4 ms·

> What I can't get is that so many people get so angry at the idea that poor people, or at least poor people younger than 65, could have access to health care i

> What I can't get is that so many people get so angry at the idea that poor people, or at least poor people younger than 65, could have access to health care in the US. That's a pretty glib dismissal for real pain. Before Obamacare, in the nearest major city I could make an appointment with a gastroenterologist on a Thursday and see him on the following Tuesday. Now it is over six months for an appointment, and then for every subsequent appointment ... to see a nurse, not a doctor. There used to be five doctors in my rural county, now there are zero. While insurance premiums have skyrocketed. From my point of view healthcare has crumped. You then summarize my dismay as anger at the idea of poor people getting access to healthcare, like what else could it be other than class bigotry?

PaulHoule 1y ago
So what you're saying is that the services are oversubscribed and if more people have access to them than you won't have access to them?
- gsf_emergency_2 1y ago
  After steeping in Fischel's tract on the proximate cause of housing inflation (linked to from Klein).. I gather that the main (meta-)issue, as you are kind of insinuating here, is that, for healthcare, there is a conflation of inflationary and deflationary processes.. (Sorry to go on what might seem to be a reductive tangent here, as I often do when pressed. I have further takes on Klein vs Shapiro for later) My roughshod framing of (one) solution is that there has to be sustained deflationary pockets in a mildly inflationary phase Probably mirrored by such proposals for housing as https://devonzuegel.com/for-the-greater-good-the-game-theory-of-zoning https://devonzuegel.com/for-the-greater-good-the-game-theory...
  - PaulHoule 1y ago
    There are lotsa issues in healthcare, not least that the medical association practices "birth control" for doctors. Plus the residency process to get board certified is absolutely grueling [1], I knew more than one doc who quit when they got their MD and got into startup land because it's an easier life! It does seem that, against all odds, Obamacare really did "bend the cost curve" and slow down the growth in health care costs. After a rough patch decade or so when we didn't get new "blockbuster" drugs we are now getting drugs like Wegovy and Cobenfy which cost a lot but promise savings elsewhere. [1] that said, a doctor really should know what to do when somebody with a rare condition that they'll only see once in their career and working a 996 schedule at a university medical center does give the experience for that.
    - gsf_emergency_2 1y ago
      Right, this take would be "zoning rules for MDs" with the caveat that healthcare outside of pharm can never be as uh industrialized as construction. Things seem to get muddled with global pipelines (your breakthru drugs come from Nordic R&D) but I'd argue that therein (Obamacare-type bipartisan stewardship) lies the real argument for a "inputs-first" post-fossil Abundance
      - gsf_emergency_2 1y ago
        *Danish R&D; Swedish R&D lives for the friggin' optics On the downside, claiming to speak for all of Nordica is quite a Danish thing to do
    - gsf_emergency_2 1y ago
      Forgot to mention that Denmark of TFA is today (culturally*, already) much more socialist than Sweden-- if you are open to that transient but indeed ontopic (state-driven) Nordisk connection *https://en.wikipedia.org/wiki/Freetown_Christiania#Culture https://en.wikipedia.org/wiki/Freetown_Christiania#Culture would be considered uh unglamorous in Sweden
kevinfiol 1y ago
On the flip-side, before Obamacare, my parents had a hell of a time finding an insurance that would accept us because of my pre-existing condition (childhood cancer). Definitely had its tradeoffs.

PaulHoule 1y ago

So what you're saying is that the services are oversubscribed and if more people have access to them than you won't have access to them?

gsf_emergency_2 1y ago
After steeping in Fischel's tract on the proximate cause of housing inflation (linked to from Klein).. I gather that the main (meta-)issue, as you are kind of insinuating here, is that, for healthcare, there is a conflation of inflationary and deflationary processes.. (Sorry to go on what might seem to be a reductive tangent here, as I often do when pressed. I have further takes on Klein vs Shapiro for later) My roughshod framing of (one) solution is that there has to be sustained deflationary pockets in a mildly inflationary phase Probably mirrored by such proposals for housing as https://devonzuegel.com/for-the-greater-good-the-game-theory-of-zoning https://devonzuegel.com/for-the-greater-good-the-game-theory...
- PaulHoule 1y ago
  There are lotsa issues in healthcare, not least that the medical association practices "birth control" for doctors. Plus the residency process to get board certified is absolutely grueling [1], I knew more than one doc who quit when they got their MD and got into startup land because it's an easier life! It does seem that, against all odds, Obamacare really did "bend the cost curve" and slow down the growth in health care costs. After a rough patch decade or so when we didn't get new "blockbuster" drugs we are now getting drugs like Wegovy and Cobenfy which cost a lot but promise savings elsewhere. [1] that said, a doctor really should know what to do when somebody with a rare condition that they'll only see once in their career and working a 996 schedule at a university medical center does give the experience for that.
  - gsf_emergency_2 1y ago
    Right, this take would be "zoning rules for MDs" with the caveat that healthcare outside of pharm can never be as uh industrialized as construction. Things seem to get muddled with global pipelines (your breakthru drugs come from Nordic R&D) but I'd argue that therein (Obamacare-type bipartisan stewardship) lies the real argument for a "inputs-first" post-fossil Abundance
    - gsf_emergency_2 1y ago
      *Danish R&D; Swedish R&D lives for the friggin' optics On the downside, claiming to speak for all of Nordica is quite a Danish thing to do
  - gsf_emergency_2 1y ago
    Forgot to mention that Denmark of TFA is today (culturally*, already) much more socialist than Sweden-- if you are open to that transient but indeed ontopic (state-driven) Nordisk connection *https://en.wikipedia.org/wiki/Freetown_Christiania#Culture https://en.wikipedia.org/wiki/Freetown_Christiania#Culture would be considered uh unglamorous in Sweden

kevinfiol 1y ago

On the flip-side, before Obamacare, my parents had a hell of a time finding an insurance that would accept us because of my pre-existing condition (childhood cancer). Definitely had its tradeoffs.