10 ms·

It's not that complicated. When we setup competition for infrastructure, we needlessly duplicate management, marketing, accounting, and everything else that doe

It's not that complicated. When we setup competition for infrastructure, we needlessly duplicate management, marketing, accounting, and everything else that does not directly result in the service being provided. The US is doubly idiotic by creating huge financial barriers for anyone who wants to enter healthcare. We make the problem even worse with a system that encourages people to delay treatment for problems that get more expensive to treat over time. The less money you have the more you delay, so the entire system eventually ends up overpaying for a worse outcome. This doesn't factor in all the time spent dealing with inscrutable billing practices for fully insured people having routine medical procedures, or the tens of thousands who are bankrupted every year by the same practices. We recently took our daughter to the ER, which is supposed to be a $400 copay. We now have three separate bills from that visit totaling $1100, and I have no idea how many hours it will take to sort out. The same billing department sent us a $380 invoice six months after her birth because (in their description) they forgot she was there.

bumby 5y ago
>It's not that complicated Just out of curiosity, what’s your proposed solution? There's been decades of very smart people working on this problem and its still a problem largely because of its complexity. If there was a simple solution, I have a feeling it would have been implemented already. The irony of your post that starts with "its not that complicated" ends with an anecdote about just how complicated the system is.
- nicoffeine 5y ago
  It was an anecdote about how complicated the US system is. Other countries figured out decades ago that adding competition to healthcare does not bring down the price or lead to better life expectancy. It is not complicated. https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthstat/life-expectancy-at-birth.htm https://data.oecd.org/healthstat/life-expectancy-at-birth.ht...
  - bumby 5y ago
    But you’re missing a crucial point: The US is not starting from a blank slate. President Obama acknowledged this much when he proposed the Affordable Care Act. He said that he’d prefer a single payer system like other countries use, but that it’s not feasible in the US because we can’t just completely uproot the current system without a ton of unintended consequences. “Just do it like other countries” isn’t a real plan. So given the current state of the healthcare system, how do you propose it gets modified to mirror those other countries? Do you have a good handle on how those proposed steps (like drastic reductions in R&D spending) will affect the overall system? When people naively think there are simple solutions to extremely complex systems, it reminds me of the quote “For every problem there is a solution that is simple, straightforward, and wrong.”
    - nicoffeine 5y ago
      Obama has also been endorsing Medicare For All since 2018. From an article about that subject: "The facts are undeniable. Citizens of developed countries with variations of single-payer systems — Britain, Germany, France, etc. — pay roughly half what Americans pay for health coverage and have better results to show for it (longer life spans, lower infant mortality). They accomplish this not through some exotic, foreign magic but by exploiting the economic benefits of large insurance pools that represent the entire population. This allows comprehensive coverage to be offered at affordable rates because everyone shares in the risks and rewards of the system. Let’s be real clear: This isn’t socialism. This isn’t communism. It’s simple risk management — the same economic principle that underlies all forms of insurance."[1] The bottom line is that nearly a third of America (over 100 million people) are already on Medicare or Medicaid. That is enough data to forecast any outcome there is. Billing, coding, everything is already at a federal standard. Hospitals, doctors, and clinics love Medicare/Medicaid because they know what they are going to be paid and they are paid. Anyone who claims that it can't work here is either unaware of these facts, or purposefully pretending they don't exist. [1] https://www.latimes.com/business/lazarus/la-fi-lazarus-obama-medicare-for-all-20180911-story.html https://www.latimes.com/business/lazarus/la-fi-lazarus-obama...
      - 5y ago

bumby 5y ago

>It's not that complicated Just out of curiosity, what’s your proposed solution? There's been decades of very smart people working on this problem and its still a problem largely because of its complexity. If there was a simple solution, I have a feeling it would have been implemented already. The irony of your post that starts with "its not that complicated" ends with an anecdote about just how complicated the system is.

nicoffeine 5y ago
It was an anecdote about how complicated the US system is. Other countries figured out decades ago that adding competition to healthcare does not bring down the price or lead to better life expectancy. It is not complicated. https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthstat/life-expectancy-at-birth.htm https://data.oecd.org/healthstat/life-expectancy-at-birth.ht...
- bumby 5y ago
  But you’re missing a crucial point: The US is not starting from a blank slate. President Obama acknowledged this much when he proposed the Affordable Care Act. He said that he’d prefer a single payer system like other countries use, but that it’s not feasible in the US because we can’t just completely uproot the current system without a ton of unintended consequences. “Just do it like other countries” isn’t a real plan. So given the current state of the healthcare system, how do you propose it gets modified to mirror those other countries? Do you have a good handle on how those proposed steps (like drastic reductions in R&D spending) will affect the overall system? When people naively think there are simple solutions to extremely complex systems, it reminds me of the quote “For every problem there is a solution that is simple, straightforward, and wrong.”
  - nicoffeine 5y ago
    Obama has also been endorsing Medicare For All since 2018. From an article about that subject: "The facts are undeniable. Citizens of developed countries with variations of single-payer systems — Britain, Germany, France, etc. — pay roughly half what Americans pay for health coverage and have better results to show for it (longer life spans, lower infant mortality). They accomplish this not through some exotic, foreign magic but by exploiting the economic benefits of large insurance pools that represent the entire population. This allows comprehensive coverage to be offered at affordable rates because everyone shares in the risks and rewards of the system. Let’s be real clear: This isn’t socialism. This isn’t communism. It’s simple risk management — the same economic principle that underlies all forms of insurance."[1] The bottom line is that nearly a third of America (over 100 million people) are already on Medicare or Medicaid. That is enough data to forecast any outcome there is. Billing, coding, everything is already at a federal standard. Hospitals, doctors, and clinics love Medicare/Medicaid because they know what they are going to be paid and they are paid. Anyone who claims that it can't work here is either unaware of these facts, or purposefully pretending they don't exist. [1] https://www.latimes.com/business/lazarus/la-fi-lazarus-obama-medicare-for-all-20180911-story.html https://www.latimes.com/business/lazarus/la-fi-lazarus-obama...
    - 5y ago