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>> the very simple solution of universal healthcare Umm no. Even if we force insurers to be nonprofit there are still huge problems. Treatments can cost arbitr

>> the very simple solution of universal healthcare Umm no. Even if we force insurers to be nonprofit there are still huge problems. Treatments can cost arbitrarily much - even in labor costs, so there will always be a limit to what can be covered. "Patients" will still use excessive amounts of service. Doctors will suggest extra tests so long as they are covered. Referral bonuses will happen behind the scenes. Price gouging is ongoing. Universal care only addresses a little of the problem, and eliminates some of the checks on others. I don't have a solution, but just wanted to refute the idea that there is a simple one. One thing I speculate is that elimination of insurance entirely might be good in some ways. Along those lines, only catastrophic things should be covered. Passing reasonable costs on to patients directly will put downward pressure on costs while also eliminating middle men. But that has downsides too.

jimbob45 2y ago
I don't have a solution, but just wanted to refute the idea that there is a simple one. Having a public insurance option to put downward pressure on existing insurance carriers was the most sensible strategy. Both Republicans and Democrats were on board too but exactly one Democrat torpedoed that idea…
IgorPartola 2y ago
I mean literally every other developed nation has a solution: universal healthcare. Some have far better healthcare systems than the US too. So saying that this is an unsolved and possible unsolvable problem is clearly disingenuous. Now, the process of transitioning to universal healthcare for such a large system is something that is likely unprecedented. But that’s not what you are talking about.
- Mountain_Skies 2y ago
  When you actually look into the details, you'll find that "universal healthcare" doesn't have a universal definition and there are incredible numbers of negative outcomes in other developed nations. People from every developed nation will complain about how much their health system sucks as long as there isn't an American in the room. Reality and Reddit are rarely the same thing.
  - IgorPartola 2y ago
    Oh I have been waiting for you! Thank you for this comment, now let’s see every single thing that’s wrong with it: First let’s break down why your argument of “people complain when Americans aren’t in the room” followed by “Reality and Reddit are rarely the same thing” is ironically flawed. The number of people unhappy with any given system is measurable. That number is not proportional to the number of complaints about said system. For example if you have 100 people, and 20 of them are unhappy but 3 will talk to everyone of the 100 about how unhappy they are the number of complaints will be 100. See how the math doesn’t math? And whether people complain on Reddit or “in a room” doesn’t matter here. Lastly, “incredible numbers” is an amazing summation of what you are saying here. You are right, they are not credible. Now that we got that out of the way, let’s look at what does matter: metrics. With so many people, so many cases, so much money the law of averages lets us make conclusions about which system on average does better. There are two metrics I can think of: cost and outcomes. You can’t of course optimize for two variables at once: what if for nearly infinite cost you could have perfect outcomes? But let’s look anyways and see if we can spot a pattern. First, outcomes: https://en.m.wikipedia.org/wiki/List_of_countries_by_quality_of_healthcare https://en.m.wikipedia.org/wiki/List_of_countries_by_quality... Notice that on any of these charts the US is not number 1. It is number 2 for one of them but the rest are far worse, including 31 out of 45 for cervical cancer! OK so maybe we don’t have great healthcare but perhaps it is just so efficient because it’s so affordable. But you already know the answer to this: https://en.m.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita https://en.m.wikipedia.org/wiki/List_of_countries_by_total_h... Go to that link, sort in descending order and see how the US has total per capita spending at 50% higher in 2022 than the next most expensive country (Switzerland). The WHO estimate isn’t quite as dramatic but it still is a huge jump from Switzerland (you’ll need to look at 2021 since more recent data isn’t available). In other words countries that objectively beat the US in outcomes ALL have cheaper per capita healthcare than the US. You cannot argue that because you have heard people complain that it means other systems are worse. But I can argue that given this data the US clearly is doing something very wrong. It pretends like the solution doesn’t exist and when the people point to the 30 countries that beat us at things like cervical cancer at a half to a third of the cost while also providing the peace of mind that you won’t go bankrupt due to medical bills, our politicians stuff dollar bills they got from insurance company lobbyists into their ears and keep yelling “la la la we are the greatest country in the world”. Thank you for coming to my TED talk on my particular area of interest. Enjoy the rest of your evening.

jimbob45 2y ago

I don't have a solution, but just wanted to refute the idea that there is a simple one. Having a public insurance option to put downward pressure on existing insurance carriers was the most sensible strategy. Both Republicans and Democrats were on board too but exactly one Democrat torpedoed that idea…

IgorPartola 2y ago

I mean literally every other developed nation has a solution: universal healthcare. Some have far better healthcare systems than the US too. So saying that this is an unsolved and possible unsolvable problem is clearly disingenuous. Now, the process of transitioning to universal healthcare for such a large system is something that is likely unprecedented. But that’s not what you are talking about.

Mountain_Skies 2y ago
When you actually look into the details, you'll find that "universal healthcare" doesn't have a universal definition and there are incredible numbers of negative outcomes in other developed nations. People from every developed nation will complain about how much their health system sucks as long as there isn't an American in the room. Reality and Reddit are rarely the same thing.
- IgorPartola 2y ago
  Oh I have been waiting for you! Thank you for this comment, now let’s see every single thing that’s wrong with it: First let’s break down why your argument of “people complain when Americans aren’t in the room” followed by “Reality and Reddit are rarely the same thing” is ironically flawed. The number of people unhappy with any given system is measurable. That number is not proportional to the number of complaints about said system. For example if you have 100 people, and 20 of them are unhappy but 3 will talk to everyone of the 100 about how unhappy they are the number of complaints will be 100. See how the math doesn’t math? And whether people complain on Reddit or “in a room” doesn’t matter here. Lastly, “incredible numbers” is an amazing summation of what you are saying here. You are right, they are not credible. Now that we got that out of the way, let’s look at what does matter: metrics. With so many people, so many cases, so much money the law of averages lets us make conclusions about which system on average does better. There are two metrics I can think of: cost and outcomes. You can’t of course optimize for two variables at once: what if for nearly infinite cost you could have perfect outcomes? But let’s look anyways and see if we can spot a pattern. First, outcomes: https://en.m.wikipedia.org/wiki/List_of_countries_by_quality_of_healthcare https://en.m.wikipedia.org/wiki/List_of_countries_by_quality... Notice that on any of these charts the US is not number 1. It is number 2 for one of them but the rest are far worse, including 31 out of 45 for cervical cancer! OK so maybe we don’t have great healthcare but perhaps it is just so efficient because it’s so affordable. But you already know the answer to this: https://en.m.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita https://en.m.wikipedia.org/wiki/List_of_countries_by_total_h... Go to that link, sort in descending order and see how the US has total per capita spending at 50% higher in 2022 than the next most expensive country (Switzerland). The WHO estimate isn’t quite as dramatic but it still is a huge jump from Switzerland (you’ll need to look at 2021 since more recent data isn’t available). In other words countries that objectively beat the US in outcomes ALL have cheaper per capita healthcare than the US. You cannot argue that because you have heard people complain that it means other systems are worse. But I can argue that given this data the US clearly is doing something very wrong. It pretends like the solution doesn’t exist and when the people point to the 30 countries that beat us at things like cervical cancer at a half to a third of the cost while also providing the peace of mind that you won’t go bankrupt due to medical bills, our politicians stuff dollar bills they got from insurance company lobbyists into their ears and keep yelling “la la la we are the greatest country in the world”. Thank you for coming to my TED talk on my particular area of interest. Enjoy the rest of your evening.