7 ms·

It will be interesting to see what happens as that funding is starting to be phased out. https://www.kff.org/medicaid/issue-brief/fiscal-implications-for-medica

It will be interesting to see what happens as that funding is starting to be phased out. https://www.kff.org/medicaid/issue-brief/fiscal-implications-for-medicaid-of-enhanced-federal-funding-and-continuous-enrollment https://www.kff.org/medicaid/issue-brief/fiscal-implications... Meanwhile, finding lower cost ways of providing health care still seems elusive in the face of provider and pharma legal efforts.

deciplex 3y ago
Providing lower-cost ways of providing health care is directly contrary to the interests of anyone with political or economic power in our country: the hospitals and pharmaceutical companies that directly benefit from high prices, the politicians who receive bribes in exchange for passing laws that keeps prices high (or just failing to pass laws that would lower prices), and the typical employer who can use the increasing importance of health insurance and the threat of medical bankruptcy as leverage against his employees when negotiating work conditions and pay. Our health care system is, like basically any other institution of note in the US, first and foremost a means to effect the transfer of wealth to our economic and political elites from the rest of us. We need to first come to recognize that our system is currently working as intended before we can think clearly on what to do about it and take effective action.
- 0xDEAFBEAD 3y ago
  "Our system is currently working as intended" implies that someone designed the system to work the way it does. What you're really arguing is that no actor is incentivized to improve things, and multiple actors are incentivized to preserve the status quo. I'd argue that strident condemnations (ala your "our system is currently working as intended") is actually one of the features of the US political system that tends to create/preserve a subpar status quo: https://twitter.com/JohnArnoldFndtn/status/1106302246449369088 https://twitter.com/JohnArnoldFndtn/status/11063022464493690... I don't believe that the US has a monopoly on greedy businesspeople or politicians, relative to other countries. But I do find myself wondering if the toxicity of our politics tends to filter out candidates with a good faith desire to serve the public. People who enjoy conflict tend to be jerks. EDIT -- Here is some specific evidence that US elites are not uniquely rapacious: A solid majority of Giving Pledge signatories hail from the US: https://gpcatalysis.blob.core.windows.net/gphostedcontent-prod/tgp_site_infographic_count_241.png https://gpcatalysis.blob.core.windows.net/gphostedcontent-pr... From the bottom of https://givingpledge.org/ https://givingpledge.org/ While the US only has 735 of the world's 2640 billionaires: https://en.wikipedia.org/wiki/List_of_countries_by_number_of_billionaires https://en.wikipedia.org/wiki/List_of_countries_by_number_of...
  - worik 3y ago
    > "Our system is currently working as intended" implies that someone designed the system to work the way it does I disagree It is intended to be profit maximizing. That it is
  - deciplex 3y ago
    You linked me to a website for a US organization that apparently encourages the extremely wealthy to create more tax shelters for themselves, and followed that up by pointing out that the US accounts for 28% of the world's billionaires while making up 4% of its population. I'm not sure what point you were trying to make. I don't think we have a monopoly on greedy businesspeople or politicians either, but I do think that as the epicenter of global capitalism, we dominate the market. You can't hope to solve problems if you won't allow yourself to accurately define them.
    - 0xDEAFBEAD 3y ago
      >You linked me to a website for a US organization that apparently encourages the extremely wealthy to create more tax shelters for themselves It's true that the tax code encourages philanthropy. That's not the same thing as philanthropy being purely a tax shelter.
jewayne 3y ago
I hope you don't actually believe that providing health care is exorbitantly expensive. Providing health care is absolutely not exorbitantly expensive. It just isn't. Paying the prices that our hospitals, insurance companies, and drug companies charge is exorbitantly expensive.
- afavour 3y ago
  I think it depends on the definition of “exorbitantly”. US healthcare costs are absolutely extreme but even European countries with universal healthcare still struggle with healthcare expenditure. > The report shows that global spending on health continually rose between 2000 and 2018 and reached US$ 8.3 trillion or 10% of global GDP https://www.who.int/publications-detail-redirect/9789240017788 https://www.who.int/publications-detail-redirect/97892400177...
  - jewayne 3y ago
    I'm trying to decide why we need to clutch our pearls because health care is 10% of global GDP? Is health care somehow an illegitimate expenditure?
    - TheGRS 3y ago
      I think people just scoff at the price tag of a lot of medical expenses, though the bill you see your insurance provider get is pretty fake IMO.
- nradov 3y ago
  How would you propose to resolve that? Should we cut physician pay in half to match their European peers? https://www.medscape.com/viewarticle/997263 https://www.medscape.com/viewarticle/997263
  - GiorgioG 3y ago
    I propose cutting administrative costs by 90%. A bunch of paper pushers in meetings all day making too much money driving up the cost of everything they touch.

deciplex 3y ago

Providing lower-cost ways of providing health care is directly contrary to the interests of anyone with political or economic power in our country: the hospitals and pharmaceutical companies that directly benefit from high prices, the politicians who receive bribes in exchange for passing laws that keeps prices high (or just failing to pass laws that would lower prices), and the typical employer who can use the increasing importance of health insurance and the threat of medical bankruptcy as leverage against his employees when negotiating work conditions and pay. Our health care system is, like basically any other institution of note in the US, first and foremost a means to effect the transfer of wealth to our economic and political elites from the rest of us. We need to first come to recognize that our system is currently working as intended before we can think clearly on what to do about it and take effective action.

0xDEAFBEAD 3y ago
"Our system is currently working as intended" implies that someone designed the system to work the way it does. What you're really arguing is that no actor is incentivized to improve things, and multiple actors are incentivized to preserve the status quo. I'd argue that strident condemnations (ala your "our system is currently working as intended") is actually one of the features of the US political system that tends to create/preserve a subpar status quo: https://twitter.com/JohnArnoldFndtn/status/1106302246449369088 https://twitter.com/JohnArnoldFndtn/status/11063022464493690... I don't believe that the US has a monopoly on greedy businesspeople or politicians, relative to other countries. But I do find myself wondering if the toxicity of our politics tends to filter out candidates with a good faith desire to serve the public. People who enjoy conflict tend to be jerks. EDIT -- Here is some specific evidence that US elites are not uniquely rapacious: A solid majority of Giving Pledge signatories hail from the US: https://gpcatalysis.blob.core.windows.net/gphostedcontent-prod/tgp_site_infographic_count_241.png https://gpcatalysis.blob.core.windows.net/gphostedcontent-pr... From the bottom of https://givingpledge.org/ https://givingpledge.org/ While the US only has 735 of the world's 2640 billionaires: https://en.wikipedia.org/wiki/List_of_countries_by_number_of_billionaires https://en.wikipedia.org/wiki/List_of_countries_by_number_of...
- worik 3y ago
  > "Our system is currently working as intended" implies that someone designed the system to work the way it does I disagree It is intended to be profit maximizing. That it is
- deciplex 3y ago
  You linked me to a website for a US organization that apparently encourages the extremely wealthy to create more tax shelters for themselves, and followed that up by pointing out that the US accounts for 28% of the world's billionaires while making up 4% of its population. I'm not sure what point you were trying to make. I don't think we have a monopoly on greedy businesspeople or politicians either, but I do think that as the epicenter of global capitalism, we dominate the market. You can't hope to solve problems if you won't allow yourself to accurately define them.
  - 0xDEAFBEAD 3y ago
    >You linked me to a website for a US organization that apparently encourages the extremely wealthy to create more tax shelters for themselves It's true that the tax code encourages philanthropy. That's not the same thing as philanthropy being purely a tax shelter.

jewayne 3y ago

I hope you don't actually believe that providing health care is exorbitantly expensive. Providing health care is absolutely not exorbitantly expensive. It just isn't. Paying the prices that our hospitals, insurance companies, and drug companies charge is exorbitantly expensive.

afavour 3y ago
I think it depends on the definition of “exorbitantly”. US healthcare costs are absolutely extreme but even European countries with universal healthcare still struggle with healthcare expenditure. > The report shows that global spending on health continually rose between 2000 and 2018 and reached US$ 8.3 trillion or 10% of global GDP https://www.who.int/publications-detail-redirect/9789240017788 https://www.who.int/publications-detail-redirect/97892400177...
- jewayne 3y ago
  I'm trying to decide why we need to clutch our pearls because health care is 10% of global GDP? Is health care somehow an illegitimate expenditure?
  - TheGRS 3y ago
    I think people just scoff at the price tag of a lot of medical expenses, though the bill you see your insurance provider get is pretty fake IMO.
nradov 3y ago
How would you propose to resolve that? Should we cut physician pay in half to match their European peers? https://www.medscape.com/viewarticle/997263 https://www.medscape.com/viewarticle/997263
- GiorgioG 3y ago
  I propose cutting administrative costs by 90%. A bunch of paper pushers in meetings all day making too much money driving up the cost of everything they touch.