5 ms·

The actual cost to treat "cancer or whatever" is extremely high in many cases. 15k a year to know you have that covered for a family isn't so bad given the true

The actual cost to treat "cancer or whatever" is extremely high in many cases. 15k a year to know you have that covered for a family isn't so bad given the true underlying cost. A family member has a rare disease and I've gone through the details of the various treatments, how many people are involved in ongoing care and treatment etc. It's a lot of very well trained people spending a lot of time. A concrete treatment example - the process to create some blood plasma treatments is very complex, expensive etc. In the end, it will be millions of dollars of real underlying costs. There is probably no cheap solution. Maybe GLP-1 type magic can put a real dent in the overall cost, but there will always be a desire to save people's lives even if the cost is very high.

rayiner 11mo ago
> but there will always be a desire to save people's lives even if the cost is very high. Also, Americans place extraordinarily high value on life. My wife's grandmother had cancer in her 60s and had a quarter of her lung removed. She then had a stroke in her late 80s. She was in rural Oregon, and they evacuated her via helicopter to Portland. They wanted to give her an aggressive treatment, but she refused, and passed away a couple of days later, having lived a full and complete life. She didn't have special health insurance or money saved up--she was a waitress before retiring, and had Medicare. I took my dad (who is also on Medicare) to the ER three times in the last couple of months. There was nothing serious--his blood pressure was rather high and he got scared. Here in exurban Maryland, the hospitals aren't that busy. He got a non-emergency CT scan/MRI (I forget which) scheduled within a day, and an outpatient procedure to insert a stent in a kidney artery within two weeks. When the surgeon got in there with some pre-surgery diagnostics, he realized the kidney artery was fine and didn't insert the stent. My parents were upper middle class, but there's no way they paid enough into Medicare to cover the amount of medical care they've used just since retiring (last 5 years or so).
- actionfromafar 11mo ago
  +1 The whole system is setup to maximise the "care" whenever possible. IMHO it would be better with a universal healthcare that asked itself some tough questions. Start from a pile of money and calculate maximum impact backwards from there. But maybe that's impossible for the US. (It's satanic and/or communist or something.)
  - rayiner 11mo ago
    I like universal healthcare in principle, but I don't think the funding mechanism is the problem. We see the same cost inflation in the U.S. in sectors that everyone agrees should be publicly funded, like community colleges or transit. U.S. public spending on tertiary education is about 0.95% of GDP, which is higher than the U.K. (0.5%), Ireland (0.57%), Italy (0.62%), Australia (0.68%), and not that much lower than Germany (1.1%): https://www.oecd.org/en/data/indicators/public-spending-on-education.html https://www.oecd.org/en/data/indicators/public-spending-on-e.... Most of those countries have what Americans would call "free college," but we spend just as much as a percentage of GDP--and more in absolute terms--without college being free. Our colleges simply spend way more money than European colleges. I grew up in Virginia, where George Mason University (GMU) is the second tier public school (behind UVA, William & Mary, and JMU). It's got a budget of $1.4 billion for about 40,000 students. Compare that to Heidelberg University, which I understand is a renowned university in Germany. Excluding the medical school (which GMU doesn't have), the budget is about 629 million euros, or about $725 million, for about 30,000 students. GMU, which is not a world-famous university, spends almost twice as much money for only 1/3 more students.
    - actionfromafar 11mo ago
      It's not the funding mechanism exactly, that matters I think. But that there's no single entity which looks at the whole pot of money and allocates according to best health for the population.
      - danielmarkbruce 11mo ago
        The idea that some entity will make a good decision is almost certainly wrong.
        actionfromafar 11mo ago
        The idea that such a system will at least be less horrible has legs though. Gestures in the general direction of Europe
- nozzlegear 11mo ago
  > My parents were upper middle class, but there's no way they paid enough into Medicare to cover the amount of medical care they've used just since retiring (last 5 years or so). It's a common misconception that the money we all pay into Medicare is going into a generational savings account, so we all need to "pull our weight" to make sure there's enough in there by the time we start withdrawing from it. Medicare is a pay-as-you-go system though – the money we pay into Medicare is being used by the people who are on Medicare right now, and when we're old enough to be using Medicare, it will be paid by the taxes of the young people who are working at that time. Your parents shouldn't feel guilty for using more of the Medicare resources than they feel they paid in. That money was used up years ago by people who needed it back then.
  - danielmarkbruce 11mo ago
    I don't think the post was about guilt. It was about math.
- danielmarkbruce 11mo ago
  Agree. As a society we probably need to accept that saving someones life when they are 80 maybe isn't worth $5 million or whatever. We have to map back to person hours and realize that it just doesn't add up in many cases.
- _DeadFred_ 11mo ago
  We were SPECIFICALLY told this system could do this, that unlike socialized healthcare, it doesn't have 'death panels' (I believe the term the politicians used).
  - deleted 11mo ago
    [deleted]

rayiner 11mo ago

> but there will always be a desire to save people's lives even if the cost is very high. Also, Americans place extraordinarily high value on life. My wife's grandmother had cancer in her 60s and had a quarter of her lung removed. She then had a stroke in her late 80s. She was in rural Oregon, and they evacuated her via helicopter to Portland. They wanted to give her an aggressive treatment, but she refused, and passed away a couple of days later, having lived a full and complete life. She didn't have special health insurance or money saved up--she was a waitress before retiring, and had Medicare. I took my dad (who is also on Medicare) to the ER three times in the last couple of months. There was nothing serious--his blood pressure was rather high and he got scared. Here in exurban Maryland, the hospitals aren't that busy. He got a non-emergency CT scan/MRI (I forget which) scheduled within a day, and an outpatient procedure to insert a stent in a kidney artery within two weeks. When the surgeon got in there with some pre-surgery diagnostics, he realized the kidney artery was fine and didn't insert the stent. My parents were upper middle class, but there's no way they paid enough into Medicare to cover the amount of medical care they've used just since retiring (last 5 years or so).

actionfromafar 11mo ago
+1 The whole system is setup to maximise the "care" whenever possible. IMHO it would be better with a universal healthcare that asked itself some tough questions. Start from a pile of money and calculate maximum impact backwards from there. But maybe that's impossible for the US. (It's satanic and/or communist or something.)
- rayiner 11mo ago
  I like universal healthcare in principle, but I don't think the funding mechanism is the problem. We see the same cost inflation in the U.S. in sectors that everyone agrees should be publicly funded, like community colleges or transit. U.S. public spending on tertiary education is about 0.95% of GDP, which is higher than the U.K. (0.5%), Ireland (0.57%), Italy (0.62%), Australia (0.68%), and not that much lower than Germany (1.1%): https://www.oecd.org/en/data/indicators/public-spending-on-education.html https://www.oecd.org/en/data/indicators/public-spending-on-e.... Most of those countries have what Americans would call "free college," but we spend just as much as a percentage of GDP--and more in absolute terms--without college being free. Our colleges simply spend way more money than European colleges. I grew up in Virginia, where George Mason University (GMU) is the second tier public school (behind UVA, William & Mary, and JMU). It's got a budget of $1.4 billion for about 40,000 students. Compare that to Heidelberg University, which I understand is a renowned university in Germany. Excluding the medical school (which GMU doesn't have), the budget is about 629 million euros, or about $725 million, for about 30,000 students. GMU, which is not a world-famous university, spends almost twice as much money for only 1/3 more students.
  - actionfromafar 11mo ago
    It's not the funding mechanism exactly, that matters I think. But that there's no single entity which looks at the whole pot of money and allocates according to best health for the population.
    - danielmarkbruce 11mo ago
      The idea that some entity will make a good decision is almost certainly wrong.
      - actionfromafar 11mo ago
        The idea that such a system will at least be less horrible has legs though. Gestures in the general direction of Europe
nozzlegear 11mo ago
> My parents were upper middle class, but there's no way they paid enough into Medicare to cover the amount of medical care they've used just since retiring (last 5 years or so). It's a common misconception that the money we all pay into Medicare is going into a generational savings account, so we all need to "pull our weight" to make sure there's enough in there by the time we start withdrawing from it. Medicare is a pay-as-you-go system though – the money we pay into Medicare is being used by the people who are on Medicare right now, and when we're old enough to be using Medicare, it will be paid by the taxes of the young people who are working at that time. Your parents shouldn't feel guilty for using more of the Medicare resources than they feel they paid in. That money was used up years ago by people who needed it back then.
- danielmarkbruce 11mo ago
  I don't think the post was about guilt. It was about math.
danielmarkbruce 11mo ago
Agree. As a society we probably need to accept that saving someones life when they are 80 maybe isn't worth $5 million or whatever. We have to map back to person hours and realize that it just doesn't add up in many cases.
_DeadFred_ 11mo ago
We were SPECIFICALLY told this system could do this, that unlike socialized healthcare, it doesn't have 'death panels' (I believe the term the politicians used).
- deleted 11mo ago
  [deleted]