hks_kansei

I presume with employers providing the care, they must have a sort of "bulk buy" agreement with the insurance providers?
(ie: Your pay slip doesnt specify "income $X, less health insurance $Y", the employer just get one massive policy for the company as a whole)



I can understand the argument that a centralised healthcare system may lead to a reduced level of care for some, but at the same time, if setup properly, it can provide a floor where everybody gets a basic level of care. (even if it's super basic like keeping you alive, and not much else)
With the private sector then essentially acting as a top up for those willing/able to pay for a better level of care.

But I guess the other side of the coin is that the US is a far more populated nation than Australia (and a lot of other nations with a medicare/NHS equivalent), so the budget needed to give everybody even the most bare bones cover would be huge.
Not to mention that the prices of healthcare and medications (without insurance) seems to be vastly more expensive than overseas (which I would tend to argue is because of privatised insurance... I know car insurance here has caused similar, get a quote for car repairs, if you say it's under insurance the price instantly jumps)

fooger03

iTrader: (2)

The US has a "keeping you alive, and not much else" sort of care: If you walk into a hospital with a serious medical emergency, the hospital will treat you until you are "releasable" (no longer have a serious medical emergency) regardless of your ability to pay - they'll still bill you for the services, but it's in the long term financial best interest of the hospital to ensure you don't end up dying as a result of denied emergency medical service.

whitrzac

iTrader: (1)

Healthcare in the US is completely fubar. The only people that win are the insurance companies.



I have dental insurance. The 2 crowns I got recently cost $1000 out of pocket after insurance paid their part.
I called both the dentist and insurance company before getting them done. I was told somewhere between $0 and $2500. Nobody could give a closer estimate.

samnavy

iTrader: (7)

Kensei, there's just something about the way and American thinks about being an "American". There's a very "work hard and you'll make it"... the "American Dream"... you can come here penniless with just the clothes on your back and become a millionaire with hard work. This still resonates loudly both to citizens and to people who legally immigrate here every year. Maybe it was how to told England to **** off and went to war... maybe it was several hundred years of marching west across the continent, exploring, dying, adventure... how during WWII, the greatest generation sacrificed everything... all that 'Merica **** is still alive and well despite current events.

Giving people things for free leaves a bad taste in our mouths. "Free" is total bullshit. If you don't have a job or don't pay taxes, somebody else is paying for it. People who feel "entitled" to free **** can **** off and die. Politicians who peddle that crap can burn in a pool of napalm.

I find that most of my foreign friends can't understand how I can be so "heartless" about GIVING people healthcare and that it's the job of the government to do so. When I ask them in turn what the responsibility of a citizen is to the collective good... crickets. The idea that a person owes anything to the gov't or to their fellow man in exchange for the benefit and protection of that body is not only confusing, but downright unfair. Healthcare is a "right"... bullshit. How about "you have the right to sit on your *** and die of starvation". Maybe I read too much Heinlein growing up.

Try this on... modern social justice thinking is that if my parents, through making good decisions in life, because they were taught properly by their parents, and that resulted in my making good grades and having a social skillset that enables me to have good job so I can pass on life experiences to my kids so they'll be successful... somehow I'm a piece of ****. Being white and middle class means that I'm a complete and utter worthless piece of **** with no redeeming qualities other than I pay taxes so my government can sell me out to poor people as a scapegoat to perpetuate whatever political gain they stand to achieve. Because I never had "struggle", I should feel guilt and shame over every aspect of my life because of the patriarchy or white guilt or appropriation or whatever flavor of bullshit is popular. Everybody else is not only a victim, but specifically a victim of what I personally have done in my life. I am literally the embodiment of the devil and Hitler and so my voice or opinions are not only wrong, but basically I should be executed as an example of how not to live my life.

Healthcare is just one ring in the 20 ring circus of our slow march towards socialism. Just ask Venezuela that one of the richest nations on Earth for 50 years... and now a dozen eggs cost $150. Somehow people are convinced that **** will never happen here because checks and balances... and I look at what's happening in Virginia right now... like it's right our of the "be like Venezuela" playbook starting with taking away the guns and making it impossible to remove a politician from office.

sixshooter

iTrader: (12)

Insurance has been damaged by the regulations imposed upon it by leftist politicians who want the system to be broken so they can justify taking the whole thing over by the State.

Politicians have mandated what must be covered by policies rather than letting consumers choose. Policies are required to cover routine care and not just catastrophic events. This is similar to using your auto insurance to cover tire rotations and oil changes. It would drive the cost of auto insurance up far above the cost of the actual oil changes or tire rotations. The answer to the artificially created high prices is actually deregulation of the industry. Let people buy catastrophic care insurance as they see fit and the market costs will drop significantly. It would also reduce the necessary staffing for processing and monitoring insurance information and put concealer404 into a different profession.

Deregulation of the prescription drug industry and simplification of the FDA approval system would significantly lower the prices there as well. There are nearly zero market influences on drug prices currently because of the requirement by the government for insurance companies to cover them. Prices for some prescription drugs at Walgreens and CVS are 3000-4000% higher than actual cost to them according to some reports (local investigative reports).

Tort reform (legal reform) would reduce the ridiculous insurance costs paid by medical professionals to a much more manageable level. Those savings would be passed on to consumers.

The requirement that employers provide health insurance and that it cover everything from alcoholism and drug treatment to other mental health issues has driven up cost significantly.

There are many ways to improve the system. The biggest one is to have the government out of the business. Every law they pass adds a layer of expense.

Schroedinger

To start with- yes, U.S. healthcare is FUBAR.

Six, I agree with you that moving healthcare towards a consumer economy is the right idea, and that government intervention has generally been counterproductive. I disagree on a bunch of the other stuff though. This theory about leftist politicians intentionally breaking insurance so they can control it... utter nonsense. Take off the tinfoil hat dude.

Healthcare is a for-profit business, and should be. It’s where I make my living. Ultimately there are several groups of potential winners that fight over profits: hospital corporations, insurance companies, drug and device manufacturers, and healthcare practitioners. Each of these groups has industry lobbyists and fight to gain an upper hand over the others, and each of them influences both Democrats and Republicans. Anyone else here actually met with Senate or Congressional staff about healthcare policy? I have. Heavy-handed government intervention has definitely caused issues but blaming only one political party or group of “others” for the problems is ignorant and naïve.

I have a strong libertarian streak like many others here, and generally favor deregulation and free markets. However, healthcare is a lot more like defense than it is like, say, telephone utilities. When you need it you need it- there really is no buying decision. I know plenty of people with good jobs and insurance that have been bankrupted by healthcare needs, this isn’t all about poor people. Fast advancing technical fields like medicine don’t have truly competitive markets, life-saving technologies are often proprietary and expensive. I make medical technologies that happen to be proprietary and expensive, and I have zero moral conflict with my role. Like any other industry, products have value and value comes with a price.

There are plenty of examples where throwing this open to "free markets" doesn't fix it, it makes it worse. The same politicians who go on about “free markets” are usually the ones tilting the tables towards monopolies that kill free markets. Get friendly with your doctor and ask them how they feel about hospital corporations if you want a full dose. On the other hand, neither does "Medicare For All" which is nonsense spouted by people who have no idea how Medicare actually works. Helpful fact: Medicare is currently administered almost entirely by private companies (look up Medicare Administrative Contractors), who have their own policies and profit incentives. Medicare also sets rates for medical procedures that are the backbone of the entire private economy. So that means that the tripe that both political parties spew is completely wrong, as usual. Effective healthcare policy can only happen when you have a functioning market economy AND sensible government regulation and intervention to serve the public interest. Either/or doesn’t get it done.

The current political climate prevents anyone from coming together on anything useful, so healthcare is probably going to be screwed for a long time. That said, we overlook the fact that despite the costs, in two generations our average U.S. lifespan has increased over 50%, all thanks to medical technologies and their administration.

Samnavy, that is one of the most committed and passionate strawman arguments I've seen, bravo. If we make this all about entitled freeloaders and socialist dictatorships, we can avoid having a sensible discussion about problems that affect all of us.

If anyone's really interested in pure free-market healthcare go listen to the Bad Batch podcast about the stem cell industry. A bunch of fraudsters who used to be in real estate scams and ponzi schemes, now illegally marketing "stem cell" products that actually have no stem cells to people who pay $40k cash out of pocket in the desperate hope that these injections will cure their kids' autism or their parents' Parkinsons.

DNMakinson

iTrader: (3)

From Schroedinger: When you need it you need it- there really is no buying decision.

There are buying decisions. I have friends who have bad teeth pulled. I have others that prefer to spend the money to have root canals and crowns.

sixshooter

iTrader: (12)

What other industry doesn't give you any indication of pricing prior to the service on big ticket sales?

Schroedinger

I agree with you, healthcare needs to move towards being a consumer economy. My point is that you can’t get all the way there, and all this “burn down the government” stuff is counterproductive because like it or not we need it.