4 ms·

I'm confused. Why a collapse versus finding new process and iterating on existing ones until we find a system that other models can transition to? A collapse is

I'm confused. Why a collapse versus finding new process and iterating on existing ones until we find a system that other models can transition to? A collapse is catastrophic, and with the amount of money and knowledge the US has, I feel this can be avoided.

noobermin 4y ago
Tbf, I was surprised he said that too, and asked in that comment thread (you can see it below) whether collapse really is the only end state, but the OP only made the post and a continuation in a comment and that was it.
donw 4y ago
Because the existing system actively fights reform.
pasquinelli 4y ago
> Why a collapse versus finding new process and iterating on existing ones until we find a system that other models can transition to? were you not around for the obamacare debate? i was, and it was made perfectly clear that a majority in the house and senate + the presidency, all in theory working toward the same thing, couldn't really change anything. without legal intervention, who's iterating and innovating process? and to what end?
- int_19h 4y ago
  It doesn't have to come at the federal level. Americans who support public healthcare generally seem to like how it works in Canada, but few seem to be aware that the Canadian system originated with the provinces - one adopted public healthcare, the voters liked it, another province followed suit etc. Eventually the feds noticed and got involved to coordinate matters, but even today, any province could, in theory, leave the federal system entirely and run their own - it's just that anyone proposing that would be committing political suicide. If Canada could do it that way, why not US?
  - jtbayly 4y ago
    Yeah, I just went back and re-read the article’s Canadian statistic… “In Canada waiting times have reached an all-time high, with a median delay of half a year between referral and treatment.” I’ll pass, thanks.
    - Jochim 4y ago
      A lot less dead mothers[0] and babies though! Swings and roundabouts and all that. Keep killing those kids [0] https://www.statista.com/statistics/1240400/maternal-mortality-rates-worldwide-by-country/ https://www.statista.com/statistics/1240400/maternal-mortali...
  - stackedinserter 4y ago
    Canadian health care system in the current state is not something that you want to copy. It's failing apart in all provinces and I would say it's a year or two from total collapse. We already have areas that closed ER for a few weeks.
palidanx 4y ago
Unfortunately the US already spends quite a bit, and has one of the worst outcomes compared to other countries https://www.commonwealthfund.org/publications/fund-reports/2021/aug/mirror-mirror-2021-reflecting-poorly#:~:text=Key%20Findings%3A%20The%20top%2Dperforming,domestic%20product%20on%20health%20care https://www.commonwealthfund.org/publications/fund-reports/2....
nostrademons 4y ago
These are not mutually exclusive - oftentimes the collapse is the impetus that creates a new market void that spurs development of new models. The problem is that you usually need the collapse before the new models can start development, because a.) it illuminates all the problems with the old system and b.) it makes switching over to the new system a matter of necessity. Humanity is very bad about pre-emptively identifying risks and avoiding them - witness our response to global warming, both world wars, falls of empires, carcinogens, peak oil, the housing crisis, the health care crisis, and so on. Problem is that until a crisis is actually upon people, it's not urgent, which means that everybody has an incentive to focus their attention on things that actually are urgent. A fair number of people may not even agree that a crisis is imminent, or what to do about it, or they may have vested interests in the old system and resist any new change.
Jochim 4y ago
They wasn't advocating for collapse. Rather, I took it that they were suggesting that the current system will not be changed until it has done so as it has been captured by non-medical interests whose goals do not take into consideration whether society is generally healthy. People have been manipulated into supporting these bad actors through media. Wanting affordable healthcare is "socialism". Single payer healthcare will kill your grandma with "death panels". The fact is that in most metrics socialised healthcare is fucking the absolute shit out of the US system, which somehow manages to kill twice as many pregnant women as Canada[0]. At this point the only thing that might change the minds of these people is to feel the consequences of their actions. [0] https://www.reuters.com/article/us-health-pregnancy-idUSKCN0T10LO20151112 https://www.reuters.com/article/us-health-pregnancy-idUSKCN0...

noobermin 4y ago

Tbf, I was surprised he said that too, and asked in that comment thread (you can see it below) whether collapse really is the only end state, but the OP only made the post and a continuation in a comment and that was it.

donw 4y ago

Because the existing system actively fights reform.

pasquinelli 4y ago

> Why a collapse versus finding new process and iterating on existing ones until we find a system that other models can transition to? were you not around for the obamacare debate? i was, and it was made perfectly clear that a majority in the house and senate + the presidency, all in theory working toward the same thing, couldn't really change anything. without legal intervention, who's iterating and innovating process? and to what end?

int_19h 4y ago
It doesn't have to come at the federal level. Americans who support public healthcare generally seem to like how it works in Canada, but few seem to be aware that the Canadian system originated with the provinces - one adopted public healthcare, the voters liked it, another province followed suit etc. Eventually the feds noticed and got involved to coordinate matters, but even today, any province could, in theory, leave the federal system entirely and run their own - it's just that anyone proposing that would be committing political suicide. If Canada could do it that way, why not US?
- jtbayly 4y ago
  Yeah, I just went back and re-read the article’s Canadian statistic… “In Canada waiting times have reached an all-time high, with a median delay of half a year between referral and treatment.” I’ll pass, thanks.
  - Jochim 4y ago
    A lot less dead mothers[0] and babies though! Swings and roundabouts and all that. Keep killing those kids [0] https://www.statista.com/statistics/1240400/maternal-mortality-rates-worldwide-by-country/ https://www.statista.com/statistics/1240400/maternal-mortali...
- stackedinserter 4y ago
  Canadian health care system in the current state is not something that you want to copy. It's failing apart in all provinces and I would say it's a year or two from total collapse. We already have areas that closed ER for a few weeks.

palidanx 4y ago

Unfortunately the US already spends quite a bit, and has one of the worst outcomes compared to other countries https://www.commonwealthfund.org/publications/fund-reports/2021/aug/mirror-mirror-2021-reflecting-poorly#:~:text=Key%20Findings%3A%20The%20top%2Dperforming,domestic%20product%20on%20health%20care https://www.commonwealthfund.org/publications/fund-reports/2....

nostrademons 4y ago

These are not mutually exclusive - oftentimes the collapse is the impetus that creates a new market void that spurs development of new models. The problem is that you usually need the collapse before the new models can start development, because a.) it illuminates all the problems with the old system and b.) it makes switching over to the new system a matter of necessity. Humanity is very bad about pre-emptively identifying risks and avoiding them - witness our response to global warming, both world wars, falls of empires, carcinogens, peak oil, the housing crisis, the health care crisis, and so on. Problem is that until a crisis is actually upon people, it's not urgent, which means that everybody has an incentive to focus their attention on things that actually are urgent. A fair number of people may not even agree that a crisis is imminent, or what to do about it, or they may have vested interests in the old system and resist any new change.

Jochim 4y ago

They wasn't advocating for collapse. Rather, I took it that they were suggesting that the current system will not be changed until it has done so as it has been captured by non-medical interests whose goals do not take into consideration whether society is generally healthy. People have been manipulated into supporting these bad actors through media. Wanting affordable healthcare is "socialism". Single payer healthcare will kill your grandma with "death panels". The fact is that in most metrics socialised healthcare is fucking the absolute shit out of the US system, which somehow manages to kill twice as many pregnant women as Canada[0]. At this point the only thing that might change the minds of these people is to feel the consequences of their actions. [0] https://www.reuters.com/article/us-health-pregnancy-idUSKCN0T10LO20151112 https://www.reuters.com/article/us-health-pregnancy-idUSKCN0...