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Can we please just implement some level of universal healthcare. The fact that healthcare is tied directly to payers, who fight over how to much to pay, is ridi

Can we please just implement some level of universal healthcare. The fact that healthcare is tied directly to payers, who fight over how to much to pay, is ridiculous. Imagine your local hospital shutting down because the hospital charged $50 for aspirin but the insurer wanted $40.

tristanb 3y ago
Its also incredibly expensive (500k) to become a doctor.
- bombcar 3y ago
  Maybe we need something like the Army, where you can join up, qualify, get trained to be a doctor for free, and all you have to do is serve out your term at army wages until you're 45, then you're retired and free to do whatever doctoring you want wherever. It's how we get a lot of our airline pilots, after all.
- lelanthran 3y ago
  > Its also incredibly expensive (500k) to become a doctor. That's a large number. I thought it was less. In any case, in most countries, the number of doctors created is artificially limited (by the professional medical society, by lack of lecturers, artificially small classes, etc). You want to double the number of doctors? Make each doctor serve (after internship) for at least one year as a fulltime lecturer in medicine. That'll more than quadruple the intake in the first year. The professional health organisation that registers doctors can enforce this. In fact, they can enforce lots of things, and the question you should be asking is not "Why are the greedy corps taking all the money", but "why is the artificial limit on doctors so low?".
  - tristanb 3y ago
    That number comes from my wife, who's a double board certified surgeon. We're still paying it off and will be for some time. That said, we'd both vote for universal healthcare, even if it bankrupted us.
tboyd47 3y ago
The issue is not confusion over who pays the bill, but the overwhelming amount of corruption and cronyism in the system.
one_level_deep 3y ago
[dead]
cheeseomlit 3y ago
If you take an industry cornered by an entrenched cartel and then socialize it as-is you are only cementing their control over it even further, making a healthy competitive market impossible. Prices are criminally exorbitant now, what makes you think they'll go down when the government is the one paying them? If history is anything to go by the effect will be the opposite
- pkaye 3y ago
  The UK NHS is able to use its monopsony powers to keep the pay for doctors and nurses extremely low. Doctors would need a 35% pay raise to bring it back to the 2008 level of pay. Many of them are looking to leave for Australia or Canada. Even US is considered but they would have do the residency over. https://i.redd.it/enukl0ljqk1b1.jpg https://i.redd.it/enukl0ljqk1b1.jpg https://www.cnn.com/2023/04/14/business/junior-doctors-strike-uk/index.html https://www.cnn.com/2023/04/14/business/junior-doctors-strik...
- jorblumesea 3y ago
  This is a ridiculous statement, the government can negotiate prices and has little profit incentive. Some level of universal healthcare works fine in 32 of 33 developed or mostly developed countries. Stop saying "but it can never be done". It is significantly cheaper in other countries that are able to negotiate drug prices. I hate this line of logic, it's basically just ignoring that almost every other developed country in the world has figured out and has done it without the need for "healthy competitive markets".
  - cheeseomlit 3y ago
    When did I say "it can never be done"? Certainly it can, but you'd have to make some pretty drastic changes to the US healthcare market as a whole first- and those changes will be staunchly opposed by all the entrenched healthcare cartels. It wouldn't be easy to do it right, and it'd be very easy to do it wrong and make the whole situation worse (which is what the healthcare cartel would push for). The US healthcare market is a uniquely fucked up monstrosity, comparing it to the universal healthcare system of a country the fraction of our size doesn't make sense. You say the government has little profit incentive, sure, but they also have little incentive to control costs. It's "other people's money", they spend it like drunken sailors, even when they're 30 trillion in debt. Look at what happened to tuition costs after the government started handing out loans for them. I'd take these calls for universal healthcare more seriously if they talked about addressing the underlying issues in the market first, but from what I can tell it's mostly idealogues pushing their pet policy without grounding it in reality. All the bad actors in the industry aren't just going to disappear or start playing nice when they start getting funded by taxpayers (more than they already are).
hospitalJail 3y ago
The problem with US healthcare isnt the payer, its the supply of workers/red tape. Physicians are clearly the worst with their complete control through the ACGME/AMA, but pharmacists were a huge lobbyist in 2008 when it mattered. The various owners, hospitals, pharma manufacturing, pharmacies, all make sure they keep the red tape strong and the medicaid + medicare payments coming.
- jorblumesea 3y ago
  Nah, the payer system is fundamentally broken. Inability to negotiate and set proper price controls on aspirin for example ends up in a huge fight over who makes the most money out of the system. While there are other areas that can be improved (supply of professionals) the reality is that the payer model, at its core, is really the big issue. All the other successful healthcare models across the world have no concept of the American Payer system.
i2cmaster 3y ago
[flagged]

tristanb 3y ago

Its also incredibly expensive (500k) to become a doctor.

bombcar 3y ago
Maybe we need something like the Army, where you can join up, qualify, get trained to be a doctor for free, and all you have to do is serve out your term at army wages until you're 45, then you're retired and free to do whatever doctoring you want wherever. It's how we get a lot of our airline pilots, after all.
lelanthran 3y ago
> Its also incredibly expensive (500k) to become a doctor. That's a large number. I thought it was less. In any case, in most countries, the number of doctors created is artificially limited (by the professional medical society, by lack of lecturers, artificially small classes, etc). You want to double the number of doctors? Make each doctor serve (after internship) for at least one year as a fulltime lecturer in medicine. That'll more than quadruple the intake in the first year. The professional health organisation that registers doctors can enforce this. In fact, they can enforce lots of things, and the question you should be asking is not "Why are the greedy corps taking all the money", but "why is the artificial limit on doctors so low?".
- tristanb 3y ago
  That number comes from my wife, who's a double board certified surgeon. We're still paying it off and will be for some time. That said, we'd both vote for universal healthcare, even if it bankrupted us.

tboyd47 3y ago

The issue is not confusion over who pays the bill, but the overwhelming amount of corruption and cronyism in the system.

one_level_deep 3y ago

[dead]

cheeseomlit 3y ago

If you take an industry cornered by an entrenched cartel and then socialize it as-is you are only cementing their control over it even further, making a healthy competitive market impossible. Prices are criminally exorbitant now, what makes you think they'll go down when the government is the one paying them? If history is anything to go by the effect will be the opposite

pkaye 3y ago
The UK NHS is able to use its monopsony powers to keep the pay for doctors and nurses extremely low. Doctors would need a 35% pay raise to bring it back to the 2008 level of pay. Many of them are looking to leave for Australia or Canada. Even US is considered but they would have do the residency over. https://i.redd.it/enukl0ljqk1b1.jpg https://i.redd.it/enukl0ljqk1b1.jpg https://www.cnn.com/2023/04/14/business/junior-doctors-strike-uk/index.html https://www.cnn.com/2023/04/14/business/junior-doctors-strik...
jorblumesea 3y ago
This is a ridiculous statement, the government can negotiate prices and has little profit incentive. Some level of universal healthcare works fine in 32 of 33 developed or mostly developed countries. Stop saying "but it can never be done". It is significantly cheaper in other countries that are able to negotiate drug prices. I hate this line of logic, it's basically just ignoring that almost every other developed country in the world has figured out and has done it without the need for "healthy competitive markets".
- cheeseomlit 3y ago
  When did I say "it can never be done"? Certainly it can, but you'd have to make some pretty drastic changes to the US healthcare market as a whole first- and those changes will be staunchly opposed by all the entrenched healthcare cartels. It wouldn't be easy to do it right, and it'd be very easy to do it wrong and make the whole situation worse (which is what the healthcare cartel would push for). The US healthcare market is a uniquely fucked up monstrosity, comparing it to the universal healthcare system of a country the fraction of our size doesn't make sense. You say the government has little profit incentive, sure, but they also have little incentive to control costs. It's "other people's money", they spend it like drunken sailors, even when they're 30 trillion in debt. Look at what happened to tuition costs after the government started handing out loans for them. I'd take these calls for universal healthcare more seriously if they talked about addressing the underlying issues in the market first, but from what I can tell it's mostly idealogues pushing their pet policy without grounding it in reality. All the bad actors in the industry aren't just going to disappear or start playing nice when they start getting funded by taxpayers (more than they already are).

hospitalJail 3y ago

The problem with US healthcare isnt the payer, its the supply of workers/red tape. Physicians are clearly the worst with their complete control through the ACGME/AMA, but pharmacists were a huge lobbyist in 2008 when it mattered. The various owners, hospitals, pharma manufacturing, pharmacies, all make sure they keep the red tape strong and the medicaid + medicare payments coming.

jorblumesea 3y ago
Nah, the payer system is fundamentally broken. Inability to negotiate and set proper price controls on aspirin for example ends up in a huge fight over who makes the most money out of the system. While there are other areas that can be improved (supply of professionals) the reality is that the payer model, at its core, is really the big issue. All the other successful healthcare models across the world have no concept of the American Payer system.

i2cmaster 3y ago

[flagged]