5 ms·

There are, uh, several different first-world countries in which health insurance is paid by the government which you could scrutinize to see if your assumption

There are, uh, several different first-world countries in which health insurance is paid by the government which you could scrutinize to see if your assumption is worth assuming. Or you could scrutinize the projected numbers, which conclude that it would be less expensive, in terms of government healthcare funding, to eliminate all of the ravenous middlemen causing all of the costs. Kinda like how it'd be cheaper to just give all the homeless people housing, rather than burn shitloads of social and criminal justice funding to keep them on the streets. These are ideological positions, though, so good luck changing any of them. So are the rolling presses -- they're not there to prop up a healthcare system, they're there to refill the troughs of irresponsible rich people whose enterprises have become "too big to fail". The problem is that the rich people have come to expect this windfall. Maybe we can save some money for them by cleaning up the healthcare and criminal justice systems!!

metalliqaz 5y ago
not to mention freeing up the costs paid by employers and employees, which would then be freed for commerce.
- revolvingocelot 5y ago
  Ahh, but holding that Sword of Damocles over employees' heads is too valuable! Disincentives quitting, or even dissent. Not sure why the owner class would go for that, TBH.
  - metalliqaz 5y ago
    indeed they lobby against it but imagine how much easier it would be to start a business if you didn't need to be a wage slave for the man to insure your family
throw8932894 5y ago
Who do you think pays that inflated price? Medicare and government. It is the same as gov backed student loans. It inflates price to sky high prices. Activists never demand cheaper (or more transparent) health care. They demand state to pay for it!
- revolvingocelot 5y ago
  >Activists never demand cheaper (or more transparent) health care. They demand state to pay for it! ...it's cheaper that way. That's-- that's why they say that. You can keep repeating yourself, but tell me, what makes almost every other first-world country better at this than the States? How is it that we can pay so much less and have, in aggregate, better health outcomes? It's a mystery!
  - throw8932894 5y ago
    You are out of reality. My country has public health insurance, but gov also works hard to keep costs down. If we paid for drugs like this, the public system would bankrupt.
    - revolvingocelot 5y ago
      Perhaps you find this unpleasant, but the reality is that my government is able to dictate terms to pharmacorps such that we do not have to "pay for drugs like this". The whole point is that the exorbitant costs are not the true costs, they're just what you'll get charged unless you stand together.
m_ke 5y ago
*almost all countries: https://en.wikipedia.org/wiki/List_of_countries_with_universal_health_care#/media/File:Universal_Healthcare_by_Country_20191229.svg https://en.wikipedia.org/wiki/List_of_countries_with_univers... or all other not poverty stricken countries https://cdn.howmuch.net/articles/poverty-world-map-142d.jpg https://cdn.howmuch.net/articles/poverty-world-map-142d.jpg
incrudible 5y ago
You are mistaking list prices with cost. Nobody pays list price. List price is an anchor for price negotiation. This works against you as an uninsured individual, because you have no negotiating power. Insurance companies act as the wholesaler and they insist on locking you into a complicated subscription model. They can only do this because drug purchases are heavily regulated.
- revolvingocelot 5y ago
  >List price is an anchor for price negotiation As someone who hails from a place whose enormous single-bloc healthcare system can dictate the terms you're describing, I don't think that statement is the explanatory gotcha you intend it to be. Those regulations are there for a reason -- to ensure your for-profit healthcare system makes profit. What if the middlemen were gone and it didn't have to?
  - incrudible 5y ago
    Sure, middlemen make profit, but nobody makes that kind of profit. Nobody pays these prices. Drug prices in the US system may be elevated, but in the grand scheme of things it's a modest part of the total cost. Furthermore, the reason that these prices can be charged is the regulatory moat, courtesy of the government. Suppose that same government would enact a single-payer system, what makes you believe it wouldn't pay outrageous drug prices, courtesy of the taxpayer? The mechanism that gives the pharma lobby free reign won't just disappear over night.
    - revolvingocelot 5y ago
      > Sure, middlemen make profit, but nobody makes that kind of profit. Nobody pays these prices. Drug prices in the US system may be elevated, but in the grand scheme of things it's a modest part of the total cost. "Aw, it's not so bad!" >Furthermore, the reason that these prices can be charged is the regulatory moat, courtesy of the government. Suppose that same government would enact a single-payer system, what makes you believe it wouldn't pay outrageous drug prices, courtesy of the taxpayer? The mechanism that gives the pharma lobby free reign won't just disappear over night. "But also it's super bad, and it's obviously the best we can do." Don't know what to tell you -- seemed to work everywhere else. I guess that's American exceptionalism for you!
vidarh 5y ago
To add something to this to illustrate just how expensive the US healthcare system is: Because of how hamstrung Medicare and Medicaid are - with laws restricting them from leveraging their size properly in negotiations, Medicare and Medicaid combined cost US taxpayers as much per taxpayer as the NHS costs per UK taxpayer. The big difference, of course, being that this buys us universal coverage in the UK, while Medicaid and Medicare only covers a portion of the US population. So the cost per recipient of care is many times higher. Then a whole lot of Americans have to pay again in private insurance to actually get cover. So for a start, Americans ought to campaign to unshackle Medicare. Remove the regulations preventing it from leveraging its size fully and make it subject to pressure to be cost effective, and put the savings into expanding coverage, and you'd already be a huge step closer to solving the problem. EDIT: This is an interesting read: https://www.commonwealthfund.org/publications/explainer/2021/may/allowing-medicare-negotiate-drug-prices https://www.commonwealthfund.org/publications/explainer/2021... " As proposed in H.R. 3, drug pricing negotiation would reduce federal spending by $456 billion and increase revenues by $45 billion over 10 years." -- this is a plan that still puts lots of restrictions on how hard Medicare can negotiate. Also: https://www.kff.org/medicare/issue-brief/whats-the-latest-on-medicare-drug-price-negotiations/ https://www.kff.org/medicare/issue-brief/whats-the-latest-on...

metalliqaz 5y ago

not to mention freeing up the costs paid by employers and employees, which would then be freed for commerce.

revolvingocelot 5y ago
Ahh, but holding that Sword of Damocles over employees' heads is too valuable! Disincentives quitting, or even dissent. Not sure why the owner class would go for that, TBH.
- metalliqaz 5y ago
  indeed they lobby against it but imagine how much easier it would be to start a business if you didn't need to be a wage slave for the man to insure your family

throw8932894 5y ago

Who do you think pays that inflated price? Medicare and government. It is the same as gov backed student loans. It inflates price to sky high prices. Activists never demand cheaper (or more transparent) health care. They demand state to pay for it!

revolvingocelot 5y ago
>Activists never demand cheaper (or more transparent) health care. They demand state to pay for it! ...it's cheaper that way. That's-- that's why they say that. You can keep repeating yourself, but tell me, what makes almost every other first-world country better at this than the States? How is it that we can pay so much less and have, in aggregate, better health outcomes? It's a mystery!
- throw8932894 5y ago
  You are out of reality. My country has public health insurance, but gov also works hard to keep costs down. If we paid for drugs like this, the public system would bankrupt.
  - revolvingocelot 5y ago
    Perhaps you find this unpleasant, but the reality is that my government is able to dictate terms to pharmacorps such that we do not have to "pay for drugs like this". The whole point is that the exorbitant costs are not the true costs, they're just what you'll get charged unless you stand together.

m_ke 5y ago

*almost all countries: https://en.wikipedia.org/wiki/List_of_countries_with_universal_health_care#/media/File:Universal_Healthcare_by_Country_20191229.svg https://en.wikipedia.org/wiki/List_of_countries_with_univers... or all other not poverty stricken countries https://cdn.howmuch.net/articles/poverty-world-map-142d.jpg https://cdn.howmuch.net/articles/poverty-world-map-142d.jpg

incrudible 5y ago

You are mistaking list prices with cost. Nobody pays list price. List price is an anchor for price negotiation. This works against you as an uninsured individual, because you have no negotiating power. Insurance companies act as the wholesaler and they insist on locking you into a complicated subscription model. They can only do this because drug purchases are heavily regulated.

revolvingocelot 5y ago
>List price is an anchor for price negotiation As someone who hails from a place whose enormous single-bloc healthcare system can dictate the terms you're describing, I don't think that statement is the explanatory gotcha you intend it to be. Those regulations are there for a reason -- to ensure your for-profit healthcare system makes profit. What if the middlemen were gone and it didn't have to?
- incrudible 5y ago
  Sure, middlemen make profit, but nobody makes that kind of profit. Nobody pays these prices. Drug prices in the US system may be elevated, but in the grand scheme of things it's a modest part of the total cost. Furthermore, the reason that these prices can be charged is the regulatory moat, courtesy of the government. Suppose that same government would enact a single-payer system, what makes you believe it wouldn't pay outrageous drug prices, courtesy of the taxpayer? The mechanism that gives the pharma lobby free reign won't just disappear over night.
  - revolvingocelot 5y ago
    > Sure, middlemen make profit, but nobody makes that kind of profit. Nobody pays these prices. Drug prices in the US system may be elevated, but in the grand scheme of things it's a modest part of the total cost. "Aw, it's not so bad!" >Furthermore, the reason that these prices can be charged is the regulatory moat, courtesy of the government. Suppose that same government would enact a single-payer system, what makes you believe it wouldn't pay outrageous drug prices, courtesy of the taxpayer? The mechanism that gives the pharma lobby free reign won't just disappear over night. "But also it's super bad, and it's obviously the best we can do." Don't know what to tell you -- seemed to work everywhere else. I guess that's American exceptionalism for you!

vidarh 5y ago

To add something to this to illustrate just how expensive the US healthcare system is: Because of how hamstrung Medicare and Medicaid are - with laws restricting them from leveraging their size properly in negotiations, Medicare and Medicaid combined cost US taxpayers as much per taxpayer as the NHS costs per UK taxpayer. The big difference, of course, being that this buys us universal coverage in the UK, while Medicaid and Medicare only covers a portion of the US population. So the cost per recipient of care is many times higher. Then a whole lot of Americans have to pay again in private insurance to actually get cover. So for a start, Americans ought to campaign to unshackle Medicare. Remove the regulations preventing it from leveraging its size fully and make it subject to pressure to be cost effective, and put the savings into expanding coverage, and you'd already be a huge step closer to solving the problem. EDIT: This is an interesting read: https://www.commonwealthfund.org/publications/explainer/2021/may/allowing-medicare-negotiate-drug-prices https://www.commonwealthfund.org/publications/explainer/2021... " As proposed in H.R. 3, drug pricing negotiation would reduce federal spending by $456 billion and increase revenues by $45 billion over 10 years." -- this is a plan that still puts lots of restrictions on how hard Medicare can negotiate. Also: https://www.kff.org/medicare/issue-brief/whats-the-latest-on-medicare-drug-price-negotiations/ https://www.kff.org/medicare/issue-brief/whats-the-latest-on...