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> The fact of the matter is that the majority of Americans have excellent, world class health coverage. The problem is that there exists a small percentage of A

> The fact of the matter is that the majority of Americans have excellent, world class health coverage. The problem is that there exists a small percentage of Americans that are totally screwed, and this is a higher percentage than most other comparable countries. There are a couple reasons why, which brings me to... Really? That is news to me, as a dual US|EU (Croatian) citizen, who is culturally American--but currently living in Croatia. Even Croatia has a higher life expectancy than the United States. Yep, even those "eastern European countries" (that are within the European Union) that Americans refer to with derision, often have higher life expectancy than the United States. See: https://www.reddit.com/r/croatia/comments/nuiyk1/hrvatska_spada_u_blok_visokorazvijenih_zemalja/ https://www.reddit.com/r/croatia/comments/nuiyk1/hrvatska_sp... Also, just in case you want to blame this on "lifestyle factors" (which means that this is a public health matter, which the United States has severely underfunded--locally, state, and nationally for more than a few decades now), the third leading cause of death is believed to be preventable medical errors. (The source I provide has been verified by several follow-up studies.) See: https://www.bmj.com/content/353/bmj.i2139/rapid-responses https://www.bmj.com/content/353/bmj.i2139/rapid-responses Also, you don't know what you are talking about here. I have studied healthcare systems worldwide for hundreds of hours. Ironically the IMHE group that does the coronavirus projections is world renowned at producing this data. All of this data is open-access. For starters (easy reading) this article is relevant: http://www.healthdata.org/news-release/how-healthy-will-we-be-2040 http://www.healthdata.org/news-release/how-healthy-will-we-b... But, seriously, we have far from the best healthcare system in the world. That is not even remotely true. There are several countries where a woman can give birth and is less likely to die, compared to the US. I wish you were joking.

bhupy 5y ago
> Really? That is news to me, as a dual US|EU (Croatian) citizen, who is culturally American--but currently living in Croatia. Yes, and just like that health policy analyst, I can attest to it. I've read more than enough plan documents, and work with health actuaries every day. > Also, just in case you want to blame this on "lifestyle factors" (which means that this is a public health matter, which the United States has severely underfunded--locally, state, and nationally for more than a few decades now), the third leading cause of death is believed to be preventable medical errors. (The source I provide has been verified by several follow-up studies.) Actually, there's a fantastic analysis that addresses this point head on, even analyzing the IHME data: https://randomcriticalanalysis.com/2017/05/16/the-explanatory-power-of-drugs-car-accidents-and-homicides-on-us-life-expectancy-gaps/ https://randomcriticalanalysis.com/2017/05/16/the-explanator... The vast majority of the variance in average life expectancy is attributable to lifestyle factors. As long as you stay away from drugs, you don't participate in a gang, or you take the bus (or any public transit), you're on roughly equal footing with the rest of the OECD. "The data suggests motor vehicle accidents, homicides, and drug overdose deaths can explain a large fraction of the US life expectancy gap as compared to several highly developed countries. Obviously this does not account for obesity, diabetes, (historical) smoking, and related lifestyle differences that are likely to have a pronounced negative affects on US life expectancy as compared to most other developed countries and which statistically explains the vast majority of the very large spatial differences in the United States." > Also, you don't know what you are talking about here. I have studied healthcare systems worldwide for hundreds of hours. Um, so have I. I literally work on health pricing systems, and have studied health policy. "For hundreds of hours" even, for whatever that's worth (not a lot, I assure you). > But, seriously, we have far from the best healthcare system in the world. That is not even remotely true. There are several countries where a woman can give birth and is less likely to die, compared to the US. I don't think I ever said that we have the best healthcare in the world. I agree that US healthcare is broken. All I'm pointing out to you is that the "profit motive" has nothing to do with that, as evidenced by counterfactuals in Switerland, Singapore, and the Netherlands; the former two of which actually have the best healthcare in the world. https://www.rd.com/article/switzerland-worlds-best-healthcare-system/ https://www.rd.com/article/switzerland-worlds-best-healthcar... https://www.forbes.com/sites/theapothecary/2011/04/29/why-switzerland-has-the-worlds-best-health-care-system/?sh=455921447d74 https://www.forbes.com/sites/theapothecary/2011/04/29/why-sw... https://www.bloomberg.com/graphics/infographics/most-efficient-health-care-around-the-world.html https://www.bloomberg.com/graphics/infographics/most-efficie... In my opinion, the profit motive has nothing to do with America's healthcare ills (no pun intended). It's the fact that it's tied to employment and purchased by employers. No other country is set up that way.
- disabled 5y ago
  > I've read more than enough plan documents, and work with health actuaries every day. So, part of your job is to analyze health benefits plans (health insurance plans) that Americans get. You also work daily with actuaries in the life sector, who assign dollar values to people's lives. Yeah, like that really makes you a good source when it comes to the well-being and long-term outcomes of a country. > In my opinion, the profit motive has nothing to do with America's healthcare ills (no pun intended). It's the fact that it's tied to employment and purchased by employers. No other country is set up that way. Congratulations on coming up with that point. That is precisely why I left the US, as somebody with a rare disease that requires an orphan drug to survive. I knew better than to stay in the US, in order to survive. In fact, there may be a major ACA Supreme Court decision coming soon. If not, it will be released in the next session. I refresh SCOTUSblog every morning, worrying for my fellow Americans, who could very well die from the outcome of the decision. Regardless, I never plan on living in the US ever again. It will never be "home" for me anymore.
  - bhupy 5y ago
    > So, part of your job is to analyze health benefits plans (health insurance plans) that Americans get. You also work daily with actuaries in the life sector, who assign dollar values to people's lives. Yes, exactly like health insurance actuaries at publicly run health insurance providers. We don't sit around trying to figure out how to make people die, like cartoon villains. We try to figure out how to make healthcare sustainable. If you read what I had written, it's clear that not only do the private sector insurance providers perform comparable with public sector ones like Original Medicare, they can even out-perform them. So we can't conclude the "privateness" as the root cause of our problems, we have to consider other confounding variables. > Congratulations on coming up with that point. That is precisely why I left the US, as somebody with a rare disease that requires an orphan drug to survive. Sorry to hear that, truly. In my opinion, the single most effective thing we can do to help folks like you is to decouple health insurance from employment, and I'm sticking around to try to make that happen. Hopefully you'll come back, and stay healthy.
    - 5y ago

bhupy 5y ago

> Really? That is news to me, as a dual US|EU (Croatian) citizen, who is culturally American--but currently living in Croatia. Yes, and just like that health policy analyst, I can attest to it. I've read more than enough plan documents, and work with health actuaries every day. > Also, just in case you want to blame this on "lifestyle factors" (which means that this is a public health matter, which the United States has severely underfunded--locally, state, and nationally for more than a few decades now), the third leading cause of death is believed to be preventable medical errors. (The source I provide has been verified by several follow-up studies.) Actually, there's a fantastic analysis that addresses this point head on, even analyzing the IHME data: https://randomcriticalanalysis.com/2017/05/16/the-explanatory-power-of-drugs-car-accidents-and-homicides-on-us-life-expectancy-gaps/ https://randomcriticalanalysis.com/2017/05/16/the-explanator... The vast majority of the variance in average life expectancy is attributable to lifestyle factors. As long as you stay away from drugs, you don't participate in a gang, or you take the bus (or any public transit), you're on roughly equal footing with the rest of the OECD. "The data suggests motor vehicle accidents, homicides, and drug overdose deaths can explain a large fraction of the US life expectancy gap as compared to several highly developed countries. Obviously this does not account for obesity, diabetes, (historical) smoking, and related lifestyle differences that are likely to have a pronounced negative affects on US life expectancy as compared to most other developed countries and which statistically explains the vast majority of the very large spatial differences in the United States." > Also, you don't know what you are talking about here. I have studied healthcare systems worldwide for hundreds of hours. Um, so have I. I literally work on health pricing systems, and have studied health policy. "For hundreds of hours" even, for whatever that's worth (not a lot, I assure you). > But, seriously, we have far from the best healthcare system in the world. That is not even remotely true. There are several countries where a woman can give birth and is less likely to die, compared to the US. I don't think I ever said that we have the best healthcare in the world. I agree that US healthcare is broken. All I'm pointing out to you is that the "profit motive" has nothing to do with that, as evidenced by counterfactuals in Switerland, Singapore, and the Netherlands; the former two of which actually have the best healthcare in the world. https://www.rd.com/article/switzerland-worlds-best-healthcare-system/ https://www.rd.com/article/switzerland-worlds-best-healthcar... https://www.forbes.com/sites/theapothecary/2011/04/29/why-switzerland-has-the-worlds-best-health-care-system/?sh=455921447d74 https://www.forbes.com/sites/theapothecary/2011/04/29/why-sw... https://www.bloomberg.com/graphics/infographics/most-efficient-health-care-around-the-world.html https://www.bloomberg.com/graphics/infographics/most-efficie... In my opinion, the profit motive has nothing to do with America's healthcare ills (no pun intended). It's the fact that it's tied to employment and purchased by employers. No other country is set up that way.

disabled 5y ago
> I've read more than enough plan documents, and work with health actuaries every day. So, part of your job is to analyze health benefits plans (health insurance plans) that Americans get. You also work daily with actuaries in the life sector, who assign dollar values to people's lives. Yeah, like that really makes you a good source when it comes to the well-being and long-term outcomes of a country. > In my opinion, the profit motive has nothing to do with America's healthcare ills (no pun intended). It's the fact that it's tied to employment and purchased by employers. No other country is set up that way. Congratulations on coming up with that point. That is precisely why I left the US, as somebody with a rare disease that requires an orphan drug to survive. I knew better than to stay in the US, in order to survive. In fact, there may be a major ACA Supreme Court decision coming soon. If not, it will be released in the next session. I refresh SCOTUSblog every morning, worrying for my fellow Americans, who could very well die from the outcome of the decision. Regardless, I never plan on living in the US ever again. It will never be "home" for me anymore.
- bhupy 5y ago
  > So, part of your job is to analyze health benefits plans (health insurance plans) that Americans get. You also work daily with actuaries in the life sector, who assign dollar values to people's lives. Yes, exactly like health insurance actuaries at publicly run health insurance providers. We don't sit around trying to figure out how to make people die, like cartoon villains. We try to figure out how to make healthcare sustainable. If you read what I had written, it's clear that not only do the private sector insurance providers perform comparable with public sector ones like Original Medicare, they can even out-perform them. So we can't conclude the "privateness" as the root cause of our problems, we have to consider other confounding variables. > Congratulations on coming up with that point. That is precisely why I left the US, as somebody with a rare disease that requires an orphan drug to survive. Sorry to hear that, truly. In my opinion, the single most effective thing we can do to help folks like you is to decouple health insurance from employment, and I'm sticking around to try to make that happen. Hopefully you'll come back, and stay healthy.
  - 5y ago