6 ms·

Why don't we just pay for veterans to go to normal hospitals? Why on earth would we think these government run hospitals would work?

by wmgries 12y ago

Nacraile 12y ago
The US has the highest per-capita health care expenditure in the OECD, by a substantial margin, despite being the only OECD country which does not provide universal health care. Why on earth would we think that private sector hospitals work any better?
- wmgries 12y ago
  I've never heard of anyone being forced to wait for weeks for this kind of stuff in a normal hospital in the US. Government run health systems overseas have well documented wait lists. Furthermore, privately run systems should be more efficient because consumers have a choice. Don't like your current doctor? Go get a new one. To be clear, I don't object to government funding these things, just running them. Monopolies are bad.
  - roma1n 12y ago
    Okay, I live in France, the quintessential socialized health-care system. The wait at hospitals is short, I can choose my doctor as I please, and an appointment costs me all of 23 euro. I have nothing against the health insurance being government-run, which does not entail that the whole system is government run. Most GPs, for instance, are independent.
    - roma1n 12y ago
      Adding to my previous comment: the French health "insurance" is a bit of a misnomer. It is as much an insurance as a wealth redistribution mechanism, and the "premiums" are not a function of your health risks but of your income, i.e. it is effectively a tax. If you believe that health-care should be granted at the same level regardless of material status, it makes sense. In other words, the French health "insurance" is meant to at most break even, or run a deficit (which it does).
  - thirsteh 12y ago
    Every country in Europe has a private healthcare industry in addition to the public one. Not only is there no "waiting list crisis", but people still have the ability to choose whatever private healthcare provider they want, provided they can pay for it. As a European who only recently moved to the U.S., it's bizarre to see the rhetoric being used here. The news are littered with "Europe is on the brink of collapse", "Will the Eurozone survive?", and "Healthcare waiting lists longer than ever in Europe", but mention those headlines to most Europeans (at least in Northern/Western Europe), and they'll look at you quizzically before asking what you've been smoking. And indeed, nearly every study into healthcare systems and their effectiveness prove many of those headlines to be wild exaggerations or downright untruths. Consider if you should take what you're reading at face value--very large corporations are heavily incentivized to mislead you. Manufacturing Consent is chillingly relevant.
    - wmgries 12y ago
      So poor people can suffer in the public hospitals and rich people can buy the very best care their money can provide? How is that a good thing? I seriously don't understand what's wrong with a system where the government gives people money to participate in a truly free market (see comment in a sibling reply about how the US market is not currently free). This is the best system: everybody is covered and there's no big, lumbering, inefficient government running the show.
      - thirsteh 12y ago
        Poor people don't suffer in public hospitals in Europe. Also, in most countries, the government pays for specialty private care when necessary (it often isn't, since doctors make a very good living in the public system.)
      - adwf 12y ago
        Because healthcare shouldn't ever be a free market. A free market implies that a doctor should be charging as much as he can get for a procedure in order to maximise his profits. Standard econ 101 stuff. However, when someone is dying, they'd happily spend every penny they have even if it's just for simple cheap antibiotics. Therefore, you can't let the standard "the price is what people are willing to pay" economics take control. Healthcare cannot ever be a free market in a just, moral society. That's not to mention the socio-economic aspect of the healthcare system. If people are dying simply because a procedure is being charged at its free market value, then the poorer end of your workforce will be decimated. And yet, the poorer end make up the vast majority of jobs! Socialised healthcare of some sort is absolutely essential to a well functioning society. The obvious counter argument is that I could pay for my highly skilled, valuable workers to have private healthcare. The free market at work! But what about the people who don't work for me yet are essential to my business? How do I ensure the guys who build and maintain my roads survive that potentially dangerous job? How do I ensure that the guys who take my trash out are covered? These are all fairly low paying jobs where the downward wage pressure would push them into not being covered. Yet these people are absolutely essential to my business running. Then there's my customers. I try and sell to all walks of life, rich and poor. Where's my market if all the poor are dying due to not affording healthcare? /rant over There's just so many reasons why free market healthcare is bad. Socialised healthcare isn't just good morally, it's good for business too.
  - kiba 12y ago
    The terribleness of healthcare in America isn't really about private versus public, it's more about the system of healthcare being horribly regulated. Let me say this: The healthcare market does not function like a normal healthy free market.
    - tormeh 12y ago
      It's hard to see how it ever could. How do you know which is the best doctor or hospital? You don't. You can't. You could if you had an education in medicine and had worked at all the hospitals but obviously that doesn't happen. Besides, patients often don't have time for window-shopping.
      - jessaustin 12y ago
        How do you know which is the best doctor or hospital? That isn't really the problem we're trying to solve. As a patient, I'd like to receive adequate health care. I don't imagine that my health is somehow more important than that of every other patient in the nation. That isn't to say I wouldn't like more information about health care providers, but maybe I can't be trusted with that...
        TheCoelacanth 12y ago
        That doesn't really change the fundamental problem. It just changes the question to "How do you know which doctors or hospitals are adequate?".
  - Nacraile 12y ago
    > Furthermore, privately run systems should be more efficient because consumers have a choice. Don't like your current doctor? Go get a new one. You are assuming an efficient market. That would imply that patients have access to perfect information about quality and cost of care, and make decisions rationally. I find this extremely questionable. > Monopolies are bad. I am far from convinced that the US health care system is competitive in any meaningful sense of the word. > I've never heard of anyone being forced to wait for weeks for this kind of stuff in a normal hospital in the US. This is not evidence that the US health care is more efficient, it is evidence that the US makes a different trade-off in cost:quality of care. Without question, a subset of the US population receives better care for non-emergency medical issues. But also without question, this improved service comes with a substantial increase in cost. Hospital capacity is extremely expensive. A Canadian (say) hospital operates at nearly 100% utilization, nearly 100% of the time. In order to do this, it must maintain queues for non-emergency care, in order to smooth demand. By comparison, in order to avoid queueing, an American hospital must maintain capacity to satisfy peak demand, which means it does not fully utilize its capacity most of the time. Both systems maintain large bureaucracies (I have been party to Canadian health care workers marvelling at how an American hospital might dedicate an entire floor to its billing department). Which is more efficient? This is hard to say. Do Americans have the freedom to choose where they stand on the cost:quality-of-care spectrum? It seems not, to me.
    - thirsteh 12y ago
      > Without question, a subset of the US population receives better care for non-emergency medical issues. But also without question, this improved service comes with a substantial increase in cost. I'm not convinced that even this is a given: A large percentage of those costs are the result of articial inflation that benefits pharmaceutical and insurance companies tremendously, but costs the average American a fortune. A month's worth of chemotherapy in the U.S. can easily cost ten times more than the equivalent in any European country (not factoring in insurance.) The rich getting quality care never seemed a particularly convincing argument against healthcare overhaul. It's even more ridiculous when you consider that there is world-class private healthcare in Europe as well.
    - 12y ago
  - hudibras 12y ago
    Wait times in normal hospitals in the U.S. only include those people who can afford medical care (including those with insurance). They don't include the millions of people who can't get on the list at all. In other words, average U.S. wait times are pretty good if you exclude people whose wait times = infinity.
  - gnaritas 12y ago
    > I've never heard of anyone being forced to wait for weeks for this kind of stuff in a normal hospital in the US. That's because here they can't afford healthcare at all and they just die. Seriously, criticizing better healthcare systems for problems that don't exist while ignoring all the worse problems with our system, c'mon. You're spewing the same ignorant bullshit you'll find on Fox News; you're brainwashed.
    - Turing_Machine 12y ago
      "That's because here they can't afford healthcare at all and they just die." http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy http://en.wikipedia.org/wiki/List_of_countries_by_life_expec... The life expectancy in the United States is lower than most European countries, but not that much lower (e.g., 81 for the UK, 79.8 for the US). I suspect much or all of this would go away if you controlled for overweight, violent crime, motor vehicle accidents, etc. The data is not consistent with masses of people dying in the streets because they can't get medical care.
      - DanBC 12y ago
        So the US has lower life expectancy despite spending more per capita than any other country? > controlling for overweight I'm not sure what this means. Removing all the over-weight related illnesses obviously reduces death rates, but so what? Obesity causes chronic problems and not treating those health problems causes death.
        Turing_Machine 12y ago
        You're trying to shift the goal posts, but okay. Life expectancy isn't the only measure. Convenience and speed also count, when it comes to quality of life. That's why you see (e.g.) wealthy Canadians crossing the border to get treated. "I'm not sure what this means." The United States has a higher rate of obesity than many other countries. Similarly, it has high rates of violent crime and motor vehicle accidents. These likely account for some of the difference in lifespan, but are not (as far as I can tell) directly related to the presence or absence of socialized medicine. Anyway, we have Obamacare now, so everything is wonderful, right?
gnaritas 12y ago
> Why on earth would we think these government run hospitals would work? It's a silly question, why do you assume they wouldn't? Government doesn't equal bad.
venomsnake 12y ago
Just for a start veterans have specific injuries (both mental and physical) that general hospital will be hard to have the expertise to deal with. We are talking about people that freak out/enter combat mode when they see a garbage can or a box near the road. Why - because for them for 10 years it has been a real and present danger. And those are the very mild cases.
- seizethecheese 12y ago
  If the VA didn't exist hospitals would have the appropriate resources, especially those near bases.
  - crpatino 12y ago
    Actually, I think the opposite would be truth. If the VA didn't exist limited resources would get spread too thin among regular hospitals, though maybe not as badly in those near bases.
jotm 12y ago
They would simply not get insurance because of the high risk of expensive injuries.
patmcc 12y ago
>>>Why on earth would we think these government run hospitals would work? Because lots of nations have successful government-run hospitals?

Why don't we just pay for veterans to go to normal hospitals? Why on earth would we think these government run hospitals would work?

by wmgries 12y ago

Why don't we just pay for veterans to go to normal hospitals? Why on earth would we think these government run hospitals would work?

Nacraile 12y ago

The US has the highest per-capita health care expenditure in the OECD, by a substantial margin, despite being the only OECD country which does not provide universal health care. Why on earth would we think that private sector hospitals work any better?

wmgries 12y ago
I've never heard of anyone being forced to wait for weeks for this kind of stuff in a normal hospital in the US. Government run health systems overseas have well documented wait lists. Furthermore, privately run systems should be more efficient because consumers have a choice. Don't like your current doctor? Go get a new one. To be clear, I don't object to government funding these things, just running them. Monopolies are bad.
- roma1n 12y ago
  Okay, I live in France, the quintessential socialized health-care system. The wait at hospitals is short, I can choose my doctor as I please, and an appointment costs me all of 23 euro. I have nothing against the health insurance being government-run, which does not entail that the whole system is government run. Most GPs, for instance, are independent.
  - roma1n 12y ago
    Adding to my previous comment: the French health "insurance" is a bit of a misnomer. It is as much an insurance as a wealth redistribution mechanism, and the "premiums" are not a function of your health risks but of your income, i.e. it is effectively a tax. If you believe that health-care should be granted at the same level regardless of material status, it makes sense. In other words, the French health "insurance" is meant to at most break even, or run a deficit (which it does).
- thirsteh 12y ago
  Every country in Europe has a private healthcare industry in addition to the public one. Not only is there no "waiting list crisis", but people still have the ability to choose whatever private healthcare provider they want, provided they can pay for it. As a European who only recently moved to the U.S., it's bizarre to see the rhetoric being used here. The news are littered with "Europe is on the brink of collapse", "Will the Eurozone survive?", and "Healthcare waiting lists longer than ever in Europe", but mention those headlines to most Europeans (at least in Northern/Western Europe), and they'll look at you quizzically before asking what you've been smoking. And indeed, nearly every study into healthcare systems and their effectiveness prove many of those headlines to be wild exaggerations or downright untruths. Consider if you should take what you're reading at face value--very large corporations are heavily incentivized to mislead you. Manufacturing Consent is chillingly relevant.
  - wmgries 12y ago
    So poor people can suffer in the public hospitals and rich people can buy the very best care their money can provide? How is that a good thing? I seriously don't understand what's wrong with a system where the government gives people money to participate in a truly free market (see comment in a sibling reply about how the US market is not currently free). This is the best system: everybody is covered and there's no big, lumbering, inefficient government running the show.
    - thirsteh 12y ago
      Poor people don't suffer in public hospitals in Europe. Also, in most countries, the government pays for specialty private care when necessary (it often isn't, since doctors make a very good living in the public system.)
    - adwf 12y ago
      Because healthcare shouldn't ever be a free market. A free market implies that a doctor should be charging as much as he can get for a procedure in order to maximise his profits. Standard econ 101 stuff. However, when someone is dying, they'd happily spend every penny they have even if it's just for simple cheap antibiotics. Therefore, you can't let the standard "the price is what people are willing to pay" economics take control. Healthcare cannot ever be a free market in a just, moral society. That's not to mention the socio-economic aspect of the healthcare system. If people are dying simply because a procedure is being charged at its free market value, then the poorer end of your workforce will be decimated. And yet, the poorer end make up the vast majority of jobs! Socialised healthcare of some sort is absolutely essential to a well functioning society. The obvious counter argument is that I could pay for my highly skilled, valuable workers to have private healthcare. The free market at work! But what about the people who don't work for me yet are essential to my business? How do I ensure the guys who build and maintain my roads survive that potentially dangerous job? How do I ensure that the guys who take my trash out are covered? These are all fairly low paying jobs where the downward wage pressure would push them into not being covered. Yet these people are absolutely essential to my business running. Then there's my customers. I try and sell to all walks of life, rich and poor. Where's my market if all the poor are dying due to not affording healthcare? /rant over There's just so many reasons why free market healthcare is bad. Socialised healthcare isn't just good morally, it's good for business too.
- kiba 12y ago
  The terribleness of healthcare in America isn't really about private versus public, it's more about the system of healthcare being horribly regulated. Let me say this: The healthcare market does not function like a normal healthy free market.
  - tormeh 12y ago
    It's hard to see how it ever could. How do you know which is the best doctor or hospital? You don't. You can't. You could if you had an education in medicine and had worked at all the hospitals but obviously that doesn't happen. Besides, patients often don't have time for window-shopping.
    - jessaustin 12y ago
      How do you know which is the best doctor or hospital? That isn't really the problem we're trying to solve. As a patient, I'd like to receive adequate health care. I don't imagine that my health is somehow more important than that of every other patient in the nation. That isn't to say I wouldn't like more information about health care providers, but maybe I can't be trusted with that...
      - TheCoelacanth 12y ago
        That doesn't really change the fundamental problem. It just changes the question to "How do you know which doctors or hospitals are adequate?".
- Nacraile 12y ago
  > Furthermore, privately run systems should be more efficient because consumers have a choice. Don't like your current doctor? Go get a new one. You are assuming an efficient market. That would imply that patients have access to perfect information about quality and cost of care, and make decisions rationally. I find this extremely questionable. > Monopolies are bad. I am far from convinced that the US health care system is competitive in any meaningful sense of the word. > I've never heard of anyone being forced to wait for weeks for this kind of stuff in a normal hospital in the US. This is not evidence that the US health care is more efficient, it is evidence that the US makes a different trade-off in cost:quality of care. Without question, a subset of the US population receives better care for non-emergency medical issues. But also without question, this improved service comes with a substantial increase in cost. Hospital capacity is extremely expensive. A Canadian (say) hospital operates at nearly 100% utilization, nearly 100% of the time. In order to do this, it must maintain queues for non-emergency care, in order to smooth demand. By comparison, in order to avoid queueing, an American hospital must maintain capacity to satisfy peak demand, which means it does not fully utilize its capacity most of the time. Both systems maintain large bureaucracies (I have been party to Canadian health care workers marvelling at how an American hospital might dedicate an entire floor to its billing department). Which is more efficient? This is hard to say. Do Americans have the freedom to choose where they stand on the cost:quality-of-care spectrum? It seems not, to me.
  - thirsteh 12y ago
    > Without question, a subset of the US population receives better care for non-emergency medical issues. But also without question, this improved service comes with a substantial increase in cost. I'm not convinced that even this is a given: A large percentage of those costs are the result of articial inflation that benefits pharmaceutical and insurance companies tremendously, but costs the average American a fortune. A month's worth of chemotherapy in the U.S. can easily cost ten times more than the equivalent in any European country (not factoring in insurance.) The rich getting quality care never seemed a particularly convincing argument against healthcare overhaul. It's even more ridiculous when you consider that there is world-class private healthcare in Europe as well.
  - 12y ago
- hudibras 12y ago
  Wait times in normal hospitals in the U.S. only include those people who can afford medical care (including those with insurance). They don't include the millions of people who can't get on the list at all. In other words, average U.S. wait times are pretty good if you exclude people whose wait times = infinity.
- gnaritas 12y ago
  > I've never heard of anyone being forced to wait for weeks for this kind of stuff in a normal hospital in the US. That's because here they can't afford healthcare at all and they just die. Seriously, criticizing better healthcare systems for problems that don't exist while ignoring all the worse problems with our system, c'mon. You're spewing the same ignorant bullshit you'll find on Fox News; you're brainwashed.
  - Turing_Machine 12y ago
    "That's because here they can't afford healthcare at all and they just die." http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy http://en.wikipedia.org/wiki/List_of_countries_by_life_expec... The life expectancy in the United States is lower than most European countries, but not that much lower (e.g., 81 for the UK, 79.8 for the US). I suspect much or all of this would go away if you controlled for overweight, violent crime, motor vehicle accidents, etc. The data is not consistent with masses of people dying in the streets because they can't get medical care.
    - DanBC 12y ago
      So the US has lower life expectancy despite spending more per capita than any other country? > controlling for overweight I'm not sure what this means. Removing all the over-weight related illnesses obviously reduces death rates, but so what? Obesity causes chronic problems and not treating those health problems causes death.
      - Turing_Machine 12y ago
        You're trying to shift the goal posts, but okay. Life expectancy isn't the only measure. Convenience and speed also count, when it comes to quality of life. That's why you see (e.g.) wealthy Canadians crossing the border to get treated. "I'm not sure what this means." The United States has a higher rate of obesity than many other countries. Similarly, it has high rates of violent crime and motor vehicle accidents. These likely account for some of the difference in lifespan, but are not (as far as I can tell) directly related to the presence or absence of socialized medicine. Anyway, we have Obamacare now, so everything is wonderful, right?

gnaritas 12y ago

> Why on earth would we think these government run hospitals would work? It's a silly question, why do you assume they wouldn't? Government doesn't equal bad.

venomsnake 12y ago

Just for a start veterans have specific injuries (both mental and physical) that general hospital will be hard to have the expertise to deal with. We are talking about people that freak out/enter combat mode when they see a garbage can or a box near the road. Why - because for them for 10 years it has been a real and present danger. And those are the very mild cases.

seizethecheese 12y ago
If the VA didn't exist hospitals would have the appropriate resources, especially those near bases.
- crpatino 12y ago
  Actually, I think the opposite would be truth. If the VA didn't exist limited resources would get spread too thin among regular hospitals, though maybe not as badly in those near bases.

jotm 12y ago

They would simply not get insurance because of the high risk of expensive injuries.

patmcc 12y ago

>>>Why on earth would we think these government run hospitals would work? Because lots of nations have successful government-run hospitals?