What are your thoughts on US healthcare?

[DynamicDidactic]

Not to hijack another thread...

What are your thoughts on the current US healthcare system or the patchwork of different types of systems (VA, Medicare/Medicaid, private insurance)?

Do you think there is a better and doable alternative (e.g., some version of universal healthcare)?

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[deleted480308]

Not to hijack another thread...

What are your thoughts on the current US healthcare system or the patchwork of different types of systems (VA, Medicare/Medicaid, private insurance)?

Do you think there is a better and doable alternative (e.g., some version of universal healthcare)?

universal healthcare is a bad idea

 

[Sanman]

Not to hijack another thread...

What are your thoughts on the current US healthcare system or the patchwork of different types of systems (VA, Medicare/Medicaid, private insurance)?

Do you think there is a better and doable alternative (e.g., some version of universal healthcare)?

I could write a book on my thoughts on this topic, but won't right now. The U.S. needs to make rates more affordable and provide universal coverage for citizens. That said, I am not for medicare for all as currently proposed. There is no plan to cover the complete cost of promises and no plan for how to manage decimating one of the largest employment sectors in the U.S.

I would eventually like to see some sort of universal public coverage for emergency hospitalizations and basic primary care (say 4 annual visits covered) with the option to purchase more comprehensive private coverage as a purchase option. I would also like to see reform of medication costs and a transition plan for the job losses associated with thes plans.

Allowing people the option to purchase medicare coverage out of pocket at a reasonable rate would not be a bad short term solution. The exchanges were a bit of s mess, IMO.

 

[PsyDr]

So long as there are those that use being a patient as a revenue generating activity, it’ll never work.

Can you imagine the number of lawsuits that would suddenly come about?

actually, I’d make awesome money off that. Let’s get on it .

 

[deleted343839]

One of the most interesting books I've ever read on the topic is T. R. Reid's "The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care." It is better read as a series of illustrative anecdotes than a scholarly comparison of health systems, but one thing that shines through is how uniquely fragmented the US healthcare system is.

 

[psych.meout]

universal healthcare is a bad idea

How so? It works in literally every other 1st world country and via many different models.

So long as there are those that use being a patient as a revenue generating activity, it’ll never work.

Can you imagine the number of lawsuits that would suddenly come about?

actually, I’d make awesome money off that. Let’s get on it .

Are you referring to patients with secondary gain to malinger illness or injury?

Do you think that these people don't exist in Canada or the UK?

I could write a book on my thoughts on this topic, but won't right now. The U.S. needs to make rates more affordable and provide universal coverage for citizens. That said, I am not for medicare for all as currently proposed. There is no plan to cover the complete cost of promises

There are absolutely plans to cover these costs, including tax increases and savings from reduced administration costs (some private plans cost $.30 of every $1 just in administration) to more preventative care to

I'm not saying any of the proposed plans are perfect, but to say that there are plans to cover the costs is disingenuous.

no plan for how to manage decimating one of the largest employment sectors in the U.S.

Some people will find similar jobs in administering Medicare to hundreds of millions more people than are currently on it and the rest will have to find new jobs. Are we really going to prevent people from having access to healthcare because some other people currently make a living off the inefficiencies and injustices of the current system and don't want to have switch jobs?

I would eventually like to see some sort of universal public coverage for emergency hospitalizations and basic primary care (say 4 annual visits covered) with the option to purchase more comprehensive private coverage as a purchase option.

Which is even more financially untenable than Medicare for All, because you're incentivizing emergency care, which is the most expensive level compared to primary care, urgent care, etc. Some people won't need 4 primary care visits a year and others are going to need a lot more. You're making this more expensive, more complicated, and obtuse by trying to fit every person into the same box of healthcare needs.

I would also like to see reform of medication costs and a transition plan for the job losses associated with thes plans.

Allowing people the option to purchase medicare coverage out of pocket at a reasonable rate would not be a bad short term solution. The exchanges were a bit of s mess, IMO.

The core problem with the PPACA is not the exchanges. It's that it's a technocratic, neoliberal solution that is financially and logistically tenuous, at best. It's going to have the same financial and access issues as the current system and be vulnerable to being torn apart the next time Republicans take control from the feckless Democrats, just like what happened with the PPACA.

The reason that programs like Social Security are so popular and have lasted so long is that they are universal and comprehensive.

 

[deleted480308]

How so? It works in literally every other 1st world country and via many different models.


Are you referring to patients with secondary gain to malinger illness or injury?

Do you think that these people don't exist in Canada or the UK?



There are absolutely plans to cover these costs, including tax increases and savings from reduced administration costs (some private plans cost $.30 of every $1 just in administration) to more preventative care to

I'm not saying any of the proposed plans are perfect, but to say that there are plans to cover the costs is disingenuous.



Some people will find similar jobs in administering Medicare to hundreds of millions more people than are currently on it and the rest will have to find new jobs. Are we really going to prevent people from having access to healthcare because some other people currently make a living off the inefficiencies and injustices of the current system and don't want to have switch jobs?



Which is even more financially untenable than Medicare for All, because you're incentivizing emergency care, which is the most expensive level compared to primary care, urgent care, etc. Some people won't need 4 primary care visits a year and others are going to need a lot more. You're making this more expensive, more complicated, and obtuse by trying to fit every person into the same box of healthcare needs.



The core problem with the PPACA is not the exchanges. It's that it's a technocratic, neoliberal solution that is financially and logistically tenuous, at best. It's going to have the same financial and access issues as the current system and be vulnerable to being torn apart the next time Republicans take control from the feckless Democrats, just like what happened with the PPACA.

The reason that programs like Social Security are so popular and have lasted so long is that they are universal and comprehensive.

Universal care only “works” if you don’t value freedom or property rights, are cool with waits and rationing, and price controls that stifle innovation

It’s a bad policy

 

[psych.meout]

Universal care only “works” if you don’t value freedom or property rights,

Hard to have freedoms or property if you're dead from easily preventable or treatable illness or injury.

And I'd strongly dispute that universal healthcare is incompatible with freedom or property rights? Is the US the only first world country with property rights and freedoms?

are cool with waits and rationing

We have these in the US as it is. In other countries with universal healthcare, everyone has access to care and the wait times tend to be for things like hip replacement and other procedures that don't deal with life-threatening issues.

and price controls that stifle innovation

Source? Do you have some kind of empirical evidence that "innovation" is "stifled" in literally every other first world nation, because they all have universal healthcare? How are you operationalizing "innovation" and "stifling?"

Also, how are you reconciling the parasitism of the current medical establishment on publicly funded research? Corporations (e.g., Big Pharma, medical device producers) don't produce basic research, because it isn't profitable to them, so they just wait for publicly funded researchers to do the work first and then make money off of translating it into something tangible and profitable. Seems like there would be more money to fund research innovation if a large portion of revenue weren't being extracted for profit or spent on marketing.

 

[deleted480308]

Hard to have freedoms or property if you're dead from easily preventable or treatable illness or injury.

And I'd strongly dispute that universal healthcare is incompatible with freedom or property rights? Is the US the only first world country with property rights and freedoms?



We have these in the US as it is. In other countries with universal healthcare, everyone has access to care and the wait times tend to be for things like hip replacement and other procedures that don't deal with life-threatening issues.


Source? Do you have some kind of empirical evidence that "innovation" is "stifled" in literally every other first world nation, because they all have universal healthcare? How are you operationalizing "innovation" and "stifling?"

Also, how are you reconciling the parasitism of the current medical establishment on publicly funded research? Corporations (e.g., Big Pharma, medical device producers) don't produce basic research, because it isn't profitable to them, so they just wait for publicly funded researchers to do the work first and then make money off of translating it into something tangible and profitable. Seems like there would be more money to fund research innovation if a large portion of revenue weren't being extracted for profit or spent on marketing.

I’m not going to be dead from preventable things because I pay for my care, making me then also pay for other people is a violation of my property rights.

No, places that operate on a universal care model do not have property rights in that regard for the reason noted above

The market should determine the wait time on procedures, not a centralgovt planning

I’m fine with ending govt funded research, your complaint of private company “parasitism” is solved!

 

[Sanman]

How so? It works in literally every other 1st world country and via many different models.


Are you referring to patients with secondary gain to malinger illness or injury?

Do you think that these people don't exist in Canada or the UK?



There are absolutely plans to cover these costs, including tax increases and savings from reduced administration costs (some private plans cost $.30 of every $1 just in administration) to more preventative care to

I'm not saying any of the proposed plans are perfect, but to say that there are plans to cover the costs is disingenuous.



Some people will find similar jobs in administering Medicare to hundreds of millions more people than are currently on it and the rest will have to find new jobs. Are we really going to prevent people from having access to healthcare because some other people currently make a living off the inefficiencies and injustices of the current system and don't want to have switch jobs?



Which is even more financially untenable than Medicare for All, because you're incentivizing emergency care, which is the most expensive level compared to primary care, urgent care, etc. Some people won't need 4 primary care visits a year and others are going to need a lot more. You're making this more expensive, more complicated, and obtuse by trying to fit every person into the same box of healthcare needs.



The core problem with the PPACA is not the exchanges. It's that it's a technocratic, neoliberal solution that is financially and logistically tenuous, at best. It's going to have the same financial and access issues as the current system and be vulnerable to being torn apart the next time Republicans take control from the feckless Democrats, just like what happened with the PPACA.

The reason that programs like Social Security are so popular and have lasted so long is that they are universal and comprehensive.

The tax increases and savings may not cover the costs that Sanders has planned given the increases in coverage. It will likely incur significant cuts in payments to hospitals and healthcare providers to be properly funded. And the job loss is not just a few people, it is estimated at 2 million. It is not just the number of jobs, but that they are good white collar jobs. I wonder what that will do to the economy. A little further reading for those interested:

Sanders Embraces New Study That Lowers ‘Medicare For All’s’ Cost, But Skepticism Abounds

 

[psych.meout]

I’m not going to be dead from preventable things because I pay for my care, making me then also pay for other people is a violation of my property rights.

Do you pay taxes for police and fire services? Are these violations of your property rights if you don't use these services, but other people do? Should we not have public fire and police services?

No, places that operate on a universal care model do not have property rights in that regard for the reason noted above

That's a pretty black and white understanding of property rights. Are building codes a violation of your property rights? What about restaurant health codes?

The market should determine the wait time on procedures, not a centralgovt planning

Except the market has shown that the current system is less efficient than literally every universal healthcare program. This is just market fetishism.

Moreover, the government isn't controlling wait times in every system, not all of them are single payor.

I’m fine with ending govt funded research, your complaint of private company “parasitism” is solved!

I thought you wanted "innovation," however you define it? Do you have a proposal for how this will occur when no private company wants to foot the bill for basic research that may not pan out and make it to the point of even starting translational or applied research?

 

[psych.meout]

The tax increases and savings may not cover the costs that Sanders has planned given the increases in coverage. It will likely incur significant cuts in payments to hospitals and healthcare providers to be properly funded. And the job loss is not just a few people, it is estimated at 2 million. It is not just the number of jobs, but that they are good white collar jobs. I wonder what that will do to the economy. A little further reading for those interested:

Sanders Embraces New Study That Lowers ‘Medicare For All’s’ Cost, But Skepticism Abounds

I'm sure buggy whip manufacturing produced some good jobs, too.

 

[foreverbull]

In California back in 2016, legislators tried to pass a bill that would cap drug prices (to VA-negotiated prices) and drug companies spent $100 million to spread disinformation that people would die because they wouldn’t get their meds if it passed. The misinformation campaign worked well and it didn’t pass.

In the US, our disparity in care is ridiculous. Some folks get VIP healthcare if they have the $$$$, some can’t afford healthcare, and many are underinsured (insurers refusing to cover preventative services that they allege they cover, yearly deductibles in the realm of a few thousand while employers are forcing employees to shoulder more of the monthly cost burden on top of the deductibles and copays). I’m very disillusioned with our system at present.

I wish we would stop looking at medical care/insurance as a way to make a lot of profit off of people; I can’t see any other feasible way to achieve this without shifting completely to universal healthcare to eliminate this mindset of putting profits above people’s health. We’ve tried this current system of letting the market decide for many years and it’s not working, with our most vulnerable and/or lower middle class suffering the most (the ones who don’t qualify for aid but have the worst insurance that won’t actually cover much and are one major health emergency away from being pulled into debt).

 

[deleted480308]

Do you pay taxes for police and fire services? Are these violations of your property rights if you don't use these services, but other people do? Should we not have public fire and police services?


That's a pretty black and white understanding of property rights. Are building codes a violation of your property rights? What about restaurant health codes?


Except the market has shown that the current system is less efficient than literally every universal healthcare program. This is just market fetishism.

Moreover, the government isn't controlling wait times in every system, not all of them are single payor.


I thought you wanted "innovation," however you define it? Do you have a proposal for how this will occur when no private company wants to foot the bill for basic research that may not pan out and make it to the point of even starting translational or applied research?

I’m fine with private fire. As police is the actual doling out of govt power (one of the few legitimate roles of govt) it makes sense

There are plenty of places without residential building codes. I was a builder, some of the codes are unecessary.

Lots of research happens in sectors without govt help. If there is potential for profit or a charitable interest, research will happen

 

[ClinicalABA]

I think its...odd? that access to health care is so tied to our jobs. The two things (e.g., employability and need for coverage of medical expenses) seem tangentially related, at best. Working with children, i think it's even stranger that a childrens' access to services depends on where their parents work (and somewhat in the opposite direction of what you would expect, with private commercial insurance often beinf the most stingy and difficult to work with. Also, when you look at general health related outcomes, the US does not fare too well when compared to other industrialized "first world" countries.

Personally/politically, I believe that providing for optimum physical well-being of the citizenship as a whole is a primary responsibility of the state. I don't believe that our current system achieves this goal.

 

[deleted480308]

I think its...odd? that access to health care is so tied to our jobs. The two things (e.g., employability and need for coverage of medical expenses) seem tangentially related, at best. Working with children, i think it's even stranger that a childrens' access to services depends on where their parents work (and somewhat in the opposite direction of what you would expect, with private commercial insurance often beinf the most stingy and difficult to work with. Also, when you look at general health related outcomes, the US does not fare too well when compared to other industrialized "first world" countries.

Personally/politically, I believe that providing for optimum physical well-being of the citizenship as a whole is a primary responsibility of the state. I don't believe that our current system achieves this goal.

The connection to employment is the govts fault. It started with wage controls during the war and then drifted into the mandatory “employer must provide” crap we have now

No your health is not the govts problem

 

[WisNeuro]

Along with the majority of Americans, I also believe that the government should be in the healthcare game. I'm all for a public option to force private insurers to be more competitive. Our current system obviously is not working well for most, though maybe I'm biased as many of my patients are elderly, and I've lost count of the times I've been told that they ration their medications due to affordability issues.

 

[ClinicalABA]

No your health is not the govts problem

What you state as fact is, in fact, opinion- and one on which we differ. I do like when the argument moves beyond policy to individual beliefs about the role of government. You (coming from what appears to be a more libertarian bent) and me (coming from a more socialist bent) could argue policy all day, and it would be a silly, useless endeavor. I'd prefer to join you for a Lagavulin and a rare porterhouse and discus our favorite finish to use on handcrafted furniture.

 

[deleted480308]

What you state as fact is, in fact, opinion- and one on which we differ. I do like when the argument moves beyond policy to individual beliefs about the role of government. You (coming from what appears to be a more libertarian bent) and me (coming from a more socialist bent) could argue policy all day, and it would be a silly, useless endeavor. I'd prefer to join you for a Lagavulin and a rare porterhouse and discus our favorite finish to use on handcrafted furniture.

Silly discussions over libations are wonderful

 

[cara susanna]

US healthcare in its current state is terrible and we need either universal healthcare or at the very least a public option. There are numerous studies demonstrating that Medicare for All would actually decrease or at least even out to current costs.

 

[deleted480308]

US healthcare in its current state is terrible and we need either universal healthcare or at the very least a public option. There are numerous studies demonstrating that Medicare for All would actually decrease or at least even out to current costs.

there aren’t any good studies showing it will decrease costs, it’s going to be an absurd increase while destroying payments and causing a ton of downstream problems

 

[WisNeuro]

There are some decent quality studies. Let's not be all hyperbolic here, it's silly. There are, of course, studies on the other side as well, but let's not dismiss out of hand things in which we have obviously not read.

 

[Ollie123]

Would love to see universal healthcare. Happy to pay more in taxes for it. Have many relatives and close friends in countries where it exists. Some of whom lived here. The most common response is "It is literally better in every way." There are some reasons the US is different. Unfortunately I think some of the things that make it challenging here (food industry) will also be fought tooth and nail. I don't want to become a socialist, but rabid capitalism is destroying us and I would love to see the pendulum swing the other way for a bit.

I am open to some hybrid options. I think it will need to be a hybrid option to make it viable politically - at least to start. I think with ClinicalABA that it especially makes zero sense for kids. Medicare for everyone of non-working age (under 18 or over 65) seems a good place to start. If we want to be a land of equal opportunity, public healthcare for kids seems critical.

 

[cara susanna]

there aren’t any good studies showing it will decrease costs, it’s going to be an absurd increase while destroying payments and causing a ton of downstream problems

I mean even some conservative think tanks have found equal or decreased costs.

 

[WisNeuro]

Heck, there's more evidence for the benefits of medicare for all, than for libertarianism ever working as a viable government system

 

[deleted480308]

I mean even some conservative think tanks have found equal or decreased costs.

link their reports and we'll go through them

Heck, there's more evidence for the benefits of medicare for all, than for libertarianism ever working as a viable government system

we had it once and abandoned it for not being popular. it works though, but personal responsibility makes a crap campaign slogan compared to "free stuff the evil rich guy will pay for"

 

[WisNeuro]

we had it once and abandoned it for not being popular. it works though, but personal responsibility makes a crap campaign slogan compared to "free stuff the evil rich guy will pay for"

We had a bastardized version, and it didn't really work. Fact is, there is no form of "pure" governmental ideology that works. Mostly because things are actually complicated, not simply black and white, and people tend to not be homogenous. Which, is why we need different ideas and different systems in place.

 

[cara susanna]

link their reports and we'll go through them
we had it once and abandoned it for not being popular. it works though, but personal responsibility makes a crap campaign slogan compared to "free stuff the evil rich guy will pay for"

You realize that ultimately we pay for uninsured people, right, and at that point it's way more expensive because they wait until their illnesses have become severe enough? Or they go to the emergency department for almost anything because the ED is forced to treat them regardless?

And with the coronavirus, I know that I feel great that we'll have a bunch of people who could be infected but won't seek treatment because they can't afford it.

 

[deleted480308]

You realize that ultimately we pay for uninsured people, right, and at that point it's way more expensive because they wait until their illnesses have become severe enough? Or they go to the emergency department for almost anything because the ED is forced to treat them regardless?

And with the coronavirus, I know that I feel great that we'll have a bunch of people who could be infected but won't seek treatment because they can't afford it.

I don’t think “we” should be forced to pay for anyone regardless of the stage so telling me it will cost more later is a false choice fallacy

 

[WisNeuro]

I don’t think “we” should be forced to pay for anyone regardless of the stage so telling me it will cost more later is a false choice fallacy

Well, that's the beauty of living in a democracy, there's some things we pay for which we agree with, there's some things we don't agree with. You don't get 100% satisfaction. But, the fact is that "we" as a society have already chosen that people that need emergent healthcare will get it. I doubt that's going anywhere anytime soon. So, you can work within the choices society has made to improve it, or live in a fantasy world.

 

[bcliff]

universal healthcare is a bad idea

Logically fallacious to draw parallels with this video but too funny not to.




As someone who falls pretty far left of center -- Yes, the government is responsible for the welfare of its citizenry, which includes ensuring adequate access to healthcare. See? I can also make this statement sound like a fact rather than an opinion.

Putting on a libertarian hat for a moment... I can imagine wanting to enjoy the money and property that I alone have earned (without the help or support of anyone else) without having to worry about catching communicable disease unecessarily propagated due to some folks refusing to engage in preventative healthcare because of high costs and un/underinsurance.

I can also imagine wanting to not have to offer my employees healthcare coverage because that's now a benefit already provided by the government.

I can also imagine enjoying the productivity boost that would likely occur because of employees taking fewer sick days secondary to increased access to preventative care and healthcare coverage more broadly.

 

[deleted480308]

Well, that's the beauty of living in a democracy, there's some things we pay for which we agree with, there's some things we don't agree with. You don't get 100% satisfaction. But, the fact is that "we" as a society have already chosen that people that need emergent healthcare will get it. I doubt that's going anywhere anytime soon. So, you can work within the choices society has made to improve it, or live in a fantasy world.

“We” don’t live in a democracy. That basic misunderstanding of civics is part of the problem in this country

 

[deleted480308]

Logically fallacious to draw parallels with this video but too funny not to.




As someone who falls pretty far left of center -- Yes, the government is responsible for the welfare of its citizenry, which includes ensuring adequate access to healthcare. See? I can also make this statement sound like a fact rather than an opinion.

Putting on a libertarian hat for a moment, then I could also imagine wanting to enjoy the money and property that I alone have earned (without the help or support of anyone else) without having to worry about catching communicable disease unecessarily propagated due to some folks refusing to engage in preventative healthcare because of high costs and un/underinsurance. I'd also like to enjoy not having to offer my employees healthcare because that's already provided. I'd also like the productivity boost that would likely occur because of employees taking fewer sick days secondary to increased healthcare access.

None of that crap is made more efficient by govt and it’s wrong to make 1 citizen fund another’s personal needs.

 

[WisNeuro]

“We” don’t live in a democracy. That basic misunderstanding of civics is part of the problem in this country

"We" live in a liberal democracy, or a federal republic, depending on who you ask.

 

[deleted480308]

"We" live in a liberal democracy, or a federal republic, depending on who you ask.

We are a constitutional republic. It’s definitely not a democracy, those are dangerous and at huge risk for violation of rights a la lord of the flies

 

[WisNeuro]

We are a constitutional republic. It’s definitely not a democracy, those are dangerous and at huge risk for violation of rights a la lord of the flies

Regardless of what you want to call it in name, the fact still remains that "we" have chosen that we will not turn away others for emergency care. I doubt that will change anytime soon.

 

[cara susanna]

I don’t think “we” should be forced to pay for anyone regardless of the stage so telling me it will cost more later is a false choice fallacy

It doesn't work that way. And if it did, do you really want poor people to die from lack of healthcare? You really don't see the benefits to a society having access to affordable healthcare?

 

[deleted480308]

Regardless of what you want to call it in name, the fact still remains that "we" have chosen that we will not turn away others for emergency care. I doubt that will change anytime soon.

Which why democracy is a bad idea. The corporate “we” is not smart or ethical

 

[deleted480308]

It doesn't work that way. And if it did, do you really want poor people to die from lack of healthcare? You really don't see the benefits to a society having access to affordable healthcare?

No. I don’t want people to be allowed to force their neighbors to fund them. And no, it’s not affordable to socialize it. It’s absurdly expensive, just to other people than the low income patient

 

[WisNeuro]

Which why democracy is a bad idea. The corporate “we” is not smart or ethical

Which is an opinion. As many would argue that it can be both, just as libertarianism is not ethical or mature in thinking.

 

[deleted480308]

Which is an opinion. As many would argue that it can be both, just as libertarianism is not ethical or mature in thinking.

THeft and lack of personal responsibility is not mature thinking

 

[WisNeuro]

THeft and lack of personal responsibility is not mature thinking

Failure to account for basic human nature and heterogeneity is not mature thinking. There is a reason most of us outgrew Randian Libertarianism after our senior year of high school/freshman year of college. It's amazingly myopic and shortsighted and ignores any understanding if human nature.

 

[cara susanna]

No. I don’t want people to be allowed to force their neighbors to fund them. And no, it’s not affordable to socialize it. It’s absurdly expensive, just to other people than the low income patient

We have the most expensive healthcare in the world, currently. And, again, we don't know that it's more expensive. It could be, but it could also be cheaper or even out. We have evidence that hospitals overcharge because insurance pays for it. We have evidence that the costs of healthcare as provided in the private sector are inflated because of our current system.

I used to be a libertarian like you. I get it. But the things you're saying, they only work in theory and you're basing it off of how things "should" be rather than how things actually are.

And what's your proposal, then? If people can't pay, they die. You're okay with that?

 

[deleted480308]

Failure to account for basic human nature and heterogeneity is not mature thinking. There is a reason most of us outgrew Randian Libertarianism after our senior year of high school/freshman year of college. It's amazingly myopic and shortsighted and ignores any understanding if human nature.

I would propose it more fully accounts for human nature. Those able to externalize the consequences of bad luck and bad behavior are incentivized to be riskier and less prudent.

 

[deleted480308]

We have the most expensive healthcare in the world, currently. And, again, we don't know that it's more expensive. It could be, but it could also be cheaper or even out. We have evidence that hospitals overcharge because insurance pays for it. We have evidence that the costs of healthcare as provided in the private sector are inflated because of our current system.

I used to be a libertarian like you. I get it. But the things you're saying, they only work in theory and you're basing it off of how things "should" be rather than how things actually are.

And what's your proposal, then? If people can't pay, they die. You're okay with that?

We all die. You don’t get to pretend that govt seizing an industry changes that. Everyone dies. Full stop.

Even part of the proposed cost savings of going full govt takeover is to start backing off on end of life “full care” and push more hospice/palliative

The libertarian crowd just accepts that reality earlier. When deciding if my treatment that might extend life by a year is worth $200k, I need to have the $200k to make a real value judgement. I shouldn’t be making that call with other people’s money. That situation doesn’t change with a maintenance treatment at $20k/yr or $500

 

[WisNeuro]

I would propose it more fully accounts for human nature. Those able to externalize the consequences of bad luck and bad behavior are incentivized to be riskier and less prudent.

Almost all of the research on human economic decision making would disagree with this sentiment.

 

[deleted480308]

Almost all of the research on human economic decision making would disagree with this sentiment.

we must deal with different humans then, we're not going to agree on this

 

[Seven_Costanza]

we must deal with different humans then, we're not going to agree on this

Which humans are you dealing with and where is the evidence to support your opinions?

 

[foreverbull]

we must deal with different humans then, we're not going to agree on this

So what exactly are you proposing healthcare-wise? I’m not clear on this...I seem to be clearer about what you don’t want.

So is it amount of personal income correlating with access to and quality of coverage that you support? Are we talking Darwinian ideas about survival of the “fittest”/richest?

 

[deleted480308]

Which humans are you dealing with and where is the evidence to support your opinions?

I consistently have patients say they aren't worried about the costs of their bad behaviors because "that's covered" or about it's impact on their income because "I'm working on getting my disability set up"