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And have UAE, Qatar, and Saudi Arabia achieved what Norway has? (Where did anyone say that social programs are the source of Norway's wealth?!) No one is ackn

by hilux 3y ago

And have UAE, Qatar, and Saudi Arabia achieved what Norway has? (Where did anyone say that social programs are the source of Norway's wealth?!) No one is acknowledging the US data I posted. Even if the US is not as rich per capita as Norway is, can we learn something from Norway (about investment in education and healthcare) with the resources we do have? BTW, US per-capita healthcare cost is much, much higher than Norway's, and US life expectancy is much lower.

AnthonyMouse 3y ago
> BTW, US per-capita healthcare cost is much, much higher than Norway's, and US life expectancy is much lower. But that's the issue -- it's not a matter of allocating the money. The US is already spending it. The question is, how do you make it more cost efficient? "Just do what Norway does" doesn't solve anything for two reasons. The first is that it doesn't tell you if that's the right answer, only that what Norway is doing is better than the status quo in the US. But the status quo in the US is uniquely dysfunctional, so that's not a high bar. You still don't know if it's better to do what Norway does or what Singapore does (same life expectancy as Norway, much different system) or some third thing which could hypothetically be better than either of them. The second is that it doesn't solve the political issue in the US, which is that all of the people making money from the status quo don't want it to change. It doesn't matter if the proposal is a public healthcare system or a market system with actual price transparency or something else entirely, until you can overcome the political inertia of the incumbent system. And these feed into each other. Because it's obvious that the existing US system is inefficient, but it's not obvious which of the potentially more efficient systems to replace it with, so the people with different ideas fight against each other instead of fighting with each other against the status quo.
- vidarh 3y ago
  I think the rest of the developed world would cheer on if the US just copied any of the dozens of other models for universal healthcare that produce better outcomes cheaper than the current US system. What we find shocking is that the US appears uniquely unable to fix these things among developed countries despite the vast wealth and resources. There's a level of political dysfunction that is really hard to watch, but also incredibly hard to ignore. EDIT: To give one example that I personally find shocking: That Medicare has restrictions on the extent of its ability to negotiate drug prices. I get your point that this is in part due to entrenched interests as seen with the attacks on the recent attempt to fix this issue by using powers under the Inflation Reduction Act, but that even chipping away on things like that is proving as hard as it is, is bizarre seen from the outside and the new ability to negotiate prices is still ridiculously limited.
  - hilux 3y ago
    Check out the tsunami of white American kids refusing to get even the most basic vaccines (because Jesus) ... polio and other long-forgotten diseases are about to make a big comeback. NY Times had a big story about this. "Insane" doesn't do it justice. We need new words.
    - vidarh 3y ago
      > "Insane" doesn't do it justice. We need new words. Norwegian has another US-inspired term for crazy: "Helt Texas" ("completely Texas") [1] (Though to be fair, that is mostly used for a hyperbolic allusion to the Hollywood version of the wild west, and translating it as something being "wild west" would perhaps better carry the meaning, but I still find it funny) [1] https://www.washingtonpost.com/news/morning-mix/wp/2015/10/26/how-texas-became-norwegian-for-crazy/ https://www.washingtonpost.com/news/morning-mix/wp/2015/10/2...
    - DeathArrow 3y ago
      >Check out the tsunami of white American kids refusing to get even the most basic vaccines (because Jesus) There's no need to be racist.
      - hilux 3y ago
        MENTIONING race is not racist. Being white, voting for Trump, and claiming a Christian-evangelical religious exemption is core to these vaccine objectors' identity. If you're American and you don't know this, you should definitely read one of many article about this trend. Because it is about to kill many people.
  - AnthonyMouse 3y ago
    > I think the rest of the developed world would cheer on if the US just copied any of the dozens of other models for universal healthcare that produce better outcomes cheaper than the current US system. "Just pick one" isn't actually a method of choosing when different people disagree on what should be done. People don't even agree that "universal healthcare" is the right target, rather than e.g. a market-based system with actual price transparency that would introduce competition for non-emergency care. This is also ignoring many of the factors that make the US system so expensive. For example, the AMA has lobbied for regulations that require doctors to do a lot of things that could reasonably be done by nurses. This has been exacerbating an existing doctor shortage, so then doctors get paid more (raising healthcare costs) while impairing outcomes (there aren't enough doctors to provide a high standard of care). This is a regulatory problem created by a powerful lobby. It's things like that which in the aggregate cause the US system to be what it is, but you can't fix them by copying some different part of the system from another country. You have to fix that problem in particular regardless of what else you do, but fixing it is the thing strongly opposed by the lobbyists. > To give one example that I personally find shocking: That Medicare has restrictions on the extent of its ability to negotiate drug prices. I get your point that this is in part due to entrenched interests as seen with the attacks on the recent attempt to fix this issue by using powers under the Inflation Reduction Act, but that even chipping away on things like that is proving as hard as it is, is bizarre seen from the outside and the new ability to negotiate prices is still ridiculously limited. You have to understand the context for things like this. Nobody is talking about negotiating the price of aspirin, which is a cheap commodity regardless of who you get it from. The issue is drugs under patent. The way the patent system is supposed to work is that if you invent something you can patent it and then charge the monopoly price for a limited time in order to recover your R&D. The monopoly price is based on the value of the invention. You can patent some dreck and try to charge a million dollars for it and nobody will buy it from you. But if you cure some fatal disease, the value of the cure is very high, which allows you to recover the cost of developing the cure, which could also be very high. This is obviously not going to be efficient when the drug is being paid for by insurance or Medicare. If the drug company patents something which is only marginally better than the generic, anyone paying out of pocket would just choose the generic and save a lot of money. But if the doctor prescribes the patented one, the insurance is now expected to cover it and by law only the patent holder can make it, so they can charge high prices even though the person choosing which drug to take isn't the person paying the bill anymore. This is dumb but it's not completely crazy. Sometimes drug companies get away with charging a lot because they patented "existing drug, but with Tylenol" and then convinced doctors to prescribe it. But it also means they can recover their costs for actual life-saving drug research. It's not serving its purpose efficiently but it's still doing something of importance. So now you want Medicare to "negotiate" these prices. Basically what you're saying is that you want to reduce the intentionally-created subsidy for drug research, or shift more of its cost from Medicare to private insurance and the uninsured. Which is bad policy, but is favored by people who want Medicare's numbers to look better. What you really want to do here is one of two things. Option one, give up on the model of patenting drugs and then having insurance cover the cost and instead just publicly subsidize drug research and immediately put the drugs into the public domain. Option two, make the patent system work as intended by exposing some of the cost to the patient, e.g. by having a 10% copay for prescription drugs. Patients would then avoid drugs which are extremely overpriced relative to their benefit and you wouldn't have Medicare paying high prices for "existing drug, but with Tylenol" anymore.
DeathArrow 3y ago
>And have UAE, Qatar, and Saudi Arabia achieved what Norway has? What does Norway have that UAE should desire?

by hilux 3y ago

AnthonyMouse 3y ago

> BTW, US per-capita healthcare cost is much, much higher than Norway's, and US life expectancy is much lower. But that's the issue -- it's not a matter of allocating the money. The US is already spending it. The question is, how do you make it more cost efficient? "Just do what Norway does" doesn't solve anything for two reasons. The first is that it doesn't tell you if that's the right answer, only that what Norway is doing is better than the status quo in the US. But the status quo in the US is uniquely dysfunctional, so that's not a high bar. You still don't know if it's better to do what Norway does or what Singapore does (same life expectancy as Norway, much different system) or some third thing which could hypothetically be better than either of them. The second is that it doesn't solve the political issue in the US, which is that all of the people making money from the status quo don't want it to change. It doesn't matter if the proposal is a public healthcare system or a market system with actual price transparency or something else entirely, until you can overcome the political inertia of the incumbent system. And these feed into each other. Because it's obvious that the existing US system is inefficient, but it's not obvious which of the potentially more efficient systems to replace it with, so the people with different ideas fight against each other instead of fighting with each other against the status quo.

vidarh 3y ago
I think the rest of the developed world would cheer on if the US just copied any of the dozens of other models for universal healthcare that produce better outcomes cheaper than the current US system. What we find shocking is that the US appears uniquely unable to fix these things among developed countries despite the vast wealth and resources. There's a level of political dysfunction that is really hard to watch, but also incredibly hard to ignore. EDIT: To give one example that I personally find shocking: That Medicare has restrictions on the extent of its ability to negotiate drug prices. I get your point that this is in part due to entrenched interests as seen with the attacks on the recent attempt to fix this issue by using powers under the Inflation Reduction Act, but that even chipping away on things like that is proving as hard as it is, is bizarre seen from the outside and the new ability to negotiate prices is still ridiculously limited.
- hilux 3y ago
  Check out the tsunami of white American kids refusing to get even the most basic vaccines (because Jesus) ... polio and other long-forgotten diseases are about to make a big comeback. NY Times had a big story about this. "Insane" doesn't do it justice. We need new words.
  - vidarh 3y ago
    > "Insane" doesn't do it justice. We need new words. Norwegian has another US-inspired term for crazy: "Helt Texas" ("completely Texas") [1] (Though to be fair, that is mostly used for a hyperbolic allusion to the Hollywood version of the wild west, and translating it as something being "wild west" would perhaps better carry the meaning, but I still find it funny) [1] https://www.washingtonpost.com/news/morning-mix/wp/2015/10/26/how-texas-became-norwegian-for-crazy/ https://www.washingtonpost.com/news/morning-mix/wp/2015/10/2...
  - DeathArrow 3y ago
    >Check out the tsunami of white American kids refusing to get even the most basic vaccines (because Jesus) There's no need to be racist.
    - hilux 3y ago
      MENTIONING race is not racist. Being white, voting for Trump, and claiming a Christian-evangelical religious exemption is core to these vaccine objectors' identity. If you're American and you don't know this, you should definitely read one of many article about this trend. Because it is about to kill many people.
- AnthonyMouse 3y ago
  > I think the rest of the developed world would cheer on if the US just copied any of the dozens of other models for universal healthcare that produce better outcomes cheaper than the current US system. "Just pick one" isn't actually a method of choosing when different people disagree on what should be done. People don't even agree that "universal healthcare" is the right target, rather than e.g. a market-based system with actual price transparency that would introduce competition for non-emergency care. This is also ignoring many of the factors that make the US system so expensive. For example, the AMA has lobbied for regulations that require doctors to do a lot of things that could reasonably be done by nurses. This has been exacerbating an existing doctor shortage, so then doctors get paid more (raising healthcare costs) while impairing outcomes (there aren't enough doctors to provide a high standard of care). This is a regulatory problem created by a powerful lobby. It's things like that which in the aggregate cause the US system to be what it is, but you can't fix them by copying some different part of the system from another country. You have to fix that problem in particular regardless of what else you do, but fixing it is the thing strongly opposed by the lobbyists. > To give one example that I personally find shocking: That Medicare has restrictions on the extent of its ability to negotiate drug prices. I get your point that this is in part due to entrenched interests as seen with the attacks on the recent attempt to fix this issue by using powers under the Inflation Reduction Act, but that even chipping away on things like that is proving as hard as it is, is bizarre seen from the outside and the new ability to negotiate prices is still ridiculously limited. You have to understand the context for things like this. Nobody is talking about negotiating the price of aspirin, which is a cheap commodity regardless of who you get it from. The issue is drugs under patent. The way the patent system is supposed to work is that if you invent something you can patent it and then charge the monopoly price for a limited time in order to recover your R&D. The monopoly price is based on the value of the invention. You can patent some dreck and try to charge a million dollars for it and nobody will buy it from you. But if you cure some fatal disease, the value of the cure is very high, which allows you to recover the cost of developing the cure, which could also be very high. This is obviously not going to be efficient when the drug is being paid for by insurance or Medicare. If the drug company patents something which is only marginally better than the generic, anyone paying out of pocket would just choose the generic and save a lot of money. But if the doctor prescribes the patented one, the insurance is now expected to cover it and by law only the patent holder can make it, so they can charge high prices even though the person choosing which drug to take isn't the person paying the bill anymore. This is dumb but it's not completely crazy. Sometimes drug companies get away with charging a lot because they patented "existing drug, but with Tylenol" and then convinced doctors to prescribe it. But it also means they can recover their costs for actual life-saving drug research. It's not serving its purpose efficiently but it's still doing something of importance. So now you want Medicare to "negotiate" these prices. Basically what you're saying is that you want to reduce the intentionally-created subsidy for drug research, or shift more of its cost from Medicare to private insurance and the uninsured. Which is bad policy, but is favored by people who want Medicare's numbers to look better. What you really want to do here is one of two things. Option one, give up on the model of patenting drugs and then having insurance cover the cost and instead just publicly subsidize drug research and immediately put the drugs into the public domain. Option two, make the patent system work as intended by exposing some of the cost to the patient, e.g. by having a 10% copay for prescription drugs. Patients would then avoid drugs which are extremely overpriced relative to their benefit and you wouldn't have Medicare paying high prices for "existing drug, but with Tylenol" anymore.

DeathArrow 3y ago

>And have UAE, Qatar, and Saudi Arabia achieved what Norway has? What does Norway have that UAE should desire?