Al Borealis, Universal Health Care Trap? |478|

Hi folks, Al Borealis here.

I see the debate is still raging on. Well, with the risk of stepping on sensitive toes, here's my frank and direct take on it:

If we have as a premise that Big Pharma should not run Health Care, no matter which model of financing is used, and that what services should be included in the health care system must be up to the citizens of each country as a separate issue from how it is financed (today Big Pharma has the power in all types of systems, including USA) - then I wonder:

Why would anyone want to keep the Corporatist model used in USA today, given that:

* It cost the nation MORE than single payer solutions (M4A saves half a trillion over 10 years according to the most anti-M4A study, financed by the Koch Brothers - much more according to fear studies) - thereby inflating taxes.

* Universal Health Care halfes your personal expanses (removes the private taxes such as deducables, co-pays, etc) because there's no longer leeches making profit from your health.

* UHC let you choose any doctor or hospital to use.

* UHC saves job-sellers (employers) fortunes as they dont have to finance it for their staff.

* UHC liberates job-buyers (employees) who has safety net and can change jobs without worrying about health care - more personal freedom.

* UHC keep the insurance companies in business as there will always be wealthy people who want more fancy options than the bottom line, plus there's tons of area which are voluntary and not included in health care (silicon boops, nose job, etc).

* Current US model rips off those who have health care on paper, in that there's an incentive for insurance not to pay out and you need to fight to get what you already should have (google it, people get sick and don't get what they are owed).

* UHC avoids the huge number of medical bankruptcies (google it, people get sick and get bankrupt).

* Current US model is highly costly for the public as people avoid going to their doc to save money, or become homeless, or chooses to do crime, etc.

* UHC keeps price of medicine down as there's a single payer who can dictate prices, rather than let Big Pharma rip you off (that's why americans who can flee to Canada and Mexico to get medicines for a normal price).

* UHC is more ethical in that it saves many families from much grief and suffering. Makes for a happier society with lower crime.

* In UHC money is spent on health, not wasted on profit, therefore Doctors still make tonns of money, and are usually the highest middle class in all countries with UHC. Nurses and others get paid better with UHC and thereby do a better job.

It's just the Oligarchs who has a rationale to favour the current corporate system, plus the politicians they owe (95%). Yet it is also supported by people who has fallen for the propaganda (same reason normal people are against legalized cannabis).

Texas implemented temporary M4A due to the winter storm. Why is that a legitimate reason and not all other reasons? There's no difference whether you die of Cancer, Car Crash, or Corona, so why should the collective safety net discriminate and just be valid in a random instance?

This leads us to an interesting question: Which health system is best?

1) NHS (National Health Service) can be defined as a left wing (socialist) plan. Free at the point of service for everyone. This is the U.K. model. Publicly run & publicly financed.

2) M4A (Medicare for all) can be defined as a centrist plan (nonetheless what Bernie is pushing). Free at the point of service for everyone. This is the Scandinavian model. Privately run, publicly financed.

3) H4A (Health care for all) can also be defined as centrist (what Tulsi is pushing). Free at the point of service for everyone. This is the Australian model. Privately run, publicly financed, + priv insurance add-on.

4) Public Option can be defined as a right-wing (capitalist) plan. For those who can't afford private insurance, the public option makes it free at the point of service. Although this covers everyone, it lead to a 2 tier quality service. Private insurance marked + pub insurance add-on.

5) Corporate Dictatorship - private insurance exploitation. Does not belong to any wing, it's just the wet dream of Wall Street psychopaths and can best be defined as Corporatism. It's a dictatorship over people, as you have no say in your own health but must be an obedient slave abiding by whatever dictate their profit motive demands. This "system" is not Universal Health Care, but rather an insane situation where life & death is regarded as commodities, governed by a needless and irrelevant middleman who price gouge & extorts, yet bails on delivery (aka "insurance companies"). Despite not being free for anyone, it actually cost tax-payers half a trillion USD more per year than M4A. It also leads to 70 000 yearly deaths and innumerable bankruptcies (before corona - much worse now). But hey, those vampire corporations are people too and need your blood. This is what peoeple in USA have today (except that small segment, like elected politicians, who receive the publicly funded free service of Medicare - which is good enough for them but not for you, as the great majority is at the mercy of the health mafia).

Personally I've never worried about my health because I knew there is a safety net no matter what happened. Health isn't an issue in my country. Here we rather debate what should be covered or not. But I would be happy under any of the first 4 options. Outside of USA, no right-wing party is arguing against Universal Health Care. If our consvervative party did, they would be eradicated by the next election. It's not a wing thing, it's just common sense and ethics.

Certain matters should not be a market place. Hospitals should focus on health, not making money. Fire department should focus on putting out fires, not making money. Prisons should focus on running the incarceration, not making money. Police should focus on keeping order, not making money. Schools should focus on education, not making money. Military should focus on defence, not making money. Courts should focus on maintaining the law, not making money. Politicians should focus on making laws & implemehnting solutions, not making money.

It is telling that only in USA half of these concerns are money-makers.

In my personal view, money should be made in the market place. Meaning commodities, trade, & services. Here I am libertarian - don't interfer with the old woman selling fish at the town square!!! But it is a crazy libertarian fundamentalism to regard everything as a market. What's next? Expropriate the parents and sell the children to the highest bidder for a more fiscally efficient family? If families are exempt, why not health care? So we agree there's a limit, we just don't agree where it should be drawn?

Wake up my american friends: Your country (richest in the world) is almost alone in not offering universal health care. But to be fair: you have Nigeria and Saudi Arabia agreeing with you on this one. (https://en.wikipedia.org/wiki/List_of_countries_with_universal_health_care)

When I learned about your health care system I couldn't believe it. My reaction was identical with this:


Watch it. I think its a wake up call even for Americans. If not, google the poor bastard who got a bill of hundreds of thousands USD for corona treatment - or the lady who even got millions (again, google it).

If any of you visit me in Norway and something happens to you, you get immediate health care. Free at the point of service. Even if your ailment is your own fault. Even if it was a condition starting before you came here. No questions asked, just treatment. From top quality providers (the rich use the same hospitals and doctors).

Because you are good enough. Because you deserve it.

Mens sana in corpore sano.

- Al
Sorry Al, but you're repeating misconceptions and outright false information.

The US delivers the best healthcare to the most people. We spend more because people get more. The socialized systems ration care. Period. Full stop. Don't tell me about WHO measures comparing outcomes of the US system until you've read about what the components of their metrics actually are. Mostly social justice stuff, not true outcomes comparing medical condition to medical condition. The life expectancy differences are due to very different definitions in the US compared to Europe; especially around new born deaths. For example, if it comes out even slightly alive, in the US, it's a living human. In Europe it's not a human until it's done more and lasted much longer than a day. That alone skews the US avg life span down. Then there's all of the homicides in the US, etc.

The US does deliver a lot of care where the marginal cost exceeds the marginal benefit whereas the socialized systems do not. That is part of the rationing. So if if it costs 10X more, but only delivers 1.5X more relief of symptoms, you still get it in the US. You don't in socialized systems. From an economics perspective the socialized systems are getting it right, but explain that to the patient. The patient will take the slight improvement and damn the cost if they have insurance.

I note that in Australia, 50% of medical care is paid for by private insurance. Guess the socialized system isn't so grand for actual citizens under it. The trend toward private insurance is increasing in the UK as well. Canadians? Well their simple frost bitten and beer soaked brains are happy enough in their numb state of being, but still, many come to the US for medical care if they can afford it. The Canadian system doesn't cover most drugs, mental health and some other services. Rationing again.

Big Pharma does NOT run US healthcare. That is a stupid position to hold. Insurance won't let them. Counter interests. Actually, Rx is a small % of total medical spend. It escapes me why people focus on it. Pharma companies have many programs to deliver drugs to those who cannot afford them.

I do healthcare economics analysis for a living. I get so sick and tired of hearing the nonsense that gets passed around by the unwashed masses. The BS isn't helpful at all.
 
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Sorry Al, but you're repeating misconceptions and outright false information.

The US delivers the best healthcare to themes people. We spend more because people get more. The socialized systems ration care. Period. Full stop. Don't tell me about WHO measures comparing outcomes of the US system until you've read about what the components of their metrics actually are. Mostly social justice stuff, not true outcomes comparing medical condition to medical condition. The life expectancy differences are due to very different definitions in the US compared to Europe; especially around new born deaths. For example, if it comes out even slightly alive, in the US, it's a living human. In Europe it's not a human until it's done more and lasted much longer than a day. That alone skews the US avg life span down. Then there's all of the homicides in the US, etc.

The US does deliver a lot of care where the marginal cost exceeds the marginal benefit whereas the socialized systems do not. That is part of the rationing. So if I costs 10X more, but only delivers 1.5X more relief of symptoms, you still get it in the US. You don't in socialized systems. From an economics perspective the socialized systems are getting it right, but explain that to the patient. The patient will take the slight improvement and damn the cost if they have insurance.

I note that in Australia, 50% of medical care is paid for by private insurance. Guess the socialized system isn't so grand for actual citizens under it. The trend toward private insurance is increasing in the UK as well. Canadians? Well their simple beer soaked brains are happy enough, but still, many come to the US for medical care if they can afford it.

Big Pharma does NOT run US healthcare. That is a stupid position to hold. Insurance won't let them. Counter interests. Actually, Rx is a small % of total medical spend.

I do healthcare economics analysis for a living. I get so sick and tired of hearing the nonsense that gets passed around by the unwashed masses.
This is endemic of many issues discussed here these days. Positions are thrown up based on individuals' own appeals to authority or small sample sizes of evidence (i.e., the experience of an individual). It fits a narrative (i.e., capitalism is evil in this case) and runs often unchallenged and ultimately accepted as reality.

I was waiting for you to wade into this discussion knowing you actually are an expert in this field. Unsurprisingly, you point out several flaws in the narrative that had been embraced. Notably, you didn't (I believe correctly) call the U.S. healthcare system a panacea but it also isn't evil incarnate. We should be considering ways to improve the bathwater (healthcare) without throwing out the baby (free markets).
 
This is endemic of many issues discussed here these days. Positions are thrown up based on individuals' own appeals to authority or small sample sizes of evidence (i.e., the experience of an individual). It fits a narrative (i.e., capitalism is evil in this case) and runs often unchallenged and ultimately accepted as reality.

I was waiting for you to wade into this discussion knowing you actually are an expert in this field. Unsurprisingly, you point out several flaws in the narrative that had been embraced. Notably, you didn't (I believe correctly) call the U.S. healthcare system a panacea but it also isn't evil incarnate. We should be considering ways to improve the bathwater (healthcare) without throwing out the baby (free markets).

By this logic, we don't have to look anything about the truth regarding how the healthcare system in the United States wrecks people's lives when they actually need it. Instead, why not just look at some stupid fucking chart that shows a line going up and down, with a bunch of asshole suits in a room who are perfectly covered, as they clap hands for next weeks quarterly profits? Yes, at least you applaud an "expert" in the field who gets paid to back up a shit system that regularly destroys people's lives and takes their property. You used the baby and the bathwater analogy. First of all, if you want to survive in this fucked up health care system, you might as well give birth in bathwater, filter it, and drink it later, rather than go to the damn hospital.
 
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Do yourself a favor: lose your posh health economics analysis job and try a job of average or below average income, and see what kind of healthcare you get when you absolutely need it. Do you know what the answer is.....none! Use the word "marginal" all you want. The truth is that healthcare in the US is absolutely NOT affordable for most of us, so we simply do not go do the damn doctor. If we are in an emergency situation and must go, the healthcare thieves are happy to fuck us with outstanding bills that we have no ability to pay whatsoever, then send them to collection agencies. Wake up, man, you have no idea what you are talking about. Al is ABSOLUTELY correct!
I have worked grunt jobs before I went back to grad school in my mid-30s. You're full of crap. Often the grunt jobs have better benefits than my "posh" employer group coverage. The ACA (Obamacare) is about the same as what I have. Knock of the working class hero schtick. It makes you sound stupid and ignorant and somewhat jealous. Many of us have been there. IMO, you are just personally challenged to get the basics right.
 
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This is endemic of many issues discussed here these days. Positions are thrown up based on individuals' own appeals to authority or small sample sizes of evidence (i.e., the experience of an individual). It fits a narrative (i.e., capitalism is evil in this case) and runs often unchallenged and ultimately accepted as reality.

I was waiting for you to wade into this discussion knowing you actually are an expert in this field. Unsurprisingly, you point out several flaws in the narrative that had been embraced. Notably, you didn't (I believe correctly) call the U.S. healthcare system a panacea but it also isn't evil incarnate. We should be considering ways to improve the bathwater (healthcare) without throwing out the baby (free markets).

Right. The US system is not a panacea, but it isn't Satan incarnate either. Some things it does a lot better than the socialized systems. If you are truly ill you want the US system. It will spend more and deliver higher quality care to keep you alive than any other.

Of course there are always the Shane's of the world, living marginal lives, becoming angry and frustrated, that want to see anything they are challenged to understand as evil. We can't help such people.
 
I definitely agree with a lot of what you're saying. I also think we have to balance all this craziness with a certain pragmatism... the thing that really sent me over the edge with the healthcare was the birthing thing. children and moms used to die in the birthing process. modern medicine helps. everyone should have access. of course they're going to rig the system... but they're going to rig it either way you go. seems like a lesser of evils thang

Alex, first off, must say, Skeptiko is getting better and better everyday and thanks for the interaction with the listeners! I think that the healthcare in the United States is good, but the financial consequences of utilizing it, for most Americans, is terrible. It is highway robbery, actually, and legal! It has systemically effected every bit of our lives, as laborers. I am one of those people who does not take advantage of systems. Furthermore, fortunately, I am optimistic enough to believe it is possible for most others to be the same. I don't regularly go to the hospital, even when I am sick or hurt.

The issue with this idiotic healthcare system is that it is nearly a death sentence for anybody of average or below average income to utilize it, if they are not covered. Also, the premiums are ridiculous, not to mention the deductibles! So, on the one hand, you have all these jack asses getting paid to talk about how this system is amazing and better than all the other systems in any other country because of the "quality of care" for those that are sick and covered. On the other hand, you have the reality of those who never go to the doctor, even if injured at work, because the fucking work place is paranoid of law suits, and the worker is paranoid of losing his job. Also, both are paranoid to hell because the cost of treatment is ridiculous! How does this make sense?
 
Sorry Al, but you're repeating misconceptions and outright false information.

The US delivers the best healthcare to the most people. We spend more because people get more. The socialized systems ration care. Period. Full stop. Don't tell me about WHO measures comparing outcomes of the US system until you've read about what the components of their metrics actually are. Mostly social justice stuff, not true outcomes comparing medical condition to medical condition. The life expectancy differences are due to very different definitions in the US compared to Europe; especially around new born deaths. For example, if it comes out even slightly alive, in the US, it's a living human. In Europe it's not a human until it's done more and lasted much longer than a day. That alone skews the US avg life span down. Then there's all of the homicides in the US, etc.

The US does deliver a lot of care where the marginal cost exceeds the marginal benefit whereas the socialized systems do not. That is part of the rationing. So if if it costs 10X more, but only delivers 1.5X more relief of symptoms, you still get it in the US. You don't in socialized systems. From an economics perspective the socialized systems are getting it right, but explain that to the patient. The patient will take the slight improvement and damn the cost if they have insurance.

I note that in Australia, 50% of medical care is paid for by private insurance. Guess the socialized system isn't so grand for actual citizens under it. The trend toward private insurance is increasing in the UK as well. Canadians? Well their simple frost bitten and beer soaked brains are happy enough in their numb state of being, but still, many come to the US for medical care if they can afford it. The Canadian system doesn't cover most drugs, mental health and some other services. Rationing again.

Big Pharma does NOT run US healthcare. That is a stupid position to hold. Insurance won't let them. Counter interests. Actually, Rx is a small % of total medical spend. It escapes me why people focus on it. Pharma companies have many programs to deliver drugs to those who cannot afford them.

I do healthcare economics analysis for a living. I get so sick and tired of hearing the nonsense that gets passed around by the unwashed masses. The BS isn't helpful at all.
thx. what about countries like Norway and Sweden?

And what about the birthing thing? does joe-six-pack really have to come out-of-pocket $20K to have a kid?
 
I have worked grunt jobs before I went back to grad school in my mid-30s. You're full of crap. Often the grunt jobs have better benefits than my "posh" employer group coverage. The ACA (Obamacare) is about the same as what I have. Knock of the working class hero schtick. It makes you sound stupid and ignorant and somewhat jealous. Many of us have been there. IMO, you are just personally challenged to get the basics right.

I don't have a "schtick," truth hits hard, buddy, doesn't it? I wouldn't call anybody's job a "grunt" job, have some respect. Happy that you went to grad school in your mid thirties. What was the fraternity process like? Do you think people are personally challenged if they don't get defined by your basic right?
 
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thx. what about countries like Norway and Sweden?

And what about the birthing thing? does joe-six-pack really have to come out-of-pocket $20K to have a kid?
Alex,
There is no insurance that makes anyone come out of pocket $20K to have a baby. Unless someone who is fairly well off deliberately purchases a catastrophic coverage only plan (low premium, kicks in only after a relatively high expense has been reached).

If you can't afford insurance there is the ACA, with a sliding federal subsidy scale based on income and there's Medicaid for those who are truly indigent. That's free.

Typically, the max OOP would be $3,500. Mostly much lower on any policy that one gets via employment or the ACA. Medicaid (for poor people) doesn't even have copays/deductibles.

Where did your $20K figure come from?

Norway and Sweden were once small homogenous countries with high taxes and social services support from profits from nationalized oil industry. Though now that they have elected to be invaded by Muslim hordes, their social network, including healthcare, is beginning to fall apart.

Apples to potatoes comparison.
 
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So you love Sharia? IMO, you wouldn't last a day under it.
These immigrants are all poor and using up the social services resources.
Btw, the Muslims don't like you.
.

Hey Eric, if you really think this way, then nobody can help you.
 
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An FYI on where US healthcare $s are spent
38% Home healthcare, nursing homes and other miscellaneous services and goods
30% on Hospital rooms and services
18% on doctors (this is different from hospitals. Hospital is the facility. Doctor is the person doing the work)
14% on pharmaceuticals (prescription drugs)

How anyone thinks 14% of the business is controlling the other 86% escapes me entirely.

Maybe they have hired former Cosa Nostra, like Sammy "the Bull" Gravano and former CIA guys to put a gun to insurance, hospital admin, home health workers and phsycisian groups collective heads. "Write prescriptions or else!" But then why doesn't so called Big Pharma" have a bigger slice of the pie? Sammy isn't earning his pay. The CIA is always incompetent accept when involved in big complicated conspiracies like working with the mafia to assassinate presidents and blow up sky scrapers and the pentagon. Uh huh.

Oh... and you know how much Canada spends on Rx? 14%. Germany? 13% France? 13% of total healthcare expenditures. Same proportion as the US.
 
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An FYI on where US healthcare $s are spent
38% Home healthcare, nursing homes and other miscellaneous services and goods
30% on Hospital rooms and services
18% on doctors (this is different from hospitals. Hospital is the facility. Doctor is the person doing the work)
14% on pharmaceuticals (prescription drugs)

How anyone thinks 14% of the business is controlling the other 86% escapes me entirely.

Maybe they have hired former Cosa Nostra, like Sammy "the Bull" Gravano and former CIA guys to put a gun to insurance, hospital admin, home health workers and phsycisian groups collective heads. "Write prescriptions or else!" But then why doesn't so called Big Pharma" have a bigger slice of the pie? Sammy isn't earning his pay. The CIA is always incompetent accept when involved in big complicated conspiracies like working with the mafia to assassinate presidents and blow up sky scrapers and the pentagon. Uh huh.

Oh... and you know how much Canada spends on? 14%. Germany? 13% France? 13% of total healthcare expenditures. Same proportion as the US.
thx. facts/links add a lot to the conversation.

I hate moderating... so I just delete all the personal stuff.
 
Sadly, for those folks in the US. My brother in law was 9 months in the hospital from various things that came from a bad heart. He was having a heart attack, then went into a coma, bleeding internally constantly, stints, shingles, pneumonia, the works. He eventually even got a new heart.
Cost? $0.
Because Canada.
My sister the nurse who has worked in both Canadian and various states in the US said it would have cost about a million and a half, which would have meant my brother in law would have lost his house and STILL died.

Just watched "Superstore" the comedy where they pointed out its 20,000 dollars to give birth in most hospitals in the US.
Really? And we talk about CONTROL.
The REAL control is keeping people financially made into peons

Oh OK. This is where the $20K to have a baby came from; from a Canadian, of course.

To start with, it doesn't cost $20K for an uncomplicated labor and delivery in the US. It's going to be more in he range of $4.5K to $10K, despite a Canadian's assertion of what "Superstore" the comedy says (really? That the source of this "understanding"?).


What the person having the baby actually pays would range from $0 to $3,500, depending on their insurance plan. Insurance would cover the balance. That's just a fact that is easily verified. I happen to know for sure what it costs, but you can simply Google it and get some more or less accurate figures. For example; https://smartasset.com/financial-advisor/cost-of-having-a-baby

But hey, if you don't want insurance and you don't want to pay anything, you can have some midwife work for barter - maybe a basket of eggs from your chicken coup - and have the baby on your living room sofa. If that's how much you care about yourself, your baby or your loved one, go for it. OTOH, if you really care and you want all of the best in case something goes wrong, you pay for insurance that pays the hospital room with all of the machines and staff and the doctors that have the latest greatest tech and training to handle any emergency. Or if you can't pay for regular employer group insurance, you seek an ACA plan or apply for Medicaid. This is not rocket science.

Now, is it seriously being proposed that in Canada doctors and nurses receive $0 salary? Hospitals just magically appear full of equipment and cost $0? Facilities just maintain themselves via little elves the appear in the middle of the night to do the work with magic pixie dust?

Come on man. Of course the cost in Canada isn't $0. People paid for your brother in-law's care through taxes. The entire Canadian medical system is maintained through taxes - except all the people that bought private insurance (rhetorical question - why would they do that?!!!?).

In the US, some of the system is paid for by taxes and a lot is paid by private citizens and corporations. Instead of paying for it through taxes they pay for it through insurance companies and sometimes directly to the care providers.

It doesn't matter what system you're working in, private or socialized, a lot of relatively healthy people are paying in money they won't personally see a return on to care for a few very sick people. It's called a "risk pool". At least in private systems, you can pick and choose which mix of level of benefits you want at what price. In socialized, you have no choice. It's one size fits all.

Now, you might ask why the middle man of insurance would be desired in the US. Don't they make a profit? Wouldn't removing that profit be a savings to "the people"?

The short answer is "no" - but, since no one on this site, given the lack of knowledge and some of the anarchist/socialist leanings, is going to believe that or take it on faith because I said so, allow me to explain.

Before we address the cost impact of profit, let's look at overhead. Both the government and insurance companies have overhead. Some say the government does it cheaper. That is a fallacy. The often quoted Medicare overhead statistic is misleading. It is calculated on the the wrong variables. They use overhead divided by cost of services provided to arrive at a % overhead (aka admin cost) that is lower than private insurance. The problem is that that Medicare members cost 4 times what under 65 costs. So that calculation dilutes the % admin cost by a factor of four. The correct calculation is admin cost per member. On that appropriate metric, Medicare is no cheaper than private insurance and, in some instances, more expensive than private insurance. In fact, the federal govt (CMS) worked with private insurance to create Medicare Advantage plans. This is Medicare that is sold and managed by private insurance - about 35% (and growing) of Medicare is Medicare Advantage plans. The govt did that because they recognized they could not manage as well as private insurance (look it up if you don't believe me). Also, many CMS administration costs are hidden in other budgets. Those costs are not in the erroneous, albeit often cited, metric I mentioned.

Profits - insurance makes profits on volume. So low margins/high volume. If you removed profits, you would need a sharp pencil to find the savings in premiums - also, much private insurance is through not-for-profit companies, like some Blue Cross/Blue shield plans. Their premiums are no more affordable than the big for profits' offerings. But that's not all. The for profits are able to make profits because they compete in the market and people buy a well managed company's products on price and quality. Competition keeps price low as possible. Insurance must implement cost savings measures and the cost savings outweighs the profits. So save $10 and keep $1 as profit. The other $9 gets passed on to the consumer (you).

How do they save money? Regional based carefully tailored contracting with care providers. Fraud detection programs (there are $billions in fraud every year perpetrated by care providers). Dropping of contracts with providers that deliver poor care. Utilization management (e.g. pre-auth checks won't authorize medically unnecessary procedures, drugs and technologies), care management programs that ensure that the chronically ill are maintaining treatment and not decompensating (e.g. one on one calls to members/patients and connecting with care providers to alert them to gaps in medically approved protocols - all through data analytics). Also, performance based contracting with care providers. There's much more. That's just a few examples to illustrate. Again. Medicare/CMS/Federal govt found it could not do these things well.

No one ever talks about any of this. They just want to gripe about their low grade poor reality non-correlations.
 
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What stage of Capitalism is this?

https://myfox8.com/news/i-hope-i-ma...lls-lemonade-to-fund-her-own-brain-surgeries/

T4AekFh.jpg
 
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nice. I have a hard time accepting that collectivism/socialism is ever the solution, but as you point out the system in the US is so horribly unfair that it's probably the best option... you've convinced me :)

it's just scary to think how something like that could be implemented inside of a completely corrupt plandemic-ized system... then again, as you point out it's hard to argue that what we have is better.


You don't have to opt for the socialist version (NHS). you can go for the centrist or right wing version. Point is they are all Univversal Health cares. Its not more "socialist" to have that, than to have a universal fire department. Also, these are not theoretical ideas or experiments, they've been around in the world fora century now. There's no surprises, we know how it works.

And yes, in the pandemic the entire society is being transformed, including the health care system - and so far not to the better. But that transformation occurs in all sectors of society no matter how we finance health.

You will have the same hospitals and doctors and nurses with UHC, there wont come marching in an army of soviet or nazi docs. Only difference is hospitals will no longer focus on profit but on treatment, and doctors will no longer focus on bureauchratic work, but on their job. But the pandemic may take over their focus in all systems, no matter how it is financed.

Sweden has same system as us and did not go for lockdown. They went for herd immunity - under a socialist government. We went for lockdown under a conservative government. Result in Sweden: More deaths but no industry killed. In norway: Less deaths, yet some industry killed (but no folks going bankrupt because everyone got their salary subsidized by government who also subsided industries so as to avoid whats going on in USA)
 
You are conflating NHS (publicly run and publicly financed) with UHC in itself (which have 5 main models as i described in my previous post).

Consequently you are arguing against publicly run system, where hospitals are nationalized and docs get their salary from the state.

Even in our social-democratic country that's not the case. You can keep hospitals run privately and owned privately and docs and other health care workers operate as small business.

We're talking about who pays on behalf of the patients. It's a single payer system.

And you are arguing against the worlds studies who all show that US system is the most expensive and least effective. For the same reasons your medicines are the most expensive. You explaining how all this reaearch is wrong doesn't have the same weight to me who live and experience an alternative model. We have more rich people per capita than USA, FYI.

It's not rocket science: Its simply like your social security system: It's an insurance system you pay into all your life, and cash out when you need it. With UHC its an insurance system that you make deposits from when you need it.

Nothing more sinister than that.

Oh OK. This is where the $20K to have a baby came from; from a Canadian, of course.

To start with, it doesn't cost $20K for an uncomplicated labor and delivery in the US. It's going to be more in he range of $4.5K to $10K, despite a Canadian's assertion of what "Superstore" the comedy says (really? That the source of this "understanding"?).


What the person having the baby actually pays would range from $0 to $3,500, depending on their insurance plan. Insurance would cover the balance. That's just a fact that is easily verified. I happen to know for sure what it costs, but you can simply Google it and get some more or less accurate figures. For example; https://smartasset.com/financial-advisor/cost-of-having-a-baby

But hey, if you don't want insurance and you don't want to pay anything, you can have some midwife work for barter - maybe a basket of eggs from your chicken coup - and have the baby on your living room sofa. If that's how much you care about yourself, your baby or your loved one, go for it. OTOH, if you really care and you want all of the best in case something goes wrong, you pay for insurance that pays the hospital room with all of the machines and staff and the doctors that have the latest greatest tech and training to handle any emergency. Or if you can't pay for regular employer group insurance, you seek an ACA plan or apply for Medicaid. This is not rocket science.

Now, is it seriously being proposed that in Canada doctors and nurses receive $0 salary? Hospitals just magically appear full of equipment and cost $0? Facilities just maintain themselves via little elves the appear in the middle of the night to do the work with magic pixie dust?

Come on man. Of course the cost in Canada isn't $0. People paid for your brother in-law's care through taxes. The entire Canadian medical system is maintained through taxes - except all the people that bought private insurance (rhetorical question - why would they do that?!!!?).

In the US, some of the system is paid for by taxes and a lot is paid by private citizens and corporations. Instead of paying for it through taxes they pay for it through insurance companies and sometimes directly to the care providers.

It doesn't matter what system you're working in, private or socialized, a lot of relatively healthy people are paying in money they won't personally see a return on to care for a few very sick people. It's called a "risk pool". At least in private systems, you can pick and choose which mix of level of benefits you want at what price. In socialized, you have no choice. It's one size fits all.

Now, you might ask why the middle man of insurance would be desired in the US. Don't they make a profit? Wouldn't removing that profit be a savings to "the people"?

The short answer is "no" - but, since no one on this site, given the lack of knowledge and some of the anarchist/socialist leanings, is going to believe that or take it on faith because I said so, allow me to explain.

Before we address the cost impact of profit, let's look at overhead. Both the government and insurance companies have overhead. Some say the government does it cheaper. That is a fallacy. The often quoted Medicare overhead statistic is misleading. It is calculated on the the wrong variables. They use overhead divided by cost of services provided to arrive at a % overhead (aka admin cost) that is lower than private insurance. The problem is that that Medicare members cost 4 times what under 65 costs. So that calculation dilutes the % admin cost by a factor of four. The correct calculation is admin cost per member. On that appropriate metric, Medicare is no cheaper than private insurance and, in some instances, more expensive than private insurance. In fact, the federal govt (CMS) worked with private insurance to create Medicare Advantage plans. This is Medicare that is sold and managed by private insurance - about 35% (and growing) of Medicare is Medicare Advantage plans. The govt did that because they recognized they could not manage as well as private insurance (look it up if you don't believe me). Also, many CMS administration costs are hidden in other budgets. Those costs are not in the erroneous, albeit often cited, metric I mentioned.

Profits - insurance makes profits on volume. So low margins/high volume. If you removed profits, you would need a sharp pencil to find the savings in premiums - also, much private insurance is through not-for-profit companies, like some Blue Cross/Blue shield plans. Their premiums are no more affordable than the big for profits' offerings. But that's not all. The for profits are able to make profits because they compete in the market and people buy a well managed company's products on price and quality. Competition keeps price low as possible. Insurance must implement cost savings measures and the cost savings outweighs the profits. So save $10 and keep $1 as profit. The other $9 gets passed on to the consumer (you).

How do they save money? Regional based carefully tailored contracting with care providers. Fraud detection programs (there are $billions in fraud every year perpetrated by care providers). Dropping of contracts with providers that deliver poor care. Utilization management (e.g. pre-auth checks won't authorize medically unnecessary procedures, drugs and technologies), care management programs that ensure that the chronically ill are maintaining treatment and not decompensating (e.g. one on one calls to members/patients and connecting with care providers to alert them to gaps in medically approved protocols - all through data analytics). Also, performance based contracting with care providers. There's much more. That's just a few examples to illustrate. Again. Medicare/CMS/Federal govt found it could not do these things well.

No one ever talks about any of this. They just want to gripe about their low grade poor reality non-correlations.
 
You are conflating NHS (publicly run and publicly financed) with UHC in itself (which have 5 main models as i described in my previous post).

Consequently you are arguing against publicly run system, where hospitals are nationalized and docs get their salary from the state.

Even in our social-democratic country that's not the case. You can keep hospitals run privately and owned privately and docs and other health care workers operate as small business.

We're talking about who pays on behalf of the patients. It's a single payer system.

And you are arguing against the worlds studies who all show that US system is the most expensive and least effective. For the same reasons your medicines are the most expensive. You explaining how all this reaearch is wrong doesn't have the same weight to me who live and experience an alternative model. We have more rich people per capita than USA, FYI.

It's not rocket science: Its simply like your social security system: It's an insurance system you pay into all your life, and cash out when you need it. With UHC its an insurance system that you make deposits from when you need it.

Nothing more sinister than that.

I'm not confusing anything. The point is that whichever of your systems, single payer = tax funded with price controls on everything, including salaries. It also means rationing.

I already addressed the "studies"that allegedly state the US is the most expensive and least effective. Those studies are not actually clinical. They are social justice goobeldyguk. A true comparison is the health outcome given the same demographic, same symptoms/same condition. That is not what the so called studies are doing.
 

What is the point of that link? It's not insurance won't cover the surgery. The family is struggling with hotel bills and other travel expenses. The insurance is allowing her to go across the country to the one hospital where the staff know how to do the surgery and the hospital has the right equipment. I'd say that's pretty damn good.

I'd say the story illustrates capitalism at its best - that there is even something medical procedure-wise that can be done that might the girl with an unusual serious complicated condition only came about because of capitalism. It's amazing.

Incidentally, a lot of the cost of these kinds of hospitalizations for children in the US are paid for by charities, like the Shriners.

Now you believe whatever the media publishes. If it were a story disparaging Trump, you'd say it was all lies. Ditto a story about how the official narrative of 9-11 is the correct one.
 
Its true that the best docs and hospitals are in the USA.

But it doesn't give that to the MOST people as you claim. You need data to backup this extraordinary claim.

The elite clinics are reserved for the oligarchs and 1 percenters. They will not vanish or somehow become incompetent when the rest of the people also get access to Health Care. They will thrieve just fine. We also have private elite clinics only the wealthiest use.

What is "Social justice stuff"? If you belong to a tribe, and that tribe makes sure everything works smooth for everyone, and protects each other against dangerous attacks from animals or other tribes, is that social justice stuff? If so, sign me on. I wont live in an incompetent tribe where they run for the hills everytime theres danger and leave children, women, elderly, sick, and weak behind...

Also: Why is it moral and practical to have universal fire department? Isnt that "social justice stuff" also? In america yuou experimented with private fire departments 100 years ago. Then you experienced what a retarded child could predict: Stuff went out of hand. Fire spread to also those who could afford to pay for putting it out. You realized you were in the same boat and might as well pull together to solve it. I suspect it was becaus efire ruins material wealth, and not becaus eof the lives it kills. Thats the only difference to UHC - it doesnt protect material assets, "just" lives...

Australian model isnt an argument against UHC. It IS a working model for UHC. You're taking parts of how it operates and use it against NHS. You might as well take part of how it operate sand use it against the US system.

Also claiming Big Pharma doesnt run USA is incredible. That's where most of Big Pharma has their HQ.

I suspect you are working in the insurance company industry. I know those people are desperatly fighting the changing sentiments in the US. and all over social media as this is our current town square. If you do, I can reassure you (pun indended): You wont go out of business when you implement UHC. There's still plenty to do for insurance companies within Health, notwithstanding outside of health.

Our insurance companies are some of the most powerful companies... It's all good bro, just dont sell your soul - let other people have their health care and become more harmonic, it will make the society more harmonic with less crimes, and thereby huge savings for insurance companies..

Sorry Al, but you're repeating misconceptions and outright false information.

The US delivers the best healthcare to the most people. We spend more because people get more. The socialized systems ration care. Period. Full stop. Don't tell me about WHO measures comparing outcomes of the US system until you've read about what the components of their metrics actually are. Mostly social justice stuff, not true outcomes comparing medical condition to medical condition. The life expectancy differences are due to very different definitions in the US compared to Europe; especially around new born deaths. For example, if it comes out even slightly alive, in the US, it's a living human. In Europe it's not a human until it's done more and lasted much longer than a day. That alone skews the US avg life span down. Then there's all of the homicides in the US, etc.

The US does deliver a lot of care where the marginal cost exceeds the marginal benefit whereas the socialized systems do not. That is part of the rationing. So if if it costs 10X more, but only delivers 1.5X more relief of symptoms, you still get it in the US. You don't in socialized systems. From an economics perspective the socialized systems are getting it right, but explain that to the patient. The patient will take the slight improvement and damn the cost if they have insurance.

I note that in Australia, 50% of medical care is paid for by private insurance. Guess the socialized system isn't so grand for actual citizens under it. The trend toward private insurance is increasing in the UK as well. Canadians? Well their simple frost bitten and beer soaked brains are happy enough in their numb state of being, but still, many come to the US for medical care if they can afford it. The Canadian system doesn't cover most drugs, mental health and some other services. Rationing again.

Big Pharma does NOT run US healthcare. That is a stupid position to hold. Insurance won't let them. Counter interests. Actually, Rx is a small % of total medical spend. It escapes me why people focus on it. Pharma companies have many programs to deliver drugs to those who cannot afford them.

I do healthcare economics analysis for a living. I get so sick and tired of hearing the nonsense that gets passed around by the unwashed masses. The BS isn't helpful at all.
 
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