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That's new in the past 45 days. For what it's worth, under the ADA the insurance subsidy I get from taxes is enough that I actually am insured, but it doesn't b

That's new in the past 45 days. For what it's worth, under the ADA the insurance subsidy I get from taxes is enough that I actually am insured, but it doesn't bring the monthly cost of an insurance plan down any ... just pushes the cost off to taxpayers. The miserable irony of this is that then the government winds up making a deal with FOR PROFIT insurance companies. Companies which would be failing their investors if they weren't wringing every cent out of the policy holders to pad their own pockets and generate wealth off the suffering of others. My personal opinion is that the ACA is a stepping stone to a single payer or something close to it in the USA. Meanwhile it is absolutely the worst of both government spending and private corporations. Now we just have to wait a whole other oscillation of the liberal-conservative pendulum, which tends to take 10-20 years.

natrius 13y ago
Insurance companies generally have to spend 80% of premiums on medical expenses[1]. The profit and marketing expenses aren't that much of your premiums. What you seem to be asking for is price fixing the way much of the rest of the world handles healthcare, which will reduce the incentives to advance medicine. I prefer our current approach, where those who can afford to pay are left to pay as much as they're willing to, which increases the number of smart people who are willing to solve everyone's medical problems. I grew up in Houston, where people from around the world go when they want to be treated for cancer at M.D. Anderson Cancer Center. It's not cheap, but the best doctors in the world head there because they can make the most money. Single-payer healthcare is worse than the Affordable Care Act. [1] https://www.healthcare.gov/how-does-the-health-care-law-protect-me/#part=10 https://www.healthcare.gov/how-does-the-health-care-law-prot...
- secstate 13y ago
  But 90% of the world doesn't die from exotic cancers, at least not below the age of 50 (or 60 ... keeps creeping up). The idea that advanced medicine is an justification for for-profit medicine is a straw man argument. The reality is that there are many more nuanced single-payer healthcare systems in the world than the one where the government tells you who gets to live and who gets to die. In the U.K. for example, there are still for-profit health care insurers and if you're wealthy enough you can buy their policy and have quadruple by-pass surgery when your 75. I'm not going to pretend we don't live in a capitalist world and that at some point rich people are going to live better than poor people. That would a fool's dream. But to argue pure Smith-style market economics will help keep people healthy is a joke. Even worse than that, while you laud the MDA Cancer Center in Houston now, wait 20 years and the cost of operating it will have sent it out of the country. In a globalized world you are competing with everyone, and while the USA has been sleeping the rest of the world has been getting very good at what we believe makes us special.
  - natrius 13y ago
    I don't fear the rest of the world getting better than us at medicine. Money motivates most people. The best doctors will go where they can get the most money. That is here. If I had to pick between the UK's system, where price controls help pay for healthcare for those who can't afford it, and the Affordable Care Act, where wealthy people pay for healthcare for those who can't afford it, I'd choose the Affordable Care Act. Price controls have such a terrible track record that we should prove why healthcare is different from the failures we've seen in housing, food and gas before trying again. Price controls give us less of what we desired so much in the first place.
    - arethuza 13y ago
      There is a private health care sector in the UK - doctors can choose to work there exclusively or share their time with the NHS. You aren't forced to use or work for the NHS - although everyone does have to pay for it.
    - andyjohnson0 13y ago
      "...the UK's system, where price controls help pay for healthcare for those who can't afford it..." I'm not sure how much you know about the UK system, but it doesn't use "price controls". Its funded by National Insurance Contributions [1], which are a form of payroll tax. The more you earn, the more you pay. People on low incomes pay nothing but still receive health care. [1] http://en.wikipedia.org/wiki/National_Insurance http://en.wikipedia.org/wiki/National_Insurance
      - natrius 13y ago
        The vast majority of the UK's health expenses flow through the NHS. This gives NHS the power to demand prices that are lower than they would be if there were many competing insurers. That is effectively a price control. If you don't agree to accept the NHS's price, you're left with few, if any customers.
    - tripzilch 13y ago
      > Money motivates most people. The best doctors will go where they can get the most money. Except that most doctors already make plenty and that most doctors are in fact also strongly motivated by the desire to help and treat people. That's why they became doctors, and the latter desire helps them achieve becoming better doctors much more than a desire for money. I'm not saying they're not motivated by money. Just that "the best doctors" are probably driven by a couple of other motivations too.
- tripzilch 13y ago
  > the best doctors in the world head there because they can make the most money. To "make the most money" is not necessarily a motivation for "the best doctors in the world". It doesn't even necessarily get you "the best doctors money can buy".

natrius 13y ago

Insurance companies generally have to spend 80% of premiums on medical expenses[1]. The profit and marketing expenses aren't that much of your premiums. What you seem to be asking for is price fixing the way much of the rest of the world handles healthcare, which will reduce the incentives to advance medicine. I prefer our current approach, where those who can afford to pay are left to pay as much as they're willing to, which increases the number of smart people who are willing to solve everyone's medical problems. I grew up in Houston, where people from around the world go when they want to be treated for cancer at M.D. Anderson Cancer Center. It's not cheap, but the best doctors in the world head there because they can make the most money. Single-payer healthcare is worse than the Affordable Care Act. [1] https://www.healthcare.gov/how-does-the-health-care-law-protect-me/#part=10 https://www.healthcare.gov/how-does-the-health-care-law-prot...

secstate 13y ago
But 90% of the world doesn't die from exotic cancers, at least not below the age of 50 (or 60 ... keeps creeping up). The idea that advanced medicine is an justification for for-profit medicine is a straw man argument. The reality is that there are many more nuanced single-payer healthcare systems in the world than the one where the government tells you who gets to live and who gets to die. In the U.K. for example, there are still for-profit health care insurers and if you're wealthy enough you can buy their policy and have quadruple by-pass surgery when your 75. I'm not going to pretend we don't live in a capitalist world and that at some point rich people are going to live better than poor people. That would a fool's dream. But to argue pure Smith-style market economics will help keep people healthy is a joke. Even worse than that, while you laud the MDA Cancer Center in Houston now, wait 20 years and the cost of operating it will have sent it out of the country. In a globalized world you are competing with everyone, and while the USA has been sleeping the rest of the world has been getting very good at what we believe makes us special.
- natrius 13y ago
  I don't fear the rest of the world getting better than us at medicine. Money motivates most people. The best doctors will go where they can get the most money. That is here. If I had to pick between the UK's system, where price controls help pay for healthcare for those who can't afford it, and the Affordable Care Act, where wealthy people pay for healthcare for those who can't afford it, I'd choose the Affordable Care Act. Price controls have such a terrible track record that we should prove why healthcare is different from the failures we've seen in housing, food and gas before trying again. Price controls give us less of what we desired so much in the first place.
  - arethuza 13y ago
    There is a private health care sector in the UK - doctors can choose to work there exclusively or share their time with the NHS. You aren't forced to use or work for the NHS - although everyone does have to pay for it.
  - andyjohnson0 13y ago
    "...the UK's system, where price controls help pay for healthcare for those who can't afford it..." I'm not sure how much you know about the UK system, but it doesn't use "price controls". Its funded by National Insurance Contributions [1], which are a form of payroll tax. The more you earn, the more you pay. People on low incomes pay nothing but still receive health care. [1] http://en.wikipedia.org/wiki/National_Insurance http://en.wikipedia.org/wiki/National_Insurance
    - natrius 13y ago
      The vast majority of the UK's health expenses flow through the NHS. This gives NHS the power to demand prices that are lower than they would be if there were many competing insurers. That is effectively a price control. If you don't agree to accept the NHS's price, you're left with few, if any customers.
  - tripzilch 13y ago
    > Money motivates most people. The best doctors will go where they can get the most money. Except that most doctors already make plenty and that most doctors are in fact also strongly motivated by the desire to help and treat people. That's why they became doctors, and the latter desire helps them achieve becoming better doctors much more than a desire for money. I'm not saying they're not motivated by money. Just that "the best doctors" are probably driven by a couple of other motivations too.
tripzilch 13y ago
> the best doctors in the world head there because they can make the most money. To "make the most money" is not necessarily a motivation for "the best doctors in the world". It doesn't even necessarily get you "the best doctors money can buy".