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Thread: Serious Healthcare Thread

  1. #1
    Synapse's Avatar
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    Serious Healthcare Thread

    Because we needed it. Thread is meant for discussion of various healthcare systems, their pro's and cons, and political discussion of healthcare reform in the US and elsewhere.

  2. #2
    Donor Sponk's Avatar
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    IMO just read http://en.wikipedia.org/wiki/Health_care_systems, but whatever.



    Australia:

    tldr is:

    * Costs ~10% of GDP
    * Paid for by 1.5% income levy, plus dipping into general revenue
    * Universal access
    * Government pays for: 100% of in-hospital costs, 75% of General Practitioner and 85% of specialist services
    * Wait times can be long for public access, but private healthcare can be purchased
    * Private healthcare is reasonably priced, let's say $1400/year but the government will probably pay 30% of it
    * Government is single-buyer for medications: either sell cheap to them, or fuck off
    * medical imaging and assorted stuff is often private, but prices are regulated (after all, the government probably ends up paying)
    * Hospitals can be private or public, and are run by each state, presumably by money given by the feds.
    Contract stuff to Seraphina Amaranth.

    "You give me the awful impression - I hate to have to say - of someone who hasn't read any of the arguments against your position. Ever."


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    http://healthland.time.com/2013/02/2...re-killing-us/

    When you follow the money, you see the choices we’ve made, knowingly or unknowingly.

    Over the past few decades, we’ve enriched the labs, drug companies, medical device makers, hospital administrators and purveyors of CT scans, MRIs, canes and wheelchairs. Meanwhile, we’ve squeezed the doctors who don’t own their own clinics, don’t work as drug or device consultants or don’t otherwise game a system that is so gameable. And of course, we’ve squeezed everyone outside the system who gets stuck with the bills.

    We’ve created a secure, prosperous island in an economy that is suffering under the weight of the riches those on the island extract.

    And we’ve allowed those on the island and their lobbyists and allies to control the debate, diverting us from what Gerard Anderson, a health care economist at the Johns Hopkins Bloomberg School of Public Health, says is the obvious and only issue: “All the prices are too damn high.”
    Long article but worth it.

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    Pacefalm's Avatar
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    Easy and cheap access to healthcare is imho a sign of living in a developed country. How Americans can live comfortably knowing they are but one illness away from bankrupcy boggles my mind.
    Quote Originally Posted by QuackBot View Post
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    Movember '12 Best Facial Hair Movember 2012Donor Lallante's Avatar
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    Quote Originally Posted by Pacefalm View Post
    Easy and cheap access to healthcare is imho a sign of living in a developed country. How Americans can live comfortably knowing they are but one illness away from bankrupcy boggles my mind.
    They pretty much dont. They either live in fear or else apply an individual version of american exceptionalism ("It wont happen to me, I'm different"). Even people with good insurance are a chronic illness away from bankruptcy

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    Alistair's Avatar
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    It all comes down to this question: Is healthcare a human right, and if so, to what degree?

    If it is a human right, the question is moot, all people (citizen or non-citizen) deserve healthcare regardless of cost or delivery system specifics.

    If it's not a human right, then it's a whole different discussion.

    Debating system is putting the cart ahead of the horse. The debate (in the U.S.) is (or should be) the position of healthcare as a human right or not, and THEN about the best way to fulfill that human right if it is one.


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    Even if the conclusion is that it isn’t a human right, the fact that we have the most inefficient, overpriced, anti-competitive, capitalism-gone-wrong system in the developed world means that there’s a HUGE room for improvement without wasting time debating philosophy.

    Healthcare used to simply be affordable. We wouldn’t be arguing whether it was a “right” if it was again.

    Actually, that’s not true, we would be arguing whether it’s a right, but the economic cost of saying that it is wouldn’t be so prohibitive as to sway the debate. In fact, we might even conclude that it isn’t a right, but it’s something we can provide for the poor at a reasonable cost to help lift them out of poverty.

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    Alistair's Avatar
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    Quote Originally Posted by Victoria Steckersaurus View Post
    ...without wasting time debating philosophy.
    With respect Victoria, we are just forum posters. We have no effect on anything on the grand scale. All we can do IS "debate philosophy".

    Until you know what the system is required to do and why, you cannot design the best possible system.

    Healthcare used to simply be affordable.
    It also used to be almost completely ineffective. Cost has risen as technology and pharmicology has risen (albeit perhaps not appropriately so, I agree), as well as industrialization of healthcare insurance has come to the fore.

    Back when healthcare was affordable, you might see your local sawbones once every few years, and maybe, once in a while, be seen at a local hospital. Now, you're seen many times more often, by a suite of doctors and specialists, with advanced technology, and a warehuse full of pharmicopia, all run by a massive industry with massive overhead, salaries, and yes, profit. Two different worlds.

    but the economic cost of saying that it is wouldn’t be so prohibitive as to sway the debate.
    The debate over it's status as a Right is vital. If it is a right, cost to provide and personal responsabillity (for example) cannot be the primary motivation of the discussion. If it is not a right, then multiple other aspects can have a place as part of the discussion/debate.

    As with the Gun debate, it is my view that Americans consistently take the wrong tact in the modern era. If you do not want gun ownership to be a right, and you do want healthcare to be a right (both very common beliefs in the U.S., specificly on the U.S. left), there is a mechanic to amend the Consitution to do so and make it so. We did it many times before.

    I strongly support that being the route taken to enshrine (or remove) these issues, thus clarifying the issue, so we can get past the basic debates we get permanently stuck on (rights vs. States role in taking away/regulating those rights) and on to the more vital and meaningful real world debate of specific delivery system design to best provide/protect those rights.


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    Keorythe's Avatar
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    Quote Originally Posted by Alistair View Post
    The debate over it's status as a Right is vital. If it is a right, cost to provide and personal responsabillity (for example) cannot be the primary motivation of the discussion. If it is not a right, then multiple other aspects can have a place as part of the discussion/debate.
    Is there any other service out there that is a "human right"? Not really. Even food isn't a right. It always has been and always will be a privilege. The only argument is how to make that privilege affordable and what steps we're willing to take.

    As with the Gun debate, it is my view that Americans consistently take the wrong tact in the modern era. If you do not want gun ownership to be a right, and you do want healthcare to be a right (both very common beliefs in the U.S., specificly on the U.S. left), there is a mechanic to amend the Consitution to do so and make it so. We did it many times before.
    Not even on the same level. The gun debate is about the US Constitution guaranteeing that an individual can have the ability to own an item. There is nothing that changes pricing or availability. And there have been many cases on both federal and State levels where high taxes or other punitive monetary challenges have been put in place to prevent people from being able to purchase them. There is nothing that is preventing people from having access to healthcare as there is guns. Cost only makes it prohibitive.

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    מלך יהודים Zeekar's Avatar
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    Quote Originally Posted by Alistair View Post
    It all comes down to this question: Is healthcare a human right, and if so, to what degree?

    If it is a human right, the question is moot, all people (citizen or non-citizen) deserve healthcare regardless of cost or delivery system specifics.

    If it's not a human right, then it's a whole different discussion.

    Debating system is putting the cart ahead of the horse. The debate (in the U.S.) is (or should be) the position of healthcare as a human right or not, and THEN about the best way to fulfill that human right if it is one.
    You could debate that if your (USA) system would be competitive , but its not so its retarded not to change it in any case.


    

  11. #11
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    One thing that really needs to be examined in US healthcare is the relationships between pharmaceutical corporations and insurance companies. It raises a serious eyebrow when a insurance company will cover upwards of $400k a year of chemo-therapy but not shit like grief counselling, or alternative medicine like enzyme theraphy which cost a tiny fraction of that. We're all currently going through the affects of what happened when they let savings & loans banks intermingle with investment banks, so I feel this is something important to address, lest your perscribed medications & treatments are determined more by which pharmaceutical corps are invested in your health insurance provider, then your ailment.

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    Quote Originally Posted by Lallante View Post
    Quote Originally Posted by Pacefalm View Post
    Easy and cheap access to healthcare is imho a sign of living in a developed country. How Americans can live comfortably knowing they are but one illness away from bankrupcy boggles my mind.
    They pretty much dont. They either live in fear or else apply an individual version of american exceptionalism ("It wont happen to me, I'm different"). Even people with good insurance are a chronic illness away from bankruptcy
    Sad state indeeed. In the USA 60% of all personal bankrupcy cases are due to medical bills. Absolutely mental in socialist Holland.
    Schopenhauer:

    All truth passes through three stages.
    First, it is ridiculed.
    Second, it is violently opposed.
    Third, it is accepted as being self-evident..

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    Quote Originally Posted by Victoria Steckersaurus View Post
    Even if the conclusion is that it isn’t a human right, the fact that we have the most inefficient, overpriced, anti-competitive, capitalism-gone-wrong system in the developed world means that there’s a HUGE room for improvement without wasting time debating philosophy.

    Healthcare used to simply be affordable. We wouldn’t be arguing whether it was a “right” if it was again.

    Actually, that’s not true, we would be arguing whether it’s a right, but the economic cost of saying that it is wouldn’t be so prohibitive as to sway the debate. In fact, we might even conclude that it isn’t a right, but it’s something we can provide for the poor at a reasonable cost to help lift them out of poverty.
    This absolutely.

    The fact that is costs us ridiculous piles of money to provide the same services provided by other countries should be independent of the universality of that care. An X ray should not cost less because it happens to take place in sweeden.

    Can anyone link some actual data as to comparative costs of atomic operations like "chest xray" in various countries?

    I've been told previously that the cost of the American system was basically paying for extreme care for the bottom 20% who had never had any preventive care and then spent the final months or years of their lives as taxpayer funded cyborgs. Yes that's wildly overstated but you get the idea.

    If FMAR and Victoria are right....If the problem is actually just that we get overcharged for everything, then it's (as we Americans like to say) a very different ballgame.

  14. #14
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    In reply to sponk in the other thread:
    Quote Originally Posted by Sponk View Post
    Quote Originally Posted by Synapse View Post
    Quote Originally Posted by Sponk View Post
    How much is US health insurance cost anyway?
    Seems to be like $10,000 a year. I combined the worker and company average 2009 premiums mentioned here:
    http://en.wikipedia.org/wiki/Health_...ing_conditions
    Jesus f christ. For us it's an extra 1.5% income tax for public + $15/week for private cover.
    I've heard 20% of one's income referenced as "low" when buying non-employer healthcare plans.

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    Donor Sponk's Avatar
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    Quote Originally Posted by Synapse View Post
    Can anyone link some actual data as to comparative costs of atomic operations like "chest xray" in various countries?
    Australia: $60.10, of which $40.10 is reimbursable by the government.

    USA: $70, but really $250, with a chance of spiralling into over a thousand.
    Contract stuff to Seraphina Amaranth.

    "You give me the awful impression - I hate to have to say - of someone who hasn't read any of the arguments against your position. Ever."


  16. #16
    Donor Aea's Avatar
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    The true cost of medical services is a major farce in America because of the lofty relationship between insurance providers and health care providers. Providers will set one cost, insurance companies will pay a small fraction and they call it good. If you don't have insurance you're usually stuck with 100% of the inflated cost, or none of it (because it is just too expensive to pay for).

    My Chest CT scan "cost" $8700 but it only "cost" me $250 (on top of existing insurance premiums), the insurance company paid out another $1000, and it probably cost the hospital ~$250. Clusterfuck.

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    Moderator Moderator F*** My Aunt Rita's Avatar
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    Quote Originally Posted by Aea View Post
    The true cost of medical services is a major farce in America because of the lofty relationship between insurance providers and health care providers. Providers will set one cost, insurance companies will pay a small fraction and they call it good. If you don't have insurance you're usually stuck with 100% of the inflated cost, or none of it (because it is just too expensive to pay for).

    My Chest CT scan "cost" $8700 but it only "cost" me $250 (on top of existing insurance premiums), the insurance company paid out another $1000, and it probably cost the hospital ~$250. Clusterfuck.
    Just remember that personnel costs were a fraction of that.

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    Quote Originally Posted by Keorythe View Post
    Quote Originally Posted by Alistair View Post
    The debate over it's status as a Right is vital. If it is a right, cost to provide and personal responsabillity (for example) cannot be the primary motivation of the discussion. If it is not a right, then multiple other aspects can have a place as part of the discussion/debate.
    Is there any other service out there that is a "human right"? Not really. Even food isn't a right. It always has been and always will be a privilege. The only argument is how to make that privilege affordable and what steps we're willing to take.

    As with the Gun debate, it is my view that Americans consistently take the wrong tact in the modern era. If you do not want gun ownership to be a right, and you do want healthcare to be a right (both very common beliefs in the U.S., specificly on the U.S. left), there is a mechanic to amend the Consitution to do so and make it so. We did it many times before.
    Not even on the same level. The gun debate is about the US Constitution guaranteeing that an individual can have the ability to own an item. There is nothing that changes pricing or availability. And there have been many cases on both federal and State levels where high taxes or other punitive monetary challenges have been put in place to prevent people from being able to purchase them. There is nothing that is preventing people from having access to healthcare as there is guns. Cost only makes it prohibitive.
    The constitution can be altered, but it takes the societal values to accept it.

    Therefore it's about American social values rather than an old document.

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    Moderator Moderator F*** My Aunt Rita's Avatar
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    Quote Originally Posted by Kanv View Post
    The constitution can be altered, but it takes the societal values to accept it.

    Therefore it's about American social values rather than an old document.
    It's already a right. No one is debating that except the crazies. With the PPACA and previous laws we have a system for determining who pays. Now we need to make sure we are getting value for that money.

  20. #20
    Keorythe's Avatar
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    Quote Originally Posted by Kanv View Post
    The constitution can be altered, but it takes the societal values to accept it.

    Therefore it's about American social values rather than an old document.
    The "old document" is the basis for most rights in the US. Social values change from decade to decade, rights do not.

    It's already a right. No one is debating that except the crazies.
    Again, confusing rights with privileges/entitlements. The only rights associated with health care are those that prevent laws or individuals from intentionally preventing access. Obamacare didn't instill any rights, only regulatory changes.

    I agree 100% with Aea about the relationship between insurance and provider/drug companies. The OP's article went into this describing the chargemaster issues. Is price fixing the answer? Maybe technology and drug development license regulations need to be reviewed

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