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On a per capita basis we already spend enough money in the US to have the best socialized medicine system on the planet: https://data.oecd.org/healthres/health-
by willcipriano 4y ago
On a per capita basis we already spend enough money in the US to have the best socialized medicine system on the planet: https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthres/health-spending.htm (if you remove voluntary spending we still spend more than anyone else)
They have the funds, our government just isn't competent enough to deliver it.
- lkxijlewlf 4y agoCruelty is the point.
- de6u99er 4y agoDon't you think it's rather corruption than incompetence?
- bobkazamakis 4y agoah yes, corruption and incompetence are exclusive to American systems in a way which no other country can deal with.
- ChrisRR 4y agoWhataboutism achieves nothing
- peanut_worm 4y agoWhy give them something for free when you can just have then work to death instead?
- dzink 4y agoMost of it is likely going to lawyers and health and malpractice insurance companies.
- stjohnswarts 4y agoNo it's not. Do some research malpractice is a tiny percentage of costs overall. That's a red herring thrown out there by doctors and insurance companies.
- dzink 4y agoYes it is. A single large judgement anywhere in the country and the malpractice insurance for all doctors everywhere in the US is bumped up just for premiums. Some disciplines like OB are forced to pay a quarter of a million in malpractice insurance every year just to practice. For others, it went up from 30 to 50K per year just this year alone. When that happens every practitioner starts requiring expensive tests that have a tiny % of catching something, but may catch that stroke that triggers the $100 million lawsuit. 60% of doctors in the US are sued every single year, with each case worth 100k for the doctor to defend, and almost all are without merit. If you want to cut down healthcare costs, insurance and tort reform would be the #1 place to do it. Create a pool of money to cover bad cases and push out bad doctors, but the current system is untenable and benefits nobody in healthcare.
- willcipriano 4y ago> Some disciplines like OB are forced to pay a quarter of a million in malpractice insurance every year just to practice That's one and a half premature babies[0], or ten c-section babies. That number could be low or high depending on the average number of babies that OB is working with. [0] "a premature baby spends an average of 25.4 days in a speciality care nursery at an average cost of $144,692" - https://www.oviahealth.com/blog/the-real-cost-of-preterm-birth-how-to-save-lives-and-save-millions https://www.oviahealth.com/blog/the-real-cost-of-preterm-bir... [1] "A cesarean section (C-section) is much more expensive, costing an average of $22,646 including standard predelivery and postdelivery expenses." - https://www.valuepenguin.com/cost-childbirth-health-insurance https://www.valuepenguin.com/cost-childbirth-health-insuranc...
- dzink 4y ago
- space_fountain 4y agoYes, but worth remembering this is more than just cutting out capitalist's profit. This would need to involve running the medical sector better + pushing wages for doctors and other medical professionals down, but yeah the fact that US federal government spends more than the UK on healthcare per capita while not actually delivering healthcare to everyone is crazy
- ceeplusplus 4y agoYep, doctors in the US make anywhere from 2-5x that of doctors in the UK. Take a look at these salaries posted by the NHS [1]. Nurses make more too. It's very common for RNs in California to make upwards of $50/h even starting out, which works out to more than the specialized doctor pay in the NHS link. Student loan debt isn't even a big factor in this because of the sheer size of the salary gap. $500k loan gets paid off fast when you make $300k+, and you get that salary for life whereas the loan only weighs you down for the first 5-10 years. [1] https://www.healthcareers.nhs.uk/explore-roles/doctors/pay-doctors/pay-doctors https://www.healthcareers.nhs.uk/explore-roles/doctors/pay-d...
- LeifCarrotson 4y agoOTOH, doctors in the US often pay $50-$200k/year in malpractice insurance[1]. In the UK, indemnity comes from the NHS automatically. https://www.nerdwallet.com/article/small-business/how-much-is-malpractice-insurance https://www.nerdwallet.com/article/small-business/how-much-i...
- joe_guy 4y agoYes, for a surgeon. Scroll down to internal medicine, which is closer to who will be prescribing insulin, and note it's 8k to 50k. (No median or mean is given?) I'm not at all shocked someone who cuts people open and removes or adds objects has a high liability insurance. I have no source for this, but blaming medical system costs on liability insurance feels like a way of blaming the patients instead of the system. "If only greedy people were not trying to get rich quick off lawsuits."
- 4y ago
- sha256sum 4y agoCompetency? The system is working as intended, it prioritizes the needs of capital flowing to the elites. You must come from somewhere else, one that places citizens on a slightly higher strata than the US does.
- ch4s3 4y agoTo believe this shows total ignorance of the history of the healthcare system in America. The whole thing is a crazy pile of hacks and accidents with 0 design or intent. It’s tape and string all the way down. We just stumble from unintended consequence to unintended consequence. Shit, the only reason it’s tied to employment is because of post war wage and price controls.
- dc-programmer 4y agoThis is true. But fatal flaws such as the fact that Medicare cannot negotiate prices with drug companies are not accidents but rather artifacts of corporate lobbying. There are many examples of rent seeking like this across the system
- ch4s3 4y agoMedicare didn't cover drugs at all until 2003 when Bush put together Medicare Part D to bolster flagging support. Medicaid doesn't negotiate prices either, but it's mandate that it will pay the lowest negotiated price in the market. When Part D was passed it almost had a similar structure. In 2016 there was a move to add negotiation but it fizzled. In both cases the CBO estimated that negotiating prices would save precisely no money. The way Medicare plans actually work is that plan provider bid to be part of the program and they are selected on a cost basis, and they then negotiate drug prices. Could Medicare administrators do a better job? Well the CBO has twice said no. Medicare Part D was a huge hack to cover a made up problem, which is to say seniors too wealthy for Medicaid not being able to afford their heart medicine. It was essentially GWB trying to buy voted before the 2004 election. So I think you're wrong on the history here.
- 4y ago
- atwood22 4y agoWhenever talking about America, you need to do a massive cost-of-living adjustment for the entire system. For instance, a general practitioner in Germany can expect to earn around 3,000 Euros after taxes per month, and a surgeon barely grosses six figures. Ask a doctor in America if they'd be willing to work for that salary. And the same adjustment needs to be made for nurses, administrative staff, pharma employees, device manufacturers, medical suppliers, etc. Edit: since I've being downvoted, I just wanted to clarify I'm neither agreeing with or disagreeing with the assertion that the U.S. spends enough to have the best medical system. I'm just highlighting the fact that, in general, highly skilled labor in the U.S. often earns 3-5x (or more) than highly skilled labor in other countries.
- bombcar 4y agoI wonder if the German surgeon would work in the US for some smaller amount of salary increase (though I suspect everything in the US is designed to prevent this).
- willcipriano 4y agoGlobalization is apparently good in all contexts except medicine and law, the two most common fields of employment for a congressperson or senator. The AMA would scream bloody murder if someone seriously proposed hiring foreign doctors to stem the shortage they caused by limiting residency slots for decades.
- kelseyfrog 4y agoThe AMA limitations of residencies and restrictions on foreign doctors should be challenged though anti-trust litigation.[1] 1. https://journalofethics.ama-assn.org/article/challenging-medical-residency-matching-system-through-antitrust-litigation/2015-02 https://journalofethics.ama-assn.org/article/challenging-med...
- throwaway5752 4y agoThat's misinterpreting data. We subsidize global pharmas (and medical device companies) based out the of US with the excessive cost we pay as patients. That is probably because of their lobbying. Since private health insurance mostly acts as a pass through, they are happy to let the cost curve rise as long as individuals and employers pay the bills. The only place in the US government that controls its formulary is the VA/Tricare and they have remarkable success in managing costs there. Otherwise, you mistakenly believe the government controls these costs. We have incompetent or corrupt private industry, and a major party that is eager to deregulate things further.
- beached_whale 4y agoInsulin is not a subsidized item. It is very old tech and they make a profit in other countries. Its about <=$5/vial to make
- throwaway5752 4y agoWe - the US consumer, not the US government - subsidize global pharma with the ridiculously high prices we are forced to pay for drugs. That is exactly my point.
- willcipriano 4y agoWith CHIP[0], Medicare[1] and Medicaid[2] that isn't really true. The US taxpayer foots the bill for the majority of medical costs in the US. If you are a child, elderly or disabled (ie. most of the people with high medical costs) it's very likely that you fall under one of those programs. [0]https://en.wikipedia.org/wiki/Children%27s_Health_Insurance_Program https://en.wikipedia.org/wiki/Children%27s_Health_Insurance_... [1]https://en.wikipedia.org/wiki/Medicare_(United_States) https://en.wikipedia.org/wiki/Medicare_(United_States) [2]https://en.wikipedia.org/wiki/Medicaid https://en.wikipedia.org/wiki/Medicaid
- oblak 4y agoCertain companies making crazy markups is not the same as subsidising the world. Get off your high horse
- neogodless 4y agoI think this comment author's use of the word "competent" means "in delivering medical treatment to Americans." But I also think "the government" shouldn't "deliver medical treatment" - I suppose they could mean "in deciding how to spend tax dollars to get medical treatment delivered." In which case, I agree that is not their competency.
- yieldcrv 4y agoit doesn't have consensus and that comes from the people and their representatives
- deleted 4y ago[deleted]
- otikik 4y agoI disagree. It is an efficient system, which pays dividends to its investors every month: https://www.statista.com/statistics/257364/top-lobbying-industries-in-the-us/ https://www.statista.com/statistics/257364/top-lobbying-indu... If the US government was really efficient, US citizens would be paying big pharma and the military industrial complex every day in order to go to work. You don't need more efficiency, you need less corruption. And that starts by severely curtailing lobbying.
- bergenty 4y agoIt’s not competency. It’s the predatory insurance companies in the middle. Socialized medicine takes away that inefficiency but the GOP will block any attempt at improving life for the common person. It’s blunt but true. They desperately want to maintain the hierarchy of men over women and white races over others. It’s really that simple but with a prime directive like that most of us in the US are going to be unhappy.
- lobocinza 4y agoOne of America's greatest paradoxes. By far largest per capita health expenditure in the World but not the best healthcare.
- smegsicle 4y agoby 'not the best healthcare' do you just mean that it's not the most efficient and affordable, or are you claiming that another country has better expensive healthcare?
- lobocinza 4y agoI think it was my choice of words. By healthcare I mean the populations's effective health care which is what matters and not just the quality of the services offered. US ranks 46th on the life expectancy. Not saying that's a perfect metric but's a strong signal. https://www.worldometers.info/demographics/life-expectancy/ https://www.worldometers.info/demographics/life-expectancy/ - Cost-plus contracts disincentive cost-benefit value delivery. - Costly healthcare disincentive use of health services. It's a system that combines the worse of public and private healthcare systems.
- smegsicle 4y agodoesn't seem like much of a paradox for the best and most expensive healthcare in the world to also not be very efficient otherwise