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(Not) Luckily the US healthcare system is already collapsing without social medicine, so it’s not a great talking point. Staffing and supply shortages paint a b

(Not) Luckily the US healthcare system is already collapsing without social medicine, so it’s not a great talking point. Staffing and supply shortages paint a bleak picture over the next few years.

Overtonwindow 4y ago
"the US healthcare system is already collapsing" What do you mean by this, specifically? People not having insurance? Increasing deaths inside the hospital? Large numbers of people turned away from emergency rooms? I'm questioning this because with the exception of malpractice, the U.S. healthcare system seems to be working quite well, despite the large numbers of uninsured and those who cannot pay. I just don't buy this argument that the U.S. healthcare system is "collapsing" because if you call an ambulance they will take you to the hospital, and if your life is in danger regardless of your ability to pay, there's a higher chance of surviving in an American medical facility than most places on earth.
- wincy 4y ago
  People just love to talk about how horrible the US healthcare system is but my disabled daughter has never paid a dime for care in her life (in Kansas, of all places!) via Medicaid. Even her birth was free due to retroactive Medicaid. Her 9 months in the NICU was billed at over $2 million. Thanks taxpayers. I was having chest pains last week and got triaged within minutes at the ER. I’m pretty sure I “owe” them $500 for a previous ER visit which nobody mentioned during my stay. My 65 year old uncle hasn’t had insurance in 20 years but when he got cancer three ago the social worker helped him sign up for disability and they got him on Medicare so fast your head would spin. He started chemo basically immediately and while his cancer is terminal the treatment has kept him alive for a long time, even longer than the doctors predicted. My wife got billed $200,000+ for a visit in the hospital when she had a critical illness and almost died. She ended up paying $2000. This was more than ten years ago and it didn’t ruin her credit and nobody ever came after her for it. And One more. The hospital messed up the billing for our first daughter’s birth and called us two years later saying we didn’t have insurance (we did). My wife said that was their problem. We never heard from them again or got a bill. I guess they just ate the cost? No idea. But it was over seven years ago and there were zero consequences and we never paid a dime.
  - czzr 4y ago
    So socialised medicine works?
    - sickofparadox 4y ago
      If by "socialized medicine" you mean public option health insurance, then yes it does work. I'm willing to bet, though, that the poster you're replying to only received care from privately run hospitals/clinics, so calling it socialized medicine seems misleading.
      - spywaregorilla 4y ago
        US health is socialized in that the public will pay for it if you're willing to game the system like the uncle in this story, plus spin the wheel of chance to see how much you'll how privately anyway. I don't think the uncle here acted maliciously or TRIED to game the system, but that is what happened and that is what will continue to happen with this shitty half implemented system.
      - triceratops 4y ago
        > public option health insurance > calling it socialized medicine seems misleading. Outside of the UK, that is how health care in developed countries is organized. It's either that or some version of Obamacare (regulated, private, with price caps and subsidies) or a combination. American conservatives call them all, without exception, "socialized medicine".
    - wincy 4y ago
      Hah, the world is complicated. I feel like me and my family are the worst case scenario in the health care system and it worked… pretty well aside from them wanting to give my daughter too much care she didn’t need. The US basically has socialized medicine that scares naive/“honest”/conscientious middle class people into paying up to subsidize it. I suspect if we passed legislation tomorrow to make the US a single payer system it’d all fall apart. But I suppose we’ve managed to trick the US taxpayers into socializing medicine while letting them pretend we haven’t.
- nradov 4y ago
  About 10% of Americans don't have medical insurance. That number has been fairly stable for several years, so it's not great but also not a sign of collapse. https://www.aha.org/news/headline/2021-11-17-cdc-reports-uninsured-first-six-months-2021 https://www.aha.org/news/headline/2021-11-17-cdc-reports-uni...
  - SketchySeaBeast 4y ago
    Isn't that 10% stat potentially hiding issues of co-pay, deductibles, network range, and actual level of coverage?
    - nradov 4y ago
      Nothing is being hidden. High deductible health plans have been popular, especially among younger consumers. The federal government has specifically promoted those as a way to hold down healthcare expenses, and enrollees receive income tax benefits. https://www.cdc.gov/nchs/products/databriefs/db317.htm https://www.cdc.gov/nchs/products/databriefs/db317.htm Health plans are required to meet network adequacy requirements. https://www.kff.org/health-reform/issue-brief/network-adequacy-standards-and-enforcement/ https://www.kff.org/health-reform/issue-brief/network-adequa...
      - SketchySeaBeast 4y ago
        My point with the "hidden" comment was that even though people have coverage they may not be able to use it due to having an unaffordably high deductible, and your first link is showing that there is a rise in high deductible plans and that lower income people don't usually have an HSA to offset the cost. It also points out that 60% of people get their insurance through their company, and that companies are increasingly moving towards the cheapest plans with the highest cost to the individual user. Is an insurance plan an insurance plan if you can't pay the deductible?
      - LorenPechtel 4y ago
        Observation: There's adverse selection at work. People do the economics and look at their expected medical spending with both low and high deductible plans--those not expecting substantial bills generally choose the high deductible plans. Insurance companies observe the results of this--those who choose low deductible plans end up costing more. I've done the math most years and I have yet to find more than a narrow window where you're better off with the low deductible plan than with a high deductible plan and putting aside the savings. Typically there's no window at all, the high deductible plan is always superior. (Note that this generally changes in situations where you pay a *percentage* of your premium, such as subsidized ACA plans.) If we want to move away from high deductible plans the only way is for Congress to impose it, market forces will always drive it as high as it can legally go.
- jrochkind1 4y ago
  I think there are a variety of ways the US healthcare system is collapsing. One way I experience, relevant to OP, is that even with "good" health insurance, I can't manage to get an appointment with most specialists faster than 3 months, and I can't even see my primary care physician faster than 3 weeks (at best) -- in case of something "urgent", maybe in 2 or 3 days. This may be especially bad in the region I live in, I'm not sure. When I ask around, many of my friends in other regions have similar experiences. It is not in fact true that those in the US can generally see physicians without long waits for appointments, currently.

(Not) Luckily the US healthcare system is already collapsing without social medicine, so it’s not a great talking point. Staffing and supply shortages paint a bleak picture over the next few years.

Overtonwindow 4y ago

"the US healthcare system is already collapsing" What do you mean by this, specifically? People not having insurance? Increasing deaths inside the hospital? Large numbers of people turned away from emergency rooms? I'm questioning this because with the exception of malpractice, the U.S. healthcare system seems to be working quite well, despite the large numbers of uninsured and those who cannot pay. I just don't buy this argument that the U.S. healthcare system is "collapsing" because if you call an ambulance they will take you to the hospital, and if your life is in danger regardless of your ability to pay, there's a higher chance of surviving in an American medical facility than most places on earth.

wincy 4y ago
People just love to talk about how horrible the US healthcare system is but my disabled daughter has never paid a dime for care in her life (in Kansas, of all places!) via Medicaid. Even her birth was free due to retroactive Medicaid. Her 9 months in the NICU was billed at over $2 million. Thanks taxpayers. I was having chest pains last week and got triaged within minutes at the ER. I’m pretty sure I “owe” them $500 for a previous ER visit which nobody mentioned during my stay. My 65 year old uncle hasn’t had insurance in 20 years but when he got cancer three ago the social worker helped him sign up for disability and they got him on Medicare so fast your head would spin. He started chemo basically immediately and while his cancer is terminal the treatment has kept him alive for a long time, even longer than the doctors predicted. My wife got billed $200,000+ for a visit in the hospital when she had a critical illness and almost died. She ended up paying $2000. This was more than ten years ago and it didn’t ruin her credit and nobody ever came after her for it. And One more. The hospital messed up the billing for our first daughter’s birth and called us two years later saying we didn’t have insurance (we did). My wife said that was their problem. We never heard from them again or got a bill. I guess they just ate the cost? No idea. But it was over seven years ago and there were zero consequences and we never paid a dime.
- czzr 4y ago
  So socialised medicine works?
  - sickofparadox 4y ago
    If by "socialized medicine" you mean public option health insurance, then yes it does work. I'm willing to bet, though, that the poster you're replying to only received care from privately run hospitals/clinics, so calling it socialized medicine seems misleading.
    - spywaregorilla 4y ago
      US health is socialized in that the public will pay for it if you're willing to game the system like the uncle in this story, plus spin the wheel of chance to see how much you'll how privately anyway. I don't think the uncle here acted maliciously or TRIED to game the system, but that is what happened and that is what will continue to happen with this shitty half implemented system.
    - triceratops 4y ago
      > public option health insurance > calling it socialized medicine seems misleading. Outside of the UK, that is how health care in developed countries is organized. It's either that or some version of Obamacare (regulated, private, with price caps and subsidies) or a combination. American conservatives call them all, without exception, "socialized medicine".
  - wincy 4y ago
    Hah, the world is complicated. I feel like me and my family are the worst case scenario in the health care system and it worked… pretty well aside from them wanting to give my daughter too much care she didn’t need. The US basically has socialized medicine that scares naive/“honest”/conscientious middle class people into paying up to subsidize it. I suspect if we passed legislation tomorrow to make the US a single payer system it’d all fall apart. But I suppose we’ve managed to trick the US taxpayers into socializing medicine while letting them pretend we haven’t.
nradov 4y ago
About 10% of Americans don't have medical insurance. That number has been fairly stable for several years, so it's not great but also not a sign of collapse. https://www.aha.org/news/headline/2021-11-17-cdc-reports-uninsured-first-six-months-2021 https://www.aha.org/news/headline/2021-11-17-cdc-reports-uni...
- SketchySeaBeast 4y ago
  Isn't that 10% stat potentially hiding issues of co-pay, deductibles, network range, and actual level of coverage?
  - nradov 4y ago
    Nothing is being hidden. High deductible health plans have been popular, especially among younger consumers. The federal government has specifically promoted those as a way to hold down healthcare expenses, and enrollees receive income tax benefits. https://www.cdc.gov/nchs/products/databriefs/db317.htm https://www.cdc.gov/nchs/products/databriefs/db317.htm Health plans are required to meet network adequacy requirements. https://www.kff.org/health-reform/issue-brief/network-adequacy-standards-and-enforcement/ https://www.kff.org/health-reform/issue-brief/network-adequa...
    - SketchySeaBeast 4y ago
      My point with the "hidden" comment was that even though people have coverage they may not be able to use it due to having an unaffordably high deductible, and your first link is showing that there is a rise in high deductible plans and that lower income people don't usually have an HSA to offset the cost. It also points out that 60% of people get their insurance through their company, and that companies are increasingly moving towards the cheapest plans with the highest cost to the individual user. Is an insurance plan an insurance plan if you can't pay the deductible?
    - LorenPechtel 4y ago
      Observation: There's adverse selection at work. People do the economics and look at their expected medical spending with both low and high deductible plans--those not expecting substantial bills generally choose the high deductible plans. Insurance companies observe the results of this--those who choose low deductible plans end up costing more. I've done the math most years and I have yet to find more than a narrow window where you're better off with the low deductible plan than with a high deductible plan and putting aside the savings. Typically there's no window at all, the high deductible plan is always superior. (Note that this generally changes in situations where you pay a *percentage* of your premium, such as subsidized ACA plans.) If we want to move away from high deductible plans the only way is for Congress to impose it, market forces will always drive it as high as it can legally go.
jrochkind1 4y ago
I think there are a variety of ways the US healthcare system is collapsing. One way I experience, relevant to OP, is that even with "good" health insurance, I can't manage to get an appointment with most specialists faster than 3 months, and I can't even see my primary care physician faster than 3 weeks (at best) -- in case of something "urgent", maybe in 2 or 3 days. This may be especially bad in the region I live in, I'm not sure. When I ask around, many of my friends in other regions have similar experiences. It is not in fact true that those in the US can generally see physicians without long waits for appointments, currently.