6 ms·

How is this sold to Americans as a good option? Is it that you have "choice" of insurance providers? Is it that you might pay less if you are healthy? I don't g

by giarc 5y ago

How is this sold to Americans as a good option? Is it that you have "choice" of insurance providers? Is it that you might pay less if you are healthy? I don't get it, why do so many American's vote in politicians who advocate for this type of healthcare?!

mulletbum 5y ago
They aren't voting for their own best interests. They are voting to stop people from killing babies and stop socialism (or whatever else they are told).
ansible 5y ago
The debate in the USA is framed with the implication that if you (the health care consumer) does not have "choice" then you will be forced to only see a really terrible doctor, and get substandard care at a high price. And that, with a little effort on your own part, you will be able to select a better doctor at a affordable price. Therefore, if you have a bad doctor or expensive care, it is your own damn fault. You just didn't try hard enough to find a good one. It is the same thing with the debate about school vouchers vs. a standard public education for everyone. A heaping dose of "the free market fixes everything", for all life's problems. I would rather not have a "choice". I would like to be able to select any nearby doctor, and be assured of getting competent care. I'm not often in the situation where I have a wacky tropical disease that presents odd and incongruous symptoms, which would take a Dr. House to figure out. I am far more likely to have run-of-the-mill heart disease or a common form of cancer. I just need a doctor with some basic level of competence, who can just listen to me and help me through the common health problems of modern life.
- dantheman 5y ago
  Are you against school vouchers? Why would you want parents to not be able to select the school their children go to?
  - ansible 5y ago
    If parents want to send their kids to religious schools, they can pay for it themselves.
    - throwawayboise 5y ago
      They are. Their taxes pay for the vouchers.
      - ansible 5y ago
        No, only a small portion of an individual parent's taxes pays for a small portion of their own kid's education.
    - g00gler 5y ago
      Religious schools aren’t the only use of vouchers either. There are also charter schools. Charter schools can often provide specialized programs. Montessori schools seem awesome as well.
      - snegu 5y ago
        Charter schools are public schools and do not require vouchers. They are not considered private schools.
  - rrrrrrrrrrrryan 5y ago
    I never understood the concept of vouchers. Taxes are connected from everyone to pay for public schools, which can be used by anyone's children. They're not to pay for the schooling of your own children. I don't have children at all, and I don't mind paying taxes to fund schools, because when I'm old I want the doctor who is younger than to have gotten a good education. I don't expect any vouchers just because I don't have kids consuming public education. Vouchers always seemed to me like an obvious scheme to defund public schools and let them rot, thereby punishing kids who were unlucky enough to be born poor.
    - 5y ago
- Amezarak 5y ago
  In my experience, doctors are like programmers. Nobody really has any effective way to evaluate them, or at least, nobody does so on a broad basis or consistently. Some of them can’t pass fizzbuzz. Some of them can churn out CRUD apps, but have no idea what they’re doing when it comes to anything else. Some of them are extremely dogmatic about design patterns and tooling and ignore anything they don’t like. Some of them are inattentive or poor listeners. Some of them assume it’s Problem X they’ve seen a million times, but it’s not. Some of them are assholes. Some of them are really sharp and really engaged, but get overly excited and reinvent the wheel or spend a lot of time doing stuff that’s completely unnecessary and maybe even harmful. I don’t know how to evaluate doctors until I see them, I have no idea if better doctors cost more or less, I doubt there’s a strong correlation because nobody else can evaluate them either. They either help me or they don’t. I think it absolutely is necessary that I should be able to have a history and see the same doctor, and that I should be able to see another doctor any time I want for the same condition for a second, third, or fourth opinion. I have seen this be absolutely necessary for myself and others with common conditions that were resolved after seeing a different doctor. I assume this is still possible in most if not all public health care systems (I live in the US but local doctors and hospitals are all government run, an interesting aside), but I am not sure. I recently had a conversation with a Canadian friend who has debilitating autoimmune disease his specialist is doing basically nothing for and he made it seem like it wasn’t possible, but I didn’t want to press.
Amezarak 5y ago
Because it’s not the insurance that’s expensive, it’s the medical care, and rooting out the zillion reasons that’s expensive is difficult and involves attacking some sacred cows. Plus, about a quarter of Americans have “free” care already, via Medicaid and Medicare. Many of the rest have their employer hiding the true cost from them - they think the premium that comes out of their check is the actual cost. Some employers apparently even pay 100% of the premium cost. So all these people are okay with the status quo, or even want to defend it. It’s the people on (increasingly common) high deductible plans, people with no insurance, or people who experience a catastrophic edge case (out of network provider for example) that hate it.
tidydata 5y ago
To be quite honest, most of it is sold by the media, who have mutually beneficial arrangements with the for-profit healthcare/insurance industry. If you’ve ever seen how many advertisements on American TV about prescriptions, health plans, etc, you know what I’m getting at. The debate is kept tightly constrained to make the capitalist system seem more robust and successful than it actually is. So: media propaganda, more or less. Also want to add: my child’s birth cost $20,000 (with insurance). When I would tell other Americans about this, the response was (usually) “you know you can get on a payment plan, right?”
dcolkitt 5y ago
The high cost of healthcare in the US has very little to do with the structure of insurance. Insurance industry profits only account for 2% of aggregate medical expenditures. The reason that Turkish healthcare is much cheaper than American healthcare is primarily because Turkish doctors are paid much less than American doctors. (As are Turkish nurses, and Turkish drug and device wholesalers, and so on.) There's a very simple solution to that. All you have to do is let Turkish doctors come to the United States and practice medicine. Or better yet let Turkish hospitals open entire branches in the United States and wholesale import their staff, equipment, and drugs from Turkey. The reason that doesn't happen is because we have a cartel called the American Medical Association that continuously lobbies for antiquated barriers to foreign competition. Unless a physician does a residency in America (which good luck, if you're a foreigner from a foreign school), you will never be allowed to practice in the US.
- nradov 5y ago
  There is a shortage of residency slots in general, not just for foreign doctors. That shortage is caused by lack of federal government funding. The AMA has actively lobbied for more residency slots. https://www.ama-assn.org/press-center/press-releases/ama-fund-graduate-medical-education-address-physician-shortages https://www.ama-assn.org/press-center/press-releases/ama-fun...
- adrianN 5y ago
  Yeah if I were a doctor with insane amounts of debt after training for ten to fifteen years I would support any "cartel" that works to increase my salary too. Cheaper healthcare is not the only thing the US needs. Cheaper college education is important too.
pyuser583 5y ago
Failed reform after failed reform after failed reform. The reforms also create a dramatic increase in bureaucracy. For example, my daughter needs to see a specialist. I call the specialists office. I’m told there are too many patients. The doctor has to chose which to see. I need to call the primary, and have them forward my daughters info. The specialist office says she is not high enough priority and cannot be seen (my daughters condition is crippling, but not fatal as it is for others). I call up the next specialist on the list. They are overbooked. I need to call up the primary and they a referral. I call primary again. I get referral again. Again the specialist decides not to see my daughter. I call the next specialist … etc. Did I mention that for some specialists the insurance info is out of date. They are not in fact in network. So once I get an appointment, I must verify with insurance they are in network. I’LL PAY THE F*KING MONEY IF YOU GET RID OF THE BUREAUCRACY!!! Obamacare increased bureaucracy. Clinton HMO increased bureaucracy. I’m a highly compensated professional. My healthcare is free.
airhead969 5y ago
You have the choice of which random areas to gamble on buried in small printing of lengthy contracts. Medicare isn't public universal healthcare. The prescription plans, Medicare Advantage plans, and medigap plans are run by for-profit companies. $300-500 per month, and many good companies, like Thrivent, are getting out of healthcare completely.
1123581321 5y ago
That person’s experience is bizarre. There’s something they aren’t telling us. Americans don’t pay anything like $1k for a checkup or pair of them, especially a virtual one.

by giarc 5y ago

mulletbum 5y ago

They aren't voting for their own best interests. They are voting to stop people from killing babies and stop socialism (or whatever else they are told).

ansible 5y ago

The debate in the USA is framed with the implication that if you (the health care consumer) does not have "choice" then you will be forced to only see a really terrible doctor, and get substandard care at a high price. And that, with a little effort on your own part, you will be able to select a better doctor at a affordable price. Therefore, if you have a bad doctor or expensive care, it is your own damn fault. You just didn't try hard enough to find a good one. It is the same thing with the debate about school vouchers vs. a standard public education for everyone. A heaping dose of "the free market fixes everything", for all life's problems. I would rather not have a "choice". I would like to be able to select any nearby doctor, and be assured of getting competent care. I'm not often in the situation where I have a wacky tropical disease that presents odd and incongruous symptoms, which would take a Dr. House to figure out. I am far more likely to have run-of-the-mill heart disease or a common form of cancer. I just need a doctor with some basic level of competence, who can just listen to me and help me through the common health problems of modern life.

dantheman 5y ago
Are you against school vouchers? Why would you want parents to not be able to select the school their children go to?
- ansible 5y ago
  If parents want to send their kids to religious schools, they can pay for it themselves.
  - throwawayboise 5y ago
    They are. Their taxes pay for the vouchers.
    - ansible 5y ago
      No, only a small portion of an individual parent's taxes pays for a small portion of their own kid's education.
  - g00gler 5y ago
    Religious schools aren’t the only use of vouchers either. There are also charter schools. Charter schools can often provide specialized programs. Montessori schools seem awesome as well.
    - snegu 5y ago
      Charter schools are public schools and do not require vouchers. They are not considered private schools.
- rrrrrrrrrrrryan 5y ago
  I never understood the concept of vouchers. Taxes are connected from everyone to pay for public schools, which can be used by anyone's children. They're not to pay for the schooling of your own children. I don't have children at all, and I don't mind paying taxes to fund schools, because when I'm old I want the doctor who is younger than to have gotten a good education. I don't expect any vouchers just because I don't have kids consuming public education. Vouchers always seemed to me like an obvious scheme to defund public schools and let them rot, thereby punishing kids who were unlucky enough to be born poor.
  - 5y ago
Amezarak 5y ago
In my experience, doctors are like programmers. Nobody really has any effective way to evaluate them, or at least, nobody does so on a broad basis or consistently. Some of them can’t pass fizzbuzz. Some of them can churn out CRUD apps, but have no idea what they’re doing when it comes to anything else. Some of them are extremely dogmatic about design patterns and tooling and ignore anything they don’t like. Some of them are inattentive or poor listeners. Some of them assume it’s Problem X they’ve seen a million times, but it’s not. Some of them are assholes. Some of them are really sharp and really engaged, but get overly excited and reinvent the wheel or spend a lot of time doing stuff that’s completely unnecessary and maybe even harmful. I don’t know how to evaluate doctors until I see them, I have no idea if better doctors cost more or less, I doubt there’s a strong correlation because nobody else can evaluate them either. They either help me or they don’t. I think it absolutely is necessary that I should be able to have a history and see the same doctor, and that I should be able to see another doctor any time I want for the same condition for a second, third, or fourth opinion. I have seen this be absolutely necessary for myself and others with common conditions that were resolved after seeing a different doctor. I assume this is still possible in most if not all public health care systems (I live in the US but local doctors and hospitals are all government run, an interesting aside), but I am not sure. I recently had a conversation with a Canadian friend who has debilitating autoimmune disease his specialist is doing basically nothing for and he made it seem like it wasn’t possible, but I didn’t want to press.

Amezarak 5y ago

Because it’s not the insurance that’s expensive, it’s the medical care, and rooting out the zillion reasons that’s expensive is difficult and involves attacking some sacred cows. Plus, about a quarter of Americans have “free” care already, via Medicaid and Medicare. Many of the rest have their employer hiding the true cost from them - they think the premium that comes out of their check is the actual cost. Some employers apparently even pay 100% of the premium cost. So all these people are okay with the status quo, or even want to defend it. It’s the people on (increasingly common) high deductible plans, people with no insurance, or people who experience a catastrophic edge case (out of network provider for example) that hate it.

tidydata 5y ago

To be quite honest, most of it is sold by the media, who have mutually beneficial arrangements with the for-profit healthcare/insurance industry. If you’ve ever seen how many advertisements on American TV about prescriptions, health plans, etc, you know what I’m getting at. The debate is kept tightly constrained to make the capitalist system seem more robust and successful than it actually is. So: media propaganda, more or less. Also want to add: my child’s birth cost $20,000 (with insurance). When I would tell other Americans about this, the response was (usually) “you know you can get on a payment plan, right?”

dcolkitt 5y ago

The high cost of healthcare in the US has very little to do with the structure of insurance. Insurance industry profits only account for 2% of aggregate medical expenditures. The reason that Turkish healthcare is much cheaper than American healthcare is primarily because Turkish doctors are paid much less than American doctors. (As are Turkish nurses, and Turkish drug and device wholesalers, and so on.) There's a very simple solution to that. All you have to do is let Turkish doctors come to the United States and practice medicine. Or better yet let Turkish hospitals open entire branches in the United States and wholesale import their staff, equipment, and drugs from Turkey. The reason that doesn't happen is because we have a cartel called the American Medical Association that continuously lobbies for antiquated barriers to foreign competition. Unless a physician does a residency in America (which good luck, if you're a foreigner from a foreign school), you will never be allowed to practice in the US.

nradov 5y ago
There is a shortage of residency slots in general, not just for foreign doctors. That shortage is caused by lack of federal government funding. The AMA has actively lobbied for more residency slots. https://www.ama-assn.org/press-center/press-releases/ama-fund-graduate-medical-education-address-physician-shortages https://www.ama-assn.org/press-center/press-releases/ama-fun...
adrianN 5y ago
Yeah if I were a doctor with insane amounts of debt after training for ten to fifteen years I would support any "cartel" that works to increase my salary too. Cheaper healthcare is not the only thing the US needs. Cheaper college education is important too.

pyuser583 5y ago

Failed reform after failed reform after failed reform. The reforms also create a dramatic increase in bureaucracy. For example, my daughter needs to see a specialist. I call the specialists office. I’m told there are too many patients. The doctor has to chose which to see. I need to call the primary, and have them forward my daughters info. The specialist office says she is not high enough priority and cannot be seen (my daughters condition is crippling, but not fatal as it is for others). I call up the next specialist on the list. They are overbooked. I need to call up the primary and they a referral. I call primary again. I get referral again. Again the specialist decides not to see my daughter. I call the next specialist … etc. Did I mention that for some specialists the insurance info is out of date. They are not in fact in network. So once I get an appointment, I must verify with insurance they are in network. I’LL PAY THE F*KING MONEY IF YOU GET RID OF THE BUREAUCRACY!!! Obamacare increased bureaucracy. Clinton HMO increased bureaucracy. I’m a highly compensated professional. My healthcare is free.

airhead969 5y ago

You have the choice of which random areas to gamble on buried in small printing of lengthy contracts. Medicare isn't public universal healthcare. The prescription plans, Medicare Advantage plans, and medigap plans are run by for-profit companies. $300-500 per month, and many good companies, like Thrivent, are getting out of healthcare completely.

1123581321 5y ago

That person’s experience is bizarre. There’s something they aren’t telling us. Americans don’t pay anything like $1k for a checkup or pair of them, especially a virtual one.