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This episode of "Adam ruins everything" covers healthcare insurance providers: https://www.youtube.com/watch?v=CeDOQpfaUc8 https://www.youtube.com/watch?v=CeDOQ

This episode of "Adam ruins everything" covers healthcare insurance providers: https://www.youtube.com/watch?v=CeDOQpfaUc8 https://www.youtube.com/watch?v=CeDOQpfaUc8 My takeaway is that the system is calibrated to aggresively punish people without insurance.

lotsofpulp 6y ago
The system was calibrated to create as much friction to receiving healthcare if you are poorer (usually meant you didn’t have insurance pre ACA). Medicaid is the “insurance” for poor people, which pays healthcare providers on the low end and a as a result is not accepted as much. The more friction that it creates for poorer people, the less healthcare they will use, and that helps keep taxes low.
- 29athrowaway 6y ago
  Interesting perspective. Although preventive care is usually cheaper for society than the alternatives IMO. I've heard in some countries, e.g.: the UK, you get summoned by your doctor for preventive care, and this approach helps reducing the overall cost of healthcare.
  - lotsofpulp 6y ago
    Preventative care is not subject to deductibles (i.e. free for people with insurance) after ACA, such as annual wellness exams, vaccinations, etc. People just don’t want to do it, or if they do, they don’t want to give up their sugar/carbs/alcohol/sat fats/sedentary lifestyle habits. Which is probably the cause for the majority of chronic healthcare spending.
    - rsynnott 6y ago
      > Which is probably the cause for the majority of chronic healthcare spending. I doubt it's a _huge_ factor, honestly. The fatter Western European nations (UK and Ireland, for instance) don't have unduly expensive systems; Ireland spends about 5k per capita, the UK about $4k per capita. Much thinner France spends $4.6k. Now, France _does_ outperform both the UK and Ireland on most metrics, but not by a huge amount.
      - lotsofpulp 6y ago
        That is an interesting comparison, but I was going by this: https://www.cdc.gov/chronicdisease/resources/infographic/chronic-diseases.htm https://www.cdc.gov/chronicdisease/resources/infographic/chr...

lotsofpulp 6y ago

The system was calibrated to create as much friction to receiving healthcare if you are poorer (usually meant you didn’t have insurance pre ACA). Medicaid is the “insurance” for poor people, which pays healthcare providers on the low end and a as a result is not accepted as much. The more friction that it creates for poorer people, the less healthcare they will use, and that helps keep taxes low.

29athrowaway 6y ago
Interesting perspective. Although preventive care is usually cheaper for society than the alternatives IMO. I've heard in some countries, e.g.: the UK, you get summoned by your doctor for preventive care, and this approach helps reducing the overall cost of healthcare.
- lotsofpulp 6y ago
  Preventative care is not subject to deductibles (i.e. free for people with insurance) after ACA, such as annual wellness exams, vaccinations, etc. People just don’t want to do it, or if they do, they don’t want to give up their sugar/carbs/alcohol/sat fats/sedentary lifestyle habits. Which is probably the cause for the majority of chronic healthcare spending.
  - rsynnott 6y ago
    > Which is probably the cause for the majority of chronic healthcare spending. I doubt it's a _huge_ factor, honestly. The fatter Western European nations (UK and Ireland, for instance) don't have unduly expensive systems; Ireland spends about 5k per capita, the UK about $4k per capita. Much thinner France spends $4.6k. Now, France _does_ outperform both the UK and Ireland on most metrics, but not by a huge amount.
    - lotsofpulp 6y ago
      That is an interesting comparison, but I was going by this: https://www.cdc.gov/chronicdisease/resources/infographic/chronic-diseases.htm https://www.cdc.gov/chronicdisease/resources/infographic/chr...