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Lots of people believe that the Healthcare system in America is broken.
Do you think it's broken, if so what is making it broken?
How should we fix it, or improve on it?
This is a very partisan question, and I think both sides disagree why Healthcare doesn't work. Be ready to back yourself up with sources if need be.
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Split the military budget in half to support infrastructure and healthcare.
Overhead and insurance are creating inefficiency, and there's no incentive to fix it, in fact, because of the way the private insurance system works, there's an incentive to actually maximize cost in certain situations. https://www.medicalbillingandcodingonline.com/medical-claims-process/
In my opinion, private insurance, is, and always has been, a bad idea, even in concept. The insurance company is incentivised to just take everyone's money and give nothing back. It warps healthcare providers' behavior too, it encourages them to bill as much as they can to the insurance companies. Of course that's going to spike up cost for the patient! Doing away with private insurance as a whole is the way to do it, unless we can actually get a competitive economy back, i'd like to see it, but i'm not holding my breath. Government or community-based insurance could potentially work, but private insurance? You're literally giving money to a capitalist on the promise that they'll be nice and take care of you when you're hurt, basically out of the goodness of their heart. That's like asking a shark to watch over your pile of raw meat for you until you get back. Of course they're just going to eat all the meat and then bite you if you try to get it back!
There is of course the issue that america is largely carrying global medical research, and the costs that come with that, entirely alone on it's back right now. I think that could still stay the case if we did away with the current system that encourages high cost. We might still have worse bang for our buck than other countries, but it probably wouldn't be the abysmal hellscape we have right now. Still, in a lot of these cases of "america pays too much for x", it's because we're footing the international bill. It's the same with military spending. We spend more because we're managing everything. Canada and Europe don't need to spend on military because the united states more or less does that for them. If we didn't have to foot the bill for every international problem, things would be so, so much better for average americans. I'd like to see Europe put as much money and effort into international peace and humanity-advancing research as they do trying to censor lolis. If they did, maybe we americans would be able to afford a fucking ambulance.
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>>3952>Do you think it's broken
Yes>if so what is making it broken?
Ill-conceived and poorly executed government regulation of healthcare. Young, healthy workers can't afford to buy health insurance because of dumb laws that prevent insurance companies from offering health insurance unless it includes gold-plated advanced cancer treatment for boomers.
Some European countries have national insurance that explicitly evaluates treatments of terms of the difference it makes to quality of life (QoL) integrated over the person's life expectancy. So an expensive treatment that adds two years of life to a person with a terrible QoL might be rejected, while an equally expensive treatment that significantly and permanently adds to the QoL of a person with a 30-year life expectancy might be covered. That seems like a reasonable route to go. And people should get to choose different levels of healthcare coverage that have different premiums, instead of a one-size-fits-all model.
The government should:
- try to ensure a functioning free market in health care (e.g., price transparency),
- allow providers to charge for emergency healthcare provided to patients who are unable consent but prevent gouging,
- prevent insurers from kicking out insureds for bogus reasons,
- have some mechanism for allowing health insurance portability (as opposed to being locked into a single company for life once pre-existing conditions make it so that no new company would take them on)
- a few other things
but should not try to micromanage the details of what services are covered or not. Also "death with dignity" laws should be adopted by all states. If a patient with a low QoL prefer to die relatively gracefully rather than cling on to a horrible life, the government has no business forcing the doctor to keep the patient alive and forcing the patient to pay for unwanted care.
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>>3961>In my opinion, private insurance, is, and always has been, a bad idea, even in concept.... You're literally giving money to a capitalist...
Not all private insurance is for-profit. Some private insurance is operated on a non-profit model. (And I agree that for-profit insurance seems like a worse idea than a non-profit.)>>3961>There is of course the issue that america is largely carrying global medical research, and the costs that come with that, entirely alone on it's back right now.
Part of the problem is that the US government makes it a criminal offense to import prescription drugs from Canada and Europe. Maybe there are reasons to prevent insurers from covering foreign drugs that aren't approved by the FDA, but the government shouldn't be threatening imprisonment for importing drugs from first-world countries.
>>3962>Young, healthy workers can't afford to buy health insurance because of dumb laws that prevent insurance companies from offering health insurance unless it includes gold-plated advanced cancer treatment for boomers.
I'd like your input on the story of my mid 20s sister in law.
She was riding her motorcycle some years back when a car suddenly clipped her while merging carelessly. She flipped over a car and in the wreckage had her abdomen torn open. Fortunately she survived, but you have to imagine it was a long time in the hospital. The bill came to something like 300-400k.
This was before the ACA, she found that her health insurance was basically useless, I think it covered about 10k of that bill. She had a plan like that because she was young and didn't think she'd need cancer treatment or whatever. She also expected it would cover more than the measly amount that it did.
Other minor details, the other driver at fault had no insurance and pretty much had no money to go after. Nothing to squeeze out of there.
My sis clearly should have read and understood her health coverage, but even if she did, she'd probably have made the same mistake. What young adult with college debts wants to pay for the kind of insurance that actually does something? Nobody, that's who. It's the first kind of thing someone on a tight budget will make a cut to. But, because of that she effectively won the shit lottery and is saddled with not just chronic pain for life, but a debt that'll ruin her for the rest of her life.
So, in your opinion, what went wrong? And how should we devise the system so that this can't happen? Or is this a scenario that you believe is perfectly acceptable in our society?
One thing the ACA brought was the end to useless plans that do next to nothing being sold, you'll have to be very convincing to me that removing regulation so that these plans can exist again is a good idea.
>>3967>Insurance. It's always been a scam, it should really count as gambling
Insurance (as in actual insurance, like fire insurance or car insurance) is the opposite of gambling. With gambling, you're looking to increase the variance of your wealth; with insurance, you're looking to decrease it.
Of course, most health """insurance""" isn't actually insurance at all; receiving a payout is the norm rather than a rare exception.
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>>3966>So, in your opinion, what went wrong? And how should we devise the system so that this can't happen?
The insurance company should not have been allowed to misleadingly market their product. The government should make sure that the insurer clearly communicates what won't be covered. And if the insurer doesn't, then it should be held liable for covering what a reasonable person would expect to be covered.>My sis clearly should have read and understood her health coverage, but even if she did, she'd probably have made the same mistake.
I'm not sure if the government should force people to purchase insurance that they don't want. Should home-owners be forced to buy fire insurance? (Car insurance is different because it covers liability to other people.) Sometimes the government does know better, but it still makes me a bit uncomfortable for the government to force it.>She had a plan like that because she was young and didn't think she'd need cancer treatment or whatever.
Insurance for cancer treatment should be cheap for young people. Cancer is predominantly a disease of older people. Cancer causes about 20% of total deaths in the country, so insurance for expensive cancer treatment is going to be expensive for the part of the population most at risk. And I'd say that it is a poor use of the nation's resources to devote so much just to eke out a couple more years for people who are already old and have a relatively poor QoL. If elderly people would rather use their money to go on vacation and enjoy life, they should have an option to choose insurance that only covers economy cancer treatment. And the government shouldn't force people like your sister-in-law to choose between no health insurance or an expensive insurance plan that subsidizes the elderly.
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Often there are different treatments possible at different price points (or at least there would be in a functional free market). If I have the options:
- spend $10,000 out-of-pocket to have a 95% chance of getting cured, or
- spend $90,000 out-of-pocket to have a 96% chance of getting cured,
I think I'd opt for the more economical option.
I think it's pretty evident that that state doesn't maintain itself when things like inelastic demand curves are having the influence they have.
I mean, just look at things like the cost of insulin. Injectable insulin has been available for over 100 years, it's not new and there is not any sort of patent on the stuff anymore, but all the generic manufacturers are just following the trends in the industry of basically embracing that inelastic demand curve and things like generic medications are getting more expensive as the push for greater profit margins and growth is leading these companies to, seemingly collectively, recognizing that they can safely charge a whole lot more than they usee to ... because insulin-dependent diabetics surving on generic prescription insulin just don't have a choice either way.
Like, the only reason generic drug companies ever had cheap prescriptions in the first place seems like they all respected the honor system, but when the companies are under pressure from investots and under legal obligation to return profits and growth, that code of honor erodes after a while.
I mean there was a period in history where operating an emergency room for a profit was considered unthinkable but realistically there was nothing stopping anyone from doing so in the past.
In that case, i think that's a pretty good argument against the idea of free-market competition. Theoretically, shouldn't a new company be able to come in and undercut the established insulin providers out of business if this is the case? I wonder why that's not happening. It should happen, and whatever is stopping it from happening needs to be fixed or we're screwed in the long term.
The fact that companies collectively seem to know not to compete with each other to a degree like that seems to me to show that putting resources into enforcing antitrust would be a worthwhile investment.
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Why do you hate it?