4 ms·

Thing is, we didn't have socialized medicine in say the 1970s, and I don't remember things being this bad or regulated. What happened?

by gedy 4y ago

Epa095 4y ago
Maybe just "time" happened? It takes time for the rot to properly develop.
- pooper 4y ago
  » Thing is, we didn't have socialized medicine in say the 1970s, and I don't remember things being this bad or regulated. What happened? Or even more simply, we grew up. I was born in the late eighties. I was simply too young to understand that the civil war was not about states' rights. It was about slavery. I thought adults knew everything and as I became an adult I realized I knew nothing. That or a lot of what was previously swept under the carpet or dog whistled is now out in the open. Back to the topic though, I agree with you Probably the easiest explanation is healthcare is now a bigger slice of a bigger pie about 20% of a USD 20T GDP iirc. There is simply too much money to be made here. There is only so much investment opportunity that has any good return so smart money will chase anything that resembles guaranteed returns. Thoughts?
WoahNoun 4y ago
EMTALA was passed under the Reagan administration. This forced hospitals to treat the uninsured, but it provided no funding to pay for those treatments. So the uninsured who don't pay are subsidized by high costs to the insured who do pay. In the 1970's, hospitals would just let the uninsured die in the parking lot / street. So that's the change. https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_an...
- spaetzleesser 4y ago
  "This forced hospitals to treat the uninsured, but it provided no funding to pay for those treatments. So the uninsured who don't pay are subsidized by high costs to the insured who do pay. " They are way overcompensating for this. I think it's just a BS excuse like pharmaceuticals having to be outrageously expensive in the US because other countries are negotiating better prices. I have read some studies where they concluded that the losses through uninsured people aren't really that high. They are only high on paper because they account for them with their chargemaster prices which are way higher than what they would get from insured people.
spaetzleesser 4y ago
Greed happened. Hospitals consolidated and bought up small practices.
thr0wawayf00 4y ago
There are a ton of reasons why, but here are a couple of the big ones. The US is still at the forefront of medical research and technology development in the world. However, many other countries won't pay "market" rates for newer technology developed here at home, so companies often overcharge domestically as a way to recoup revenue they can't collect in other places. Note that American hospitals (particularly newer ones) tend to be obsessed with having state-of-the-art technology, and they're damn sure gonna get paid for that. Another major factor driving healthcare costs is the increasing barriers to access for millions of people. Lots of folks don't realize this, but the US already has a quasi-socialized healthcare system mandated through Federal law. Basically, it's illegal for hospitals to turn ER patients away that cannot prove ability to pay, so folks without insurance often come to the ER for routine medical treatment because its the only way they can be seen, and they know the hospital isn't going to chase them down for their bill because they can't pay for it anyway. Who winds up eating those extra costs? Folks with insurance. I used to work in an ER and I saw this happen all the time.
- ivan_gammel 4y ago
  Do you have any data proving those points? Both are highly questionable from economic PoV. USA is not doing the majority of research, for sure (e.g.EU does a lot too), and it’s not that expensive. Besides that, drugs and equipment are not the only cost drivers. In other countries those who cannot pay for the insurance get it from the taxpayer money, basically the same redistribution just called differently. This does not explain why in USA costs are much higher than in countries where redistribution is codified in the law.
  - Omniusaspirer 4y ago
    The data on biotech and pharmaceutical patents per nation is easy to look up and firmly supports the parent posters point- Google is your friend here. Your second point is a false equivalency as from a private payor perspective the cost of providing care to the indignant is reflected on their localized hospital bill, not on their federal taxes. In struggling rural/inner city hospitals the majority of payors don't cover the cost of the care received (and that includes medicare/medicaid patients), which means hospital bills will be highest in poor regions despite higher rates of federal coverage/subsidy.
joe_the_user 4y ago
The glory days of the semi-welfare state in the US were indeed the 1950s-to-mid-1970s. A lot of those were regulated monopolies - in the case of health care, Blue Shield was a single, private but regulated insurance company owned by hospitals (some portion of which weren't for-profit). The main way Blue Shield was regulated (and it was definitely regulated) was it allowed to maintain complete control of the health insurance market, so that it operated like "single payer" without officially being "socialized medicine". The elimination of this system indeed brought us to the disaster that we're looking at now.
kevin_thibedeau 4y ago
Boomers are old enough now to fuel the growth of medical profiteering. In the 70's 65+ was 10% of the total population and they spent less time in that age bracket before death. Now they're 16% and living longer.

Thing is, we didn't have socialized medicine in say the 1970s, and I don't remember things being this bad or regulated. What happened?

by gedy 4y ago

Thing is, we didn't have socialized medicine in say the 1970s, and I don't remember things being this bad or regulated. What happened?

Epa095 4y ago

Maybe just "time" happened? It takes time for the rot to properly develop.

pooper 4y ago
» Thing is, we didn't have socialized medicine in say the 1970s, and I don't remember things being this bad or regulated. What happened? Or even more simply, we grew up. I was born in the late eighties. I was simply too young to understand that the civil war was not about states' rights. It was about slavery. I thought adults knew everything and as I became an adult I realized I knew nothing. That or a lot of what was previously swept under the carpet or dog whistled is now out in the open. Back to the topic though, I agree with you Probably the easiest explanation is healthcare is now a bigger slice of a bigger pie about 20% of a USD 20T GDP iirc. There is simply too much money to be made here. There is only so much investment opportunity that has any good return so smart money will chase anything that resembles guaranteed returns. Thoughts?

WoahNoun 4y ago

EMTALA was passed under the Reagan administration. This forced hospitals to treat the uninsured, but it provided no funding to pay for those treatments. So the uninsured who don't pay are subsidized by high costs to the insured who do pay. In the 1970's, hospitals would just let the uninsured die in the parking lot / street. So that's the change. https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_an...

spaetzleesser 4y ago
"This forced hospitals to treat the uninsured, but it provided no funding to pay for those treatments. So the uninsured who don't pay are subsidized by high costs to the insured who do pay. " They are way overcompensating for this. I think it's just a BS excuse like pharmaceuticals having to be outrageously expensive in the US because other countries are negotiating better prices. I have read some studies where they concluded that the losses through uninsured people aren't really that high. They are only high on paper because they account for them with their chargemaster prices which are way higher than what they would get from insured people.

spaetzleesser 4y ago

Greed happened. Hospitals consolidated and bought up small practices.

thr0wawayf00 4y ago

There are a ton of reasons why, but here are a couple of the big ones. The US is still at the forefront of medical research and technology development in the world. However, many other countries won't pay "market" rates for newer technology developed here at home, so companies often overcharge domestically as a way to recoup revenue they can't collect in other places. Note that American hospitals (particularly newer ones) tend to be obsessed with having state-of-the-art technology, and they're damn sure gonna get paid for that. Another major factor driving healthcare costs is the increasing barriers to access for millions of people. Lots of folks don't realize this, but the US already has a quasi-socialized healthcare system mandated through Federal law. Basically, it's illegal for hospitals to turn ER patients away that cannot prove ability to pay, so folks without insurance often come to the ER for routine medical treatment because its the only way they can be seen, and they know the hospital isn't going to chase them down for their bill because they can't pay for it anyway. Who winds up eating those extra costs? Folks with insurance. I used to work in an ER and I saw this happen all the time.

ivan_gammel 4y ago
Do you have any data proving those points? Both are highly questionable from economic PoV. USA is not doing the majority of research, for sure (e.g.EU does a lot too), and it’s not that expensive. Besides that, drugs and equipment are not the only cost drivers. In other countries those who cannot pay for the insurance get it from the taxpayer money, basically the same redistribution just called differently. This does not explain why in USA costs are much higher than in countries where redistribution is codified in the law.
- Omniusaspirer 4y ago
  The data on biotech and pharmaceutical patents per nation is easy to look up and firmly supports the parent posters point- Google is your friend here. Your second point is a false equivalency as from a private payor perspective the cost of providing care to the indignant is reflected on their localized hospital bill, not on their federal taxes. In struggling rural/inner city hospitals the majority of payors don't cover the cost of the care received (and that includes medicare/medicaid patients), which means hospital bills will be highest in poor regions despite higher rates of federal coverage/subsidy.

joe_the_user 4y ago

The glory days of the semi-welfare state in the US were indeed the 1950s-to-mid-1970s. A lot of those were regulated monopolies - in the case of health care, Blue Shield was a single, private but regulated insurance company owned by hospitals (some portion of which weren't for-profit). The main way Blue Shield was regulated (and it was definitely regulated) was it allowed to maintain complete control of the health insurance market, so that it operated like "single payer" without officially being "socialized medicine". The elimination of this system indeed brought us to the disaster that we're looking at now.

kevin_thibedeau 4y ago

Boomers are old enough now to fuel the growth of medical profiteering. In the 70's 65+ was 10% of the total population and they spent less time in that age bracket before death. Now they're 16% and living longer.