Conservapedia: The funniest site in the world
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Things I learned today: there are 3 sides to this "debate". For, against, and "fuck it, too hard".
That's complete crap and you know it. The current system, and the new one that supposedly intends to replace it, is flawed. That's a given, but you can't proclaim future systems impossible because the current implementation is broken.
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but you can't proclaim future systems impossible because the current implementation is broken.
Much of what's to be found in this direction
from your post would tend to indicate the contrary.
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No, you lot have ignorance. We're the ones with the bliss. Or something a damn sight closer to it than you have, anyway.
I don't know what you know about the US, but @aapis has shown a fair amount of ignorance. And our country is currently more concerned about how to add people and territory than to keep it from leaving.
If that were true there would be no debate at all because you'd already have a world-class public healthcare system.
TDEMSYR
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Tempted to exploit the multiple like bug for this one.
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@boomzilla so far your argument, in it's entirety, is that everyone who disagrees with you is ignorant. I would be offended, but I have the combined might of every country who has ever successfully implemented universal healthcare systems on my side and you have abysmal failure on yours. Typical American attitude. Everyone else is wrong because you're not from here. Nothing works unless we create it from scratch.
And our country is currently more concerned about how to add people and territory than to keep it from leaving
What does that even mean? Do you mean to suggest that your country shouldn't worry about people leaving it through death due to incompetent medicare?
Does "TDEMSYR" have an English translation?
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It will be hellishly expensive to actually fix, particularly in terms of political capital. (Money too, but the system it would replace is so utterly expensive that that shouldn't be so much of a problem.) That means that clearing this particular swamp is going to be awfully difficult; ordinary people are very attached to having some form of healthcare and very fearful of anyone doing anything that might be slanted by someone as taking it away. A lot of people, many of whom are making a very nice living right now thankyouverymuch, would have an incentive to be a bit less than 100% honest in describing the effects of reform proposals…
It's not fighting left/right. It's against the healthcare-industrial-complex. They make the military-industrial-complex look like puny amateurs in terms of total spend and political influence…
First: political capital? Where does one find it? It sure isn't on the store shelves, especially not in Washington, D.C.
Second: Yeah. What is it with some corporations and having no long-term vision at all? It makes me wonder if there's going to be a mass corporate die-off of sorts soon...
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Well those posts would be wrong, then. Skipped most of the thread, only showed up to express the warm fuzzy feeling I get when Americans discuss this topic. For whatever reason, boomzilla decided to be offended so now I've been dragged into this quagmire too.
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Things I learned today: there are 3 sides to this "debate". For, against, and "fuck it, too hard".
That's complete crap and you know it. The current system, and the new one that supposedly intends to replace it, is flawed. That's a given, but you can't proclaim future systems impossible because the current implementation is broken.
We current spend 17% of our GDP on health care and get crappy results. It isn't a matter of "who pays that 17%", it's a matter of "oh crap, if this goes up again we won't be able to afford the crappy level of care we already have."I've worked in the health care field in both insurance and supply chain. I can tell you that the insurance industry only has a 5 to 8 percent overhead and supply chain has 4 to 5 percent overhead. There isn't much to squeeze out of them. If all of our health care payments were processed by magic fairies that did it for no cost, we would still be paying about 16% of our GDP for crappy health care. I'm certain that no payment system in any country runs as efficiently as volunteer magic fairies.
The UK pays about 10% of it's GDP for health care and Germany pays about 12%. Both get better results than the US system does.
I'm not saying "Fuck it". I'm saying "Stop solving the payer problem!!!!". I would happily take the worst payer system imaginable, if it was paired with affordable health care delivery. I don't care if the CEO of an insurance company heats his house with $100 bills - he isn't the biggest problem.
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@boomzilla so far your argument, in it's entirety, is that everyone who disagrees with you is ignorant.
No, I'm saying that you said things that are trivially and obviously wrong.
What does that even mean? Do you mean to suggest that your country shouldn't worry about people leaving it through death due to incompetent medicare?
Good lord, please try to read things. @tufty was riffing on the "bliss" part of "ignorance is bliss," and I was replying.
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We current spend 17% of our GDP on health care and get crappy results.
Except that we don't, really.
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Except that we don't, really.
My question is, compared to our investment, or compared to other countries?
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Except that we don't, really.
I don't think anyone was suggesting that you, personally, pay 17% of US GDP for healthcare. ;-)
Basically, it looks like this: the overall cost is too high. (People don't pay equally, but then they never do.) There are other things that some of the money would be better spent on.
Reducing the costs probably requires moving towards a single-payer system at least for bulk healthcare, so that there's someone who can pressure to keep costs down. (Competition doesn't seem to be working to do that, so another approach is needed.) It probably also needs a bigger focus on preventative healthcare, fixing things while they're cheap to deal with (and can allow people to keep working while undergoing treatment) rather than waiting until they're a major problem, when they'll cost more to treat and incapacitate the patient more severely (with knock-on economic effects). I suppose it's not that different from doing maintenance on your car or your house: leaving dealing with the chimney until it crashes through your roof isn't a good plan!
What we can say from the national-level statistics is that something is badly wrong. Really badly wrong. Given the population age profile and actual wealth available, aggregate outcomes out to be really rather good (because you've got a comparatively young population for a G7 country, and younger adults are in general fitter and less likely to need medical attention). Yet that's not observed in the stats: your outcomes are overall rather… well… meh.
I wonder if a state-by-state analysis would be more indicative of what's going on? (Could it be coupled to problem poverty? Perceived lack of social status has been found to have a distinctly negative effect on people's health, so maybe.)
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My question is, compared to our investment, or compared to other countries?
And how do you even start to compare to other countries? Most of these Universal Health Care Paradises have pretty small and homogeneous populations relative to the US.
My wife had shoulder surgery a few months ago (rotator cuff). We tried a few doctors in our network but ultimately chose a doctor who came highly recommended from several people whom I trust and regard highly. It's a lot more expensive, but we ended up with a really good result.
I have family and friends with similar orthopedic issues (though different joints) who have less choice. They're unsatisfied with their doctors and/or not getting appropriate treatment. I'm sure I'm spending tons more money on this than they are, but I'm damn happy with the money I spent (and will continue to spend for a few more months of physical therapy), and not just on medical costs, but the extra gas (the doctor is about 40 miles away, often through heavy traffic).
I don't think anyone was suggesting that you, personally, pay 17% of US GDP for healthcare.
My quote was with respect to the outcomes: "get crappy results."
Competition doesn't seem to be working to do that, so another approach is needed.
THAT'S BECAUSE THERE'S NO FUCKING COMPETITION. Actually, that's not quite true. There is competition in things like Lasik eye surgery, and guess what, it's been getting better and cheaper! I'm not saying that every single medical thing could work like that, anyone who says that the US health care industry is based on competition hasn't got a fucking clue.
It probably also needs a bigger focus on preventative healthcare, fixing things while they're cheap to deal with
Sweet. Another fallacy of health care economics. Sure, it's maybe cheaper for you, if you actually catch something, but we spend a lot of money on, say, mamograms that aren't very cost effective. "Well, don't you want to catch cancer in your mom/sister/daughter?" Yes, motherfucker, THAT'S ONE REASON WE SPEND SHITLOADS OF MONEY ON HEALTH CARE.
What we can say from the national-level statistics is that something is badly wrong. Really badly wrong. Given the population age profile and actual wealth available, aggregate outcomes out to be really rather good (because you've got a comparatively young population for a G7 country, and younger adults are in general fitter and less likely to need medical attention). Yet that's not observed in the stats: your outcomes are overall rather… well… meh.
For one, we're more honest about our reporting (this especially hurts us with infant mortality). And the demographics are very different, and you're lying with statistics here. Typically, when you look at people in the US who came from other places, they're healthier and live longer than do the people back home (this actually happens in education, which is a different topic, but hey). This includes life expectancy darlings the Japanese.
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Typically, when you look at people in the US who came from other places, they're healthier and live longer than do the people back home (this actually happens in education, which is a different topic, but hey). This includes life expectancy darlings the Japanese.
needs sauce (am interested to see).
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I have family and friends with similar orthopedic issues (though different joints) who have less choice. They're unsatisfied with their doctors and/or not getting appropriate treatment. I'm sure I'm spending tons more money on this than they are, but I'm damn happy with the money I spent (and will continue to spend for a few more months of physical therapy), and not just on medical costs, but the extra gas (the doctor is about 40 miles away, often through heavy traffic).
Your own example shows that routine medical procedures are expensive enough here that many people are forced to compromise. In most countries, a procedure that costs thousands here will cost hundreds there. Shopping for a better physician is an option for more people there.That's a good example of "crappy results".
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anyone who says that the US health care industry is based on competition hasn't got a fucking clue.
Ain't that the truth. Who has time to shop around for the best price when they're suffering a heart attack? Or appendicitis? Even if you have a condition that gives you time to shop around, you often don't have many competing choices. For example, here in the Phoenix area, most of the hospitals are owned by Banner Medical. There's not a lot of difference in prices from hospital to hospital.
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In most countries, a procedure that costs thousands here will cost hundreds there.
Like what?
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Ain't that the truth. Who has time to shop around for the best price when they're suffering a heart attack?
That's the straw man that people bring up to say that you can't have competition for anything. That sort of argument just shows a @blakeyrat level of imagination and critical thinking skills.
But no one has any clue what anything costs. Go to any medical facility and ask them for a price. It won't happen.
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Like what?
Are you saying that you don't believe that the US is the most expensive place to get pretty much any medical procedure done? And it's not because we're the best, either.Here's a good example. It's not just some guy saying "my mother had that done in Canada and it was cheaper". This is the NIH looking at over a thousand procedures and finding dramatic differences in price.
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But no one has any clue what anything costs. Go to any medical facility and ask them for a price. It won't happen.
One of the premises behind high-deductible health plans is they help keep costs down because the consumer has to pay so much out-of-pocket that he will shop around (for non-emergency care, of course) for providers that are less expensive. Obviously, this fails completely if providers refuse to divulge their fees (I haven't tried, myself). It also doesn't work well in those families where a custodial parent is responsible for raising the children, including obtaining medical services, but the non-custodial is entirely responsible for paying for said care; the custodial parent has no incentive to limit medical costs. Finally, even if you can find the lowest priced doctor in town, do you really want to put your life in the hands of Dr. Joe's Discount Medical Clinic?
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Sure, focus on just half of my argument. However, just because it's not an in depth analysis doesn't mean it isn't true.
As for getting a price list, you're generally right. They are difficult to obtain, and are generally indecipherable when you can get them.
With the second half of my earlier post, I was trying to indicate that in many areas there is limited competition. Unless you are willing to travel, some portions of the health care industry are starting to develop a service provider setup: legal, localized monopolies.
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I also understand, though anecdotally, that the US has a high fondness for new (and hence in-patent, expensive) drugs by comparison with the rest of the world, together with a keen enthusiasm for being very… thorough during the diagnostic phase. The new drugs might be better, but are they that much better to be worth all that extra money all the time? Knowing more about what's going on can be helpful, but earlier treatment is also helpful and some diagnostic procedures are very expensive (and invasive and/or even iatrogenic).
The health care system is fucked up in many countries, but the fuck up is much larger in the US than anywhere else.
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Are you saying that you don't believe that the US is the most expensive place to get pretty much any medical procedure done? And it's not because we're the best, either.
No, I think there are all sorts of stupid reasons why stuff is expensive. None of this goes to talking about health outcomes, of course.
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Here's a good example. It's not just some guy saying "my mother had that done in Canada and it was cheaper". This is the NIH looking at over a thousand procedures and finding dramatic differences in price.
This bit is interesting, and points to patients in the US having a better experience:
Higher in-hospital costs were found for the American hospitals despite the fact that they had a significantly shorter patient length of stay compared with Canadian centers (p < 0.0001). Canadian hospitals should follow the lead of their counterparts in the United States and implement strategies to decrease the length of stay in the hospital, while institutions in the United States should revisit their ability to better manage the costs related to a primary total hip arthroplasty, particularly by controlling unit costs.
Of course, the surgery costs for the Americans are subsidizing other stuff that goes on, which Canadians deal with differently. There's all sorts of absurdities in American health care financing, and so much of it goes back to FDR's stupid wage controls in WWII.
Then, of course, there is the issue of timely access to care. The US does pretty well there.
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Sure, focus on just half of my argument. However, just because it's not an in depth analysis doesn't mean it isn't true.
As for getting a price list, you're generally right. They are difficult to obtain, and are generally indecipherable when you can get them.
With the second half of my earlier post, I was trying to indicate that in many areas there is limited competition. Unless you are willing to travel, some portions of the health care industry are starting to develop a service provider setup: legal, localized monopolies.
Yes, I know. I didn't disagree with anything there. I was just trying to focus on simple bits that even Europeans should be able to understand.
I also understand, though anecdotally, that the US has a high fondness for new (and hence in-patent, expensive) drugs by comparison with the rest of the world, together with a keen enthusiasm for being very… thorough during the diagnostic phase.
It's also a problem for us that most countries free ride (to greater or lesser extents) on our investment in new drugs. Part of the reason for going for expensive stuff is, again, that no one knows what anything costs. This is actually a silver lining in Obamacare. Everyone is getting bigger deductibles, so we can't simply get by with a tiny co-pay for expensive services.
The health care system is fucked up in many countries, but the fuck up is much larger in the US than anywhere else.
As long as we're talking about health care financing, you're not wrong.
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No, I think there are all sorts of stupid reasons why stuff is expensive. None of this goes to talking about health outcomes, of course.
We pay 50% more than the next country. I don't think anyone can argue that we get substantially better outcomes for that money. Even of we did, we can't afford it for much longer.The World Health Organization rated our outcomes the 12th best in the world. I understand you hold a different opinion, but as long as you are just going to give me examples (anecdotes are not data) and opinions, I don't think I'll ever convince you. You are entitled to your opinion and I don't have the energy to try to change your mind.
My opinion of why we pay more has two parts. First is salaries. Health care workers, particularly doctors, make much more in the US than elsewhere.
Second is the legal protection afforded to pharmaceutical companies. Most of them try to recoup all of their R&D costs from US sales and only try to make a profit on production from foreign sales. There are two reasons for this: strong patent protection and strong import restrictions.
If both of the above lead to the US becoming the place where people come to get healthy, I would have no problem with it. Overly bureaucratic approval processes and top-level stupidity like low-fat dietary recommendations ensure that our medical system is no better than the rest of the world's. It's worth noting that our most wealthy people often go to other countries for cutting-edge medical treatments.
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Even of we did, we can't afford it for much longer.
We are definitely in agreement here.
My opinion of why we pay more has two parts. First is salaries. Health care workers, particularly doctors, make much more in the US than elsewhere.
Second is the legal protection afforded to pharmaceutical companies. Most of them try to recoup all of their R&D costs from US sales and only try to make a profit on production from foreign sales. There are two reasons for this: strong patent protection and strong import restrictions.
Those are both true, though I think the bigger reason again is that the incentives in the screwy system we've come up with encourage inefficiencies.
It's worth noting that our most wealthy people often go to other countries for cutting-edge medical treatments.
Yes, the FDA is in the business of keeping in business.
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@Jaime said:
My opinion of why we pay more has two parts. First is salaries. Health care workers, particularly doctors, make much more in the US than elsewhere.
Second is the legal protection afforded to pharmaceutical companies. Most of them try to recoup all of their R&D costs from US sales and only try to make a profit on production from foreign sales. There are two reasons for this: strong patent protection and strong import restrictions.
Those are both true, though I think the bigger reason again is that the incentives in the screwy system we've come up with encourage inefficiencies.
I suspect that fixing things will require tackling the bad incentives and the artificial barriers to entry and failures in prevention and the salary inflation and the unhealthy (hah!) relationship between medicine and business and politics. Probably all at the same time too, and it'll likely be horrendously painful to everyone concerned in terms of political and economic fallout.
You guys are in deep trouble.
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You guys are in deep trouble.
Yeah. You guys will likely notice when all that stuff causes us to fold up our tanks and go home. We're currently a military with a pension plan, but soon just the pension plan will be left.
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I suspect that fixing things will require tackling the bad incentives and the artificial barriers to entry and failures in prevention and the salary inflation and the unhealthy (hah!) relationship between medicine and business and politics. Probably all at the same time too, and it'll likely be horrendously painful to everyone concerned in terms of political and economic fallout.
You guys are in deep trouble.
Yes, and I suspect that everyone knows it if only on a subconscious level, which may explain why the common reactions to the Affordable Care Act didn't include:
You crazies are putting a band-aid on top of a gunshot wound! If healthcare costs keep going up the way they are now, it won't matter who pays for it because no one will have enough money! Why not try addressing that instead?
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I've been saying for a while that the solution to the looming Medicare tsunami is mandatory smoking. Think of all the revenue from tobacco taxes? Probably balance the budget, to boot.
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I've been saying for a while that the solution to the looming Medicare tsunami is mandatory smoking. Think of all the revenue from tobacco taxes? Probably balance the budget, to boot.
And the Supreme Court will allow it because
they bloody well feel like itit's a tax.
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You crazies are putting a band-aid on top of a gunshot wound! If healthcare costs keep going up the way they are now, it won't matter who pays for it because no one will have enough money! Why not try addressing that instead?
This was a common reaction, we were simply dismissed as racist crazy rednecks for bringing it up.
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Also, we don't want anyone to have health care, and our preferred plan is "Don't get sick."
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Alternatively :
U.S. Ranks Last Among Seven Countries on Health System Performance Based on Measures of Quality, Efficiency, Access, Equity, and Healthy Lives
Despite having the most expensive health care system, the United States ranks last overall compared to six other industrialized countries—Australia, Canada, Germany, the Netherlands, New Zealand, and the United Kingdom—on measures of health system performance in five areas: quality, efficiency,...
Despite having the most expensive health care system, the United States ranks last overall compared to six other industrialized countries—Australia, Canada, Germany, the Netherlands, New Zealand, and the United Kingdom—on measures of health system performance in five areas: quality, efficiency, access to care, equity and the ability to lead long, healthy, productive lives, … While there is room for improvement in every country, the U.S. stands out for not getting good value for its health care dollars, ranking last despite spending $7,290 per capita on health care in 2007 compared to the $3,837 spent per capita in the Netherlands, which ranked first overall.
It's hardly the only report to suggest this, either. OECD, UN, everyone but you seems to agree the US health system is a hideously expensive shambles.
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No one disagrees that it isn't hideously expensive. I've already talked about some of the demographic challenges that make comparing to other relatively small countries difficult.
Ignoramuses like @tufty and @aapis think that a better solution is to hand everything over to the people who brought us the Veteran's Administration and the Bureau of Indian Affairs.
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I should also add, any study that says something like "the US does poorly, ranking last when it comes to infant mortality" instantly loses credibility. A lot of these studies end up being basically proxies for a government run / single payer / etc health system.
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A lot of these studies end up being basically proxies for a government run / single payer / etc health system.
And what about the rest of them?
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And what about the rest of them?
Clearly every study that disagrees with a person's opinion is wrong. That's how science works.
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And the Supreme Court will allow it because <strike>they bloody well feel like it</strike> it's a tax.
And then they'll later rule that religious groups (such as Seventh Day Adventists and Latter-day Saints) are exempt, which will mess the estimated intake just enough that it will cost more to enforce than the program takes in.
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hand everything over to the people who brought us the Veteran's Administration and the Bureau of Indian Affairs.
NO!!!! PLEASE DON'T!!! My brother can't even get proper treatment for his back injury (sustained while serving in Afghanistan) through the VA.
Yes, I know @boomzilla wasn't advocating this. I was merely trying to emphasize his point.
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And what about the rest of them?
They don't say monumentally misleading things like, "The US has terrible infant mortality rates."
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How about "The US has significantly worse infant mortality rates than Cuba"?
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How about "The US has significantly worse infant mortality rates than Cuba"?
That's a great example of someone who doesn't understand what's going on (not to mention trusts Cuban statistics).
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I don't trust Cuban statistics. That's why I asked the CIA.
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Click to download chart as a powerpoint slide links to a gif....
http://www.commonwealthfund.org/~/media/images/publications/fund-report/2010/jun/mm2010l.gif
I mean.. .I guess powerpoint can open gifs?
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Like what?
I've had multiple people tell me that major dental work, like removing several teeth and getting a bridge--is considerably cheaper if you go to the US, Mexico, Turkey, India, etc. As in you could in certain circumstances save thousands of dollars even after factoring in airfare, hotels, and stuff.
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But no one has any clue what anything costs. Go to any medical facility and ask them for a price. It won't happen.
Interestingly enough, concierge medicine is putting the lie to that. There's a surgery center in Oklahoma that has posted prices for something like 70 relatively common surgeries like hernia repair, with a breakdown like "costs cover the surgery, doctor's fees, a set number of pre- and post-operative visits." The article I read about this particular place points out that some of the surgeons there also work at regular hospitals, and managed to get some price comparison. A surgery that might cost $2500, say, at this place, would be billed to insurance as $10000 or more at the regular hospital. (Now we all know the insurance companies will reimburse far less than that, and the hospitals take what they get, but the quoted price, not the discounted one is what you'd pay if you were a cash customer.)
