Your thoughts on The US Healthcare System

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kiri3tsubasa:
I would prefer that not a single penny from the government goes to the health insurance companies, thus forcing them to rely on the free market capitalist system forcing them to actually compete by means of providing good service for cheap when compared to the other company. By doing this we have competition in health insurance providers, something desperately needed. But then again what do I know, I'm just someone that supports free market capitalism.

Well, except in healthcare that doesn't happen. In normal free-market capitalism, if the price of...well let me just quote myself here to save time:

Lilani:
...The reason the base cost of medicines and medical procedures in the US is so expensive is because normal free market rules do not apply to something like medicine. Remember when the price of an EpiPen went up 400% for no good reason? That happened because, unlike other products, there is no price people won't pay for a life-saving medicine or medical procedure. If the price of Cheetos were to suddenly go up 400%, I'd stop buying Cheetos. If the price of an emergency medical device I use to save my life when I have an allergic reaction goes up 400%, I will spend all the money I have plus quite a bit that I don't in order to get it. In economics this is called inelastic demand, because no matter what happens to the cost the demand remains the same.

Socialized healthcare systems fix this problem by setting up the government as a price negotiator. With free market healthcare, while customers are subject to whatever prices pharmaceutical companies offer, they are not in a position to negotiate that price or drive competition for pricing. However with socialized healthcare, the government is in a position of power to cause pharmaceutical companies to compete with one another to be "the one" to provide medicine or medical equipment for that entire country. And the government DOES have incentive to make sure the things covered by their plan are both affordable and safe, because if people get sicker from what services they are provided, that only costs them MORE to fix.

Inelastic demand is also the reason that Martin Shkreli shitbag was able to raise the price of that HIV drug from $13.50 per pill to $750 literally overnight. And before even that, back in 2011 the price of a medicine to treat Crohn's disease went up 1200%. Prominent YouTuber Hank Green happens to have Crohn's disease, and you can see him talking about this exact subject here. His brother John Green is another prominent YouTuber, and actually made a fiscally conservative argument for universal healthcare, based on healthcare's unique economic situation.

Long story short: Wishing for free market capitalism to rule healthcare is grand in theory, but due to the nature of medicine and healthcare this only facilitates the current level of price hiking and exploitation of patients that plagues America's healthcare system (and was actually worse back before the ACA because until that, people with Crohn's disease often didn't even get insurance and had to pay for everything out of pocket).

Lilani:
Snip

Another thing to take into account is "patents". They also make typical free market competition much harder. And while this doesn't affect "mainstream" pharmaceuticals, for specific treatments/diseases you might end up having only one or two suppliers. Price fixing becomes really too easy at that point.

BeetleManiac:

inu-kun:
Besides that in general people don't like paying more taxes to sponsor others people's medical treatments.

Which is a stupid argument, because what do you think insurance is?

Depends on which nation you are speaking of when you are talking about "insurance", as they are very different things depending on the nation due to the regulations of those nations.
In the US, insurance often means paying for something that you use rarely and increases all the time until you become too sick or injured to work to make those insurance payments, then you lose that insurance when you need it most if you miss a payment and you lose access to the medication, medical devices, and physicians you need to survive and wind up in the ER where they will stabilize you but not treat chronic conditions or surgeries that you have to make an appointment for and will more often than not send you on your way where you very well could die in the parkinglot, or at home the next day or next week because you cannot afford to stay in the hospital. Patient dumping is REAL and happens entirely too often. In the US, insurance means pay for something until you need it most and then it gets taken from you due to lack of regulation. Insurance in the US means pay for something then they charge you MORE if you actually need it ( increased costs to those who are sick or injured via "preexisting conditions" when you go to renew policies, which you have to renew every year and they take away current policies often to be able to exclude preexisting conditions to people as well). Insurance in the US means have them attempt to get out of paying for things you paid to have covered in the first place ( aka frequent preauthorization denials, making appeals take forever so maybe you will just not get the medication, surgery or test you need and they wont have to pay for it.) Insurance in the US means high deductible and copayments so when you are sick or injured you cannot afford to get the needed tests, surgeries, treatments or medications you need to survive. This works well for them when people cannot afford an $800 copayment for an MRI, they do not even get to find out what is wrong with them to be able to start treatment in the first place thus making it so the Insurance company does not have to pay for the test OR the treatment.
If you die, oh well they already have the money you paid when you are well and they don;t have to pay the costs of you being sick, so you dying is actually a win for them as well. Insurance in the US is essentially pay when you are well and can afford it and then die when you need it and they keep your money and their investors profit!

http://www.pnhp.org/news/2015/september/more-americans-gain-health-coverage-but-many-can%E2%80%99t-afford-to-use-it-doctors-grou
http://www.foxnews.com/health/2015/05/14/patient-dumping-in-america-hospitals-discharging-sick-homeless-back-onto-street.html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2571592/

OT: Access to Healthcare in the US is Atrocious and the sooner the US goes to a single payer system AND THE GOVERNMENT FULLY FUNDS IT TO GUARANTEE QUALITY OF CARE (as governments failing to properly fund is the only reason why quality of care suffers anywhere) the better. Once they stop debating over who is allowed to access healthcare the sooner they can start debating over how to improve quality of care. The idea they should skimp/ restrict access to/ refuse to cover treatments ect on any healthcare program is what prevents it from being quality. Privatizing only ensures investor profits are all that matter and patients lives do not. Medicaid/medicare cuts only ensures less doctors and hospitals get paid and less people have access to the healthcare they need to survive.

They need to remove investors hands from the cookie jar and have doctors and patients determine their care, not have insurance companies, bureaucrats, or employers determining whether or not someone can receive a colonoscopy, MRI, or a breathing treatment.

kiri3tsubasa:
I would prefer that not a single penny from the government goes to the health insurance companies, thus forcing them to rely on the free market capitalist system forcing them to actually compete by means of providing good service for cheap when compared to the other company. By doing this we have competition in health insurance providers, something desperately needed. But then again what do I know, I'm just someone that supports free market capitalism.

That is not how this works. How it works is investors provide your insurance policy, so their goal is to make sure they ONLY take your money when you are well and they spend as little as possible on you. If you get too expensive they do everything possible to make you leave so they do not have to pay for you. They discontinue polices frequently in order to make you renew and make sure they can charge you more for specific things to prevent you from having access to the care you need. They add hurdles such as preauthorization, denials, high deductibles and copays to prevent you from having tests needed to start your treatment since if you cannot find out what is wrong, they keep your money from when you are well and hopefully will either leave, miss a payment or die before they have to pay for you being sick and they keep all your money instead. This is the actual reality of private insurance in the US.

If you are wealthy, you do not need insurance as it is less expensive in the long run to just pay for what you want anyhow. Everyone else needs insurance because they cannot even afford to pay for everything needed prior to being treated. They are not competing for " quality of care" at all, they are competing for Highest profits per person aka only insure healthy people and dump everyone else. Healthy people do not need "quality of care" since they do not really use it. Insurance companies do not want people who want quality of care as they cause profit loss.

Republican healthcare plan will cost 23 million people their coverage, CBO says

The hastily redrawn Republican plan to overhaul Obamacare would leave an extra 23 million people without health insurance over the next decade, the first independent analysis of the plan has found.

The health reforms, forced through the House earlier this month and exuberantly celebrated by Donald Trump and scores of Republicans in the White House rose garden, would reduce the federal budget deficit by $119bn over the same period, according to an estimate by the nonpartisan Congressional Budget Office on Wednesday.

The analysis comes almost three weeks after House Republicans took the unusual step of passing their healthcare plan before the agency had time to estimate how much it would cost and how many people would be affected.

The bill - which some Republicans admitted they had not read - was pushed through after a first attempt was cancelled at the last moment when it became clear that Republicans could not muster enough support in their own ranks to pass it.

Having discovered the popular opposition to the first attempt, the House Republicans just do it again, showing their utter contempt for the electorate. These are the people the US actually vote in to represent them. Every day, the US provides something deliberately stupid to laugh at.

warmachine:
Republican healthcare plan will cost 23 million people their coverage, CBO says

The hastily redrawn Republican plan to overhaul Obamacare would leave an extra 23 million people without health insurance over the next decade, the first independent analysis of the plan has found.

The health reforms, forced through the House earlier this month and exuberantly celebrated by Donald Trump and scores of Republicans in the White House rose garden, would reduce the federal budget deficit by $119bn over the same period, according to an estimate by the nonpartisan Congressional Budget Office on Wednesday.

The analysis comes almost three weeks after House Republicans took the unusual step of passing their healthcare plan before the agency had time to estimate how much it would cost and how many people would be affected.

The bill ? which some Republicans admitted they had not read ? was pushed through after a first attempt was cancelled at the last moment when it became clear that Republicans could not muster enough support in their own ranks to pass it.

Having discovered the popular opposition to the first attempt, the House Republicans just do it again, showing their utter contempt for the electorate. These are the people the US actually vote in to represent them. Every day, the US provides something deliberately stupid to laugh at.

A little gem from the report;

"Community-rated premiums would rise over time, and people who are less healthy (including those with preexisting or newly acquired medical conditions) would ultimately be unable to purchase comprehensive nongroup health insurance at premiums comparable to those under current law, if they could purchase it at all-despite the additional funding that would be available under H.R. 1628 to help reduce premiums. As a result, the nongroup markets in those states would become unstable for people with higher-than-average expected health care costs. That instability would cause some people who would have been insured in the nongroup market under current law to be uninsured."

So despite flat-out statements to the contrary, you are indeed fucked if you have a preexisting condition. =P

SeventhSigil:

warmachine:
Republican healthcare plan will cost 23 million people their coverage, CBO says

The hastily redrawn Republican plan to overhaul Obamacare would leave an extra 23 million people without health insurance over the next decade, the first independent analysis of the plan has found.

The health reforms, forced through the House earlier this month and exuberantly celebrated by Donald Trump and scores of Republicans in the White House rose garden, would reduce the federal budget deficit by $119bn over the same period, according to an estimate by the nonpartisan Congressional Budget Office on Wednesday.

The analysis comes almost three weeks after House Republicans took the unusual step of passing their healthcare plan before the agency had time to estimate how much it would cost and how many people would be affected.

The bill ? which some Republicans admitted they had not read ? was pushed through after a first attempt was cancelled at the last moment when it became clear that Republicans could not muster enough support in their own ranks to pass it.

Having discovered the popular opposition to the first attempt, the House Republicans just do it again, showing their utter contempt for the electorate. These are the people the US actually vote in to represent them. Every day, the US provides something deliberately stupid to laugh at.

A little gem from the report;

"Community-rated premiums would rise over time, and people who are less healthy (including those with preexisting or newly acquired medical conditions) would ultimately be unable to purchase comprehensive nongroup health insurance at premiums comparable to those under current law, if they could purchase it at all?despite the additional funding that would be available under H.R. 1628 to help reduce premiums. As a result, the nongroup markets in those states would become unstable for people with higher-than-average expected health care costs. That instability would cause some people who would have been insured in the nongroup market under current law to be uninsured."

So despite flat-out statements to the contrary, you are indeed fucked if you have a preexisting condition. =P

Of course. Because Republicans are catering toward the ignorant fucks telling them to get rid of the individual mandate because "we should be able to choose to not have healthcare if we don't want!" without putting anything in place to manage the spike in price that would cause for high-risk patients.

In other words, the GOP health plan caters to people who people who A: are healthy and already have good, stable access to healthcare, and B: people who don't understand how dysfunctional free-market healthcare is and are so afraid of SHOSHALISHM (read: socialism) they're willing to continue to blindly accept their routine fuckings by pharmaceutical and insurance companies. Because they'll be caught DEAD before they shell out a DIME for some jobless hippie's inhaler or cancer treatment or whatever.

The senate still won't pass this. It can't even be called an improvement, it's a fucking joke. Though it has got me wondering exactly HOW many is an acceptable number of people to become uninsured by Republican meddling with the ACA. 24 million definitely not, 23 million will still be a no...but what happens if they get it down to 5 or 10 million? I doubt even senate Republicans are going to wait until they've got a version that will cause 0 to be left out in the cold. It's no longer a question of whether or not the Republicans are willing to fuck the poor, that's been their MO for some time now. Now it's just a numbers game--HOW MANY can they get away with fucking and not alienate too much of their base?

That is the reality of it, most people are terribly ignorant about how healthcare works. A large part of it is that too many people live with the very false idea that " these things only happen to others" until it happens to them and think their decision to not pay for healthcare will not affect them. The reality is the opposite, the vast majority of people need healthcare at some point and the older they get the more likely it is to happen.

The other issue is people mistakeningly think insurance is a customer service based industry when it is the opposite of that. Insurance companies are only competing to insure healthy people and want to dump everyone else as their investor profits are the primary concern, not your health. In fact, you could go as far to say that providing you access to healthcare is the opposite of what they are there to do, they are there to provide obstacles to that care so that they do not lose profits by paying for just enough to keep their profits growing and if their profits are not growing fast enough, they make policy changes to cut out the things cutting into those profits ( actually paying for healthcare for those who need it most) so they have to eliminate doing that to increase their investments.

Until people wake up and realize we need a system that you pay into when you are healthy and when you are capable of doing so and it covers you when you need it most even if you are too sick or injured to make payments, this will remain terrible. Otherwise, the US "healthcare" system isn't even really a "health care" system, but instead it is a system of denying access to medical treatment to those who need it most.The best I can hope for at this point is the republicans bill keeps getting locked up and dragged out long enough to get the existing republicans replaced with people who will actually act in the best interests of the people. I am not convinced that will even remotely happen here, but one can dream.

Parasondox:
Your thoughts on the Healthcare System in the US?

Adequate. Though Health insurance is kind of a mess.

Why do many shun the idea of something affordable for those sick and poor?

Because good medicine is expensive

Additional, what are your thoughts on the current governments handling and proposal for the ACA?

ACA has done nothing but screw me over. I hope it gets repealed soon.

The more horror stories and stories in general I hear coming out of "The Greatest Nation on Earth", the more I wonder why certainly politicians just despise the poor getting treated to where it doesn't cost them their home.

ACA doesn't meaningfully address this, Overhauls in how insurance pools are allowed to operate would have been better.

Healthcare shouldn't be a political ping pong match between any group. This is not a game. Egos shouldn't come into play here.

When the end game is taking money from people and giving it to other people it is very much a political sticking point.

I will say the U.S. healthcare system is useful in that it is, and especially going to be, such a massive catastrophe of public policy that the idea of universal coverage is cheaper, better, and less taxing on a populace is true simply by contrast, and the debate is forever over. I mean the U.S. HCS is jusy bad by all understanding of conventional economics.

I would say all forms of economic theory... but maybe there is a parallel universe out there where things are MORE expensive the more money you have and the greater your means to offset expenditures while promoting household consumption is somehow bad.

But why take myword for it? Trump says Australia's healthcare is better than what the U.S. has ... despite pushing the antithesis of what model Australia uses. And don't just take Trump's word on Australian healthcare being better than whatever Trump is proposing, because the rest of the world says our healthcare syustem is the best in the world.

Which is shameful, given I have massive problems with our healthcare and yet no one else seems to be doing better with theirs. Thus when you add all these conditions together, the only opinion I can come to is that the world's healthcare systems are a fucking joke.

Though I will say that Australia serves as an example of both systems are their most touted in strengths and most spectacular of lows. Go into public and if you have an 'interesting' reason for admittance ... prepare for a crowd of med students observing you as a doctor asks you a barrage of questions. Then again, you haven't lived until you have had a sex induced injury and had to explain yourself to 20+ med students from your former alma mater ... and in the private health system you can expect your first question to be 'just how much you think you're covered for?'...

As for strengths, yeah ... go into private and you can expect a doctor of your choosing ... and far more individualized treatments, with a wealth of options.

Ask any doctor in Australia. Private cannot compete with public beyond comfort and perhaps avoiding the potentially embarassing moments you might have to explain to a crowd of med students. That's only a problem if you have pride or shame, however. Totally a 'you' problem if you can't get over it. In exchange for that embarassment you get access to a bigger pool of money that has bulk bought meical equipment making it cheaper, and a far greater focus on the consolidation and integration of medical talent. Where doctors and nurses operate as teams rather than assorted 'staff'. Also cutting edge treatments that private institutions couldn't really afford, medical trials, the smartest technicians who might be in public because of research reasons and the advancement of medicine rather than a comfortable rut of for service pay.

When it comes to Healthcare everybody misses the whole problem with it because they are so focused upon insurance, from the average joe to the President, they all completely ignore the elephant in the room. Insurance is terrible yes, but it's not the problem, massive and rising healthcare costs across the board are the problem and always have been. Insurance is something that should be necessary only in order to pay for the most extreme medical procedures and everything else feasible for the average person to pay for out of pocket while barely making a dent in in their budget, but that's not the reality.

The reality is that even the cheapest of procedures and medications for the most simple of problems cost hundreds of dollars without insurance to pay for most of it, something even the middle class can't reasonably afford on a regular basis, not to mention the costs for things that are life or death. This is the result of everybody jacking up prices as far as they can get away with to make as much of a profit as possible, despite the fact that the actual costs for production and distribution are a tiny fraction of what they charge for it at every level. A single routine surgery doesn't cost in the area of several thousand dollars because it costs anywhere near thousands of dollars to actually make all the tools and drugs for the surgery and the reasonably pay the surgeons, it costs that much because everything, from production and selling to the companies that distribute, to shipping, to doctor's fees, to recovery costs dozens and dozens of times more than is actually needed so that profit can be made. Not just a reasonable amount of profit either, as much as they think they can get away with, which given that Healthcare is an essential service is basically as much as they want to.

Even if miraculously Obamacare or Trumpcare or any other similar laws that try to fix insurance successfully managed to get affordable insurance to everyone with no drawbacks it STILL would have failed to address the core problem with Healthcare itself.

immortalfrieza:
Even if miraculously Obamacare or Trumpcare or any other similar laws that try to fix insurance successfully managed to get affordable insurance to everyone with no drawbacks it STILL would have failed to address the core problem with Healthcare itself.

More or less correct, although the idea that Trumpcare "tries to fix insurance" is a bit of a crock.

Of course, there are measures like allowing drug imports by pharmacists and consumers (not just pharmaceutical companies) which do address the core issue of the price of healthcare.

Legislation about that has once again been blocked:

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