Sometimes I read stories about American healthcare and feel utterly sick(democraticunderground.com)
democraticunderground.com
Sometimes I read stories about American healthcare and feel utterly sick
http://www.democraticunderground.com/1002252691
2 comments
When I read such stories I'm inclined to wonder if such a mess could ever be fixed by (idealistic) entrepreneurs, even in part. It doesn't seem like a problem startups can directly address; it seems almost purely a political problem. I can only hope people with brighter imaginations and keener minds than me will turn their attention to this problem.
Good luck America, I hope you beat this one.
Good luck America, I hope you beat this one.
I am a pretty bitter idealist who is currently homeless and trying to declare bankruptcy. I have an incurable genetic disorder, as does my 24 year old son. We figured out how to get well. I would love to offer alternatives but damn few people care or are interested.
I also worked for an insurance company for five years. So I have an insider's view of that aspect of it as well. I don't think our current system works. But it has inertia on its side.
I also worked for an insurance company for five years. So I have an insider's view of that aspect of it as well. I don't think our current system works. But it has inertia on its side.
People dying of preventable disease in the USA every day because insurance companies decide they deserve to die.
Dying sucks. But everyone dies, regardless of how much they deserve it. So he's claiming that someone "owes" him >$300k. Why? What claim does he have to $300k of other people's money?
Dying sucks. But everyone dies, regardless of how much they deserve it. So he's claiming that someone "owes" him >$300k. Why? What claim does he have to $300k of other people's money?
The same claim you have to public funds raised via taxes?
The conversation in my country is not about "claims on others' money" or other such matters of pure principle, but rather what produces humane outcomes. Having a medical safety net for everyone is kind of taken for granted here - a poor-to-middling option, but far preferable to a you're-(mostly)-on-your-own system like in the US.
One principle from an ethics class in school comes back to me: before we were born, while we were behind the "veil of ignorance", if we didn't know what sort of family we'd be born in, what rules would we prefer in life? If you didn't know what sort of family background or medical conditions you'd have in your life, would you prefer social insurance or take your chances? I'd definitely prefer insurance for everyone, because then I'd have a fighting chance if I were born to poor parents.
> But everyone dies, regardless of how much they deserve it. So why shouldn't we try to reduce it happening?
Your comment seems to be saying this state of affairs is somehow more desirable than the alternative...that it's better that the guy died than other people be forced to pay taxes to insure him. That kind of boggles my mind, to be honest.
The conversation in my country is not about "claims on others' money" or other such matters of pure principle, but rather what produces humane outcomes. Having a medical safety net for everyone is kind of taken for granted here - a poor-to-middling option, but far preferable to a you're-(mostly)-on-your-own system like in the US.
One principle from an ethics class in school comes back to me: before we were born, while we were behind the "veil of ignorance", if we didn't know what sort of family we'd be born in, what rules would we prefer in life? If you didn't know what sort of family background or medical conditions you'd have in your life, would you prefer social insurance or take your chances? I'd definitely prefer insurance for everyone, because then I'd have a fighting chance if I were born to poor parents.
> But everyone dies, regardless of how much they deserve it. So why shouldn't we try to reduce it happening?
Your comment seems to be saying this state of affairs is somehow more desirable than the alternative...that it's better that the guy died than other people be forced to pay taxes to insure him. That kind of boggles my mind, to be honest.
Reduce what happening? Dying? I'm pretty sure the death rate will remain 100% even if you were willing to spend $1B to "prevent" it. Everyone dies.
I'm not saying that the guy should die instead of using other people's money to postpone death. I'm saying that he has no more right to that money than those other people do. You're talking as if there is an infinite amount of money to be spent on this one person. But spending money on this guy takes it away from other people. The world doesn't revolve around this one guy, you know?
Someone has to make the decision: how much money is it worth to postpone my death for a while? And if I arbitrarily decide that one more breath is worth all the money in the world, that doesn't automatically mean that I now get to spend all the money in the world on it. Even with "universal health care" there are limits.
Also, all the money that gets paid out by the state has to be paid in first by taxpayers. Moving responsibility to the state doesn't magically make health care cheaper, or free. On average, the taxpayers are still paying for all their health care.
I'm not saying that the guy should die instead of using other people's money to postpone death. I'm saying that he has no more right to that money than those other people do. You're talking as if there is an infinite amount of money to be spent on this one person. But spending money on this guy takes it away from other people. The world doesn't revolve around this one guy, you know?
Someone has to make the decision: how much money is it worth to postpone my death for a while? And if I arbitrarily decide that one more breath is worth all the money in the world, that doesn't automatically mean that I now get to spend all the money in the world on it. Even with "universal health care" there are limits.
Also, all the money that gets paid out by the state has to be paid in first by taxpayers. Moving responsibility to the state doesn't magically make health care cheaper, or free. On average, the taxpayers are still paying for all their health care.
> Also, all the money that gets paid out by the state has to be paid in first by taxpayers. Moving responsibility to the state doesn't magically make health care cheaper, or free. On average, the taxpayers are still paying for all their health care.
US pays more state money to health care than other nations, yet has much worse health outcomes.
US pays more state money to health care than other nations, yet has much worse health outcomes.
What makes you think that will change if the government mandates that everyone pay in to the broken system?
Insurance companies have a powerful incentive to maximise profits. They are oversighted by shareholders and maybe some law enforcement.
Governments have dual interests - have better benefit:cost ratio and spend less tax. They are oversighted by quangos and tax-payers.
But a more interesting question is why people don't help themselves - we know about the importance of good food and exercise and sensible drinking and not smoking and not driving like an idiot etc, yet a lot of illness is caused by entirely preventable stuff.
We know that even if people can get medication they don't take it properly. (There's no difference between the UK (where most people getting meds don't have to pay for them) or the US (where most people have to pay) or the severity of the illness (most transplanted organ failures are because people don't comply with the medication regime.)
This is a significant cost. Just the cost of the meds - in the UK we spend about £9billion per year on meds, of which about half (£4.5billion) is wasted because people don't comply with the instructions. And then there's the additional cost of treating those people.
Governments have dual interests - have better benefit:cost ratio and spend less tax. They are oversighted by quangos and tax-payers.
But a more interesting question is why people don't help themselves - we know about the importance of good food and exercise and sensible drinking and not smoking and not driving like an idiot etc, yet a lot of illness is caused by entirely preventable stuff.
We know that even if people can get medication they don't take it properly. (There's no difference between the UK (where most people getting meds don't have to pay for them) or the US (where most people have to pay) or the severity of the illness (most transplanted organ failures are because people don't comply with the medication regime.)
This is a significant cost. Just the cost of the meds - in the UK we spend about £9billion per year on meds, of which about half (£4.5billion) is wasted because people don't comply with the instructions. And then there's the additional cost of treating those people.
"Some law enforcement" actually it's one of the most heavily-regulated industries, after stock trading and telecommunications probably. Also we don't have quangos.
How would an insurance company get customers, if their services aren't good for customers?
How would an insurance company get customers, if their services aren't good for customers?
How many people chose an insurance company, over have one provided for them via work?
And the only time you know your insurance is lousy is when you're trying to make a claim - at that point you may have years of time with and payments to that company.
And the only time you know your insurance is lousy is when you're trying to make a claim - at that point you may have years of time with and payments to that company.
> I'm pretty sure the death rate will remain 100%
You and I know this is a complete red herring. When we talk about preventing deaths, we're talking about delaying deaths and lengthening lives toward their natural lifespans.
> Someone has to make the decision: how much money is it worth to postpone my death for a while? And if I arbitrarily decide that one more breath is worth all the money in the world, that doesn't automatically mean that I now get to spend all the money in the world on it. Even with "universal health care" there are limits.
Absolutely true. That's why every insurance system - public or private - has rationing, whether you call it that or not. I don't get why you bring up this point, when it clearly doesn't detract from the usefulness of public health insurance at all. Having everyone insured just means more people will live longer lives and/or endure less pain.
> Also, all the money that gets paid out by the state has to be paid in first by taxpayers. Moving responsibility to the state doesn't magically make health care cheaper, or free. On average, the taxpayers are still paying for all their health care.
Sure. I didn't say anything about social insurance making it cheaper. But it is a fact that healthcare's a lot cheaper mostly anywhere besides the US of A. I remember seeing comparison tables showing that US health outcomes per dollar are much poorer than elsewhere, so you guys are clearly getting a raw deal.
(edit: Let's not forget that lots of diseases don't get stopped in their early stages because the sufferers don't have insurance, so they end up in heavy debt due to the high cost of a cure or late treatment. Prevention or early treatment would probably save money, and would also give these people significantly longer lives. Surely that's something worth paying for.)
If you're against wealth redistribution (or whatever they like to call it), just come right out and say it. Don't tiptoe around the issue with irrelevant points.
You and I know this is a complete red herring. When we talk about preventing deaths, we're talking about delaying deaths and lengthening lives toward their natural lifespans.
> Someone has to make the decision: how much money is it worth to postpone my death for a while? And if I arbitrarily decide that one more breath is worth all the money in the world, that doesn't automatically mean that I now get to spend all the money in the world on it. Even with "universal health care" there are limits.
Absolutely true. That's why every insurance system - public or private - has rationing, whether you call it that or not. I don't get why you bring up this point, when it clearly doesn't detract from the usefulness of public health insurance at all. Having everyone insured just means more people will live longer lives and/or endure less pain.
> Also, all the money that gets paid out by the state has to be paid in first by taxpayers. Moving responsibility to the state doesn't magically make health care cheaper, or free. On average, the taxpayers are still paying for all their health care.
Sure. I didn't say anything about social insurance making it cheaper. But it is a fact that healthcare's a lot cheaper mostly anywhere besides the US of A. I remember seeing comparison tables showing that US health outcomes per dollar are much poorer than elsewhere, so you guys are clearly getting a raw deal.
(edit: Let's not forget that lots of diseases don't get stopped in their early stages because the sufferers don't have insurance, so they end up in heavy debt due to the high cost of a cure or late treatment. Prevention or early treatment would probably save money, and would also give these people significantly longer lives. Surely that's something worth paying for.)
If you're against wealth redistribution (or whatever they like to call it), just come right out and say it. Don't tiptoe around the issue with irrelevant points.
If you're against wealth redistribution (or whatever they like to call it), just come right out and say it.
Yes, that is my point. If you're sick that doesn't give you a unilateral claim to take other people's money. In fact this story is a pretty good example: He got healthcare way beyond what a sane government program would mandate (held his job for a full year, paid for an MRI etc). And it was paid for "socially".
But it is a fact that healthcare's a lot cheaper mostly anywhere besides the US of A.
Yes, the US healthcare system is screwed up. But I don't understand the knee-jerk "universal healthcare" reactions.
Yes, that is my point. If you're sick that doesn't give you a unilateral claim to take other people's money. In fact this story is a pretty good example: He got healthcare way beyond what a sane government program would mandate (held his job for a full year, paid for an MRI etc). And it was paid for "socially".
But it is a fact that healthcare's a lot cheaper mostly anywhere besides the US of A.
Yes, the US healthcare system is screwed up. But I don't understand the knee-jerk "universal healthcare" reactions.
But moving it to the state can remove the profit motive and can help foster saner rules about what is covered. Then paying for prevention begins to make more sense.
Not saying it automatically would improve everything. I don't know that. Just saying the current American system is pretty broken.
Not saying it automatically would improve everything. I don't know that. Just saying the current American system is pretty broken.
Paying for prevention makes more sense now because it would reduce large payouts, increasing profits for insurance companies. Profit motive should be an incentive for this. Removing the profit motive would remove any incentive to pay for prevention. Either way, the government could just increase taxes to pay for increased costs. Anyway, once regulatory capture is achieved (and the stakes are far to high for me to believe that won't happen), the profit motive will be back in play.
Not really. Because right now, simply excluding expensive individuals is far easier. You have more incentive to pay for prevention with universal coverage.
Again: Not sure what would work in the U.S. because there are more differences between the U.S. and Europe than just who pays the doctor's bill and there are a great many more things which impact health outcomes than how the bills are paid. Unfortunately, Americans seem largely oblivious to those facts, which is why we keep talking about who to bill rather than how to get genuinely better health outcomes.
Again: Not sure what would work in the U.S. because there are more differences between the U.S. and Europe than just who pays the doctor's bill and there are a great many more things which impact health outcomes than how the bills are paid. Unfortunately, Americans seem largely oblivious to those facts, which is why we keep talking about who to bill rather than how to get genuinely better health outcomes.
If you bought insurance, you'd expect they live up to their contract. This isn't asking for money from nothing. This is asking for money owed to him by the three insurance companies involved because of their legal obligations.
Because many of us believe that universal health care is a human right. In a state which claims to be democratic and progressive it becomes the responsibility of the state.
Why? You might as well say that food is a human right, but feeding the population is not the responsibility of the state.
Maybe not your state, but many places have policies that reflect that people believe it is.
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Outside of prisons, people generally spend their own money at privately-owned grocery stores and restaurants. We don't use a "universal food access" system paid for by tax dollars and negotiated by the government.
You don't have any system of food-vouchers or welfare stamps?
As Mz mentioned, we have quite a few, at various levels of government. None of them are mandated, automatic, universal, or even slightly like the proposed "universal health care" programs.
You seem opposed to universal health care in principle.
I suspect your opinion will change radically when you are faced with a life-threatening condition that requires medical attention. The probability you will have one of these increases steadily with age and will eventually reach 100%. There is no escaping it.
Maybe it'll be like the person who wrote the article where they get in a wreck and end up dying not because they weren't responsible or lacked insurance or expected a hand-out, but because it was more convenient for the insurance companies to ignore him until he just went away.
Sometimes shit happens, and when it does a functioning, civilized society will help you through the worst of it so that you can either recover and be a productive citizen once again, or at the very least live with a measure of dignity.
It doesn't benefit anyone to constantly lose productive workers, family members, fathers and mothers, scientists, researchers, artists or even those in less glamorous positions to what could've been treated in the early stages at marginal cost.
I suspect your opinion will change radically when you are faced with a life-threatening condition that requires medical attention. The probability you will have one of these increases steadily with age and will eventually reach 100%. There is no escaping it.
Maybe it'll be like the person who wrote the article where they get in a wreck and end up dying not because they weren't responsible or lacked insurance or expected a hand-out, but because it was more convenient for the insurance companies to ignore him until he just went away.
Sometimes shit happens, and when it does a functioning, civilized society will help you through the worst of it so that you can either recover and be a productive citizen once again, or at the very least live with a measure of dignity.
It doesn't benefit anyone to constantly lose productive workers, family members, fathers and mothers, scientists, researchers, artists or even those in less glamorous positions to what could've been treated in the early stages at marginal cost.
because it was more convenient for the insurance companies to ignore him until he just went away.
Why can't we just fix this part? Why do we have to throw out everything and start over?
get in a wreck and end up dying not because they weren't responsible or lacked insurance or expected a hand-out
Is it less of a tragedy then? Does dying with a different kind of disease make you feel better about it?
Edit: I'm not against it in principle. I think it looks fine on paper. I'm against it because it leads to massive conflicts of interest and corruption. I don't think it's a solution to our current problems.
Why can't we just fix this part? Why do we have to throw out everything and start over?
get in a wreck and end up dying not because they weren't responsible or lacked insurance or expected a hand-out
Is it less of a tragedy then? Does dying with a different kind of disease make you feel better about it?
Edit: I'm not against it in principle. I think it looks fine on paper. I'm against it because it leads to massive conflicts of interest and corruption. I don't think it's a solution to our current problems.
> Why can't we just fix this part?
Insurance companies. They lobby. They make it very, very hard to do anything useful.
If you think it leads to "massive conflicts of interest and corruption", then you obviously think relative to the current system. Can you find one example of a country with a more corrupt, more prohibitively expensive medical system than the US?
If you look at the various implementations of universal healthcare, of which there are dozens, you'll find varying levels of corruption, efficiency, and effectiveness, but the current US system is by far the worst in virtually every category. It is the worst possible outlier.
People shouldn't die of easily treatable medical conditions, not in this age. Most countries agree with this in principle and provide medical coverage for their people regardless of income or age. It's expected because people have worked hard to provide it for themselves collectively.
Insurance companies. They lobby. They make it very, very hard to do anything useful.
If you think it leads to "massive conflicts of interest and corruption", then you obviously think relative to the current system. Can you find one example of a country with a more corrupt, more prohibitively expensive medical system than the US?
If you look at the various implementations of universal healthcare, of which there are dozens, you'll find varying levels of corruption, efficiency, and effectiveness, but the current US system is by far the worst in virtually every category. It is the worst possible outlier.
People shouldn't die of easily treatable medical conditions, not in this age. Most countries agree with this in principle and provide medical coverage for their people regardless of income or age. It's expected because people have worked hard to provide it for themselves collectively.
Can you find one example of a country with a more corrupt, more prohibitively expensive medical system than the US?
I'm not advocating doing nothing! I just don't think universal healthcare is the only (or best) solution.
the current US system is by far the worst in virtually every category. It is the worst possible outlier.
Exactly, even other non-universal systems have better results than what we have now. I'm not sure why "universal healthcare" is being promoted as the only possible answer.
I'm not advocating doing nothing! I just don't think universal healthcare is the only (or best) solution.
the current US system is by far the worst in virtually every category. It is the worst possible outlier.
Exactly, even other non-universal systems have better results than what we have now. I'm not sure why "universal healthcare" is being promoted as the only possible answer.
Maybe because 7 of the 8 countries in the G8 have universal healthcare?
Why is it that the country with the largest economy in the world, with the highest per-capita GDP, is reluctant to do what other countries have long committed to?
Do you know what it's like to live in a country that has it? You see the doctor, you visit a hospital, you need tests done, you just present your health card and it's all taken care of. The only thing most people see a bill for is for their prescriptions, and even then some countries cover this, too.
When you're in a bind and rushing someone you know to the hospital because they have a life-threatening condition, the last thing you need is the shake-down at the door to see if you have the correct insurance, that you're at the correct hospital, that you've filled out the correct paperwork. There's no question they're covered. You rarely need to worry. You won't get refused on a technicality. You won't be shuttled to a different hospital that's in your network even though the one you're in has the same facilities.
I've had relatives that lived in the US and slowly died of treatable things, but couldn't afford the right kind of treatment and had to make do with second-rate service that even then bankrupted them anyway. How is that fair to anyone?
Universal healthcare. Try it, you'll like it.
Why is it that the country with the largest economy in the world, with the highest per-capita GDP, is reluctant to do what other countries have long committed to?
Do you know what it's like to live in a country that has it? You see the doctor, you visit a hospital, you need tests done, you just present your health card and it's all taken care of. The only thing most people see a bill for is for their prescriptions, and even then some countries cover this, too.
When you're in a bind and rushing someone you know to the hospital because they have a life-threatening condition, the last thing you need is the shake-down at the door to see if you have the correct insurance, that you're at the correct hospital, that you've filled out the correct paperwork. There's no question they're covered. You rarely need to worry. You won't get refused on a technicality. You won't be shuttled to a different hospital that's in your network even though the one you're in has the same facilities.
I've had relatives that lived in the US and slowly died of treatable things, but couldn't afford the right kind of treatment and had to make do with second-rate service that even then bankrupted them anyway. How is that fair to anyone?
Universal healthcare. Try it, you'll like it.
I don't think it can be fixed. Insurance operates like Las Vegas, but minus the benefit of entertainment value. They have really smart math people (actuarials) help design things and the payments have to cover the costs of running the business plus the occasional large pay out. When the payouts get too big, they find excuses to deny more. That is how they make their money. They are not designed to take care of people. I really do not think they can be.
Example: My medical diagnosis is an automatic disqualifier for many of the policies my former employer sold. Working at the company did not change that. Why? Because there is no gamble involved. It is all down side. Someone like me is guaranteed to have high healthcare expenses. There is no hope of making money off me. So they don't bother to offer coverage.
Example: My medical diagnosis is an automatic disqualifier for many of the policies my former employer sold. Working at the company did not change that. Why? Because there is no gamble involved. It is all down side. Someone like me is guaranteed to have high healthcare expenses. There is no hope of making money off me. So they don't bother to offer coverage.
the payments have to cover the costs of running the business plus the occasional large pay out. When the payouts get too big, they find excuses to deny more.
How could it be different? How could any corporation or government operate differently?
How could it be different? How could any corporation or government operate differently?
For starters, by emphasizing more preventive care.
I did a paper on the topic some years ago. Unfortunately, I have to leave for an appointment. I would be happy to discuss it with you further if you are genuinely interested.
FWIW: I don't entirely disagree with you. I am not convinced that mandating universal healthcare would fix the US system. I just don't think your callous perspective on the topic is a real solution.
Catch you later.
I did a paper on the topic some years ago. Unfortunately, I have to leave for an appointment. I would be happy to discuss it with you further if you are genuinely interested.
FWIW: I don't entirely disagree with you. I am not convinced that mandating universal healthcare would fix the US system. I just don't think your callous perspective on the topic is a real solution.
Catch you later.
The U.S. has foodstamps, WIC,* and other programs to help feed the poor.
* Women, Infant, Children. It is a supplemental nutrition program.
* Women, Infant, Children. It is a supplemental nutrition program.
Actually, he said he was out that much due to lost pay alone because he lost his job over this. That doesn't include cost of the medical treatments he needed. Since the insurance's refusal to pay is why he lost his job, I can understand why he felt they owed him.
It looks like this guy was a long-time member of that site, so I'm somewhat inclined to believe the story. But even if it were not real, I've read enough about what goes on in the US to know it's a very possible scenario that plays out all the time.
Plainly barbaric, to many of us in other countries.