4 ms·

All good points, but the fact remains that at my income, it simply doesn't make financial sense for me to be insured. If I must declare bankruptcy in case of c

by acabal 16y ago

All good points, but the fact remains that at my income, it simply doesn't make financial sense for me to be insured. If I must declare bankruptcy in case of cataclysm, then the system just lost much more money than they would have were I paying an affordable (sliding?) amount per month over my lifespan. Anyway, this isn't the place to get in a discussion about how to fix the system. But as it stands now, it's just a fact that my bank account is better served by not being insured, having minor procedures done in another country, and declaring bankruptcy in the event of a cataclysm. That's not what the system in the richest and most powerful country in the world should look like.

Groxx 16y ago
Totally agree, for relatively healthy younger people willing to risk bankruptcy, it's a massively cheaper option. I'm merely saying that that kind of cost is nearly impossible to achieve, as reaching it would incur costs elsewhere. Distributing the cost doesn't make it less real.
- dalke 16y ago
  You say it, but you don't back it up with evidence. How is it that the US already pays more money per person for health care but with measurably worse results (measured as life expectancy, infant mortality, etc). How do they achieve what you call impossible?
  - Groxx 16y ago
    Measurably worse results than where? It's measurably better than many places. I say it because many many many other places subsidize healthcare at least as much as America does. And people don't seem to count the taxes they pay as part of the monthly cost. edit: edited my top comment, sources are there. Canadians, famous for cheap healthcare, pay $324 per month per person for healthcare. The government covers $227 of that, which means $227 per person per month comes from taxes.
    - ible 16y ago
      Measurably worse than the rest of the G8, according to your source (http://en.wikipedia.org/wiki/Health_care_in_Canada http://en.wikipedia.org/wiki/Health_care_in_Canada) at least on life expectancy, infant mortality, per capita expenditure, costs as % of GDP, and % of government revenue spent on health.
      - yummyfajitas 16y ago
        Not true. We beat Japan on life expectancy, provided you restrict the comparison to people of Japanese descent. Japanese Americans live 84.5 years on average, Japanese only 82.6. http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlID=53 http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&#3... http://www.google.com/publicdata?ds=wb-wdi&met=sp_dyn_le00_in&idim=country:JPN&dl=en&hl=en&q=japan+life+expectancy http://www.google.com/publicdata?ds=wb-wdi&met=sp_dyn_le... (Would love to see data doing similar comparisons to other G8 nations.)
        ible 16y ago
        That's funny, but I'm not sure it's true. Your first link seems to say (it's worded awkwardly) that Japanese women in the US have a 84.5 year life expectancy. This isn't quite as high as the 85.66 life expectancy Japanese women have in Japan (https://www.cia.gov/library/publications/the-world-factbook/geos/ja.html https://www.cia.gov/library/publications/the-world-factbook/...) That's despite people of Asian descent in the US having higher income and education than the average, both of which are positively correlated with life expectancy. Even if it is true, I'm not sure what the significance would be. I would be surprised if you couldn't pick out many subgroups in the US which do better in the US than in their places of origin, without it supporting an argument about the quality of the overall system.
        yummyfajitas 16y ago
        Oops, I think I misread the article. I stand corrected. Even if it is true, I'm not sure what the significance would be. I would be surprised if you couldn't pick out many subgroups in the US which do better in the US than in their places of origin, without it supporting an argument about the quality of the overall system. Very true. To actually make the argument you are trying to make, you'd actually need to do a carefully controlled study. But most such studies (which include ethnicity, rural living, diet, etc as predictors) actually show no significant relationship between marginal changes in health care and health outcomes.
  - bzbarsky 16y ago
    The US pays more money because it has more health care being provided, in many cases. It just so happens that more health care doesn't necessarily translate to measurably better outcomes (e.g. cancer screening helps reduce mortality for some cancers but not others). It also just so happens that it's very rare to study whether a particular care regimen actually improves overall outcomes as opposed to just the thing it's ostensibly aimed at treating. Continuing our cancer example, cancer screening helps reduce mortality from _cancer_ for almost all if not all cancers, but for some the increased mortality from operations and other cancer therapies cancels out the improvement. That's not to mention the fact that people in the US prefer to get care even if they know it'll likely make them worse than not getting care. I'll dig up the reference for this; I don't have it offhand.
    - pessimizer 16y ago
      >The US pays more money because it has more health care being provided Reference for this, too, please.
    - bzbarsky 16y ago
      Reference for the last part there: http://www.ncbi.nlm.nih.gov/pubmed/16282212 http://www.ncbi.nlm.nih.gov/pubmed/16282212
    - bzbarsky 16y ago
      The first claim above is pretty broad; coming up with a single reference to support it would be hard, and coming up with a wide range of references time-consuming. But as examples: http://www.ncbi.nlm.nih.gov/pubmed/2268793 http://www.ncbi.nlm.nih.gov/pubmed/2268793 (2.5x more coronary artery bypasses per capita in the US than in Canada in 1988; admittedly somewhat dated). http://www.pillsforall.com/blog/cardiac-stents-are-used-twice-more-in-u-s-than-in-canada/ http://www.pillsforall.com/blog/cardiac-stents-are-used-twic... I realize that's pretty weak support; I don't have anything better off the top of my head, unfortunately.
    - dalke 16y ago
      So we pay more money then other countries but don't get better outcomes? Could we save money and get the same outcomes? And since we get worse outcomes then they do, could we spend less and still get better outcomes? How do you defined "more health care?"
gte910h 16y ago
> declaring bankruptcy in the event of a cataclysm Some procedures are not covered in your scenario depending on your state. Organ Transplants in Arizona etc.

by acabal 16y ago

Groxx 16y ago

Totally agree, for relatively healthy younger people willing to risk bankruptcy, it's a massively cheaper option. I'm merely saying that that kind of cost is nearly impossible to achieve, as reaching it would incur costs elsewhere. Distributing the cost doesn't make it less real.

dalke 16y ago
You say it, but you don't back it up with evidence. How is it that the US already pays more money per person for health care but with measurably worse results (measured as life expectancy, infant mortality, etc). How do they achieve what you call impossible?
- Groxx 16y ago
  Measurably worse results than where? It's measurably better than many places. I say it because many many many other places subsidize healthcare at least as much as America does. And people don't seem to count the taxes they pay as part of the monthly cost. edit: edited my top comment, sources are there. Canadians, famous for cheap healthcare, pay $324 per month per person for healthcare. The government covers $227 of that, which means $227 per person per month comes from taxes.
  - ible 16y ago
    Measurably worse than the rest of the G8, according to your source (http://en.wikipedia.org/wiki/Health_care_in_Canada http://en.wikipedia.org/wiki/Health_care_in_Canada) at least on life expectancy, infant mortality, per capita expenditure, costs as % of GDP, and % of government revenue spent on health.
    - yummyfajitas 16y ago
      Not true. We beat Japan on life expectancy, provided you restrict the comparison to people of Japanese descent. Japanese Americans live 84.5 years on average, Japanese only 82.6. http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlID=53 http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&#3... http://www.google.com/publicdata?ds=wb-wdi&met=sp_dyn_le00_in&idim=country:JPN&dl=en&hl=en&q=japan+life+expectancy http://www.google.com/publicdata?ds=wb-wdi&met=sp_dyn_le... (Would love to see data doing similar comparisons to other G8 nations.)
      - ible 16y ago
        That's funny, but I'm not sure it's true. Your first link seems to say (it's worded awkwardly) that Japanese women in the US have a 84.5 year life expectancy. This isn't quite as high as the 85.66 life expectancy Japanese women have in Japan (https://www.cia.gov/library/publications/the-world-factbook/geos/ja.html https://www.cia.gov/library/publications/the-world-factbook/...) That's despite people of Asian descent in the US having higher income and education than the average, both of which are positively correlated with life expectancy. Even if it is true, I'm not sure what the significance would be. I would be surprised if you couldn't pick out many subgroups in the US which do better in the US than in their places of origin, without it supporting an argument about the quality of the overall system.
        yummyfajitas 16y ago
        Oops, I think I misread the article. I stand corrected. Even if it is true, I'm not sure what the significance would be. I would be surprised if you couldn't pick out many subgroups in the US which do better in the US than in their places of origin, without it supporting an argument about the quality of the overall system. Very true. To actually make the argument you are trying to make, you'd actually need to do a carefully controlled study. But most such studies (which include ethnicity, rural living, diet, etc as predictors) actually show no significant relationship between marginal changes in health care and health outcomes.
- bzbarsky 16y ago
  The US pays more money because it has more health care being provided, in many cases. It just so happens that more health care doesn't necessarily translate to measurably better outcomes (e.g. cancer screening helps reduce mortality for some cancers but not others). It also just so happens that it's very rare to study whether a particular care regimen actually improves overall outcomes as opposed to just the thing it's ostensibly aimed at treating. Continuing our cancer example, cancer screening helps reduce mortality from _cancer_ for almost all if not all cancers, but for some the increased mortality from operations and other cancer therapies cancels out the improvement. That's not to mention the fact that people in the US prefer to get care even if they know it'll likely make them worse than not getting care. I'll dig up the reference for this; I don't have it offhand.
  - pessimizer 16y ago
    >The US pays more money because it has more health care being provided Reference for this, too, please.
  - bzbarsky 16y ago
    Reference for the last part there: http://www.ncbi.nlm.nih.gov/pubmed/16282212 http://www.ncbi.nlm.nih.gov/pubmed/16282212
  - bzbarsky 16y ago
    The first claim above is pretty broad; coming up with a single reference to support it would be hard, and coming up with a wide range of references time-consuming. But as examples: http://www.ncbi.nlm.nih.gov/pubmed/2268793 http://www.ncbi.nlm.nih.gov/pubmed/2268793 (2.5x more coronary artery bypasses per capita in the US than in Canada in 1988; admittedly somewhat dated). http://www.pillsforall.com/blog/cardiac-stents-are-used-twice-more-in-u-s-than-in-canada/ http://www.pillsforall.com/blog/cardiac-stents-are-used-twic... I realize that's pretty weak support; I don't have anything better off the top of my head, unfortunately.
  - dalke 16y ago
    So we pay more money then other countries but don't get better outcomes? Could we save money and get the same outcomes? And since we get worse outcomes then they do, could we spend less and still get better outcomes? How do you defined "more health care?"

gte910h 16y ago

> declaring bankruptcy in the event of a cataclysm Some procedures are not covered in your scenario depending on your state. Organ Transplants in Arizona etc.