Jump to content
disgruntledemployee

The Next President is...

Recommended Posts

7 hours ago, Homestar said:

I won't derail the thread any further, but I'm not convinced that any of those models can work in a country of 325 million. Again, show me an affordable system that provides quality health care for little to no cost to that many citizens and then let's talk.  I'm tired of hearing "hey! they do it in Finland!"  Too bad America isn't an ethnically homogenous country of 5 million people. 

Well considering we're the third most populous country on the planet, and neither us nor the top 2 provide universal healthcare for their citizens, I can't give you an answer based on how you asked the question. China does it, so can we. No excuses for, "too many people."

What I can tell you is that Japan has 127 million people and they do it. Germany has 83 million people and they do it. The UK & France have 66 million people a piece and they do it. All using very different systems. This isn't just something that works for tiny, homogenous Nordic countries. We can develop a system that covers all Americans and works with the unique geographic, cultural and historical factors present in our country; it's not like some kind of impossible problem. It just takes the national will to do so.

Right now we accept, through collective inaction, that we'll all just have to pay more than anyone else in the world by far and that on average we'll receive worse care than many other advanced nations.

I've got opinions on what parts and pieces of other countries systems would work best here as well as new ideas that could help make those systems more compatible with the unique aspects of our country, but like you said, no need to derail further on the thread. :beer:

Edit to add: looks like China has made huge strides toward universal basic health insurance coverage in the last few years. They've got almost 1.4 billion people, so I'm sure we can find a way to make it work with a measly 325 million.

https://www.sciencedirect.com/science/article/pii/S0168851015001864#bib0355

Edited by nsplayr

Share this post


Link to post
Share on other sites
I believe an estimate was released that Medicare for all would run about $32 Trillion for 10 years. Government run healthcare is not the answer, we already have tens of trillions in unfunded liabilities for social security and medicare.


It won’t matter what it costs to supporters of the system, they’ll continue to pull numbers out of thin air because on the end all that needs to be done is establish the government program. Once it’s built it’ll never be removed short of the total collapse of the government and the people at the head of the show (Warren/Sanders/etc) know this.

It’ll be no different than social security; an entity which in no way was formed to be what is is for so many millions of Americans today (a crappy retirement program). But now it’s so engraved into stone as an “entitlement” when it was really designed to be “the social protection to keep you from dying in the street as destitute when despite your best efforts the system crushes you,” that you can move millions of votes to your side or the other simply by saying we need to do something to fix it.
  • Upvote 1

Share this post


Link to post
Share on other sites

If I hear another “but Europe does it”....

Sadly The US provides Europe its defense enabling them to put more of their high taxes towards sub-par healthcare systems since again, they don’t have to do things like defend themselves or NATO allies.

I’ll start looking to Europe for solutions when they fund their own defense, don’t pay $6+ per gallon of gas, don’t steal 50% of citizens incomes etc. etc.

  • Like 7
  • Upvote 2

Share this post


Link to post
Share on other sites
1 hour ago, nsplayr said:

They've got almost 1.4 billion people, so I'm sure we can find a way to make it work with a measly 325 million.

Yes, the amazing things you can accomplish when you don’t have to worry about pesky things like elections and individual rights. 

Japan: ethnically homogenous

Germany: ethnically homogenous (more or less)

France: French. No thanks. 

UK: Heck, even based on the wiki article you posted earlier the British doctors told the author he should just learn to live with the shoulder problem he had. 

Edited by Homestar
  • Like 1

Share this post


Link to post
Share on other sites

Don't really have an opinion on this, but what does ethnic homogenousness have to do with anyhing?

  • Upvote 1

Share this post


Link to post
Share on other sites
3 hours ago, sputnik said:

Don't really have an opinion on this, but what does ethnic homogenousness have to do with anyhing?

It makes law development and spending allocation incredibly easier to agree on. Suggest you read Paul Collier’s Bottom Billion and Wars, Guns, and Votes. He goes into detail on the how and why certain governmental models seemingly work some places and not others. 

 

Edit: suggest purely because they’re interesting reads. 

Edited by SurelySerious

Share this post


Link to post
Share on other sites

So to the socialized medicine we already have:

Medicaid

Medicare

VA

DoD Tricare

Ladies and gentlemen, the defense rests...

 

 

Friend of the court brief:  Look up how big a deficit the oft-touted British NHS runs year after year with significant growth for each year.

  • Like 1

Share this post


Link to post
Share on other sites
5 hours ago, sputnik said:

Don't really have an opinion on this, but what does ethnic homogenousness have to do with anyhing?

As was mentioned before, homogenous means people think alike and thus it is easier to come to consensus and pass common laws.  If you’ve ever been to Japan you know what I’m talking about.  The Japanese are wonderful people, but most of them are not just ethnically homogenous but culturally as well.  Most act, think and even speak alike. 

Also consider this, in Japan - it is considered a grave family sin to be a dead beat in society.  You won’t see many homeless people.  They are all ingrained with a common sense of work ethic and crime is pretty much non existent.  Thus, things like socialized medicine and even strict gun laws work there - the same can’t be said about the US. 

 

Edited by dream big
  • Upvote 1

Share this post


Link to post
Share on other sites
On 8/7/2018 at 4:11 PM, SurelySerious said:

You are correct, you are on a different planet. 

We will see.  Healthcare is one of the hot button topics that touches just about everyone.  Trump himself campaigned on providing better and cheaper healthcare, but has yet to deliver on that promise.  His actions against the mandate has caused the ACA price to rise, and his words suggest he wants it to completely collapse, which doesn't provide a lot of comfort to constituents who rely on it.  He has made some progress on drug prices with generics and possibly medicare negotiations, but overall has failed to live up to his own hype.  I think this topic will push more voters to the polls this year, but we will see.

Share this post


Link to post
Share on other sites
5 hours ago, brickhistory said:

So to the socialized medicine we already have:

Medicaid

Medicare

VA

DoD Tricare

Ladies and gentlemen, the defense rests...

 

 

Friend of the court brief:  Look up how big a deficit the oft-touted British NHS runs year after year with significant growth for each year.

Perfect is the enemy of good.  While these systems aren't perfect, they are often better than what people have.

So how would you fix our broken healthcare system?

Share this post


Link to post
Share on other sites
16 minutes ago, drewpey said:

Perfect is the enemy of good.  While these systems aren't perfect, they are often better than what people have.

So how would you fix our broken healthcare system?

I'm not doing your homework.  You want it changed, you propose your solutions complete with how it's funded.

I've got popcorn to make...

Edited by brickhistory
  • Upvote 2

Share this post


Link to post
Share on other sites
On 8/8/2018 at 10:42 AM, MooseAg03 said:

I believe an estimate was released that Medicare for all would run about $32 Trillion for 10 years. Government run healthcare is not the answer, we already have tens of trillions in unfunded liabilities for social security and medicare.

Didn't that same report say that the $32T was a $2T savings over what we'll spend with our current system?

  • Upvote 1

Share this post


Link to post
Share on other sites
21 hours ago, nsplayr said:

The UK & France have 66 million people a piece and they do it.

Puhleezzz...if your liberal utopian vision of universal healthcare is what they are doing in the UK I sincerely hope you never need medical attention.  The NHS system in the UK is in full on meltdown, they themselves have stated they are Condition BLACK.  Analysis by the Royal College of Surgeons found that over the past year an average of 193,406 people a month did not get surgery within 18 weeks of being referred.

https://www.theguardian.com/society/2017/jan/13/193000-nhs-patients-a-month-waiting-beyond-target-for-surgery

  • Like 1
  • Upvote 2

Share this post


Link to post
Share on other sites

You spent a considerable amount of time in a universal healthcare system (tricare) and are now presumably retired into a similar system, yes?  So it appears you are in this type of system but encourage everyone to know how bad that system will work.  I do not follow your logic.

Share this post


Link to post
Share on other sites
Didn't that same report say that the $32T was a $2T savings over what we'll spend with our current system?

Savings from negotiating directly with drug makers and reduced administrative costs (I’m guessing from fewer insurance executives) would total about $2.4T.

From the same article: “It’s showing that if you are going to go in this direction, it’s going to cost the federal government $2.5 trillion to $3 trillion a year in terms of spending,” said Thorpe. “Even though people don’t pay premiums, the tax increases are going to be enormous. There are going to be a lot of people who’ll pay more in taxes than they save on premiums.” Thorpe was a senior health policy adviser in the Clinton administration.”

Who cares if insurance companies are spending less on administration if it means more money in taxes paid by the average American. All while taking away their liberty to get whatever sort of health care they want or don’t want. It’s not fitting with the spirit of the Constitution to steal 40%+ of my income just to make sure I can have treatment if I ever develop cancer, and I don’t give a shit what the legislate-from-the-bench Supreme Court said about it. Our country is about having liberty and freedom to do what you want, it wasn’t fought for and founded to become a nanny state to take care of people from cradle to grave.

Share this post


Link to post
Share on other sites
You spent a considerable amount of time in a universal healthcare system (tricare) and are now presumably retired into a similar system, yes?  So it appears you are in this type of system but encourage everyone to know how bad that system will work.  I do not follow your logic.

Are you saying because we use Tricare that it can’t be a bad system? Have you ever argued with them over referrals? Has your family ever tried to get an appointment on base? I had to wait 5 weeks for my flight physical appointment a few months ago.

Plus our med group has multiple doctor vacancies. Turns out spending a quarter million on med school isn’t very conducive to a career in socialized medicine.

Share this post


Link to post
Share on other sites

TRICARE works fine for me and most of the 2 million or so it serves.

That doesn't mean that it will work for 325 million.

Share this post


Link to post
Share on other sites

- The appointed Special Counsel is friends with one the primary players in the drama

- The Deputy Attorney General signed one of the FISA renewal applications that led to the appointment of the Special Counsel.

- The Deputy Attorney General is the one who selected this specific individual to be the Special Counsel.

- The lead FBI investigator for the Special Counsel was fired for the appearance of bias.

- The FISA warrants themselves were based, at least in part, if not large part, on political opposition research that is unsubstantiated.

- The number 4 guy in DOJ had continuing contact with the dossier's ex-spy author even after the ex-spy was fired by the FBI for lying to the FBI about media contacts.

- The wife of the number 4 DOJ guy worked for the opposition research firm who funded and disiminated the opposition research dossier.

 

Shenanigans = a duck?

 

If you, personally, were in the crosshairs of a federal investigation with these issues, would you be good with it?

Edited by brickhistory
  • Like 2

Share this post


Link to post
Share on other sites

Substitute AFOSI for FBI and WG/CC for Deputy Attorney General and imagine the "harrumphs" that would be filling the thread.

  • Upvote 2

Share this post


Link to post
Share on other sites
You spent a considerable amount of time in a universal healthcare system (tricare) and are now presumably retired into a similar system, yes?  So it appears you are in this type of system but encourage everyone to know how bad that system will work.  I do not follow your logic.


Yeah so I actively pulled my wife out of Tricare prime specifically because there were better options available when I’m not dictated by my government what form of care she would receive during her pregnancy.

But hey maybe the 3 year fight to get her knee surgery or watching my retired father (who works for the VA after a 20 year medical career in the AF) have his standard of care eroded every single year under “tricare for life” is all just an illusion.

Do you seriously want to sit there and tell us our benefits haven’t gotten worse as the belts have tightened? You think something as well funded for as low a population it has is going to work better when you dump a couple hundred million more people into it and leave them with no real recourse against it that it’s all gonna work better?
  • Upvote 1

Share this post


Link to post
Share on other sites
23 hours ago, drewpey said:

Perfect is the enemy of good.  While these systems aren't perfect, they are often better than what people have.

So how would you fix our broken healthcare system?

I'm a bit more charitable than brick.

Simple fixes:

  1. We have to establish an actual marketplace for healthcare. How? Start by allowing private insurance to be bought across state lines.
  2. Require hospitals and doctors to advertise the cost of their services either online, or in a publicly accessible database where people can shop around.
  3. HSA's should be mandatory for everyone over the age of 18, be tax free, have no spending caps or limits, but allow no cash withdrawals (I guess an age has to be given for expiration, but make it very very very old)

I mean, you could even give a tax break or federal deposit to your HSA if you can prove that you attended a physician x times a year (incentivize preventative medicine).

My end goal would be to move private insurance more towards a catastrophic coverage focus and let doctors/specialists have the ability to operate more on a cash basis (through HSAs and $) moving forward. 

We shouldn't try socialized medicine until every market-based option is exhausted. In 30 min, I came up with 4 ideas that haven't been tried. Let's start there.

 

Edited by Kiloalpha

Share this post


Link to post
Share on other sites

I want everyone to have access to health care.  It sucks to hear stories about people who go bankrupt over medical costs or who suffer permanent or prolonged poor health because of the barriers to care.  I want universal health care to work.  I especially feel for those with expensive pre-existing conditions.

Most people point out the tough financial realities of such a government, or single-payer, program.  I don’t disagree that the costs would require a significant increase in taxes from one or more sources.  Depending on how much it cost, I wouldn’t necessarily be opposed to it. For example, if taxes went up 4% and everyone was covered, cool, I could live with that.  If they go up 15-20% overall, that’s a tough pill to swallow, sts.

But my opposition is primarily tied to two other issues that I think are more important long-term.  The first is my concern about government creep, a historical near-certainty.  Imagine that the government runs health care and sees costs starting to rise; or maybe costs are going down but Congress wants to fund something else and needs to cut its health care costs to fund this other project.  Meanwhile, people are pissed because their taxes are going to treat people who smoke, drink, and eat crappy all the time.  So, government does what it always does and tries to “fix” this unfairness.  Maybe this would result in limiting cigarette purchases, or banning them altogether.  Alcohol is unhealthy, so that eventually goes down the same path.  Unhealthy foods are taxed more with the idea that these taxes will go to fund the health care system.  Over the course of a couple decades, small, almost imperceptible regulations that are passed in the interest of fairness lead to a situation where the government controls (more or less) what you eat, drink, and perhaps even how you act (ie. extreme sports have a higher correlation to injury and long-term health care costs, so even they are restricted). I know hyperbole and the “what-if” game is a poor argument, I’m just trying to suggest that government-run healthcare could EASILY be an invitation to the government to enter the most personal aspects of your life and freedoms.

Second, profit-motive is a very hospitable environment to medical advancements.  The U.S. is unquestionably the leader in world medical breakthroughs whether that is measured by private and public research expenditures, Nobel prize awards, or published articles and research in medical journals.  Today, for a company to bring a generic drug to market it costs between $600-800 million dollars.  A brand new drug costs between $2-3 billion dollars.  This is the cost of the research, chemistry, FDA wickets, studies, wait times, etc.  The reason a company is willing to spend billions is the guarantee of patent protection that allows them to exclusively sell that drug, once it is approved, for a given number of years.  (This year, Viagra loses its patent protection FYI)  So, Pfizer pays $2 billion for drug X, they have a patent and sell it for whatever they want to recover the costs of development and to make a profit.  Government health care necessarily uses price fixing methods to control costs, which removes the profitability of medical research by private companies.  If you take away a company’s patent rights or exclusive pricing control, they don’t make money and they don’t research and develop new medicine.  (By the way, this isn’t just pharmaceuticals, it’s relevant to medical devices, procedures, techniques, etc)  It sucks that medicine might be too expensive for people who need it, or some jackass buys the patent and increases the price 100 fold; I agree they are playing with people’s lives.  But I also know that if they didn’t get paid, they wouldn’t have invented or developed the drug in the first place.

So I don’t know, I don’t have an answer, just thoughts. But I do think two good places to start would be to look at policies surrounding patent duration and also cutting the cost of FDA approval, thought I know that’s a health and safety concern.  Nevertheless…

  • Like 2

Share this post


Link to post
Share on other sites

I’m weary of a fully cash based system for healthcare, even if doctors provide their prices upfront. Vets are almost all cash based and prices are competitive. But if the cost is too high, or the suffering is too great, I can put the dog down. That isn’t something I would do for my kid or my wife. So people expect to do whatever it takes to keep their family members alive and healthy. I don’t know what will solve this problem; personally I think Medicare for all would be the solution for most people, but it would not be without cost.

 

Of course a portion of expensive health problems can be solved by reducing obesity but that opens up a whole different can of worms, since it is a problem across every demographic in the US. I don’t want the government or google tracking my weight and denying healthcare if I don’t get my steps in.

 

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now



×