5 ms·

> You're in the minority Does that make their opinion irrelevant?

toomuchtodo 5y ago
No, the data showing Americans spend more on healthcare than every other OECD country with worse outcomes does that. https://www.harvardmagazine.com/2020/05/feature-forum-costliest-health-care https://www.harvardmagazine.com/2020/05/feature-forum-costli... https://www.kff.org/health-costs/issue-brief/americans-challenges-with-health-care-costs/ https://www.kff.org/health-costs/issue-brief/americans-chall... https://insights.som.yale.edu/insights/why-is-healthcare-so-expensive https://insights.som.yale.edu/insights/why-is-healthcare-so-... Not even the wealthy get better healthcare with their dollars. https://astralcodexten.substack.com/p/highlights-from-the-comments-on-health https://astralcodexten.substack.com/p/highlights-from-the-co... > GummyBearDoc writes: > I want to push back on the assertion Scott made that "Certainly rich people in America get good health care." After he published this book in June 2020, Ezekiel Emmanuel published an article in JAMA IM (link: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2774561 https://jamanetwork.com/journals/jamainternalmedicine/fullar...) called "Comparing Health Outcomes of Privileged US Citizens With Those of Average Residents of Other Developed Countries." He wanted to test the commonly stated trope that a feature of the US healthcare system is that the rich here get the very best care in the world. To do that, he looked at outcomes across six benchmark diseases (heart attack, colon cancer, breast cancer, infant mortality, maternal mortality, and pediatric acute lymphocytic leukemia). He compared outcomes for white people in the 1% of richest counties in the US, 5% richest counties in the US, and average outcomes in 12 rich countries (i'm not going to type them all out but they're places like Australia, Canada, and Germany). The results were...not so great for rich Americans! > While rich people in the US do better than average people in other rich countries with breast cancer, RICH children in the US have outcomes worse than AVERAGE citizens in 11/12 of this group of rich countries. Rich people in America have about the same outcomes after heart attack that average people in other rich countries have. In other words, in most cases, you're about as well off having a heart attack being the average bozo in France (for example) as you are having one in one of the wealthiest counties in the US. I was pretty shocked when I read this paper. > The reason I think this is important is because I think it's extremely politically useful sometimes to be able to claim that rich people in the US get great healthcare! People like to imagine themselves as more privileged than they are, and think that, if and when they get sick, they'll have access to this incredible care. So we should reframe from "average care in the US is shitty but care for the upper echelons is the envy of the world" to "average care in the US is shitty, and also in the upper echelons we are about the same as the average person in America's peer countries." Emphasis on the last paragraph.
- colechristensen 5y ago
  How many drugs, medical devices, etc. were developed in the US and are being sold to all of those OECD countries at a significant discount? If that pricing was forced on Americans as well, where would the now missing money come from? Is it a bunch of corporate fatcats getting rich or is the richest country in the world subsidizing the healthcare of the rest of the world? (I mean, probably both, but is your intention to nationalize and make nonprofit every aspect of healthcare including drugs and research?)
  - actually_a_dog 5y ago
    Wait up. The US develops all these things, and yet, you think they should be given away to the world at a discount, while Americans pay full fare or more? How does that make any sense to you?
    - colechristensen 5y ago
      The only countries with higher median incomes than the US are Norway, UAE, Luxembourg, and Switzerland. UAE and Norway because oil, Luxembourg and Switzerland because they are tiny and very specialized. The rest of the world can't afford as much, plenty of people will argue for humanitarian reasons that things should be lower cost to those countries which can't pay as much, and in order to sell in those other countries companies simply have to lower prices. A similar thing happens with video games, movies, streaming services, etc. etc. etc. it's called price discrimination. (it is of course not universal, but it is still quite common for companies to lower their prices in markets which can't afford as much)
      - actually_a_dog 5y ago
        I'm sorry, but that still does not make sense to me. The US (meaning really, the American people) is expected both to innovate and subsidize the world? Come on, now. If the US develops it, why shouldn't the US benefit the most? If prices keep going the way they have over the past 40 years, we're not going to be able to afford all these fancy treatments and drugs, anyway. Imagine a corporation developing a product, then marketing it for sale, yet not only not giving its employees a corporate discount, but making them pay more for it. Again, how does that make sense?

No, the data showing Americans spend more on healthcare than every other OECD country with worse outcomes does that. https://www.harvardmagazine.com/2020/05/feature-forum-costliest-health-care https://www.harvardmagazine.com/2020/05/feature-forum-costli... https://www.kff.org/health-costs/issue-brief/americans-challenges-with-health-care-costs/ https://www.kff.org/health-costs/issue-brief/americans-chall... https://insights.som.yale.edu/insights/why-is-healthcare-so-expensive https://insights.som.yale.edu/insights/why-is-healthcare-so-... Not even the wealthy get better healthcare with their dollars. https://astralcodexten.substack.com/p/highlights-from-the-comments-on-health https://astralcodexten.substack.com/p/highlights-from-the-co... > GummyBearDoc writes: > I want to push back on the assertion Scott made that "Certainly rich people in America get good health care." After he published this book in June 2020, Ezekiel Emmanuel published an article in JAMA IM (link: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2774561 https://jamanetwork.com/journals/jamainternalmedicine/fullar...) called "Comparing Health Outcomes of Privileged US Citizens With Those of Average Residents of Other Developed Countries." He wanted to test the commonly stated trope that a feature of the US healthcare system is that the rich here get the very best care in the world. To do that, he looked at outcomes across six benchmark diseases (heart attack, colon cancer, breast cancer, infant mortality, maternal mortality, and pediatric acute lymphocytic leukemia). He compared outcomes for white people in the 1% of richest counties in the US, 5% richest counties in the US, and average outcomes in 12 rich countries (i'm not going to type them all out but they're places like Australia, Canada, and Germany). The results were...not so great for rich Americans! > While rich people in the US do better than average people in other rich countries with breast cancer, RICH children in the US have outcomes worse than AVERAGE citizens in 11/12 of this group of rich countries. Rich people in America have about the same outcomes after heart attack that average people in other rich countries have. In other words, in most cases, you're about as well off having a heart attack being the average bozo in France (for example) as you are having one in one of the wealthiest counties in the US. I was pretty shocked when I read this paper. > The reason I think this is important is because I think it's extremely politically useful sometimes to be able to claim that rich people in the US get great healthcare! People like to imagine themselves as more privileged than they are, and think that, if and when they get sick, they'll have access to this incredible care. So we should reframe from "average care in the US is shitty but care for the upper echelons is the envy of the world" to "average care in the US is shitty, and also in the upper echelons we are about the same as the average person in America's peer countries." Emphasis on the last paragraph.

colechristensen 5y ago
How many drugs, medical devices, etc. were developed in the US and are being sold to all of those OECD countries at a significant discount? If that pricing was forced on Americans as well, where would the now missing money come from? Is it a bunch of corporate fatcats getting rich or is the richest country in the world subsidizing the healthcare of the rest of the world? (I mean, probably both, but is your intention to nationalize and make nonprofit every aspect of healthcare including drugs and research?)
- actually_a_dog 5y ago
  Wait up. The US develops all these things, and yet, you think they should be given away to the world at a discount, while Americans pay full fare or more? How does that make any sense to you?
  - colechristensen 5y ago
    The only countries with higher median incomes than the US are Norway, UAE, Luxembourg, and Switzerland. UAE and Norway because oil, Luxembourg and Switzerland because they are tiny and very specialized. The rest of the world can't afford as much, plenty of people will argue for humanitarian reasons that things should be lower cost to those countries which can't pay as much, and in order to sell in those other countries companies simply have to lower prices. A similar thing happens with video games, movies, streaming services, etc. etc. etc. it's called price discrimination. (it is of course not universal, but it is still quite common for companies to lower their prices in markets which can't afford as much)
    - actually_a_dog 5y ago
      I'm sorry, but that still does not make sense to me. The US (meaning really, the American people) is expected both to innovate and subsidize the world? Come on, now. If the US develops it, why shouldn't the US benefit the most? If prices keep going the way they have over the past 40 years, we're not going to be able to afford all these fancy treatments and drugs, anyway. Imagine a corporation developing a product, then marketing it for sale, yet not only not giving its employees a corporate discount, but making them pay more for it. Again, how does that make sense?