4 ms·

quicker to start from scratch

rqtwteye 3y ago
That's lie rewriting a code base from scratch because the current is deemed unmaintainable. Most of the time you end up with the same number, but different problems or it's even worse. In my view Medicare for all would be a viable path but even the Democrats are not interested in tackling healthcare.
- terr-dav 3y ago
  Let's refactor it then: The government simply takes ownership of UHC and they get a new charter to run it like the Postal Service.
  - kelseyfrog 3y ago
    Curious, how at this point could BigGov make UHC worse?
  - thallium205 3y ago
    My mailman refuses to take my stamped envelopes out of my mailbox. Can't be bothered.
    - ascagnel_ 3y ago
      I’ve lived at my current address for about five years. The first year, zero issues. Starting at around the 2020 election, service dropped off precipitously, to the point where I’ve had a piece of outgoing mail in my box since Friday. I can’t trust the mail with anything time sensitive any longer. I blame this on Louis DeJoy, who was appointed Postmaster General in May 2020, and has numerous conflicts of interest.
      - rqtwteye 3y ago
        It’s hard to make government services efficient when you have people in power who want to prove that government services are always bad.
        throw10920 3y ago
        The DMVs in many states have been inefficient for decades. As has the VA. Most inefficiency is completely non-partisan.
    - vanattab 3y ago
      Count your self lucky he is not stealing your packages.
- sjwhevvvvvsj 3y ago
  At this point I’m open to new and exciting problems, whatever they may be. Hell, I’d be ok with leeches making a comeback if it meant I didn’t have to pay a copay on top of a premium.
- AgentOrange1234 3y ago
  A code base doesn’t have tons of middlemen taking their cut. The current system is unsalvageable. Massive disruption is needed.
- diob 3y ago
  Honesty at this point I'm planning to move to a country with sane healthcare sooner rather than later.
lostlogin 3y ago
> quicker to start from scratch How would you even do that? You need nurses and doctors and buildings and training. The lead time is decades and the cost incredible. Best start now guess.
- greenavocado 3y ago
  Imagine a time before health insurance existed
  - lostlogin 3y ago
    I’ve lived in a situation close to that. Sadly it’s changing fast here in New Zealand.
  - DANmode 3y ago
    More doctors, less work per day per doctor, more attention to each patient?
happytiger 3y ago
What evidence do you have that this would be a good thing? And to the larger question, which I hear all the time, what does “starting from scratch” even mean when it comes to ongoing health care? You can’t seriously argue that we should risk medication interruptions so your friend loses her dad to his heart condition so we can somehow “start over?” We need a smooth transition to a more sustainable system with incentives aligned to customers and not investors in one scenario, single payer in another, or some other working idea to continue to provide care while reducing the insane profits and aligning health and well being of patients, as well as the health and well being of the people providing it, with the actual service delivery again. Burning everything down could kill a lot of people. I think this position is actually not particularly compassionate.
- NoblePublius 3y ago
  Ban all health insurance. And Medicare. And Medicaid. Require all healthcare services be transparently and consistently priced in cash. Transform the IRS into an insurer of last resort by providing 100% tax credits for all medical care in excess of 8% of income. Fixed.
  - candiddevmike 3y ago
    Would you keep or get rid of EMTALA in this scenario? What would happen with medical debt? I'd hate my healthcare options to be tied to my credit score.
    - NoblePublius 3y ago
      Ending Medicare would make EMTALA obsolete
  - throw10920 3y ago
    > Ban all health insurance. Health insurance is good, as long as it remains actually insurance - that is, risk pooling. Over the past few decades, "health insurance" transformed into "healthcare subsidization" - which caused costs (and complexity, and fraud, and many other bad things) to skyrocket. Insurance should not be used for routine doctor visits - it should literally be "insurance" against catastrophic events like getting your spine broken. The combination between pricing that is completely invisible to the buyer (which you mentioned) and "insurance" that is really just spreading costs around (instead of risk pooling) is one of the biggest reasons why healthcare is so expensive. If the price for a CPAP machine was as transparent as that of an iPhone, and you had to pay 100% out-of-pocket (because sleep apnea is not a catastrophic event and your insurance wouldn't cover it), then we'd very quickly see the prices of CPAP machines plummet (as well as every other piece of medical equipment and procedure) because of how price-sensitive consumers are, and because now they'd have the ability to use that price-sensitivity.
ants_everywhere 3y ago
Obligatory Gall's law > A complex system that works is invariably found to have evolved from a simple system that worked. A complex system designed from scratch never works

That's lie rewriting a code base from scratch because the current is deemed unmaintainable. Most of the time you end up with the same number, but different problems or it's even worse. In my view Medicare for all would be a viable path but even the Democrats are not interested in tackling healthcare.

terr-dav 3y ago
Let's refactor it then: The government simply takes ownership of UHC and they get a new charter to run it like the Postal Service.
- kelseyfrog 3y ago
  Curious, how at this point could BigGov make UHC worse?
- thallium205 3y ago
  My mailman refuses to take my stamped envelopes out of my mailbox. Can't be bothered.
  - ascagnel_ 3y ago
    I’ve lived at my current address for about five years. The first year, zero issues. Starting at around the 2020 election, service dropped off precipitously, to the point where I’ve had a piece of outgoing mail in my box since Friday. I can’t trust the mail with anything time sensitive any longer. I blame this on Louis DeJoy, who was appointed Postmaster General in May 2020, and has numerous conflicts of interest.
    - rqtwteye 3y ago
      It’s hard to make government services efficient when you have people in power who want to prove that government services are always bad.
      - throw10920 3y ago
        The DMVs in many states have been inefficient for decades. As has the VA. Most inefficiency is completely non-partisan.
  - vanattab 3y ago
    Count your self lucky he is not stealing your packages.
sjwhevvvvvsj 3y ago
At this point I’m open to new and exciting problems, whatever they may be. Hell, I’d be ok with leeches making a comeback if it meant I didn’t have to pay a copay on top of a premium.
AgentOrange1234 3y ago
A code base doesn’t have tons of middlemen taking their cut. The current system is unsalvageable. Massive disruption is needed.
diob 3y ago
Honesty at this point I'm planning to move to a country with sane healthcare sooner rather than later.

lostlogin 3y ago

> quicker to start from scratch How would you even do that? You need nurses and doctors and buildings and training. The lead time is decades and the cost incredible. Best start now guess.

greenavocado 3y ago
Imagine a time before health insurance existed
- lostlogin 3y ago
  I’ve lived in a situation close to that. Sadly it’s changing fast here in New Zealand.
- DANmode 3y ago
  More doctors, less work per day per doctor, more attention to each patient?

happytiger 3y ago

What evidence do you have that this would be a good thing? And to the larger question, which I hear all the time, what does “starting from scratch” even mean when it comes to ongoing health care? You can’t seriously argue that we should risk medication interruptions so your friend loses her dad to his heart condition so we can somehow “start over?” We need a smooth transition to a more sustainable system with incentives aligned to customers and not investors in one scenario, single payer in another, or some other working idea to continue to provide care while reducing the insane profits and aligning health and well being of patients, as well as the health and well being of the people providing it, with the actual service delivery again. Burning everything down could kill a lot of people. I think this position is actually not particularly compassionate.

NoblePublius 3y ago
Ban all health insurance. And Medicare. And Medicaid. Require all healthcare services be transparently and consistently priced in cash. Transform the IRS into an insurer of last resort by providing 100% tax credits for all medical care in excess of 8% of income. Fixed.
- candiddevmike 3y ago
  Would you keep or get rid of EMTALA in this scenario? What would happen with medical debt? I'd hate my healthcare options to be tied to my credit score.
  - NoblePublius 3y ago
    Ending Medicare would make EMTALA obsolete
- throw10920 3y ago
  > Ban all health insurance. Health insurance is good, as long as it remains actually insurance - that is, risk pooling. Over the past few decades, "health insurance" transformed into "healthcare subsidization" - which caused costs (and complexity, and fraud, and many other bad things) to skyrocket. Insurance should not be used for routine doctor visits - it should literally be "insurance" against catastrophic events like getting your spine broken. The combination between pricing that is completely invisible to the buyer (which you mentioned) and "insurance" that is really just spreading costs around (instead of risk pooling) is one of the biggest reasons why healthcare is so expensive. If the price for a CPAP machine was as transparent as that of an iPhone, and you had to pay 100% out-of-pocket (because sleep apnea is not a catastrophic event and your insurance wouldn't cover it), then we'd very quickly see the prices of CPAP machines plummet (as well as every other piece of medical equipment and procedure) because of how price-sensitive consumers are, and because now they'd have the ability to use that price-sensitivity.

ants_everywhere 3y ago

Obligatory Gall's law > A complex system that works is invariably found to have evolved from a simple system that worked. A complex system designed from scratch never works