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Since moving to America from the UK, 8 years ago, I am completely baffled by the whole system. You could blame capitalism but the reality is that it seems to be

Since moving to America from the UK, 8 years ago, I am completely baffled by the whole system. You could blame capitalism but the reality is that it seems to be where the government intervenes that causes the problem, every time they try to do something they cause unintended incentives and break more of the system. The government needs to take charge of insurance like we have in the UK, at the very least they need to stop doing stupid things that break the system. Nothing is worse in my opinion than some sort of half capitalist, half arsed regulation, it’s the worst of all the worlds, it’s not free markets and it’s not socialist, it’s Frankenstein.

robocat 3y ago
> The government needs to take charge of insurance like we have in the UK Let's compare outcomes. Do you personally think the healthcare received by the average UK citizen is better than the US? It is easy to whinge about the problems. It is hard to find solutions. For all the glaring deficits of the US systems - maybe it works okay? Democracy is the worst system... I'm in NZ. The public healthcare system has its benefits but it definitely has its costs (I've recently been dealing with expensive private healthcare providers in a situation where the public system wasn't achieving the outcomes we needed).
- fzeroracer 3y ago
  > Let's compare outcomes. Do you personally think the healthcare received by the average UK citizen is better than the US? It is easy to whinge about the problems. It is hard to find solutions. For all the glaring deficits of the US systems - maybe it works okay? Democracy is the worst system... Our life expectancy is falling (and is worse than the UK), people are afraid to go to the hospital because of bankruptcy and we pay far more than other nations on healthcare. In all aspects of outcome our healthcare system costs more for less. The only exception is if you're extremely wealthy, and the gap between wealthy and not has widened. I, as a fairly well-off software engineer could be bankrupted by healthcare costs if a hospital decides I'm out of network during an emergency.
- verteu 3y ago
  It seems the US compares quite poorly in life expectancy and rankings by experts. It does better in cancer survival rates (but the data seems old). - https://www.internationalinsurance.com/health/systems/ https://www.internationalinsurance.com/health/systems/ - https://www.healthsystemtracker.org/chart-collection/quality-u-s-healthcare-system-compare-countries/ https://www.healthsystemtracker.org/chart-collection/quality... - https://en.wikipedia.org/wiki/List_of_countries_by_quality_of_healthcare https://en.wikipedia.org/wiki/List_of_countries_by_quality_o... - https://worldpopulationreview.com/country-rankings/best-healthcare-in-the-world https://worldpopulationreview.com/country-rankings/best-heal...
  - HDThoreaun 3y ago
    The US also has a huge uninsured population and a 50% higher obesity rate. Life expectancy tells us nothing about healthcare quality without correcting for confounders.
    - robocat 3y ago
      What are the top five factors for life expectancy? How active you are? Dietary choices? Your childhood? Bad life choices? Drugs, fast cars, unsafe activities? Work environment? Shift work, lung exposure to harms? What percentage of life expectancy is due to good healthcare? Noticably we can get some extra years at the end, but they can be low quality years. High quality years come from your context and life choices outside of doctoring.
- lmm 3y ago
  > Do you personally think the healthcare received by the average UK citizen is better than the US? Objectively it is. Average US healthcare outcomes are towards the bottom end of industrialized countries, comparable to Czechia or Turkey. And they pay a hell of a lot more for it. US outcomes for "I can pay as much as it takes" wealthy people are very good - but they're very good in the UK too (private medicine does exist in the UK, it's just not very popular because why waste money on something you can get for free?).
fragmede 3y ago
I've taken to calling it Americanism. That wraps up so many of the weird cultural issues, because it's not capitalism to have basically no monopoly abuse protection, regulated-but-not-markets, and exclusivity and non-compete agreements. It's closer to anarchy or fedualism, with a veneer of "let's not devolve into mad max" on top.
- AnthonyMouse 3y ago
  It's definitely not closer to anarchy. Feudalism is much closer. The problem is the regulations we have are the ones that prevent competition rather than preserve it, and then people want to call it capitalism but capitalism without competition is shit. And then people don't want to pay attention to the details and pretend that the solution is some generic political ideal like "more regulation" or "less regulation" when in fact what you need is to remove the regulations that inhibit competition and preserve or bolster the ones that protect it. Then we do the exact opposite and continue to pile on regulations that impair competition, the effects of which corporations use to justify removing ones that preserve it, the consequences of which are used by regulators to keep piling on the ones that destroy competition. They're not all the same. It's not about "regulation" or "deregulation" -- it's about promoting competition instead of destroying it. You need to keep costs low on small businesses while inhibiting corporation consolidation.
- e2le 3y ago
  Perhaps crapitalism would be a better name?
refurb 3y ago
This is very true. I worked in healthcare and the US system is a bizarre mix of government regulations and half-measures that actually make the system worse. A great example is the 340B law. It forces drug makers to give hospitals that have a high proportion of indigents (low income patients) massive discounts. So what happened? Hospitals saw a cash cow and bought up a ton of small oncology clinics and brought them in house. The cost of providing oncology care in a hospital system is more expensive. Basically the law did nothing for passing savings to patients and actualy drove up healthcare costs. It one example of many in the US system.

robocat 3y ago

> The government needs to take charge of insurance like we have in the UK Let's compare outcomes. Do you personally think the healthcare received by the average UK citizen is better than the US? It is easy to whinge about the problems. It is hard to find solutions. For all the glaring deficits of the US systems - maybe it works okay? Democracy is the worst system... I'm in NZ. The public healthcare system has its benefits but it definitely has its costs (I've recently been dealing with expensive private healthcare providers in a situation where the public system wasn't achieving the outcomes we needed).

fzeroracer 3y ago
> Let's compare outcomes. Do you personally think the healthcare received by the average UK citizen is better than the US? It is easy to whinge about the problems. It is hard to find solutions. For all the glaring deficits of the US systems - maybe it works okay? Democracy is the worst system... Our life expectancy is falling (and is worse than the UK), people are afraid to go to the hospital because of bankruptcy and we pay far more than other nations on healthcare. In all aspects of outcome our healthcare system costs more for less. The only exception is if you're extremely wealthy, and the gap between wealthy and not has widened. I, as a fairly well-off software engineer could be bankrupted by healthcare costs if a hospital decides I'm out of network during an emergency.
verteu 3y ago
It seems the US compares quite poorly in life expectancy and rankings by experts. It does better in cancer survival rates (but the data seems old). - https://www.internationalinsurance.com/health/systems/ https://www.internationalinsurance.com/health/systems/ - https://www.healthsystemtracker.org/chart-collection/quality-u-s-healthcare-system-compare-countries/ https://www.healthsystemtracker.org/chart-collection/quality... - https://en.wikipedia.org/wiki/List_of_countries_by_quality_of_healthcare https://en.wikipedia.org/wiki/List_of_countries_by_quality_o... - https://worldpopulationreview.com/country-rankings/best-healthcare-in-the-world https://worldpopulationreview.com/country-rankings/best-heal...
- HDThoreaun 3y ago
  The US also has a huge uninsured population and a 50% higher obesity rate. Life expectancy tells us nothing about healthcare quality without correcting for confounders.
  - robocat 3y ago
    What are the top five factors for life expectancy? How active you are? Dietary choices? Your childhood? Bad life choices? Drugs, fast cars, unsafe activities? Work environment? Shift work, lung exposure to harms? What percentage of life expectancy is due to good healthcare? Noticably we can get some extra years at the end, but they can be low quality years. High quality years come from your context and life choices outside of doctoring.
lmm 3y ago
> Do you personally think the healthcare received by the average UK citizen is better than the US? Objectively it is. Average US healthcare outcomes are towards the bottom end of industrialized countries, comparable to Czechia or Turkey. And they pay a hell of a lot more for it. US outcomes for "I can pay as much as it takes" wealthy people are very good - but they're very good in the UK too (private medicine does exist in the UK, it's just not very popular because why waste money on something you can get for free?).

fragmede 3y ago

I've taken to calling it Americanism. That wraps up so many of the weird cultural issues, because it's not capitalism to have basically no monopoly abuse protection, regulated-but-not-markets, and exclusivity and non-compete agreements. It's closer to anarchy or fedualism, with a veneer of "let's not devolve into mad max" on top.

AnthonyMouse 3y ago
It's definitely not closer to anarchy. Feudalism is much closer. The problem is the regulations we have are the ones that prevent competition rather than preserve it, and then people want to call it capitalism but capitalism without competition is shit. And then people don't want to pay attention to the details and pretend that the solution is some generic political ideal like "more regulation" or "less regulation" when in fact what you need is to remove the regulations that inhibit competition and preserve or bolster the ones that protect it. Then we do the exact opposite and continue to pile on regulations that impair competition, the effects of which corporations use to justify removing ones that preserve it, the consequences of which are used by regulators to keep piling on the ones that destroy competition. They're not all the same. It's not about "regulation" or "deregulation" -- it's about promoting competition instead of destroying it. You need to keep costs low on small businesses while inhibiting corporation consolidation.
e2le 3y ago
Perhaps crapitalism would be a better name?

refurb 3y ago

This is very true. I worked in healthcare and the US system is a bizarre mix of government regulations and half-measures that actually make the system worse. A great example is the 340B law. It forces drug makers to give hospitals that have a high proportion of indigents (low income patients) massive discounts. So what happened? Hospitals saw a cash cow and bought up a ton of small oncology clinics and brought them in house. The cost of providing oncology care in a hospital system is more expensive. Basically the law did nothing for passing savings to patients and actualy drove up healthcare costs. It one example of many in the US system.