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This isn't at all surprising, for multiple reasons. The entire insurance industry existing is a big one. That we are all overweight is another. I'm generally

This isn't at all surprising, for multiple reasons. The entire insurance industry existing is a big one. That we are all overweight is another. I'm generally a very conservative person. But even I am for government funded healthcare. Who in the hell is against it? I've not met a single person completely against it, mostly just people against people abusing emergency rooms. Certain big media and politicians are against it, saying we have the best in the world and often pointing at waiting lists in other places. My last gastro had a 7 month waitlist. What in the hell am I paying a fortune for every paycheck, then?

stuaxo 4y ago
The Insurance industry is a bug vampire squid sucking money out of the system, and ironicly stopping many from getting the health outcomes they need.
- pigsty 4y ago
  A small group chat I’m a part of has one person who works for an insurance company. Reading his messages about his work day is just depressing. “Oh, yeah, if someone has that cancer and they’re under 45 it’s an auto-reject from me. Just too unlikely for them to have it” was one message that’s stuck with me. You (or your company) pays thousands of dollars a year (or more) to an insurance company to cover you for when the worst things happen—and despite you or your doctors trying to get your shit together, somebody chilling 1500 miles away skims your report and auto-declines any form of coverage just because it seems unlikely. Then it’s an uphill battle of trying to not only battle your illness and your daily life, but a company that has employees with worse judgement than an AI thrown together by some dude on Twitter in a weekend. It’s disgusting to think about.
  - bosie 4y ago
    how.... how... can they reject anything that the hospital says?
    - 1123581321 4y ago
      They are rejecting on the presumption that the billing is erroneous. The hospital would follow up and get it approved. It’s a crude system and I’m not excusing it.
    - soco 4y ago
      Because they are allowed to. Having no (useful) regulation allows that and more. And no it's not abuse, it's the system working as designed. If there's a problem with it, don't take it with the people in the system, as tempting as it might be. They will be replaced by others with the same reject-happy finger. It needs a new system, heavily regulated like in Europe, and this means exactly the uphill battle you would expect.
    - lotsofpulp 4y ago
      They are not rejecting what the hospital says. I imagine pigsty’s account is missing some nuance, such as an uncommon diagnosis or prescription requiring further proof. The doctor might think (and might very well be guessing correctly), but the protocols require a certain level of evidence that was not provided. It could also be malfeasance, but I doubt that is happening on a systemic level at the big health insurance companies. They benefit from more healthcare spending, so I do not see why they would want to tamp down on necessary expenses.
    - callahad 4y ago
      Propublica just ran a good article on UHG's attempts to deny coverage to a university student with severe ulcerative colitis. Apparently the insurer has its own panels of MDs that it can deploy to lobby the patient's doctor into different courses of treatment. In this case, UHG staff completely fabricated statements from the patient's doctor in order to justify reducing care to an ineffective level. https://www.propublica.org/article/unitedhealth-healthcare-insurance-denial-ulcerative-colitis https://www.propublica.org/article/unitedhealth-healthcare-i...
- hackeraccount 4y ago
  You understand that if the Insurance industry didn't exist we would just re-create it right? I mean, if you tell people they can spend any amount of money on healthcare they will bankrupt whatever pot of money is available. You're just suggesting we go from saying the Insurance industry is terrible to saying whatever Government agency is running healthcare is terrible. Read about how doctors and patients talk about Medicaid, Medicare or Tricare. If you say they're popular I'd agree with you - but you need to see what people say when they're asked if they like their own private insurance; generally that's popular too. Most people like whatever health insurance they have most of the time because insurance only pinches in edge cases - not when I'm healthy and only in the subset of sick case called "I want a treatment that my insurance won't pay for." Those cases are always going to happen and sometimes it will be for legitimate reasons.
khazhoux 4y ago
> Who in the hell is against it? Roughly half the country is against it! And ironically, it's often because they want "choice" in their medical care, despite the fact that health insurance is tied to your employment and you barely have any choices under your control anyway -- you go with the clinic or hospital that takes your plan, and you go with the doctor that's available.
- silisili 4y ago
  This is an extremely popular liberal talking point. I do not believe it to be true. The article linked below has it at 60/40. But that's just a simple yes/no survey. When you probe the 40, they are mostly for it too, just with extreme reservations. Talk to some. It's definitely not an 'I got mine, let everyone else die' as is painted. https://thehill.com/policy/healthcare/3826215-57-percent-support-federal-government-ensuring-universal-health-care-survey/ https://thehill.com/policy/healthcare/3826215-57-percent-sup...
  - forgetfreeman 4y ago
    You don't believe it to be true based on what? The fact that it's an extremely popular liberal talking point, or some actual data?
    - silisili 4y ago
      The actual data is closer to 1/3 against than 1/2. Nothing more is usually collected than that vote. I don't believe, even given revised data above, that even 1/3 are against it. I'd estimate less than 1/5 are against it no matter what. The remainder has doubts and conditions, a given considering how awful government projects usually go. If I thought healthcare would be run like the DMV, I'd vote against it too.
      - forgetfreeman 4y ago
        How awful which government projects go? Yeah the DMV is a thing, but so is NOAA and NASA.
0xy 4y ago
It's a fallacy to claim US healthcare is not "government funded". Aside from that, Canadian wait times for surgery are substantially worse than the United States (even before they stopped necessary surgeries during lockdown). [1] The amount of Canadians who visit the United States has increased dramatically over the last 10 years, many of which seek services which are simply not available at all in Canada -- such as specialist cancer treatment. The NHS in the UK, commonly cited as the golden child of government-run healthcare, has the longest wait lists ever with tens of thousands waiting over a year. [2] NHS spending has increased over 6.5% yearly since 2010, with even more massive increases planned for 2024-25. With the massive NHS spending, UK's nurses and doctors are treated like slave cattle. They earn less than 1/3rd of their US counterparts. This indicates administrative incompetence, skyrocketing middle management, waste and fraud. [1] https://fee.org/articles/america-outperforms-canada-in-surgery-wait-times-and-its-not-even-close/ https://fee.org/articles/america-outperforms-canada-in-surge... [2] https://www.bbc.com/news/health-61825071 https://www.bbc.com/news/health-61825071
- smcl 4y ago
  The NHS in the UK is after a decade of sabotage by a Conservative government who would like nothing more than to see it scrapped and replaced with private healthcare insurance like the US has. As it stands it is a system that is being starved of resources and yet it is still outperforming the US.
  - 0xy 4y ago
    Can you explain how 6.5%/year increases in budget over 12 years is "starving"? Also curious how you square "outperforming" with the worst ever waiting times for critical surgeries.
    - smcl 4y ago
      > Can you explain how 6.5%/year increases in budget Yes! It needs more. Glad to have cleared that up. > Also curious how you square "outperforming" ... This is the conclusion of the study in the article you're commenting on
mcv 4y ago
Private insurance doesn't have to be bad. Netherland has private insurance, and it works fine. Admittedly we've got probably the most expensive healthcare system in Europe, but it's still about half of what the US pays. But it does need to be tightly regulated, and more importantly, the healthcare system itself needs to be regulated. There needs to be a drive to lower costs while increasing quality. And of course the insurance company needs to take care of the costs. I see far too many stories about people having to fight their own insurance company. The real fundamental problem I think is that the US healthcare system is primarily run for profit, and not for the health of the people. Both by insurance companies (who strongly resist paying), and by hospitals and other healthcare providers (who love to spring unexpected costs on you). That's the primary difference between the US and Dutch systems.
- forgetfreeman 4y ago
  It may not have to be bad but it is absolutely an unnecessary siphon of funds out of the healthcare system. Simply put every single ass in a seat at an insurance company is $N not being spent on providing actual healthcare.
  - jrockway 4y ago
    Some administrators are going to be necessary to run any sort of healthcare system. Just as an example, someone has to prepare and send each doctor a W-2 every year.
    - forgetfreeman 4y ago
      Ok so are we now pretending hospital administration staff doesn't already exist? Or that the simple majority of employees in Dr's offices aren't there solely to process insurance claims? So again, for the cheap seats, insurance companies: 100% overhead, 0% healthcare provided.
      - jrockway 4y ago
        Good point. Not sure what I was thinking when I wrote that. No insurance adjusters around, nobody needs to issue them paychecks.
vjk800 4y ago
In David Graeber's book "Bullshit jobs", there's a quote from Barack Obama saying that strongest argument against overhauling the US health system is the millions of lost jobs from the insurance and adjacent industries. So there seems to be your answer, from the horse's mouth.
chmod600 4y ago
I'm a conservative also. Stuff that basically everyone needs to deal with should be out of pocket with tranparent ahead-of-time pricing. Doctors and occasional specialists, non-exotic meds, normal chronic conditions, etc. State covers/helps it if you can't (means testing with sliding scale, no cliff). Paying for stuff kinda sucks, but less so than brutal waste pulled out of your paycheck or taxes. Financially major issues could be covered by private insurance or some government plan. Vaccines subsidized by feds. Invincibles aren't such a huge problem that we need to twist the whole system around for people who can pay but don't. Done.
- alkonaut 4y ago
  > but less so than brutal waste pulled out of your paycheck or taxes. Are you suggesting that universal systems are more wasteful? Wouldn't that imply that a simple natural experiment of total healthcare spending vs average health outcomes should show a benefit to private over universal/tax funded?
  - chmod600 4y ago
    In the US a lot of tax dollars are wasted on healthcare. A lot more would be wasted if we tried some kind of universal health care in the US.
    - soneil 4y ago
      It seems to me that a lot of waste in this area is tax dollars paying for commercial prices. The US has some truly insane baseline costs in healthcare. Having the state pay for them, or having the state provide an insurer, only kicks the ball into someone else's court. Figure out why a hospital can charge you $25 for an aspirin, and start there. If you just let the state pay that $25, yes your taxes are being wasted.
TechnicolorByte 4y ago
> That we are all overweight is another. https://en.wikipedia.org/wiki/List_of_countries_by_obesity_rate https://en.wikipedia.org/wiki/List_of_countries_by_obesity_r... Obesity vs overweight (the former is surely a better predictor of health outcomes anyway) aside, we’re definitely higher than comparable nations, but I wouldn’t say significantly so.
- deleted 4y ago
  [deleted]
- lynx23 4y ago
  The trick is to spread consumerism ads and fastfood chains all other the world, such that this list doesn't show a big difference. If you manage to pollute everyone else fast enough, statistics can be blurred to a point where there is obviously no reason to act.
  - deleted 4y ago
    [deleted]
  - forgetfreeman 4y ago
    Did that already. There's a pizza hut within line of site of the Great Pyramids at Giza.
- ghayes 4y ago
  Definitely an interesting read, though I'd counter that 30% higher in the US than in the UK feels significant (36.2% versus 27.8%).
  - FartyMcFarter 4y ago
    For extra context, the UK has a higher rate of obesity than any EU country. So the US is a definite outlier amongst advanced economies.
- inglor_cz 4y ago
  Yes you are, especially when it comes to the "landwhale" category of 400+ pounds. Even the link you provided says that the US would fit among the Arab countries, but would be a major outlier in Europe. There are people with bellies here, BMI > 30, but the "unable to walk without a motorized wheelchair" category is rare. I live in the Czech Republic, a notorious beer-guzzling nation that was never known for being slim. But the kind of obscene, ballooning fatness that is ubiquitous in the US was never seen here until, say, 2015. Unfortunately I slowly see it slowly emerging among the youth, probably the ones who live on the fastfood diet. (Fast food used to be relatively expensive compared to Czech salaries, so people wouldn't gorge on it everyday, but this has changed and now it one of the cheaper options out there.)
MisterBastahrd 4y ago
The entire insurance industry, and almost all of the industries who make money from it, are against it, for one. There are many doctors and nurses who would also be incensed if you told them that they had to take less pay EVEN IF you also immediately eliminated all their education debts. Nurses in particular are heavily incentivized to work overtime because they usually work insane 12 hour shifts to begin with. You also can't reform it if you aren't going to touch the pharmaceutical industry. There are medicines that cost $3K a month here that cost $0.50 in Africa for the same dosage. I can understand that the US is funding the military to a ridiculous degree to maintain its global hegemony... but I can't understand why voters think it's a good idea to allow pharmaceutical manufacturers to gouge the crap out of people. Nothing about medical care is a traditional manufacturer / consumer relationship. I'd rather nationalize the pharma companies and all medical patents for medicines or devices which are sold more than a factor of 5x in the US over its lowest price.
- sokoloff 4y ago
  Is the long-run alternative that future medicines like that are available for $0.50/month worldwide or not available at all? > many doctors and nurses who would also be incensed if you told them that they had to take less pay EVEN IF you also immediately eliminated all their education debts If the reduction in current value of their lifetime pay is greater than the value of their education debts, why wouldn’t they be incensed? I would be as well, as would most people.
  - MisterBastahrd 4y ago
    > Is the long-run alternative that future medicines like that are available for $0.50/month worldwide or not available at all? Not if the government nationalizes the pharmaceutical industry and treats it like NASA, which it should have done a LONG time ago. > If the reduction in current value of their lifetime pay is greater than the value of their education debts, why wouldn’t they be incensed? I would be as well, as would most people. Hospitals are overworking medical staff. The average nursing shift is 12 hours long. Most surgeons are putting in 60+ hours a week. The number of medical staff needs to increase and their work hours need to be normalized as much as possible. We've allowed medical associations to artificially gatekeep the populations of staff for no damned good reason.
nivenkos 4y ago
> I'm generally a very conservative person. But even I am for government funded healthcare. Who in the hell is against it? I'm European but there are major issues with waiting times, terribly low wages, strikes, ambulance provision, etc. in almost every country I've lived in. Overall I think public healthcare is well worth it - in theory you can save a lot with one central purchaser, and even moreso if the government was willing to do drug discovery and production directly too. But it is difficult to ensure future governments don't ruin it. It's kind of like why the unemployment funds and minimum wage negotiations being in the hands of trade unions instead of the government has worked out better in Sweden.
- splix 4y ago
  In US there is also major issues with waiting time. Like months for anything non-emergency. And emergency is just partially covered by an insurance anyway, so it doesn't really count. Also an Uber instead of ambulance. Not sure about the wages and strikes though. But considering the fact that our neighbor doctor is a member of a yacht club, and the landlord who is another doctor had invested in a bunch of apartments that he lost the track of them, I guess they are fine.
lr1970 4y ago
In US there are two useless armies of administrators sucking money out of providing patient's care -- one army employed by insurance industry to deny a claim whenever they can, the other one employed by hospitals and healthcare providers to fight back. It doubles the waste and unproductive work in the best tradition of "bullshit jobs".
yucky 4y ago
> But even I am for government funded healthcare. Who in the hell is against it? Anybody who has ever had to deal with Medicaid?
- wyre 4y ago
  Medicaid in Washington state (Apple Health) is fantastic, all things considered.
  - yucky 4y ago
    The "all things considered" must be doing some heavy lifting in that sentence. Medicaid is almost universally hated by health care professionals. Many places won't take it.

stuaxo 4y ago

The Insurance industry is a bug vampire squid sucking money out of the system, and ironicly stopping many from getting the health outcomes they need.

pigsty 4y ago
A small group chat I’m a part of has one person who works for an insurance company. Reading his messages about his work day is just depressing. “Oh, yeah, if someone has that cancer and they’re under 45 it’s an auto-reject from me. Just too unlikely for them to have it” was one message that’s stuck with me. You (or your company) pays thousands of dollars a year (or more) to an insurance company to cover you for when the worst things happen—and despite you or your doctors trying to get your shit together, somebody chilling 1500 miles away skims your report and auto-declines any form of coverage just because it seems unlikely. Then it’s an uphill battle of trying to not only battle your illness and your daily life, but a company that has employees with worse judgement than an AI thrown together by some dude on Twitter in a weekend. It’s disgusting to think about.
- bosie 4y ago
  how.... how... can they reject anything that the hospital says?
  - 1123581321 4y ago
    They are rejecting on the presumption that the billing is erroneous. The hospital would follow up and get it approved. It’s a crude system and I’m not excusing it.
  - soco 4y ago
    Because they are allowed to. Having no (useful) regulation allows that and more. And no it's not abuse, it's the system working as designed. If there's a problem with it, don't take it with the people in the system, as tempting as it might be. They will be replaced by others with the same reject-happy finger. It needs a new system, heavily regulated like in Europe, and this means exactly the uphill battle you would expect.
  - lotsofpulp 4y ago
    They are not rejecting what the hospital says. I imagine pigsty’s account is missing some nuance, such as an uncommon diagnosis or prescription requiring further proof. The doctor might think (and might very well be guessing correctly), but the protocols require a certain level of evidence that was not provided. It could also be malfeasance, but I doubt that is happening on a systemic level at the big health insurance companies. They benefit from more healthcare spending, so I do not see why they would want to tamp down on necessary expenses.
  - callahad 4y ago
    Propublica just ran a good article on UHG's attempts to deny coverage to a university student with severe ulcerative colitis. Apparently the insurer has its own panels of MDs that it can deploy to lobby the patient's doctor into different courses of treatment. In this case, UHG staff completely fabricated statements from the patient's doctor in order to justify reducing care to an ineffective level. https://www.propublica.org/article/unitedhealth-healthcare-insurance-denial-ulcerative-colitis https://www.propublica.org/article/unitedhealth-healthcare-i...
hackeraccount 4y ago
You understand that if the Insurance industry didn't exist we would just re-create it right? I mean, if you tell people they can spend any amount of money on healthcare they will bankrupt whatever pot of money is available. You're just suggesting we go from saying the Insurance industry is terrible to saying whatever Government agency is running healthcare is terrible. Read about how doctors and patients talk about Medicaid, Medicare or Tricare. If you say they're popular I'd agree with you - but you need to see what people say when they're asked if they like their own private insurance; generally that's popular too. Most people like whatever health insurance they have most of the time because insurance only pinches in edge cases - not when I'm healthy and only in the subset of sick case called "I want a treatment that my insurance won't pay for." Those cases are always going to happen and sometimes it will be for legitimate reasons.

khazhoux 4y ago

> Who in the hell is against it? Roughly half the country is against it! And ironically, it's often because they want "choice" in their medical care, despite the fact that health insurance is tied to your employment and you barely have any choices under your control anyway -- you go with the clinic or hospital that takes your plan, and you go with the doctor that's available.

silisili 4y ago
This is an extremely popular liberal talking point. I do not believe it to be true. The article linked below has it at 60/40. But that's just a simple yes/no survey. When you probe the 40, they are mostly for it too, just with extreme reservations. Talk to some. It's definitely not an 'I got mine, let everyone else die' as is painted. https://thehill.com/policy/healthcare/3826215-57-percent-support-federal-government-ensuring-universal-health-care-survey/ https://thehill.com/policy/healthcare/3826215-57-percent-sup...
- forgetfreeman 4y ago
  You don't believe it to be true based on what? The fact that it's an extremely popular liberal talking point, or some actual data?
  - silisili 4y ago
    The actual data is closer to 1/3 against than 1/2. Nothing more is usually collected than that vote. I don't believe, even given revised data above, that even 1/3 are against it. I'd estimate less than 1/5 are against it no matter what. The remainder has doubts and conditions, a given considering how awful government projects usually go. If I thought healthcare would be run like the DMV, I'd vote against it too.
    - forgetfreeman 4y ago
      How awful which government projects go? Yeah the DMV is a thing, but so is NOAA and NASA.

0xy 4y ago

It's a fallacy to claim US healthcare is not "government funded". Aside from that, Canadian wait times for surgery are substantially worse than the United States (even before they stopped necessary surgeries during lockdown). [1] The amount of Canadians who visit the United States has increased dramatically over the last 10 years, many of which seek services which are simply not available at all in Canada -- such as specialist cancer treatment. The NHS in the UK, commonly cited as the golden child of government-run healthcare, has the longest wait lists ever with tens of thousands waiting over a year. [2] NHS spending has increased over 6.5% yearly since 2010, with even more massive increases planned for 2024-25. With the massive NHS spending, UK's nurses and doctors are treated like slave cattle. They earn less than 1/3rd of their US counterparts. This indicates administrative incompetence, skyrocketing middle management, waste and fraud. [1] https://fee.org/articles/america-outperforms-canada-in-surgery-wait-times-and-its-not-even-close/ https://fee.org/articles/america-outperforms-canada-in-surge... [2] https://www.bbc.com/news/health-61825071 https://www.bbc.com/news/health-61825071

smcl 4y ago
The NHS in the UK is after a decade of sabotage by a Conservative government who would like nothing more than to see it scrapped and replaced with private healthcare insurance like the US has. As it stands it is a system that is being starved of resources and yet it is still outperforming the US.
- 0xy 4y ago
  Can you explain how 6.5%/year increases in budget over 12 years is "starving"? Also curious how you square "outperforming" with the worst ever waiting times for critical surgeries.
  - smcl 4y ago
    > Can you explain how 6.5%/year increases in budget Yes! It needs more. Glad to have cleared that up. > Also curious how you square "outperforming" ... This is the conclusion of the study in the article you're commenting on

mcv 4y ago

Private insurance doesn't have to be bad. Netherland has private insurance, and it works fine. Admittedly we've got probably the most expensive healthcare system in Europe, but it's still about half of what the US pays. But it does need to be tightly regulated, and more importantly, the healthcare system itself needs to be regulated. There needs to be a drive to lower costs while increasing quality. And of course the insurance company needs to take care of the costs. I see far too many stories about people having to fight their own insurance company. The real fundamental problem I think is that the US healthcare system is primarily run for profit, and not for the health of the people. Both by insurance companies (who strongly resist paying), and by hospitals and other healthcare providers (who love to spring unexpected costs on you). That's the primary difference between the US and Dutch systems.

forgetfreeman 4y ago
It may not have to be bad but it is absolutely an unnecessary siphon of funds out of the healthcare system. Simply put every single ass in a seat at an insurance company is $N not being spent on providing actual healthcare.
- jrockway 4y ago
  Some administrators are going to be necessary to run any sort of healthcare system. Just as an example, someone has to prepare and send each doctor a W-2 every year.
  - forgetfreeman 4y ago
    Ok so are we now pretending hospital administration staff doesn't already exist? Or that the simple majority of employees in Dr's offices aren't there solely to process insurance claims? So again, for the cheap seats, insurance companies: 100% overhead, 0% healthcare provided.
    - jrockway 4y ago
      Good point. Not sure what I was thinking when I wrote that. No insurance adjusters around, nobody needs to issue them paychecks.

vjk800 4y ago

In David Graeber's book "Bullshit jobs", there's a quote from Barack Obama saying that strongest argument against overhauling the US health system is the millions of lost jobs from the insurance and adjacent industries. So there seems to be your answer, from the horse's mouth.

chmod600 4y ago

I'm a conservative also. Stuff that basically everyone needs to deal with should be out of pocket with tranparent ahead-of-time pricing. Doctors and occasional specialists, non-exotic meds, normal chronic conditions, etc. State covers/helps it if you can't (means testing with sliding scale, no cliff). Paying for stuff kinda sucks, but less so than brutal waste pulled out of your paycheck or taxes. Financially major issues could be covered by private insurance or some government plan. Vaccines subsidized by feds. Invincibles aren't such a huge problem that we need to twist the whole system around for people who can pay but don't. Done.

alkonaut 4y ago
> but less so than brutal waste pulled out of your paycheck or taxes. Are you suggesting that universal systems are more wasteful? Wouldn't that imply that a simple natural experiment of total healthcare spending vs average health outcomes should show a benefit to private over universal/tax funded?
- chmod600 4y ago
  In the US a lot of tax dollars are wasted on healthcare. A lot more would be wasted if we tried some kind of universal health care in the US.
  - soneil 4y ago
    It seems to me that a lot of waste in this area is tax dollars paying for commercial prices. The US has some truly insane baseline costs in healthcare. Having the state pay for them, or having the state provide an insurer, only kicks the ball into someone else's court. Figure out why a hospital can charge you $25 for an aspirin, and start there. If you just let the state pay that $25, yes your taxes are being wasted.

TechnicolorByte 4y ago

> That we are all overweight is another. https://en.wikipedia.org/wiki/List_of_countries_by_obesity_rate https://en.wikipedia.org/wiki/List_of_countries_by_obesity_r... Obesity vs overweight (the former is surely a better predictor of health outcomes anyway) aside, we’re definitely higher than comparable nations, but I wouldn’t say significantly so.

deleted 4y ago
[deleted]
lynx23 4y ago
The trick is to spread consumerism ads and fastfood chains all other the world, such that this list doesn't show a big difference. If you manage to pollute everyone else fast enough, statistics can be blurred to a point where there is obviously no reason to act.
- deleted 4y ago
  [deleted]
- forgetfreeman 4y ago
  Did that already. There's a pizza hut within line of site of the Great Pyramids at Giza.
ghayes 4y ago
Definitely an interesting read, though I'd counter that 30% higher in the US than in the UK feels significant (36.2% versus 27.8%).
- FartyMcFarter 4y ago
  For extra context, the UK has a higher rate of obesity than any EU country. So the US is a definite outlier amongst advanced economies.
inglor_cz 4y ago
Yes you are, especially when it comes to the "landwhale" category of 400+ pounds. Even the link you provided says that the US would fit among the Arab countries, but would be a major outlier in Europe. There are people with bellies here, BMI > 30, but the "unable to walk without a motorized wheelchair" category is rare. I live in the Czech Republic, a notorious beer-guzzling nation that was never known for being slim. But the kind of obscene, ballooning fatness that is ubiquitous in the US was never seen here until, say, 2015. Unfortunately I slowly see it slowly emerging among the youth, probably the ones who live on the fastfood diet. (Fast food used to be relatively expensive compared to Czech salaries, so people wouldn't gorge on it everyday, but this has changed and now it one of the cheaper options out there.)

MisterBastahrd 4y ago

The entire insurance industry, and almost all of the industries who make money from it, are against it, for one. There are many doctors and nurses who would also be incensed if you told them that they had to take less pay EVEN IF you also immediately eliminated all their education debts. Nurses in particular are heavily incentivized to work overtime because they usually work insane 12 hour shifts to begin with. You also can't reform it if you aren't going to touch the pharmaceutical industry. There are medicines that cost $3K a month here that cost $0.50 in Africa for the same dosage. I can understand that the US is funding the military to a ridiculous degree to maintain its global hegemony... but I can't understand why voters think it's a good idea to allow pharmaceutical manufacturers to gouge the crap out of people. Nothing about medical care is a traditional manufacturer / consumer relationship. I'd rather nationalize the pharma companies and all medical patents for medicines or devices which are sold more than a factor of 5x in the US over its lowest price.

sokoloff 4y ago
Is the long-run alternative that future medicines like that are available for $0.50/month worldwide or not available at all? > many doctors and nurses who would also be incensed if you told them that they had to take less pay EVEN IF you also immediately eliminated all their education debts If the reduction in current value of their lifetime pay is greater than the value of their education debts, why wouldn’t they be incensed? I would be as well, as would most people.
- MisterBastahrd 4y ago
  > Is the long-run alternative that future medicines like that are available for $0.50/month worldwide or not available at all? Not if the government nationalizes the pharmaceutical industry and treats it like NASA, which it should have done a LONG time ago. > If the reduction in current value of their lifetime pay is greater than the value of their education debts, why wouldn’t they be incensed? I would be as well, as would most people. Hospitals are overworking medical staff. The average nursing shift is 12 hours long. Most surgeons are putting in 60+ hours a week. The number of medical staff needs to increase and their work hours need to be normalized as much as possible. We've allowed medical associations to artificially gatekeep the populations of staff for no damned good reason.

nivenkos 4y ago

> I'm generally a very conservative person. But even I am for government funded healthcare. Who in the hell is against it? I'm European but there are major issues with waiting times, terribly low wages, strikes, ambulance provision, etc. in almost every country I've lived in. Overall I think public healthcare is well worth it - in theory you can save a lot with one central purchaser, and even moreso if the government was willing to do drug discovery and production directly too. But it is difficult to ensure future governments don't ruin it. It's kind of like why the unemployment funds and minimum wage negotiations being in the hands of trade unions instead of the government has worked out better in Sweden.

splix 4y ago
In US there is also major issues with waiting time. Like months for anything non-emergency. And emergency is just partially covered by an insurance anyway, so it doesn't really count. Also an Uber instead of ambulance. Not sure about the wages and strikes though. But considering the fact that our neighbor doctor is a member of a yacht club, and the landlord who is another doctor had invested in a bunch of apartments that he lost the track of them, I guess they are fine.

lr1970 4y ago

In US there are two useless armies of administrators sucking money out of providing patient's care -- one army employed by insurance industry to deny a claim whenever they can, the other one employed by hospitals and healthcare providers to fight back. It doubles the waste and unproductive work in the best tradition of "bullshit jobs".

yucky 4y ago

> But even I am for government funded healthcare. Who in the hell is against it? Anybody who has ever had to deal with Medicaid?

wyre 4y ago
Medicaid in Washington state (Apple Health) is fantastic, all things considered.
- yucky 4y ago
  The "all things considered" must be doing some heavy lifting in that sentence. Medicaid is almost universally hated by health care professionals. Many places won't take it.