, because I'm reminded of the story Erehwon, where physical ailment vs. Social ailment was flipped around in how it was handled. If you had a chest congestion, you'd be locked away in a prison, away from everyone else, but moral failings like stealing things were not crimes, but things treated as being in need of slight adjustment. The argument put forth against "Doctoring/Medicine" in the story is that eventually, a medical Doctor would accrue too much power over too many people's lives. It seemed ridiculous to meat the time; but as I look at what we have now, I see echoes of it. If you can't afford to exist in the system, you are cast aside. Can you receive treatment? Yes. Will you financially weather that storm without the advantages of full-time representation, negotiation, and legal counsel? No. "First, do no harm" means something; and harm comes in many forms nowadays. I know not where the capacity for ruinous financial inflation is being introduced; the exorbitant costs of medical schooling, the production and certification of medical equipment/research, administrative overhead and profit skimming; but it needs to be addressed and evaluated at each point. Prescription drugs are a start, but the entire infrastructure needs an audit and readjustment in my opinion to bring it back within some semblance of sane operating parameters.
zeveb 7y ago
> For profit healthcare in America is devouring its people and economy, full stop. We can either have a society where half a million people go bankrupt from medical debt each year, thousands die from treatable illnesses or lack of access to medicines, while hospital CEOS and insurance execs walk away with millions, or we can have one that excises their parasitism like the rest of the developed world figured out was necessary decades ago. The majority of the world still has, to my knowledge, for-profit health care: Britain, Germany, France, Switzerland , Sweden and Italy all have at least some form of private health care. The United States definitely have a problem with health care prices. It doesn't appear from where I sit to be an issue with individual bad actors (although of course they do exist) but rather structural. In part, the well-intended federal and state attempts to improve things have backfired — as they tend to do — and made things even more expensive (which reminds me of federal student loans, another instance of well-meaning attempts to help the lesser-off which somehow seem to benefit the upper middle classes most of all; cf. also federally-subsidised mortgages).
- ptah 7y ago
  > at least some form of private health care. a very tiny proportion of them yes, in the US the whole thing is private
  - kube-system 7y ago
    > the whole thing is private The US has several public insurers. About 72 million Americans are enrolled in Medicaid or CHIP. About 60 million are enrolled in Medicare. The MHS covers about 9.5 million people. The IHS covers another 2.2 million people.
    - ptah 7y ago
      insurance is not the same as e.g. UK NHS which is wholly run publically
      - kube-system 7y ago
kasey_junk 7y ago
Without tackling the obesity/sedentary/nutrition problems the healthcare issue will persist. Similarly the opioid/meth epidemics of the last 2 decades are not (just) healthcare problems.
- deleted 7y ago
  [deleted]
- xtian 7y ago
  You can’t divorce poor life choices from the economic context they are made within. These are complex issues, but is it controversial to say that people are more interested in investing in their health when they have less stress and more opportunity? Likewise, you aren’t going to get a healthcare system which can make a meaningful impact on improving the lifestyles of the kinds of people you’re talking about without changing the current economic incentives.
- dragonwriter 7y ago
  > Without tackling the obesity/sedentary/nutrition problems the healthcare issue will persist. Without healthcare system improvements, you aren't going to succeed in tackling those. But, yes, it's true that there are more problems with US health than the health care system (though the issues in the broader economy that are at issue are very similar to those effecting the helathcare system.)
  - ronnier 7y ago
    What kind of improvements?
    - toomuchtodo 7y ago
      I imagine being able to go to a doctor without worrying about whether they can afford the copay. Wellness is as much about needing a coach as it is a medical practitioner.
- Angostura 7y ago
  A good public healthcare system actually puts money into trying to address those problems, as does the government who pays for it. A private healthcare system may be a little more... ambivalent.
turk73 7y ago
Reading between the lines, the cause is alcoholism and drug abuse. If you want to live longer don't drink, smoke, or do drugs. Duh.
davidw 7y ago
There's also an entrepreneurial angle: If you don't have to worry about health care, it becomes much easier to start and run a small company.
- claudeganon 7y ago
  Indeed. As someone who works in the arts, it’s quite apparent how much easier it is to survive for my friends and colleagues in Canada and Europe. Even discounting the public funding for the arts many of them receive, simply not having to worry about healthcare and medicine costs as a freelancer makes a huge, obvious differences the length and viability of their careers.
  - tinyhouse 7y ago
    Not to worry about healthcare and medicine costs is not really true. I just commented about it. Most people pay extra for private insurance even if they get public healthcare for free.
    - claudeganon 7y ago
      I’m in regular contact with artist friends in the UK and Canada and absolutely none of them do this. And neither did any of my family in the UK. Not sure where you’re getting this idea from.
      - arethuza 7y ago
        The only people who generally have private health insurance in the UK (other than dental care) are those who work for companies where, usually senior, staff get this as a taxable part of their package. I wouldn't have thought that artists would belong to this category.
      - tinyhouse 7y ago
        That's true for the UK but not for many European countries. See https://www.oecd-ilibrary.org/docserver/health_glance-2015-39-en.pdf?expires=1575305434&id=id&accname=guest&checksum=9D19D04B300E74512459F5C13EC2C57F https://www.oecd-ilibrary.org/docserver/health_glance-2015-3...
tinyhouse 7y ago
The US private healthcare system has lots of problems and I'm not trying to defend it. However, the public European model is very misleading. The reason is that most people who can afford it pay for private insurance, even in Europe. Otherwise they need to wait months for a doctor appointment.
- lentil_soup 7y ago
  How healthcare works in Europe changes quite a lot per country. Which country specifically are you talking about?
  - tinyhouse 7y ago
    Ones I know of based on friends and family are Israel (follows the European public healthcare model) and Spain. I'm not saying it's the same everywhere in Europe, but I wouldn't be surprised if it's the case in many European countries.
    - igravious 7y ago
      In Spain the rate is 4.4% Israel is not in Europe, but anyway the rate there is 10.3% This indicates to me that the circle of people that you know is not representative of the population at large at least when it comes to health insurance coverage. There's no need to infer statistics about the whole of Europe from your small sample size. All you have to do is look up† the data. Page 4 (Figure 2.1) here: http://www.euro.who.int/__data/assets/pdf_file/0005/310838/Voluntary-health-insurance-Europe-role-regulation.pdf?ua=1 http://www.euro.who.int/__data/assets/pdf_file/0005/310838/V... The majority of countries (38 versus 11) are below 5%, only 5 are above 10% --- † I googled: percentage private health insurance european countries
      - tinyhouse 7y ago
        I guess it depends what qualifies as private insurance. See Figure 7.2: https://www.oecd-ilibrary.org/docserver/health_glance-2015-39-en.pdf?expires=1575305434&id=id&accname=guest&checksum=9D19D04B300E74512459F5C13EC2C57F https://www.oecd-ilibrary.org/docserver/health_glance-2015-3... Israel is 83% and not 10%...
dade_ 7y ago
Private health insurance and lack of universal public health insurance that is. All doctor offices in Canada are private corporations, for whatever reason the hospitals are not and that is where the worst of our problems lay.
- willhslade 7y ago
  Care to expound?
whiddershins 7y ago
The fact that our healthcare system is messed up is not synonymous with getting rid of profit. Every time something is screwed up in the US, there’s a bunch of people who scream “See! Capitalism!” This, to my mind is unproductive and rather transparent advocacy for an underlying ideological inclination. Sometimes things can be fixed without resorting to “Socializing” them. Here’s something broken under a socialized mechanism: every piece of NYC infrastructure.
- igravious 7y ago
  "This, to my mind is unproductive and rather transparent advocacy for an underlying ideological inclination." And you're not ideologically inclined in the opposite direction? Look at what is already socialized: fire departments, court system, police service, the three-letter agencies, military, politicians presumably?, a lot of education (despite student loans), a chunk of the health service already, road network, probably a lot more things. I put it to you – given that so much related to the public good is publicly funded and given that examples from the rest of the world abound that public health services are cheaper why wouldn't you socialize the bulk (> 90%) of health. Clearly, to my mind, the reason why it hasn't yet happened in the States is down to government capture, a.k.a. lobbying, a.k.a. legal bribery.
- Brain_Thief 7y ago
  I find it interesting that your condemnation of unproductive ideological advocacy is couched within a hyperbolic rant wherein you seem to assume the privilege of having your words taken metaphorically and not literally ("every piece" of NYC infrastructure is broken, implicitly due to "Socialism"; people are "screaming" about the ills of capitalism) while simultaneously refusing to extend that same privilege to the people you decry. Whatever your intentions, your use of bad-faith argumentation practices reflects poorly on your stance and mirrors the condescending messaging employed by advocates of the obviously untenable status quo. I claim that your comment was written in bad faith because it feels both divisive and derisive and makes no attempt at offering a bridge of understanding for balanced discussion to occur.
bernierocks 7y ago
The dirty secret is that for profit healthcare runs the rest of the world. The majority of new drugs are created in the US and nations that have government-run healthcare create generics by ripping off/taking the IP and creating cheap alternatives. This is the only reason drugs are cheaper in other parts of the world. The R&D, which costs millions (and sometimes billions) still needs to be paid for by someone..and the government just isn't efficient enough to do this effectively and within a decent time frame. The problem isn't for-profit healthcare. The problem is the insurance companies. They create an un-needed middleman that inflates the cost of everything. A better alternative would be to get rid of insurance for most things, allow doctors and hospitals to charge directly to consumers (which would bring the costs way down). Surgeries would also come down in cost because of competition. The ones that don't come down are most likely because they are rare and have little competition. These can be covered under insurance.
- Daishiman 7y ago
  > The majority of new drugs are created in the US and nations that have government-run healthcare create generics by ripping off/taking the IP and creating cheap alternatives. This is the only reason drugs are cheaper in other parts of the world. So all those Swiss, German and French pharmaceutical companies are a figment of my imagination then.
  - claudeganon 7y ago
    Not to mention the hundreds of millions of dollars in NIH funding and public university research that makes any of these drugs possible in the first place.
  - hokumguru 7y ago
    The United States spends the lion's share (>50 percent!) of R&D money on pharmaceuticals worldwide. https://www.abpi.org.uk/facts-and-figures/science-and-innovation/worldwide-pharmaceutical-company-rd-expenditure-by-country/ https://www.abpi.org.uk/facts-and-figures/science-and-innova...
    - 7y ago
scottlocklin 7y ago
It's certainly true that the health care system in the US is bonkers, and there are manifest injustices in how things work, but it also represents an enormous failure in public health efforts. 4/10 US adults are obese. Only 30% of the country manages to not be overweight!
- claudeganon 7y ago
  The absence of good public health initiatives is also the result of the fractured, poor quality, expensive, private healthcare system in the US.
  - scottlocklin 7y ago
    That doesn't at all follow. People aren't fat and out of shape because health care (aka being able to see a doctor) is private or because it sucks; they are so because it isn't considered a national priority like it was at one point in US history. How many people graduate high school knowing how to take care of their bodies? For example: https://www.youtube.com/watch?v=fISgKl8dB3M https://www.youtube.com/watch?v=fISgKl8dB3M
smartstakestime 7y ago
Healthcare has little to do with health. Its this thinking that is the reason why Americans are declining in quality of life. Stop blaming the other, its not making you stronger or better. Better healthcare will not stop you from drinking too much , eating too much, not exercising enough. No drug is going to fix your social anxiety. Drugs fix symptoms not causes. This "health disadvantage" what is it exactly. I bet its lung and diabetes issues. We do it to ourselves. Once you accept that you will see the fix. Its not some billionaire giving you money , it you not giving money to the drug dealing (alcohol, unhealthy food, weed/tobacco/vape) billionaires and getting active. Religion used to be a good way to get out before, a secular nation needs to find a similar motivation that gets people out of their houses. Maybe the worst drug is the media keeping us planted in our chair. Either way I dont trust the gov. so even if we put more money into "healthcare" they would fuck it up. Prove me wrong.
- etrautmann 7y ago
  This is a diversion and a false dilemma. What you're saying is not wrong in that people should live healthy lifestyles, but it is also true that the health care system is now strongly disincentivizing preventative care, early treatment (or any treatment) in a way that can lead to increased mortality.
- SolaceQuantum 7y ago
  "No drug is going to fix your social anxiety." But access to afforable medicine will definitely fix a big chunk of my anxiety about not being able to afford medicine! "I bet its lung and diabetes issues." It's really hard to take care of diabetes in america, due to the costs of adequate insulin and related medical purchases such as bloodwork and glucose testing devices.
hindsightbias 7y ago
You can have the best healthcare in the world and it won’t overcome modern lifestyle choices. I spent the last week in 4 different states and airports. The BMI variety between them was staggering. Diabetes rates aren’t soaring because some healthplan is expensive. People blame opoids like they’re causal. Those people have always been in physical agony, there’s just a magic pill now for their disability and as more people make worse choices that population is only going to grow. Until K-12 diets and physical activity become mandates I don’t see how we get ahead of this problem with tech or cheaper healthcare.
RickJWagner 7y ago
But from 2010 to 2017 (the cited years) are the years of the ACA. Was it a failure?
- frockington1 7y ago
  Unpopular opinion but I think the ACA did more to cripple hourly workers than any other legislation in history. The mandate to provide healthcare to anyone working over 30 hours resulted in work weeks being cut to 29.5 hours for many
  - joshmarlow 7y ago
    Do you have data/citations? I could believe this happens, but would like to see data on how wide-spread an impact this is. There are always consequences and tradeoffs - if we had actual numbers about the magnitude of the impact, we could start to discuss if ACA was worth this particular tradeoff.

tenebrisalietum 7y ago

So let's say the worst case scenario happens, and 500,000 people do go bankrupt due to medical expenses every year for a while. Let's say this happens pretty consistently over 10 years. How will that affect the broader political landscape, economy and society?

claudeganon 7y ago
I dunno, maybe you would see things like sharp curbs in life expectancy among middle class people. Or a rise of reactionary politics that cynically (but not falsely) targets affluent liberals who turn a blind eye to the suffering of the poor...
PopeDotNinja 7y ago
Your healthcare costs more, and the lives of 500k people suck more than they needed to.
- tenebrisalietum 7y ago
  500k people per year would be bankrupt and basically ineligible for credit, probably unwilling to work if all their wages get garnished to service medical debt, yet ERs still can't turn these financially crushed people away. So I think at some point or threshold there will be more elaborate effects than simply "healthcare costs up, people's lives suck".
  - learc83 7y ago
    Not to diminish the argument that it would cause huge problems. But federal law limits wage garnishment to the lesser of 25% of disposable income or income over 30x the minimum wage.
  - salawat 7y ago
    So, first thing I see is a Public Health crisis. The medical profession is cripplingly dependent on trust. Decreased faith in the goodwill of medical practitioners may lead to people not doing things that have major impacts non overall public health, like getting immunizations. I'd expect a potential rise in suicide rates due to mental problems becoming more prevalent; if not because of escalating paranoia due to "don't get hurt, you can't afford the medical costs", then due to the over-time integration of the assumption of not having any societal value assigned to some injury being fixed. I think this is an oft overlooked aspect of the social experience of having a problem. There are many who look at people with medical issues that are dismissive that it must somehow be all that person's own fault. While the argument can be made in some cases, in the case where you can't afford medical treatment, the message is sent that your (the injured party's) suffering doesn't matter at a social level unless somehow you can demonstrate you can produce X amount of worth where that worth becomes at least strongly correlated to some significant fraction of whatever the Medical Industrial Complex decides. It is funny, because I'm reminded of the story Erehwon, where physical ailment vs. Social ailment was flipped around in how it was handled. If you had a chest congestion, you'd be locked away in a prison, away from everyone else, but moral failings like stealing things were not crimes, but things treated as being in need of slight adjustment. The argument put forth against "Doctoring/Medicine" in the story is that eventually, a medical Doctor would accrue too much power over too many people's lives. It seemed ridiculous to meat the time; but as I look at what we have now, I see echoes of it. If you can't afford to exist in the system, you are cast aside. Can you receive treatment? Yes. Will you financially weather that storm without the advantages of full-time representation, negotiation, and legal counsel? No. "First, do no harm" means something; and harm comes in many forms nowadays. I know not where the capacity for ruinous financial inflation is being introduced; the exorbitant costs of medical schooling, the production and certification of medical equipment/research, administrative overhead and profit skimming; but it needs to be addressed and evaluated at each point. Prescription drugs are a start, but the entire infrastructure needs an audit and readjustment in my opinion to bring it back within some semblance of sane operating parameters.

zeveb 7y ago

> For profit healthcare in America is devouring its people and economy, full stop. We can either have a society where half a million people go bankrupt from medical debt each year, thousands die from treatable illnesses or lack of access to medicines, while hospital CEOS and insurance execs walk away with millions, or we can have one that excises their parasitism like the rest of the developed world figured out was necessary decades ago. The majority of the world still has, to my knowledge, for-profit health care: Britain, Germany, France, Switzerland , Sweden and Italy all have at least some form of private health care. The United States definitely have a problem with health care prices. It doesn't appear from where I sit to be an issue with individual bad actors (although of course they do exist) but rather structural. In part, the well-intended federal and state attempts to improve things have backfired — as they tend to do — and made things even more expensive (which reminds me of federal student loans, another instance of well-meaning attempts to help the lesser-off which somehow seem to benefit the upper middle classes most of all; cf. also federally-subsidised mortgages).

ptah 7y ago
> at least some form of private health care. a very tiny proportion of them yes, in the US the whole thing is private
- kube-system 7y ago
  > the whole thing is private The US has several public insurers. About 72 million Americans are enrolled in Medicaid or CHIP. About 60 million are enrolled in Medicare. The MHS covers about 9.5 million people. The IHS covers another 2.2 million people.
  - ptah 7y ago
    insurance is not the same as e.g. UK NHS which is wholly run publically
    - kube-system 7y ago

kasey_junk 7y ago

Without tackling the obesity/sedentary/nutrition problems the healthcare issue will persist. Similarly the opioid/meth epidemics of the last 2 decades are not (just) healthcare problems.

deleted 7y ago
[deleted]
xtian 7y ago
You can’t divorce poor life choices from the economic context they are made within. These are complex issues, but is it controversial to say that people are more interested in investing in their health when they have less stress and more opportunity? Likewise, you aren’t going to get a healthcare system which can make a meaningful impact on improving the lifestyles of the kinds of people you’re talking about without changing the current economic incentives.
dragonwriter 7y ago
> Without tackling the obesity/sedentary/nutrition problems the healthcare issue will persist. Without healthcare system improvements, you aren't going to succeed in tackling those. But, yes, it's true that there are more problems with US health than the health care system (though the issues in the broader economy that are at issue are very similar to those effecting the helathcare system.)
- ronnier 7y ago
  What kind of improvements?
  - toomuchtodo 7y ago
    I imagine being able to go to a doctor without worrying about whether they can afford the copay. Wellness is as much about needing a coach as it is a medical practitioner.
Angostura 7y ago
A good public healthcare system actually puts money into trying to address those problems, as does the government who pays for it. A private healthcare system may be a little more... ambivalent.

turk73 7y ago

Reading between the lines, the cause is alcoholism and drug abuse. If you want to live longer don't drink, smoke, or do drugs. Duh.

davidw 7y ago

There's also an entrepreneurial angle: If you don't have to worry about health care, it becomes much easier to start and run a small company.

claudeganon 7y ago
Indeed. As someone who works in the arts, it’s quite apparent how much easier it is to survive for my friends and colleagues in Canada and Europe. Even discounting the public funding for the arts many of them receive, simply not having to worry about healthcare and medicine costs as a freelancer makes a huge, obvious differences the length and viability of their careers.
- tinyhouse 7y ago
  Not to worry about healthcare and medicine costs is not really true. I just commented about it. Most people pay extra for private insurance even if they get public healthcare for free.
  - claudeganon 7y ago
    I’m in regular contact with artist friends in the UK and Canada and absolutely none of them do this. And neither did any of my family in the UK. Not sure where you’re getting this idea from.
    - arethuza 7y ago
      The only people who generally have private health insurance in the UK (other than dental care) are those who work for companies where, usually senior, staff get this as a taxable part of their package. I wouldn't have thought that artists would belong to this category.
    - tinyhouse 7y ago
      That's true for the UK but not for many European countries. See https://www.oecd-ilibrary.org/docserver/health_glance-2015-39-en.pdf?expires=1575305434&id=id&accname=guest&checksum=9D19D04B300E74512459F5C13EC2C57F https://www.oecd-ilibrary.org/docserver/health_glance-2015-3...

tinyhouse 7y ago

The US private healthcare system has lots of problems and I'm not trying to defend it. However, the public European model is very misleading. The reason is that most people who can afford it pay for private insurance, even in Europe. Otherwise they need to wait months for a doctor appointment.

lentil_soup 7y ago
How healthcare works in Europe changes quite a lot per country. Which country specifically are you talking about?
- tinyhouse 7y ago
  Ones I know of based on friends and family are Israel (follows the European public healthcare model) and Spain. I'm not saying it's the same everywhere in Europe, but I wouldn't be surprised if it's the case in many European countries.
  - igravious 7y ago
    In Spain the rate is 4.4% Israel is not in Europe, but anyway the rate there is 10.3% This indicates to me that the circle of people that you know is not representative of the population at large at least when it comes to health insurance coverage. There's no need to infer statistics about the whole of Europe from your small sample size. All you have to do is look up† the data. Page 4 (Figure 2.1) here: http://www.euro.who.int/__data/assets/pdf_file/0005/310838/Voluntary-health-insurance-Europe-role-regulation.pdf?ua=1 http://www.euro.who.int/__data/assets/pdf_file/0005/310838/V... The majority of countries (38 versus 11) are below 5%, only 5 are above 10% --- † I googled: percentage private health insurance european countries
    - tinyhouse 7y ago
      I guess it depends what qualifies as private insurance. See Figure 7.2: https://www.oecd-ilibrary.org/docserver/health_glance-2015-39-en.pdf?expires=1575305434&id=id&accname=guest&checksum=9D19D04B300E74512459F5C13EC2C57F https://www.oecd-ilibrary.org/docserver/health_glance-2015-3... Israel is 83% and not 10%...

dade_ 7y ago

Private health insurance and lack of universal public health insurance that is. All doctor offices in Canada are private corporations, for whatever reason the hospitals are not and that is where the worst of our problems lay.

willhslade 7y ago
Care to expound?

whiddershins 7y ago

The fact that our healthcare system is messed up is not synonymous with getting rid of profit. Every time something is screwed up in the US, there’s a bunch of people who scream “See! Capitalism!” This, to my mind is unproductive and rather transparent advocacy for an underlying ideological inclination. Sometimes things can be fixed without resorting to “Socializing” them. Here’s something broken under a socialized mechanism: every piece of NYC infrastructure.

igravious 7y ago
"This, to my mind is unproductive and rather transparent advocacy for an underlying ideological inclination." And you're not ideologically inclined in the opposite direction? Look at what is already socialized: fire departments, court system, police service, the three-letter agencies, military, politicians presumably?, a lot of education (despite student loans), a chunk of the health service already, road network, probably a lot more things. I put it to you – given that so much related to the public good is publicly funded and given that examples from the rest of the world abound that public health services are cheaper why wouldn't you socialize the bulk (> 90%) of health. Clearly, to my mind, the reason why it hasn't yet happened in the States is down to government capture, a.k.a. lobbying, a.k.a. legal bribery.
Brain_Thief 7y ago
I find it interesting that your condemnation of unproductive ideological advocacy is couched within a hyperbolic rant wherein you seem to assume the privilege of having your words taken metaphorically and not literally ("every piece" of NYC infrastructure is broken, implicitly due to "Socialism"; people are "screaming" about the ills of capitalism) while simultaneously refusing to extend that same privilege to the people you decry. Whatever your intentions, your use of bad-faith argumentation practices reflects poorly on your stance and mirrors the condescending messaging employed by advocates of the obviously untenable status quo. I claim that your comment was written in bad faith because it feels both divisive and derisive and makes no attempt at offering a bridge of understanding for balanced discussion to occur.

bernierocks 7y ago

The dirty secret is that for profit healthcare runs the rest of the world. The majority of new drugs are created in the US and nations that have government-run healthcare create generics by ripping off/taking the IP and creating cheap alternatives. This is the only reason drugs are cheaper in other parts of the world. The R&D, which costs millions (and sometimes billions) still needs to be paid for by someone..and the government just isn't efficient enough to do this effectively and within a decent time frame. The problem isn't for-profit healthcare. The problem is the insurance companies. They create an un-needed middleman that inflates the cost of everything. A better alternative would be to get rid of insurance for most things, allow doctors and hospitals to charge directly to consumers (which would bring the costs way down). Surgeries would also come down in cost because of competition. The ones that don't come down are most likely because they are rare and have little competition. These can be covered under insurance.

Daishiman 7y ago
> The majority of new drugs are created in the US and nations that have government-run healthcare create generics by ripping off/taking the IP and creating cheap alternatives. This is the only reason drugs are cheaper in other parts of the world. So all those Swiss, German and French pharmaceutical companies are a figment of my imagination then.
- claudeganon 7y ago
  Not to mention the hundreds of millions of dollars in NIH funding and public university research that makes any of these drugs possible in the first place.
- hokumguru 7y ago
  The United States spends the lion's share (>50 percent!) of R&D money on pharmaceuticals worldwide. https://www.abpi.org.uk/facts-and-figures/science-and-innovation/worldwide-pharmaceutical-company-rd-expenditure-by-country/ https://www.abpi.org.uk/facts-and-figures/science-and-innova...
  - 7y ago

scottlocklin 7y ago

It's certainly true that the health care system in the US is bonkers, and there are manifest injustices in how things work, but it also represents an enormous failure in public health efforts. 4/10 US adults are obese. Only 30% of the country manages to not be overweight!

claudeganon 7y ago
The absence of good public health initiatives is also the result of the fractured, poor quality, expensive, private healthcare system in the US.
- scottlocklin 7y ago
  That doesn't at all follow. People aren't fat and out of shape because health care (aka being able to see a doctor) is private or because it sucks; they are so because it isn't considered a national priority like it was at one point in US history. How many people graduate high school knowing how to take care of their bodies? For example: https://www.youtube.com/watch?v=fISgKl8dB3M https://www.youtube.com/watch?v=fISgKl8dB3M

smartstakestime 7y ago

Healthcare has little to do with health. Its this thinking that is the reason why Americans are declining in quality of life. Stop blaming the other, its not making you stronger or better. Better healthcare will not stop you from drinking too much , eating too much, not exercising enough. No drug is going to fix your social anxiety. Drugs fix symptoms not causes. This "health disadvantage" what is it exactly. I bet its lung and diabetes issues. We do it to ourselves. Once you accept that you will see the fix. Its not some billionaire giving you money , it you not giving money to the drug dealing (alcohol, unhealthy food, weed/tobacco/vape) billionaires and getting active. Religion used to be a good way to get out before, a secular nation needs to find a similar motivation that gets people out of their houses. Maybe the worst drug is the media keeping us planted in our chair. Either way I dont trust the gov. so even if we put more money into "healthcare" they would fuck it up. Prove me wrong.

etrautmann 7y ago
This is a diversion and a false dilemma. What you're saying is not wrong in that people should live healthy lifestyles, but it is also true that the health care system is now strongly disincentivizing preventative care, early treatment (or any treatment) in a way that can lead to increased mortality.
SolaceQuantum 7y ago
"No drug is going to fix your social anxiety." But access to afforable medicine will definitely fix a big chunk of my anxiety about not being able to afford medicine! "I bet its lung and diabetes issues." It's really hard to take care of diabetes in america, due to the costs of adequate insulin and related medical purchases such as bloodwork and glucose testing devices.

hindsightbias 7y ago

You can have the best healthcare in the world and it won’t overcome modern lifestyle choices. I spent the last week in 4 different states and airports. The BMI variety between them was staggering. Diabetes rates aren’t soaring because some healthplan is expensive. People blame opoids like they’re causal. Those people have always been in physical agony, there’s just a magic pill now for their disability and as more people make worse choices that population is only going to grow. Until K-12 diets and physical activity become mandates I don’t see how we get ahead of this problem with tech or cheaper healthcare.

RickJWagner 7y ago

But from 2010 to 2017 (the cited years) are the years of the ACA. Was it a failure?

frockington1 7y ago
Unpopular opinion but I think the ACA did more to cripple hourly workers than any other legislation in history. The mandate to provide healthcare to anyone working over 30 hours resulted in work weeks being cut to 29.5 hours for many
- joshmarlow 7y ago
  Do you have data/citations? I could believe this happens, but would like to see data on how wide-spread an impact this is. There are always consequences and tradeoffs - if we had actual numbers about the magnitude of the impact, we could start to discuss if ACA was worth this particular tradeoff.