4 ms·

Some people somewhere, with cigars, in $5,000 suits. "Look at all those schmucks! $400 per shot and $1,000 per stitch." The whole healthcare system needs to be

Some people somewhere, with cigars, in $5,000 suits. "Look at all those schmucks! $400 per shot and $1,000 per stitch." The whole healthcare system needs to be regulated by the government end-to-end. All procurement must be transparent. Every cent traced. Pharma mafia dismantled - on a federal level.

smabie 5y ago
Who are these people? Where are they? Not really convinced they exist.
- donatj 5y ago
  They don’t exist. They’re the imagined scapegoat for what is actually just a much harder to comprehend creeping bureaucracy cost. The human mind loves clear enemies but Hanlon’s Razor almost always applies. Almost no one ever actually has malicious intent, but our brain evolved to watch for enemies and loves seeing patterns where they aren’t.
  - LightG 5y ago
    Cool story. So what you're saying is there is an horrendous creeping bueaucracy cost here. Funny, because that's exactly what free market proponents argue is the cause of inefficiency in publicly managed healthcare systems, and the reason to move towards models based on the US system. Someone is lying.
    - rsj_hn 5y ago
      The costs are more diffuse than this. First, the U.S. system costs twice as much as other systems because we have more people employed delivering care and they make higher salaries. Doctors, nurses, they all make more in the U.S. than in Europe. So more people, getting paid higher wage, results in double the costs. But wait, the financing in the U.S. is quite predatory, so a lot of people pay nothing, and a few people are stuck with outrageous bills. It's like the infamous SF General Hospital that offered loads of free care to the poor and to immigrants and then refused to take any insurance so that normal people were regularly driven to bankruptcy if the ambulence took them there. The U.S. healthcare is one in which a half a million is spent on emergency care for an indigent person and 10 middle class families lose their life savings of 50K treating snakebites and broken arms. Once you wrap your head around this, you'll understand we have a very similar problem in higher education, and for very similar reasons.
      - LightG 5y ago
        Ok, I'll take all of that at face value and as given. It just sounds completely broken over there and I'm not sure I will manage to wrap my head around it. All I know is simpler systems around the world exist and work such that those 10 middle class families would never get stiffed like that, whilst also looking after the needy. I can't fathom it.
        rsj_hn 5y ago
        > It just sounds completely broken over there and I'm not sure I will manage to wrap my head around it. Agreed. But that's the way it is, and it's important to understand why it's this way. When Europe and Australia adopted national healthcare systems, the industry was ~3-5% of GDP. So at that point it wasn't politically strong enough to resist either nationalization or strict controls. Then healthcare mushroomed in size, being ~10% of GDP in Europe and 20% of GDP in the U.S. So now, when you try to do the politics that the europeans did, it doesn't work. The industry is too powerful. Merely blaming the US for not doing what Europe did misses this essential point. There are millions of nurses, lab techs, administrators, and doctors, and they have money and they vote. So the left keeps looking for some villain -- greedy insurance executives, Wall Street, Evil Billionaires, etc. And basically refuses to understand that these are not the ones standing in the way of reform. It's the 13% of our labor force that earns 20% of national income, and these are not the same easy targets that the left can attack, because they are a large portion of the US middle class, and are core Democratic constituencies. That's why healthcare reform in the U.S. always focuses on having the government pay some of the costs charged to consumers rather then reducing the costs of providing healthcare. E.g. more subsidies for this bloated industry, which only results in costs rising even more, and then calls for even more subsidies when people can't afford to pay the costs. When what we should do is fire 50% of the staff and cut the pay of those that remain by another 50%. That's the only way to get affordable healthcare. And you have a similar problem with higher ed.
        hallway_monitor 5y ago
        I think we can all agree the US healthcare system is broken. The above describes exactly why it can't just be "fixed"; only after taking those steps would moving to a universal solution make sense. No one, including healthcare workers, wants to be downsized or get a pay cut.
    - donatj 5y ago
      > Someone is lying. It’s you, to yourself. What we have is not by any stretch of the imagination a free market solution. It’s insane amounts of paper pushers created by the government. The whole insurance system we have is an impractical mess designed to fail. The free market would never have designed something so customer unfriendly, people would have gone elsewhere had competing solutions been allowed to exist. In a free market, you are free to go somewhere else. Our health system is designed by the government, by way of outlawing everything else. If you want to talk free market, in the early 1900s it was common for large companies to keep a doctor on staff and offer their services to employees. That was essentially outlawed. The rise of cash only flat rate doctors in current years is the closest thing we have to free market, and they’re great. Prices posted up front. No back and forth with insurance companies.
      - LightG 5y ago
        There can never be a free market solution as long as there is a need allocate resources between those who have and those who do not have, without letting the latter not die on the street. I'd be interested in how the free market develops that solution. At the very least, regulation would be involved. And we all know how adept the free market is at getting around regulation. Anyway. I'm off to go lie to myself some more. Cheers.
      - deleted 5y ago
        [deleted]
      - DangitBobby 5y ago
        When was it outlawed and by whom?
      - soraki_soladead 5y ago
        > They don’t exist. They’re the imagined scapegoat for what is actually just a much harder to comprehend creeping bureaucracy cost. > The whole insurance system we have is an impractical mess designed to fail. You shifted the boogeyman from corporate suits to politicians in the space of a few comments. If nobody has malicious intent then nothing was "designed to fail". It just doesn't work as expected or wanted by anyone involved.
  - RobertoG 5y ago
    The USA expenditure in healthcare per capita is, more or less, the double that the Netherlands (1) and doesn't cover all the population. Where the difference goes? Sorry if some of us, in our biased minds, suspect that some of that money is spent in cigars and expensive suits. (1) - https://data.worldbank.org/indicator/SH.XPD.CHEX.PC.CD?most_recent_value_desc=true https://data.worldbank.org/indicator/SH.XPD.CHEX.PC.CD?most_...
- LightG 5y ago
  Owners, private equity firms, VC's ... whoever is the ultimate lever in this arena. It's not hard.
  - tartoran 5y ago
    Yep, wallstreet is heavily invested in this space. People fail to connect the dots.
- alistairSH 5y ago
  Whoever categorized the subject’s stitches as a Level 4 trauma, for starters. That was damn near fraudulent.
- praptak 5y ago
  "Both the physicians and the hospital are part of companies recently taken over by private-equity investors."
- blackhaz 5y ago
  These people are rarely public, you don't even need to know they exist. They exist behind the figures we see on the TV. Where there is money and a chance of corruption, they definitely exist.

smabie 5y ago

Who are these people? Where are they? Not really convinced they exist.

donatj 5y ago
They don’t exist. They’re the imagined scapegoat for what is actually just a much harder to comprehend creeping bureaucracy cost. The human mind loves clear enemies but Hanlon’s Razor almost always applies. Almost no one ever actually has malicious intent, but our brain evolved to watch for enemies and loves seeing patterns where they aren’t.
- LightG 5y ago
  Cool story. So what you're saying is there is an horrendous creeping bueaucracy cost here. Funny, because that's exactly what free market proponents argue is the cause of inefficiency in publicly managed healthcare systems, and the reason to move towards models based on the US system. Someone is lying.
  - rsj_hn 5y ago
    The costs are more diffuse than this. First, the U.S. system costs twice as much as other systems because we have more people employed delivering care and they make higher salaries. Doctors, nurses, they all make more in the U.S. than in Europe. So more people, getting paid higher wage, results in double the costs. But wait, the financing in the U.S. is quite predatory, so a lot of people pay nothing, and a few people are stuck with outrageous bills. It's like the infamous SF General Hospital that offered loads of free care to the poor and to immigrants and then refused to take any insurance so that normal people were regularly driven to bankruptcy if the ambulence took them there. The U.S. healthcare is one in which a half a million is spent on emergency care for an indigent person and 10 middle class families lose their life savings of 50K treating snakebites and broken arms. Once you wrap your head around this, you'll understand we have a very similar problem in higher education, and for very similar reasons.
    - LightG 5y ago
      Ok, I'll take all of that at face value and as given. It just sounds completely broken over there and I'm not sure I will manage to wrap my head around it. All I know is simpler systems around the world exist and work such that those 10 middle class families would never get stiffed like that, whilst also looking after the needy. I can't fathom it.
      - rsj_hn 5y ago
        > It just sounds completely broken over there and I'm not sure I will manage to wrap my head around it. Agreed. But that's the way it is, and it's important to understand why it's this way. When Europe and Australia adopted national healthcare systems, the industry was ~3-5% of GDP. So at that point it wasn't politically strong enough to resist either nationalization or strict controls. Then healthcare mushroomed in size, being ~10% of GDP in Europe and 20% of GDP in the U.S. So now, when you try to do the politics that the europeans did, it doesn't work. The industry is too powerful. Merely blaming the US for not doing what Europe did misses this essential point. There are millions of nurses, lab techs, administrators, and doctors, and they have money and they vote. So the left keeps looking for some villain -- greedy insurance executives, Wall Street, Evil Billionaires, etc. And basically refuses to understand that these are not the ones standing in the way of reform. It's the 13% of our labor force that earns 20% of national income, and these are not the same easy targets that the left can attack, because they are a large portion of the US middle class, and are core Democratic constituencies. That's why healthcare reform in the U.S. always focuses on having the government pay some of the costs charged to consumers rather then reducing the costs of providing healthcare. E.g. more subsidies for this bloated industry, which only results in costs rising even more, and then calls for even more subsidies when people can't afford to pay the costs. When what we should do is fire 50% of the staff and cut the pay of those that remain by another 50%. That's the only way to get affordable healthcare. And you have a similar problem with higher ed.
        hallway_monitor 5y ago
        I think we can all agree the US healthcare system is broken. The above describes exactly why it can't just be "fixed"; only after taking those steps would moving to a universal solution make sense. No one, including healthcare workers, wants to be downsized or get a pay cut.
  - donatj 5y ago
    > Someone is lying. It’s you, to yourself. What we have is not by any stretch of the imagination a free market solution. It’s insane amounts of paper pushers created by the government. The whole insurance system we have is an impractical mess designed to fail. The free market would never have designed something so customer unfriendly, people would have gone elsewhere had competing solutions been allowed to exist. In a free market, you are free to go somewhere else. Our health system is designed by the government, by way of outlawing everything else. If you want to talk free market, in the early 1900s it was common for large companies to keep a doctor on staff and offer their services to employees. That was essentially outlawed. The rise of cash only flat rate doctors in current years is the closest thing we have to free market, and they’re great. Prices posted up front. No back and forth with insurance companies.
    - LightG 5y ago
      There can never be a free market solution as long as there is a need allocate resources between those who have and those who do not have, without letting the latter not die on the street. I'd be interested in how the free market develops that solution. At the very least, regulation would be involved. And we all know how adept the free market is at getting around regulation. Anyway. I'm off to go lie to myself some more. Cheers.
    - deleted 5y ago
      [deleted]
    - DangitBobby 5y ago
      When was it outlawed and by whom?
    - soraki_soladead 5y ago
      > They don’t exist. They’re the imagined scapegoat for what is actually just a much harder to comprehend creeping bureaucracy cost. > The whole insurance system we have is an impractical mess designed to fail. You shifted the boogeyman from corporate suits to politicians in the space of a few comments. If nobody has malicious intent then nothing was "designed to fail". It just doesn't work as expected or wanted by anyone involved.
- RobertoG 5y ago
  The USA expenditure in healthcare per capita is, more or less, the double that the Netherlands (1) and doesn't cover all the population. Where the difference goes? Sorry if some of us, in our biased minds, suspect that some of that money is spent in cigars and expensive suits. (1) - https://data.worldbank.org/indicator/SH.XPD.CHEX.PC.CD?most_recent_value_desc=true https://data.worldbank.org/indicator/SH.XPD.CHEX.PC.CD?most_...
LightG 5y ago
Owners, private equity firms, VC's ... whoever is the ultimate lever in this arena. It's not hard.
- tartoran 5y ago
  Yep, wallstreet is heavily invested in this space. People fail to connect the dots.
alistairSH 5y ago
Whoever categorized the subject’s stitches as a Level 4 trauma, for starters. That was damn near fraudulent.
praptak 5y ago
"Both the physicians and the hospital are part of companies recently taken over by private-equity investors."
blackhaz 5y ago
These people are rarely public, you don't even need to know they exist. They exist behind the figures we see on the TV. Where there is money and a chance of corruption, they definitely exist.