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https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthres/health-spending.htm And already, US healthcare spending is at least twice t

https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthres/health-spending.htm And already, US healthcare spending is at least twice that of other developed countries, at arguably much reduced availability to the average American. as an outsider, the inability of the USA to change its healthcare system is baffling.

CPLX 7y ago
If you’re baffled you can start with the concept that all that extra money being spent is going to specific people and organizations, who will work to preserve it. It’s a textbook tragedy of the commons example.
- danharaj 7y ago
  It's not a tragedy of the commons if there's a specific class of people who control the resources who dictate what is politically possible.
- scrollbar 7y ago
  Can you elaborate more on your point about tragedy of the commons? Maybe I'm dense but it sounds a lot less like many commoners taking advantage of a common shared resource to the point of destruction. More like "corporate socialism", "regulatory capture", or "corruption"
  - leetcrew 7y ago
    tragedy of the commons is not the best way of describing it. a large fraction of the US workforce works in healthcare (doctors, nurses) and related fields (insurance, pharma, etc.). they may have their gripes with the current system, but ultimately it pays their bills so they don't want to see too much of a change to the status quo. then you have most fulltime employees getting insurance through their employer. even the ones on shitty plans are somewhat protected from seeing the full costs because the employer doesn't usually disclose their share of premiums. I have a decent high-deductible plan that I pay zero premiums for; I have literally no idea how much it costs and no real way to find out (short of harassing our benefits manager). on top of this, you have the powerful institutions/individuals who are making real money of the situation and lobby to perpetuate it. the small subset of the population that isn't more or less apathetic faces an uphill battle to change anything.
- kstenerud 7y ago
  > It’s a textbook tragedy of the commons example. It's not tragedy of the commons. https://en.wikipedia.org/wiki/Tragedy_of_the_commons https://en.wikipedia.org/wiki/Tragedy_of_the_commons This is an example of an inefficient system with powerful stakeholders working to preserve the gravy train that's developed around it.
  - CPLX 7y ago
    My analogy was that the pool of money available to fund health care was a “commons” and without being rationed by a government it would be exploited. Perhaps the better public policy jargon to use would be logic of collective action, in the sense that the profiteers are the special interest group and the rest of us are the diffuse group, but the concepts are pretty conceptually related in my opinion.
nickbauman 7y ago
There are a number of problems with the US health care system (insurers and providers). But on the insurance side, it has come to more closely resemble a legalized protection racket. You never know what it's going to actually cost you, you and your family members can be "hung out over a bridge" by the system, and when you really need the protection, the system decides what is protection and how much you can have. It needs to end. It's hollowing out the vitality of the country in its increasing conflict-of-mission.
kuzimoto 7y ago
I don't think it's entirely fair to just look at overall spending. For instance, nearly half of new drugs were produced in the US, so presumably you pay a premium to get access to the newest stuff. Second, other countries have price controls set by the government. This means that US is likely subsidizing for other countries to have cheaper meds. Due to the price controls, if a life saving drug is too expensive it may not even be available at all. I'm not saying the US is perfect, but it does have some benefits other countries do not.
- digi59404 7y ago
  What are you talking about? We’re subsidizing every other nations healthcare system. Not just the medications. The US in finances provides 60% of the worlds medical research. We produce 40% of the worlds medical journals, and research. People bitch about the United States healthcare being this or that. But what they’re really saying is our healthcare is too expensive, bloated in cost, and inaccessible to lower income and at risk individuals. Which I would agree.
BurningFrog 7y ago
We change the system all the time. Latest revolution was Obamacare. The more things change, the more they stay the same...
kube-system 7y ago
That spending is exactly why it is difficult to change. Every dollar spent is a dollar someone else earns.

CPLX 7y ago

If you’re baffled you can start with the concept that all that extra money being spent is going to specific people and organizations, who will work to preserve it. It’s a textbook tragedy of the commons example.

danharaj 7y ago
It's not a tragedy of the commons if there's a specific class of people who control the resources who dictate what is politically possible.
scrollbar 7y ago
Can you elaborate more on your point about tragedy of the commons? Maybe I'm dense but it sounds a lot less like many commoners taking advantage of a common shared resource to the point of destruction. More like "corporate socialism", "regulatory capture", or "corruption"
- leetcrew 7y ago
  tragedy of the commons is not the best way of describing it. a large fraction of the US workforce works in healthcare (doctors, nurses) and related fields (insurance, pharma, etc.). they may have their gripes with the current system, but ultimately it pays their bills so they don't want to see too much of a change to the status quo. then you have most fulltime employees getting insurance through their employer. even the ones on shitty plans are somewhat protected from seeing the full costs because the employer doesn't usually disclose their share of premiums. I have a decent high-deductible plan that I pay zero premiums for; I have literally no idea how much it costs and no real way to find out (short of harassing our benefits manager). on top of this, you have the powerful institutions/individuals who are making real money of the situation and lobby to perpetuate it. the small subset of the population that isn't more or less apathetic faces an uphill battle to change anything.
kstenerud 7y ago
> It’s a textbook tragedy of the commons example. It's not tragedy of the commons. https://en.wikipedia.org/wiki/Tragedy_of_the_commons https://en.wikipedia.org/wiki/Tragedy_of_the_commons This is an example of an inefficient system with powerful stakeholders working to preserve the gravy train that's developed around it.
- CPLX 7y ago
  My analogy was that the pool of money available to fund health care was a “commons” and without being rationed by a government it would be exploited. Perhaps the better public policy jargon to use would be logic of collective action, in the sense that the profiteers are the special interest group and the rest of us are the diffuse group, but the concepts are pretty conceptually related in my opinion.

nickbauman 7y ago

There are a number of problems with the US health care system (insurers and providers). But on the insurance side, it has come to more closely resemble a legalized protection racket. You never know what it's going to actually cost you, you and your family members can be "hung out over a bridge" by the system, and when you really need the protection, the system decides what is protection and how much you can have. It needs to end. It's hollowing out the vitality of the country in its increasing conflict-of-mission.

kuzimoto 7y ago

I don't think it's entirely fair to just look at overall spending. For instance, nearly half of new drugs were produced in the US, so presumably you pay a premium to get access to the newest stuff. Second, other countries have price controls set by the government. This means that US is likely subsidizing for other countries to have cheaper meds. Due to the price controls, if a life saving drug is too expensive it may not even be available at all. I'm not saying the US is perfect, but it does have some benefits other countries do not.

digi59404 7y ago
What are you talking about? We’re subsidizing every other nations healthcare system. Not just the medications. The US in finances provides 60% of the worlds medical research. We produce 40% of the worlds medical journals, and research. People bitch about the United States healthcare being this or that. But what they’re really saying is our healthcare is too expensive, bloated in cost, and inaccessible to lower income and at risk individuals. Which I would agree.

BurningFrog 7y ago

We change the system all the time. Latest revolution was Obamacare. The more things change, the more they stay the same...

kube-system 7y ago

That spending is exactly why it is difficult to change. Every dollar spent is a dollar someone else earns.