3 ms·

You really think 5 months of a pandemic is going to expose this? New York is returning back to normal. The new surges will pass in the same time frame (5 months

You really think 5 months of a pandemic is going to expose this? New York is returning back to normal. The new surges will pass in the same time frame (5 months). The looming primary care crisis will show itself on a much longer time frame. It’s a snake that’s wrapping around, slow acting venom, and we’ll finally see it when it’s not just the ailing boomers that will need continuous care for ubiquitous things like Diabetes, but gen x, y, and z after it. No one’s gonna die, that’s when it’s all going to come to a head. We cannot afford Medicare for all when everybody is fucking sick.

controversy 6y ago
We should be able to afford it when the government takes its rightful place as health dictator. Ban alcohol. Ban tobacco. Ban fatty foods. Ban meat. Ban high fructose corn syrup. If not ban, make it so only rich white people can afford it. Then we can afford things by requiring doctors to either work within the system or they can’t be doctors. That takes care of them going into private care.
- 1996 6y ago
  Ban, ban, ban, then force people to work for the government? I'm not sure I want to live in the country you are suggesting we make. What about drugs are legalized instead, and the medical sector is deregulated for example by removing residency requirements? If a rating system can let anyone become the equivalent of a cab, we certainly can do the same with doctors educated abroad while also educating more at home.
  - controversy 6y ago
    The republicans had their chance. They fucked it up. They are the Washington Team Named To Be Determines of policy makers. All they did was piss people off. Unfortunately we now have to fall into the lap of big daddy government.
  - runawaybottle 6y ago
    You guys are missing the point. I’m saying the general public is too unhealthy for this not to be extremely costly going forward, whether it’s for profit or non profit. The only thing we solved is making sure you can live with the ailment. We didn’t solve the cost of continuous care. Whoever is born today, will enter the demographic of questionable health in just 40 years. That means in our lifetime we’ll have almost 3 generations with garbage health inundating the healthcare system. Try to flatten that curve.
    - baix777 6y ago
      If you look at this from a socioeconomic standpoint, the poor are more obese and exercise less than the better off. Being poor is hard, so the wealth gap of the US looks to be partial cause of this, but the whole cause and effect is hard to determine here.
dimensi0nal 6y ago
Should health insurance, private or public, really pay to deal with people's self-induced health problems from eating too much, smoking, etc?
- coronadisaster 6y ago
  Maybe the health insurance companies should sue tobacco and fast food companies amoung others?
- maxerickson 6y ago
  A healthcare system should strive to make the care people need affordable. Your framing is boring, we need to figure out how to make the care as widely available as possible regardless of the payment model.
- wwweston 6y ago
  Certainly an issue insurers have been thinking about for a while. Funding certain kinds of care with heavy taxes on things like smoking makes a lot sense. Other things like unhealthy eating (or sitting, HN participants, lookin' at you) are so much harder to draw easy lines dividing contributing activity from everyday liberties that it makes less sense. You can work at the margins with something like soda taxes or maybe even incentives around bloodwork but the tradeoffs are less clear along with the dividing lines.
- paulcole 6y ago
  Yes.
wwweston 6y ago
Your last sentence is logically equivalent to saying that no society can afford to give medical care to everyone, the only choice is who to ration it for, since Medicare-for-all is characteristically no different from any other comprehensive risk pool bridged over an entire population. And under conditions you're describing where the population truly is uniformly ill, every sub-population will look similar to the population at large, so no private insurance pool will do better by excluding some of the population. Sounds like a problem.

controversy 6y ago

We should be able to afford it when the government takes its rightful place as health dictator. Ban alcohol. Ban tobacco. Ban fatty foods. Ban meat. Ban high fructose corn syrup. If not ban, make it so only rich white people can afford it. Then we can afford things by requiring doctors to either work within the system or they can’t be doctors. That takes care of them going into private care.

1996 6y ago
Ban, ban, ban, then force people to work for the government? I'm not sure I want to live in the country you are suggesting we make. What about drugs are legalized instead, and the medical sector is deregulated for example by removing residency requirements? If a rating system can let anyone become the equivalent of a cab, we certainly can do the same with doctors educated abroad while also educating more at home.
- controversy 6y ago
  The republicans had their chance. They fucked it up. They are the Washington Team Named To Be Determines of policy makers. All they did was piss people off. Unfortunately we now have to fall into the lap of big daddy government.
- runawaybottle 6y ago
  You guys are missing the point. I’m saying the general public is too unhealthy for this not to be extremely costly going forward, whether it’s for profit or non profit. The only thing we solved is making sure you can live with the ailment. We didn’t solve the cost of continuous care. Whoever is born today, will enter the demographic of questionable health in just 40 years. That means in our lifetime we’ll have almost 3 generations with garbage health inundating the healthcare system. Try to flatten that curve.
  - baix777 6y ago
    If you look at this from a socioeconomic standpoint, the poor are more obese and exercise less than the better off. Being poor is hard, so the wealth gap of the US looks to be partial cause of this, but the whole cause and effect is hard to determine here.

dimensi0nal 6y ago

Should health insurance, private or public, really pay to deal with people's self-induced health problems from eating too much, smoking, etc?

coronadisaster 6y ago
Maybe the health insurance companies should sue tobacco and fast food companies amoung others?
maxerickson 6y ago
A healthcare system should strive to make the care people need affordable. Your framing is boring, we need to figure out how to make the care as widely available as possible regardless of the payment model.
wwweston 6y ago
Certainly an issue insurers have been thinking about for a while. Funding certain kinds of care with heavy taxes on things like smoking makes a lot sense. Other things like unhealthy eating (or sitting, HN participants, lookin' at you) are so much harder to draw easy lines dividing contributing activity from everyday liberties that it makes less sense. You can work at the margins with something like soda taxes or maybe even incentives around bloodwork but the tradeoffs are less clear along with the dividing lines.
paulcole 6y ago
Yes.

wwweston 6y ago

Your last sentence is logically equivalent to saying that no society can afford to give medical care to everyone, the only choice is who to ration it for, since Medicare-for-all is characteristically no different from any other comprehensive risk pool bridged over an entire population. And under conditions you're describing where the population truly is uniformly ill, every sub-population will look similar to the population at large, so no private insurance pool will do better by excluding some of the population. Sounds like a problem.