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Actually, the median American has access to exceptional care. What is actually the case is that care available to the bottom quartile of Americans is below the

Actually, the median American has access to exceptional care. What is actually the case is that care available to the bottom quartile of Americans is below the care received on average in a top-tier universal care nation, and the US spends an absolute fortune delivering this quartile with substandard care. We also spend a bit more than average providing exceptional care to everyone else, except that we also spend a truly ludicrous amount (compared with every place on earth except possibly Japan, which is still less than us but not quite as much less) on care for roughly everybody above the median during the last year of life, because we have baked some very expensive decisions in as the default (basically, if you don't specifically ask otherwise, you will get absolute treatment maximalism basically until 30 days from death)

marricks 4y ago
Why do Americans always have to play a zero sum game with human lives. If a quarter of our country has the worst healthcare in the developed world that is unacceptable. Answers like this are just begging us to give up our humanity.
- codefreeordie 4y ago
  I have made no statements about how things should be. I have lots of opinions about how things should be, which I don't share on HN. I was making statements about how things actually are, since no discussion about how to make the world we want is likely to be meaningful or useful if there is not a shared view of what is first.
  - marricks 4y ago
    And what you focus on brings about thoughts of a zero sum game which I called out. You can safely assume I don’t agree with what you find most pertinent. I think a country which lets some get rich off of other’s cancer is an abhorrent, indefensible, system.
    - RHSeeger 4y ago
      I'm not seeing that out of his comment. I see him saying we spend a ton of money, and there's the implication that we could be spending that money better/differently. That doesn't imply a zero-sum game. It does imply that the money available for health care is not unlimited. That's pretty much a fact, though.
    - mattmcknight 4y ago
      How do you incentivize smart people to go into cancer treatment instead of other careers? If they can't get rich treating cancer, talent will choose other fields where they can get rich. The market allocates funding to that which people find important. Health care is extremely important, so it gets a lot money thrown at it.
      - fzeroracer 4y ago
        Countries other than the US exist. Doctors, health care workers etc are significantly less paid in Japan and yet they still exist. The idea of 'market forces dictating absolutely everything' is proven objectively wrong by countries that still have a large amount of doctors despite being paid less. The market theory would posit that all of those doctors and what not would move to a country that pays them more but there are many, many other factors other than just pay.
    - nceqs3 4y ago
      > I think a country which lets some get rich off of other’s cancer is an abhorrent, indefensible, system. lol
    - codefreeordie 4y ago
      You are assuming that I believe many things which I do not. You should just assume I'm a misanthrope who enjoys watching people suffer. I mean, it's not true, but lots of idiots assume it.
- ryan93 4y ago
  What fraction of your income goes to the third world?
karpierz 4y ago
> Actually, the median American has access to exceptional care. Is there a source for this? I'd guess that there's a percentile where American health care has better outcomes than other countries, but 50th seems pretty low.
jorblumesea 4y ago
60% of the US has access to "good" healthcare. Why is it ok to throw the under 40% under the bus?
- q1w2 4y ago
  Why is it ok to force the 60% to pay higher taxes and accept WORSE healthcare so that the 40% get better healtcare for nothing? We already pay to cover our own family members on our plans. Why are we being forced to now cover everyone else's family? I'm more likely to move to the adjacent state than pay 15% higher tax rate and literally get LOWER quality care.
  - jorblumesea 4y ago
    1) It's not clear it will be worse, many countries with single insurer/single payer have just as high quality care (Canada) 2) Leaving these people uninsured is not cheaper, you're paying for it already with significant healthcare costs. The same people complaining about the cost of healthcare turn around and deny preventative coverage to people who end up in the ER and you pay for it regardless. 3) It's the right thing to do, ethically, morally and financially (long term) What an incredibly ignorant take, no wonder we don't have any healthcare solutions.
    - OrvalWintermute 4y ago
      My wife, a practicing surgeon, refuses to work as a wage slave. She already performs a significant amount of her practice as "charity care" where she gets no reimbursement whatsoever. Given that for a fellowship-trained (3) board-certified (2) surgeon the train-up period is measured in ~2+ decades, not 4 years for regular professions. > What an incredibly ignorant take, no wonder we don't have any healthcare solutions Please don't assign false morality to the compensation people expect when their working career is effectively halved due to their extensive training requirements, and their educational bills dwarf by comparison every other profession. The US already subsidizes medical research and bigpharma profits for the entire planet. We're not the freeloaders you're making us out to be.

marricks 4y ago

Why do Americans always have to play a zero sum game with human lives. If a quarter of our country has the worst healthcare in the developed world that is unacceptable. Answers like this are just begging us to give up our humanity.

codefreeordie 4y ago
I have made no statements about how things should be. I have lots of opinions about how things should be, which I don't share on HN. I was making statements about how things actually are, since no discussion about how to make the world we want is likely to be meaningful or useful if there is not a shared view of what is first.
- marricks 4y ago
  And what you focus on brings about thoughts of a zero sum game which I called out. You can safely assume I don’t agree with what you find most pertinent. I think a country which lets some get rich off of other’s cancer is an abhorrent, indefensible, system.
  - RHSeeger 4y ago
    I'm not seeing that out of his comment. I see him saying we spend a ton of money, and there's the implication that we could be spending that money better/differently. That doesn't imply a zero-sum game. It does imply that the money available for health care is not unlimited. That's pretty much a fact, though.
  - mattmcknight 4y ago
    How do you incentivize smart people to go into cancer treatment instead of other careers? If they can't get rich treating cancer, talent will choose other fields where they can get rich. The market allocates funding to that which people find important. Health care is extremely important, so it gets a lot money thrown at it.
    - fzeroracer 4y ago
      Countries other than the US exist. Doctors, health care workers etc are significantly less paid in Japan and yet they still exist. The idea of 'market forces dictating absolutely everything' is proven objectively wrong by countries that still have a large amount of doctors despite being paid less. The market theory would posit that all of those doctors and what not would move to a country that pays them more but there are many, many other factors other than just pay.
  - nceqs3 4y ago
    > I think a country which lets some get rich off of other’s cancer is an abhorrent, indefensible, system. lol
  - codefreeordie 4y ago
    You are assuming that I believe many things which I do not. You should just assume I'm a misanthrope who enjoys watching people suffer. I mean, it's not true, but lots of idiots assume it.
ryan93 4y ago
What fraction of your income goes to the third world?

karpierz 4y ago

> Actually, the median American has access to exceptional care. Is there a source for this? I'd guess that there's a percentile where American health care has better outcomes than other countries, but 50th seems pretty low.

jorblumesea 4y ago

60% of the US has access to "good" healthcare. Why is it ok to throw the under 40% under the bus?

q1w2 4y ago
Why is it ok to force the 60% to pay higher taxes and accept WORSE healthcare so that the 40% get better healtcare for nothing? We already pay to cover our own family members on our plans. Why are we being forced to now cover everyone else's family? I'm more likely to move to the adjacent state than pay 15% higher tax rate and literally get LOWER quality care.
- jorblumesea 4y ago
  1) It's not clear it will be worse, many countries with single insurer/single payer have just as high quality care (Canada) 2) Leaving these people uninsured is not cheaper, you're paying for it already with significant healthcare costs. The same people complaining about the cost of healthcare turn around and deny preventative coverage to people who end up in the ER and you pay for it regardless. 3) It's the right thing to do, ethically, morally and financially (long term) What an incredibly ignorant take, no wonder we don't have any healthcare solutions.
  - OrvalWintermute 4y ago
    My wife, a practicing surgeon, refuses to work as a wage slave. She already performs a significant amount of her practice as "charity care" where she gets no reimbursement whatsoever. Given that for a fellowship-trained (3) board-certified (2) surgeon the train-up period is measured in ~2+ decades, not 4 years for regular professions. > What an incredibly ignorant take, no wonder we don't have any healthcare solutions Please don't assign false morality to the compensation people expect when their working career is effectively halved due to their extensive training requirements, and their educational bills dwarf by comparison every other profession. The US already subsidizes medical research and bigpharma profits for the entire planet. We're not the freeloaders you're making us out to be.