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This is really detached from reality in the USA. In USA, health care is not important. Insurance companies decide which treatments should be given to patients,

This is really detached from reality in the USA. In USA, health care is not important. Insurance companies decide which treatments should be given to patients, not doctors. There should theoretically be incentive to pretend to care about people and keep them alive, but no one has time to pretend. One way to break the cycle killing everyone is to remove "health" insurance companies from the system.

s1artibartfast 2y ago
That is more of a politically driven position than a rational one. Healthcare is important in the US. We spend more on it than any other country on the planet. There are tons of European countries that have highly functional Healthcare and private insurance.
billy99k 2y ago
"insurance companies decide which treatments should be given to patients, not doctors" In counties that have universal health-care, the government gets to decide which treatments are given to patients. "One way to break the cycle killing everyone is to remove "health" insurance companies from the system." I agree with you here. We should only have insurance for surgeries that won't benefit from competition (IE: are really expensive and don't happen that often). The rest should be paid for directly without insurance. This would reduce the cost quickly, as doctors and hospitals need to get paid and remove the middleman inflating all of our prices. Lasik eye surgery is a good example of this working in practice. It's not covered by most health insurance and was $50,000 a decade ago. It's now less than $3000 now.
- whoitwas 2y ago
  Doctors and patients should dictate health care, not a third party. Insurance obviously creates misaligned demand at least as consumer and doctor's demand is ignored. Being from the US, anything would be better as it's impossible to get health care here as the system is centered around insurance.
  - jghn 2y ago
    > Doctors and patients should dictate health care, not a third party. Sort of. As long as other people are helping to shoulder the bill: via US style health insurance, single payer, universal health care, etc then there needs to be a cost/benefit consideration based on population scale data. Example: There's a treatment for Condition X where the data show a 0.001% chance of benefit and costs $50 million dollars to provide. It'd be absurd to suggest that a single patient & their doctor should be making that choice, unless the patient is the one footing the entire bill. So then the trick is to determine where to draw the cost/benefit threshold and then to determine which treatments generally do vs do not meet those thresholds.
- Tade0 2y ago
  > It's not covered by most health insurance and was $50,000 a decade ago. Is there a specific type of this procedure that was this expensive? I ask because over here in Europe a friend of mine had lasik done for the equivalent of $600 per eye over a decade ago. Nowadays it's like $1000 per eye.
  - hulitu 2y ago
    > Is there a specific type of this procedure that was this expensive? As far as i know LASERs were expensive. Powerful, movable ones, more so. And those where you could modulate the intensity were also more expensive.
red-iron-pine 2y ago
pull up the list of Fortune 500 (and Global F500) companies. look at how many of them are healthcare related (answer: a lot, including many of the top 10). and then ask yourself if the US will ever be able to remove them from the system.
snikeris 2y ago
Hmm, I think it’s more like Medicare / Medicaid decides these matters, and the rest of the system is shaped around these programs. People with insurance have the worst of both worlds: they get socialized quality medicine but still have to pay for it.

s1artibartfast 2y ago

That is more of a politically driven position than a rational one. Healthcare is important in the US. We spend more on it than any other country on the planet. There are tons of European countries that have highly functional Healthcare and private insurance.

billy99k 2y ago

"insurance companies decide which treatments should be given to patients, not doctors" In counties that have universal health-care, the government gets to decide which treatments are given to patients. "One way to break the cycle killing everyone is to remove "health" insurance companies from the system." I agree with you here. We should only have insurance for surgeries that won't benefit from competition (IE: are really expensive and don't happen that often). The rest should be paid for directly without insurance. This would reduce the cost quickly, as doctors and hospitals need to get paid and remove the middleman inflating all of our prices. Lasik eye surgery is a good example of this working in practice. It's not covered by most health insurance and was $50,000 a decade ago. It's now less than $3000 now.

whoitwas 2y ago
Doctors and patients should dictate health care, not a third party. Insurance obviously creates misaligned demand at least as consumer and doctor's demand is ignored. Being from the US, anything would be better as it's impossible to get health care here as the system is centered around insurance.
- jghn 2y ago
  > Doctors and patients should dictate health care, not a third party. Sort of. As long as other people are helping to shoulder the bill: via US style health insurance, single payer, universal health care, etc then there needs to be a cost/benefit consideration based on population scale data. Example: There's a treatment for Condition X where the data show a 0.001% chance of benefit and costs $50 million dollars to provide. It'd be absurd to suggest that a single patient & their doctor should be making that choice, unless the patient is the one footing the entire bill. So then the trick is to determine where to draw the cost/benefit threshold and then to determine which treatments generally do vs do not meet those thresholds.
Tade0 2y ago
> It's not covered by most health insurance and was $50,000 a decade ago. Is there a specific type of this procedure that was this expensive? I ask because over here in Europe a friend of mine had lasik done for the equivalent of $600 per eye over a decade ago. Nowadays it's like $1000 per eye.
- hulitu 2y ago
  > Is there a specific type of this procedure that was this expensive? As far as i know LASERs were expensive. Powerful, movable ones, more so. And those where you could modulate the intensity were also more expensive.

red-iron-pine 2y ago

pull up the list of Fortune 500 (and Global F500) companies. look at how many of them are healthcare related (answer: a lot, including many of the top 10). and then ask yourself if the US will ever be able to remove them from the system.

snikeris 2y ago

Hmm, I think it’s more like Medicare / Medicaid decides these matters, and the rest of the system is shaped around these programs. People with insurance have the worst of both worlds: they get socialized quality medicine but still have to pay for it.