4 ms·

Article is paywalled but the healthcare system is death by a thousand cuts, there's no one boogeyman to blame, it's a very classic tragedy of the commons. Anyon

Article is paywalled but the healthcare system is death by a thousand cuts, there's no one boogeyman to blame, it's a very classic tragedy of the commons. Anyone claiming they've found the root cause of the broken healthcare system is selling you a bill of goods.

bookofjoe 2y ago
Try this: https://www.wsj.com/health/healthcare/you-can-thank-private-equity-for-that-enormous-doctors-bill-3a2fc90b?st=0kgfqua8mo3pui4&reflink=desktopwebshare_permalink https://www.wsj.com/health/healthcare/you-can-thank-private-...
llamaimperative 2y ago
True but “there’s no one boogeyman to blame” should read as “there are many, many boogeymen, all of whom bear blame, and all of whom need to corrected/removed/circumvented/improved.”
- Galatians4_16 2y ago
  If only we could take our money elsewhere, but we are mandated to pay with insurance, which makes them the defacto customer, to decide with the doctors, cutting us out of the process (which is handy under circumstances where the patient can't talk; There's a use case for everything, but coercion and blanket enforcement seems to ruin everything)
  - bluGill 2y ago
    We can't even choose our insurance - it comes from your employer with no choice (or no real choice - I have two slightly different choices from United Health Care). All the negotiation on how it works is done by HR not me, and HR likes the current rules as it makes it hard for me to leave. In theory I can bypass my employer insurance - but if I do I throw away thousands of dollars that my employer is paying directly and so anything I find elsewhere either cannot be as good, or is has to cost a lot more money.
    - tracker1 2y ago
      Even then, good luck... I couldn't find a personal plan either the Health gov compliant plans or out of pocket that matched my employer insurance... I'm pretty sure if I try again, I'll wind up creating a company again, using one of the HR based collective payroll options just for better Insurance options. The system sucks a lot, and for a lot of different reasons. Namely is that there's no room for individual negotiation, and there are dozens of pricing models for the same drugs, procedures, etc.
- ToucanLoucan 2y ago
  We don't do that in America. We pick whichever boogeymen are more scary to our given political team and make that the only cause while arguing back and forth and not actually doing anything while we all get robbed fucking blind and pay our politicians six figure salaries for doing fuck-all. I fucking hate it here.
  - llamaimperative 2y ago
    Not really. The current administration has been going after healthcare on several fronts: lots of FTC enforcement against PE in healthcare; increased number of funded medical residency slots; allowed Medicare to negotiate prices directly with drug companies; attempted to stop excessive consolidation in healthcare businesses. All of these are reasonable attempts to solve big, important problems and I don't think it's helpful to throw your hands in the air and say no one is trying to do anything.
    - ToucanLoucan 2y ago
      And the next republican president, Trump or otherwise, will undo it all on day one. We need ACTUAL SOLUTIONS. Changes to existing laws, or new laws. Consensus governance, not just executive orders.
      - llamaimperative 2y ago
        Sure, but that's not a "both sides" problem. Lay blame where blame lies.
        ToucanLoucan 2y ago
        I do. We have the Democrats who are mostly alright and well meaning, with exceptions but in practice are not capable of handling what the Republicans have become, which is theocratic-fascists. And the Republicans are filling the legislature with dipshits who scream about Jewish space-lasers and want to regress us socially to the 1920's. They both suck, one side notably more so.
DaveExeter 2y ago
The problem is health insurance! Get rid of that and most problems vanish.
- schmidtleonard 2y ago
  Providers point at insurance and drug companies. Insurance points at providers and drug companies. Drug companies point at providers and insurance. Don't let any of them fool you, there are three heads on this monster and when they aren't busy blaming the other two heads they do a remarkably even job of splitting the loot.
  - jewayne 2y ago
    This. They all benefit from the lack of price consistency/transparency. Nothing in our system has a single price - why charge what the market will bear, when you can charge the individual as much as they can personally bear, and make 3X as much?
- lenerdenator 2y ago
  A problem is that health insurance has no bare minimum to compete against. There is no saying "alright, fine, your rates are insane so I'm gonna just go with the state-operated option". That's more-or-less what happens in most Western countries; you can still get private insurance which gets you faster/better treatment, but if you're a fairly healthy person who just wants to cover their bases for a catastrophic occurrence, the state will do that for you. If the private guy wants any of your money, he has to justify it with more than "what happens if you get in a bad car accident or get a cancer diagnosis?". In the US private insurance is the only way to go, and many of them are operated by people who have profit motives, even if they themselves work for an entity that is non-profit.
  - bluGill 2y ago
    In the US private insurance from your employer is the only way to go. My company puts in a lot of money towards my health insurance that I lose if try to find someone else. I can in theory find a different private insurance but there is no competition as no private can afford to compete with deal my company has - either they have to provide substantially worse service or they have to charge substantially more than my employer. Since I don't have a real choice nobody tries to serve me. Complex billing and codes I don't understand - the people paying the bills like that.
jewayne 2y ago
I think the root cause is transparent for all to see. Humans need their bodies. And profit-maximizing entities of multiple kinds have figured this out, and bought politicians to prevent laws from reining them in. That's all.

bookofjoe 2y ago

Try this: https://www.wsj.com/health/healthcare/you-can-thank-private-equity-for-that-enormous-doctors-bill-3a2fc90b?st=0kgfqua8mo3pui4&reflink=desktopwebshare_permalink https://www.wsj.com/health/healthcare/you-can-thank-private-...

llamaimperative 2y ago

True but “there’s no one boogeyman to blame” should read as “there are many, many boogeymen, all of whom bear blame, and all of whom need to corrected/removed/circumvented/improved.”

Galatians4_16 2y ago
If only we could take our money elsewhere, but we are mandated to pay with insurance, which makes them the defacto customer, to decide with the doctors, cutting us out of the process (which is handy under circumstances where the patient can't talk; There's a use case for everything, but coercion and blanket enforcement seems to ruin everything)
- bluGill 2y ago
  We can't even choose our insurance - it comes from your employer with no choice (or no real choice - I have two slightly different choices from United Health Care). All the negotiation on how it works is done by HR not me, and HR likes the current rules as it makes it hard for me to leave. In theory I can bypass my employer insurance - but if I do I throw away thousands of dollars that my employer is paying directly and so anything I find elsewhere either cannot be as good, or is has to cost a lot more money.
  - tracker1 2y ago
    Even then, good luck... I couldn't find a personal plan either the Health gov compliant plans or out of pocket that matched my employer insurance... I'm pretty sure if I try again, I'll wind up creating a company again, using one of the HR based collective payroll options just for better Insurance options. The system sucks a lot, and for a lot of different reasons. Namely is that there's no room for individual negotiation, and there are dozens of pricing models for the same drugs, procedures, etc.
ToucanLoucan 2y ago
We don't do that in America. We pick whichever boogeymen are more scary to our given political team and make that the only cause while arguing back and forth and not actually doing anything while we all get robbed fucking blind and pay our politicians six figure salaries for doing fuck-all. I fucking hate it here.
- llamaimperative 2y ago
  Not really. The current administration has been going after healthcare on several fronts: lots of FTC enforcement against PE in healthcare; increased number of funded medical residency slots; allowed Medicare to negotiate prices directly with drug companies; attempted to stop excessive consolidation in healthcare businesses. All of these are reasonable attempts to solve big, important problems and I don't think it's helpful to throw your hands in the air and say no one is trying to do anything.
  - ToucanLoucan 2y ago
    And the next republican president, Trump or otherwise, will undo it all on day one. We need ACTUAL SOLUTIONS. Changes to existing laws, or new laws. Consensus governance, not just executive orders.
    - llamaimperative 2y ago
      Sure, but that's not a "both sides" problem. Lay blame where blame lies.
      - ToucanLoucan 2y ago
        I do. We have the Democrats who are mostly alright and well meaning, with exceptions but in practice are not capable of handling what the Republicans have become, which is theocratic-fascists. And the Republicans are filling the legislature with dipshits who scream about Jewish space-lasers and want to regress us socially to the 1920's. They both suck, one side notably more so.

DaveExeter 2y ago

The problem is health insurance! Get rid of that and most problems vanish.

schmidtleonard 2y ago
Providers point at insurance and drug companies. Insurance points at providers and drug companies. Drug companies point at providers and insurance. Don't let any of them fool you, there are three heads on this monster and when they aren't busy blaming the other two heads they do a remarkably even job of splitting the loot.
- jewayne 2y ago
  This. They all benefit from the lack of price consistency/transparency. Nothing in our system has a single price - why charge what the market will bear, when you can charge the individual as much as they can personally bear, and make 3X as much?
lenerdenator 2y ago
A problem is that health insurance has no bare minimum to compete against. There is no saying "alright, fine, your rates are insane so I'm gonna just go with the state-operated option". That's more-or-less what happens in most Western countries; you can still get private insurance which gets you faster/better treatment, but if you're a fairly healthy person who just wants to cover their bases for a catastrophic occurrence, the state will do that for you. If the private guy wants any of your money, he has to justify it with more than "what happens if you get in a bad car accident or get a cancer diagnosis?". In the US private insurance is the only way to go, and many of them are operated by people who have profit motives, even if they themselves work for an entity that is non-profit.
- bluGill 2y ago
  In the US private insurance from your employer is the only way to go. My company puts in a lot of money towards my health insurance that I lose if try to find someone else. I can in theory find a different private insurance but there is no competition as no private can afford to compete with deal my company has - either they have to provide substantially worse service or they have to charge substantially more than my employer. Since I don't have a real choice nobody tries to serve me. Complex billing and codes I don't understand - the people paying the bills like that.

jewayne 2y ago

I think the root cause is transparent for all to see. Humans need their bodies. And profit-maximizing entities of multiple kinds have figured this out, and bought politicians to prevent laws from reining them in. That's all.