4 ms·

If we get the government more involved in funding these things directly, it can only improve the outcome.

vkou 3y ago
Funding directly by issuing a blank check to the vendors? No, it won't. Funding directly by setting a price cap, and paying vendors that amount for services rendered? Seems to work for almost every other developed country in the world. With the monetary savings of #2, it could even give every medical student a fully free ride.
- NoMoreNicksLeft 3y ago
  > Seems to work for I love when someone says "seems to work". In the strict sense, that only ever means "does something". Not necessarily "does what someone wants"... and never "does what I want". When it works for those other countries, does it "do what you want"? Because it doesn't "do what I want" at all. > With the monetary savings of #2, it could even give every medical student a fully free ride. Won't someone think of the millionaire heart surgeons in the 1%? They obviously needed free rides back when they started, it's why they're only single digit millionaires! > Funding directly by setting a price cap, Starving the people you want to provide your medical treatment isn't the brightest strategy. Increases to price caps are always reactive, after they've been complaining for years. The bureaucracy demands that it take years more to raise the price caps. And by the time that happens, they've been bleeding money the whole time. It's a strong incentive for them to do all sorts of things that you don't want... and if you do it for any length of time at all, it trains them to do these bad things so even if you realize the error of your ways and withdrawn the bad policy, they keep on doing the bad things. Quite clearly, the problem with health insurance is that we need a gigantic insurance company larger than any other in history, and that it needs to be managed by the paragons of competency, the federal government. Of course, they'll need to staff up... and with all the layoffs in the private insurance industry, we'll hire all those empathetic, kind-hearted subject matter experts. Should be the best thing ever. I can't possibly see anything that might go wrong.
  - verteu 3y ago
    I suspect GP is referring to the fact that the US has the one of the worst health outcomes per dollar spent vs peer countries [1] [2]. If "better health outcomes per dollar" is not "what you want" -- how come? [1] https://www.pgpf.org/blog/2022/07/how-does-the-us-healthcare-system-compare-to-other-countries https://www.pgpf.org/blog/2022/07/how-does-the-us-healthcare... [2] https://www.piie.com/blogs/realtime-economic-issues-watch/what-comparing-healthcare-costs-really-reveals https://www.piie.com/blogs/realtime-economic-issues-watch/wh...
    - vkou 3y ago
      People making this argument tend to want 'better health outcomes for millionaires/healthy white collar people', either because they are one, or they think they will be one.
      - nathan_compton 3y ago
        What I always point out is that markets are a form of rationing too. They are just form where people with money are allocated more goods than people without it, sometimes to the total exclusion of large parts of the population. Given that we set up polities for the common good, I'd argue that any necessity which markets fail to deliver to everyone should use some other kind of rationing strategy.
    - zer8k 3y ago
      The US's healthcare system is so bleak because we quite literally fund healthcare for the rest of the planet. Taxpayers in the US get access to the best treatment decades earlier if they're rich enough. Prices are increased on US citizens to account for the strong arming other governments do to get prices lower for their citizens. If the pharma companies couldn't do this, for example, they'd refuse to negotiate with other countries. A microcosm of this behavior is medicare here is the US. Yes, the US taxpayers even have to be charitable to them. IMO, if the US decided to actually help its citizens every country the average progressive considers "great at healthcare" would likely implode under the sudden increase in cost. The cost of medication alone would likely nearly bankrupt several governments. Imagine if the price of insulin, almost completely funded by US citizens paying absurd prices, went up to its US price. Much like with defense, the US taxpayer is the hero of the rest of the world's healthcare. Without US tax cattle the rest of the world would not be as nice as it is. It's just like when prices go up at your favorite store due to theft. The US is punished by insurance companies because other countries refuse to pay more.

vkou 3y ago

Funding directly by issuing a blank check to the vendors? No, it won't. Funding directly by setting a price cap, and paying vendors that amount for services rendered? Seems to work for almost every other developed country in the world. With the monetary savings of #2, it could even give every medical student a fully free ride.

NoMoreNicksLeft 3y ago
> Seems to work for I love when someone says "seems to work". In the strict sense, that only ever means "does something". Not necessarily "does what someone wants"... and never "does what I want". When it works for those other countries, does it "do what you want"? Because it doesn't "do what I want" at all. > With the monetary savings of #2, it could even give every medical student a fully free ride. Won't someone think of the millionaire heart surgeons in the 1%? They obviously needed free rides back when they started, it's why they're only single digit millionaires! > Funding directly by setting a price cap, Starving the people you want to provide your medical treatment isn't the brightest strategy. Increases to price caps are always reactive, after they've been complaining for years. The bureaucracy demands that it take years more to raise the price caps. And by the time that happens, they've been bleeding money the whole time. It's a strong incentive for them to do all sorts of things that you don't want... and if you do it for any length of time at all, it trains them to do these bad things so even if you realize the error of your ways and withdrawn the bad policy, they keep on doing the bad things. Quite clearly, the problem with health insurance is that we need a gigantic insurance company larger than any other in history, and that it needs to be managed by the paragons of competency, the federal government. Of course, they'll need to staff up... and with all the layoffs in the private insurance industry, we'll hire all those empathetic, kind-hearted subject matter experts. Should be the best thing ever. I can't possibly see anything that might go wrong.
- verteu 3y ago
  I suspect GP is referring to the fact that the US has the one of the worst health outcomes per dollar spent vs peer countries [1] [2]. If "better health outcomes per dollar" is not "what you want" -- how come? [1] https://www.pgpf.org/blog/2022/07/how-does-the-us-healthcare-system-compare-to-other-countries https://www.pgpf.org/blog/2022/07/how-does-the-us-healthcare... [2] https://www.piie.com/blogs/realtime-economic-issues-watch/what-comparing-healthcare-costs-really-reveals https://www.piie.com/blogs/realtime-economic-issues-watch/wh...
  - vkou 3y ago
    People making this argument tend to want 'better health outcomes for millionaires/healthy white collar people', either because they are one, or they think they will be one.
    - nathan_compton 3y ago
      What I always point out is that markets are a form of rationing too. They are just form where people with money are allocated more goods than people without it, sometimes to the total exclusion of large parts of the population. Given that we set up polities for the common good, I'd argue that any necessity which markets fail to deliver to everyone should use some other kind of rationing strategy.
  - zer8k 3y ago
    The US's healthcare system is so bleak because we quite literally fund healthcare for the rest of the planet. Taxpayers in the US get access to the best treatment decades earlier if they're rich enough. Prices are increased on US citizens to account for the strong arming other governments do to get prices lower for their citizens. If the pharma companies couldn't do this, for example, they'd refuse to negotiate with other countries. A microcosm of this behavior is medicare here is the US. Yes, the US taxpayers even have to be charitable to them. IMO, if the US decided to actually help its citizens every country the average progressive considers "great at healthcare" would likely implode under the sudden increase in cost. The cost of medication alone would likely nearly bankrupt several governments. Imagine if the price of insulin, almost completely funded by US citizens paying absurd prices, went up to its US price. Much like with defense, the US taxpayer is the hero of the rest of the world's healthcare. Without US tax cattle the rest of the world would not be as nice as it is. It's just like when prices go up at your favorite store due to theft. The US is punished by insurance companies because other countries refuse to pay more.