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It’s terrible that this is an area that is caught up in political ideology. Somehow, healthcare MUST be decoupled from capitalistic incentives. I don’t pretend

It’s terrible that this is an area that is caught up in political ideology. Somehow, healthcare MUST be decoupled from capitalistic incentives. I don’t pretend to have the answer but continuing on this path will lead to worsening patient outcomes. We cannot have corporations expecting to make a dollar off human life.

tiahura 1y ago
United Healthcare isn’t the reason healthcare is unaffordable any more than Geico causes car repairs to be expensive. American demand for healthcare is insatiable, and doctors are a scarce and greedy bunch. That there is a middle man trying to get his 5% isn’t the problem.
- PaulDavisThe1st 1y ago
  > any more than Geico causes car repairs to be expensive Given how much cheaper things like body shop repairs are if you do not have insurance, is it really clear that Geico does not cause car repairs to be expensive? And for that matter, get emergency health care without insurance and then fight the cost to get a massive reduction, and you'll wonder whether it actually is UHC and their ilk that help make healthcare unaffordable ...
- stephenitis 1y ago
  What is the problem breakdown by % in your eatimate?
- mystraline 1y ago
  Wrong. 'Medical insurance companies' do absolutely nothing in terms of health care, drain massive amounts of money in what amounts to a Brazil-style (movie) system, corporate death panels, and a drain on all of our resources. And its not even a product we want. We dont buy it. The companies we work for do, and never have to dogfood any of it. But for the rest of us, its a take it or leave it proposition. > doctors are a scarce and greedy bunch. Speaking of that, an MD is the ONLY profession who is solely controlled how many can apply is controlled by Congress. Get rid of that, and that would fix a facet. But getting rid of insurance companies would also work a great deal. Or at least, decoupling work/med insurance would be a start. Even going full competitive capitalism OR full socialism would be better than the garbage we have now.
- yieldcrv 1y ago
  there is a multi-pronged solution necessary that is both intertwined with insurers and also completely separate, so in that part I agree with you the costs of services are arbitrary and need to be addressed before we can realistically deal with how any insurance pool works, in the US both parties have chiseled at this over the last decade - from getting prices more transparent, to attempting to have a large scale state negotiator - and this makes the conversation more palatable in gaining consensus not close, but it's not as partisan as people think, despite the parallel existence of entrenched interests what doesn't have consensus is a forced insurance pool that doesn't address the costs and has no ability to negotiate those costs (yes, this is partially due to the bill being gutted and a handicapped version being the only thing that passed) a deeper review and regulation of costs is the only thing that can help reach consensus
- cycomanic 1y ago
  > United Healthcare isn’t the reason healthcare is unaffordable any more than Geico causes car repairs to be expensive. American demand for healthcare is insatiable, and doctors are a scarce and greedy bunch. That there is a middle man trying to get his 5% isn’t the problem. Spoken as a software developer who's salaries are approaching or even surpassing doctor salaries while working on optimising "engagement" (or how to make their app the most addictive).
  - tiahura 1y ago
    I’m a personal injury lawyer who looks at medical bills all day.
- stop50 1y ago
  I recommend you to look at Dr. Glaukomfleckens videos about pre authorization.
tormeh 1y ago
Afaict the original sin of the US healthcare system is having the healthcare providers chosen by employers. That means that the patient is not the customer, the patient's employer is. That in itself has dire consequences. Privatized health care need not be so bad. Germany has privatized health care, but it's pretty much fine, at least for patients. It's regulated to the moon and back, but afaict so is the US system, just with very different goals. The ACA feels a bit like the beginnings of a German-style system.
danans 1y ago
> Somehow, healthcare MUST be decoupled from capitalistic incentives. I don’t pretend to have the answer but continuing on this path will lead to worsening patient outcomes. We cannot have corporations expecting to make a dollar off human life. Give yourself more credit! You just stated the answer above.
wredcoll 1y ago
> We cannot have corporations expecting to make a dollar off human life. That's literally a political ideology. The answer to problems like this isn't to pretend politics is some kind of abstract system imposed by higher-order beings, its to use political power to fix it.
platevoltage 1y ago
But the answer is easy. Just look toward the North.
- shrubble 1y ago
  Canadian health care sucks but in a different way; so that’s not the solution either. You can look up the wait times for different procedures on the provincial websites. Things you can get in 72 hours anywhere near a decently sized American city such as an MRI scan can take months in Canada.
  - seanmcdirmid 1y ago
    Every developed country would say their medical system sucks in some way. We (Americans) happen to both pay more for a system that sucks more than those. The results are in our poor life expectancies, and we basically pay twice (privately and once again via taxes) for it.
  - platevoltage 1y ago
    Yeah, that same MRI scan can, and often takes an infinite amount of time here. I never said Canada's system was perfect, but it might as well be compared to what we have going on here.
kfterrg67 1y ago
I think the incentive itself is good, but there's too much corrupt abstraction in between. Ultimately I want good providers to be paid well and poor providers to struggle. That is a good system. We don't have that. We MUST recouple healthcare and capitalistic incentives.
anonym29 1y ago
Food, housing, and a living wage too. The bare necessities to live must be decoupled from capitalistic incentives.
- JumpCrisscross 1y ago
  > The bare necessities to live must be decoupled from capitalistic incentives We don’t have evidence we live in sufficient abundance to guarantee this sustainably even in rich countries. Particularly when bare necessities are decried as cruelty and so cost creep comes to pass. What we can do: free basic nutrition for all, free prenatal and neonatal care, free preventative medicine and annual check-ups, free access to generics where medically necessary, and a fixed amount of water and electricity to each household. Not enough to be remotely comfortable or long lived. But enough to survive.
  - robocat 1y ago
    So easy to say free when you're expecting others to pay. Who votes for higher taxes on themselves?
    - JumpCrisscross 1y ago
      > Who votes for higher taxes on themselves? People who don't want to have to live amidst poverty. Or vote alongside folks who are struggling. In summary, good people.
    - ben_w 1y ago
      > Who votes for higher taxes on themselves? Even if you're selfish (and a lot of people are community spirited), the same people who as shareholders vote for the company to grow rather than to pay out more dividends.
robocat 1y ago
> healthcare MUST be decoupled from capitalistic incentives Capitalism pays for our healthcare. The problem is that Healthcare has an infinite hunger for resources - there is always more that could be spent - and it is always morally correct to spend more (people's lives have high priority). There needs to be some manner of allocating limited resources between different people with different needs. Every country seems to find different ways to deal with the fundamental friction of healthcare (unlimited demand and limited resources). Unfortunately voters don't like the reality of limitations.

tiahura 1y ago

United Healthcare isn’t the reason healthcare is unaffordable any more than Geico causes car repairs to be expensive. American demand for healthcare is insatiable, and doctors are a scarce and greedy bunch. That there is a middle man trying to get his 5% isn’t the problem.

PaulDavisThe1st 1y ago
> any more than Geico causes car repairs to be expensive Given how much cheaper things like body shop repairs are if you do not have insurance, is it really clear that Geico does not cause car repairs to be expensive? And for that matter, get emergency health care without insurance and then fight the cost to get a massive reduction, and you'll wonder whether it actually is UHC and their ilk that help make healthcare unaffordable ...
stephenitis 1y ago
What is the problem breakdown by % in your eatimate?
mystraline 1y ago
Wrong. 'Medical insurance companies' do absolutely nothing in terms of health care, drain massive amounts of money in what amounts to a Brazil-style (movie) system, corporate death panels, and a drain on all of our resources. And its not even a product we want. We dont buy it. The companies we work for do, and never have to dogfood any of it. But for the rest of us, its a take it or leave it proposition. > doctors are a scarce and greedy bunch. Speaking of that, an MD is the ONLY profession who is solely controlled how many can apply is controlled by Congress. Get rid of that, and that would fix a facet. But getting rid of insurance companies would also work a great deal. Or at least, decoupling work/med insurance would be a start. Even going full competitive capitalism OR full socialism would be better than the garbage we have now.
yieldcrv 1y ago
there is a multi-pronged solution necessary that is both intertwined with insurers and also completely separate, so in that part I agree with you the costs of services are arbitrary and need to be addressed before we can realistically deal with how any insurance pool works, in the US both parties have chiseled at this over the last decade - from getting prices more transparent, to attempting to have a large scale state negotiator - and this makes the conversation more palatable in gaining consensus not close, but it's not as partisan as people think, despite the parallel existence of entrenched interests what doesn't have consensus is a forced insurance pool that doesn't address the costs and has no ability to negotiate those costs (yes, this is partially due to the bill being gutted and a handicapped version being the only thing that passed) a deeper review and regulation of costs is the only thing that can help reach consensus
cycomanic 1y ago
> United Healthcare isn’t the reason healthcare is unaffordable any more than Geico causes car repairs to be expensive. American demand for healthcare is insatiable, and doctors are a scarce and greedy bunch. That there is a middle man trying to get his 5% isn’t the problem. Spoken as a software developer who's salaries are approaching or even surpassing doctor salaries while working on optimising "engagement" (or how to make their app the most addictive).
- tiahura 1y ago
  I’m a personal injury lawyer who looks at medical bills all day.
stop50 1y ago
I recommend you to look at Dr. Glaukomfleckens videos about pre authorization.

tormeh 1y ago

Afaict the original sin of the US healthcare system is having the healthcare providers chosen by employers. That means that the patient is not the customer, the patient's employer is. That in itself has dire consequences. Privatized health care need not be so bad. Germany has privatized health care, but it's pretty much fine, at least for patients. It's regulated to the moon and back, but afaict so is the US system, just with very different goals. The ACA feels a bit like the beginnings of a German-style system.

danans 1y ago

> Somehow, healthcare MUST be decoupled from capitalistic incentives. I don’t pretend to have the answer but continuing on this path will lead to worsening patient outcomes. We cannot have corporations expecting to make a dollar off human life. Give yourself more credit! You just stated the answer above.

wredcoll 1y ago

> We cannot have corporations expecting to make a dollar off human life. That's literally a political ideology. The answer to problems like this isn't to pretend politics is some kind of abstract system imposed by higher-order beings, its to use political power to fix it.

platevoltage 1y ago

But the answer is easy. Just look toward the North.

shrubble 1y ago
Canadian health care sucks but in a different way; so that’s not the solution either. You can look up the wait times for different procedures on the provincial websites. Things you can get in 72 hours anywhere near a decently sized American city such as an MRI scan can take months in Canada.
- seanmcdirmid 1y ago
  Every developed country would say their medical system sucks in some way. We (Americans) happen to both pay more for a system that sucks more than those. The results are in our poor life expectancies, and we basically pay twice (privately and once again via taxes) for it.
- platevoltage 1y ago
  Yeah, that same MRI scan can, and often takes an infinite amount of time here. I never said Canada's system was perfect, but it might as well be compared to what we have going on here.

kfterrg67 1y ago

I think the incentive itself is good, but there's too much corrupt abstraction in between. Ultimately I want good providers to be paid well and poor providers to struggle. That is a good system. We don't have that. We MUST recouple healthcare and capitalistic incentives.

anonym29 1y ago

Food, housing, and a living wage too. The bare necessities to live must be decoupled from capitalistic incentives.

JumpCrisscross 1y ago
> The bare necessities to live must be decoupled from capitalistic incentives We don’t have evidence we live in sufficient abundance to guarantee this sustainably even in rich countries. Particularly when bare necessities are decried as cruelty and so cost creep comes to pass. What we can do: free basic nutrition for all, free prenatal and neonatal care, free preventative medicine and annual check-ups, free access to generics where medically necessary, and a fixed amount of water and electricity to each household. Not enough to be remotely comfortable or long lived. But enough to survive.
- robocat 1y ago
  So easy to say free when you're expecting others to pay. Who votes for higher taxes on themselves?
  - JumpCrisscross 1y ago
    > Who votes for higher taxes on themselves? People who don't want to have to live amidst poverty. Or vote alongside folks who are struggling. In summary, good people.
  - ben_w 1y ago
    > Who votes for higher taxes on themselves? Even if you're selfish (and a lot of people are community spirited), the same people who as shareholders vote for the company to grow rather than to pay out more dividends.

robocat 1y ago

> healthcare MUST be decoupled from capitalistic incentives Capitalism pays for our healthcare. The problem is that Healthcare has an infinite hunger for resources - there is always more that could be spent - and it is always morally correct to spend more (people's lives have high priority). There needs to be some manner of allocating limited resources between different people with different needs. Every country seems to find different ways to deal with the fundamental friction of healthcare (unlimited demand and limited resources). Unfortunately voters don't like the reality of limitations.