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posted by martyb on Tuesday March 21 2017, @04:46PM   Printer-friendly
from the ham-and-mayo-on-wry? dept.

Mayo Clinic, one of the country's top hospitals, is in the midst of controversy after its CEO said that the elite medical facility would prioritize the care of patients with private health insurance over those with Medicare and Medicaid.

The prioritization by the Rochester, MN-headquartered medical practice was recently revealed by the Minneapolis Star Tribune. And it has quickly drawn out some sharp critics—as well as sympathizers.

In a statement to the Minnesota Post Bulletin, Dr. Gerard Anderson, the director of the Johns Hopkins Center for Hospital Finance and Management, compared the prioritization to policies seen in developing countries. "This is what happens in many low-income countries. The health system is organized to give the most affluent preference in receiving health care," he wrote.

Likewise, Minnesota Department of Human Services Commissioner Emily Piper, expressed surprise and concern by the statements of Mayo's CEO, Dr. John Noseworthy. "Fundamentally, it's our expectation at DHS that Mayo Clinic will serve our enrollees in public programs on an equal standing with any other Minnesotan that walks in their door," she said. "We have a lot of questions for Mayo Clinic about how and if and through what process this directive from Dr. Noseworthy is being implemented across their health system."

Specifically, Noseworthy said in a video to Mayo employees late last year:

We're asking... if the patient has commercial insurance, or they're Medicaid or Medicare patients and they're equal, that we prioritize the commercial insured patients enough so... we can be financially strong at the end of the year.

In statements, Mayo has confirmed Noseworthy's prioritization and added that about 50 percent of its patients are beneficiaries of government programs. "Balancing payer mix is complex and isn't unique to Mayo Clinic. It affects much of the industry, but it's often not talked about. That's why we feel it is important to talk transparently about these complex issues with our staff."

Source: Ars Technica


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  • (Score: 4, Insightful) by Unixnut on Tuesday March 21 2017, @04:53PM (74 children)

    by Unixnut (5779) on Tuesday March 21 2017, @04:53PM (#482239)

    Disclaimer: not from the USA, and not sure how all these programs work.

    However the concept of the more affluent getting priority is not unheard of. In fact that is usually how things work. A service is expensive initially, attracting richer people who can spend the money, with time (and funding from dealing with the rich people) they can extend/improve their service to the rest.

    Not unlike things like SpaceX. I sure can't afford a ticket, and amongst those that could afford it, it would not surprise me to find that those who are richest get highest priority.

    However I am not going to be upset that people more affluent than me can go up to space. The idea is that one day, if all goes well, they will expand/improve their service to the point I can consider feeing the effects of zero gravity myself.

    How is this different? Presumably the private medical insurance people are being charged more for the priority access, but otherwise the costs are the same (so more income for the health facility). Eventually that should result in improvement across the board, no?

    • (Score: 0) by Anonymous Coward on Tuesday March 21 2017, @05:02PM (1 child)

      by Anonymous Coward on Tuesday March 21 2017, @05:02PM (#482242)

      One of my private practice doctors in the USA only sees patients who have private insurance or pay with cash, he refuses to deal with any govt healthcare insurance.

      • (Score: 2, Insightful) by boxfetish on Wednesday March 22 2017, @12:26AM

        by boxfetish (4831) on Wednesday March 22 2017, @12:26AM (#482477)

        Perfectly fine, as long as the Mayo Clinic isn't being (or hasn't been) subsidized by any public dollars (or tax breaks). I wonder...

    • (Score: 2, Insightful) by Anonymous Coward on Tuesday March 21 2017, @05:14PM (39 children)

      by Anonymous Coward on Tuesday March 21 2017, @05:14PM (#482246)

      The difference is that this is not "early adopters pay more" this is "the rich get priority for equal treatment."
      At some point that degrades to "we let poor people die."

      There are two ways to handle the problem of expensive medical treatments:

      (1) Cut patients who do not contribute as much to the bottom-line
      (2) Improve efficiencies so the treatments are less expensive

      Mayo's made it official that they are going with #1. In the long run, that's bad for everyone, rich and poor.

      • (Score: 2, Insightful) by VLM on Tuesday March 21 2017, @05:28PM (37 children)

        by VLM (445) Subscriber Badge on Tuesday March 21 2017, @05:28PM (#482257)

        Their mistake is in going public about it and being honest.
        Due to the backlash they'll have to revert, then destruction of the bottom line means they'll have to close entirely or close entire services to everyone, then your prediction of it being bad for everyone rich and poor will come true because no one will be served.

        Everyone can't afford a Ferrari. You must give everyone a Ferrari regardless of their ability to pay or your ability to fund the giveaway program. OK we'll fire everyone and close instead. Net result everyone comes out behind. Nobody gets a Ferrari and nobody has a job anymore, but hey, at least we're all equal now?

        This is a symptom of the end of an empire. You build a first world economy, then the services like first world class of hospitals follow assuming first world economic support will last forever, then you methodically and intentionally destroy the first world economy and demographically replace the people capable of making another, then the mystery of how a 3rd world nation getting poorer every year can financially provide for a 1st world infrastructure strikes for awhile until the collapse. This applies to roads, public schools, bridges, all that stuff. Why can't a country "like Germany" have roads like Germany? Well we used to be a country "like Germany" but now we're more "like Guatemala" and our roads kick butt compared to Guatemala so you can expect going forward for our roads to look more "like Guatemala" than "like Germany" because that will match our future even lower economy, new demographics, maybe with global warming even match the climate.

        • (Score: 1, Insightful) by Anonymous Coward on Tuesday March 21 2017, @06:02PM

          by Anonymous Coward on Tuesday March 21 2017, @06:02PM (#482276)

          > Their mistake is in going public about it and being honest.

          Leave it to VLM to be opposed to honesty and transparency.

          If you think this policy could have been conducted in secret you are a fool.
          Most people get into medicine because they want to help people, not milk them for cash.
          The information would have come out soon enough.

          > You must give everyone a Ferrari regardless of their ability to pay or your ability to fund the giveaway program.

          Your ideology has caused you to fundamentally misunderstand the situation. This isn't about giving 'everyone' anything. This is about treating people equally regardless of their ability to pay. It is about saying that you have an equal chance of dying whether you are rich or poor. That money should not be final arbiter of a person's value. It is no different from saying that everyone who needs to drive on a road is allowed to drive on that road as long as there is space on the road for them and that paying extra doesn't get them priority.

        • (Score: 2, Insightful) by Anonymous Coward on Tuesday March 21 2017, @06:22PM

          by Anonymous Coward on Tuesday March 21 2017, @06:22PM (#482293)

          All hail the wisdom of VLM's propaganda!

          Why does everybody in every 1st world country except the USA have Ferraris then? Why do fucking Cubans all have Ferraris?

          I'm assuming everybody who modded this up were endorsing VLM's "womb warfare" in the concluding paragraph.

        • (Score: 5, Insightful) by edIII on Tuesday March 21 2017, @06:23PM (17 children)

          by edIII (791) on Tuesday March 21 2017, @06:23PM (#482294)

          Medical isn't a fucking Ferrari you fucking asshole. I notice that the biggest issue you have was them being honest because they might have to walk it back due to "resistance".

          What the fuck is wrong with you? You think medical is at the same level of a fucking iPhone too? You fucking idiots are hilarious. First you compare it to something as cheap as an iPhone and then blame the poor for their lack of character and poor decision making processes. Now you mental giants switch gears and compare it to an expensive Ferrari and speak out your ass saying, "Well, not everyone can have the luxury items you know".

          So, VLM, are you saying you have good medical? That must mean you have a couple of Ferraris in the garage huh?

          "This is what happens in many low-income countries. The health system is organized to give the most affluent preference in receiving health care," he wrote.

          The rest of the fecal effluence of your post basically restates the quote. The operative part of it being "low-income countries", which is what the United States is. We are not a 1st world super power anymore living in luxury, as that is only the Owning Class. The working class cannot afford medical, good food, or decent housing. The level of exploitation and oppression is fucking epic.

          You, and others, are just too fucking sociopathic and obsessed with who deserves what, who is working (hard enough to you), to see the truth. OUR MEDICAL IS TOO FUCKING EXPENSIVE. There is way too much profit in it, other countries show us how stupid we are doing it, and we cannot get past the divisive politics keeping the 1% pushing medical AWAY FROM THE WORKING CLASS. It has been that way for 40 years or so ever since Title 19 and its bullshit. We've seen what happens when profit takes over industries, and that's the consumer and working class getting the fucking shaft.

          If our medical system cannot be setup to PRIORITIZE the WORKING CLASS, then the only option is to rise up and gut the rich, letting them bleed out into the street. It has failed, abjectly and utterly. Medical is NOT something just for the rich and elite, it is NOT something just for the Owning Classes.

          We are creating for ourselves a medical Armageddon whereby the working classes, that really make America Great, cannot afford the very basics of care. So, you "smart" sociopathic mother fucker, how do we construct a society based on a working class that cannot ever afford good food, basic medical, and anything resembling a future to fight for?

          Intelligence, which you've been deprived of because of how lost you are in the White Nationalist bullshit, tells us what happens when we deny people the basics like this. However, that world is apparently okay for you on an ethical and moral basis. I guess you've cozied up to the Owning Class so you don't have to worry. So who's rich dick are you sucking? Otherwise your decisions ultimately affect you to.

          Or haven't you seen how the working class Trump supporters are now losing and being backstabbed by Trump? ;P

          --
          Technically, lunchtime is at any moment. It's just a wave function.
          • (Score: 4, Informative) by Anonymous Coward on Tuesday March 21 2017, @06:39PM (4 children)

            by Anonymous Coward on Tuesday March 21 2017, @06:39PM (#482305)

            Got news for you sunshine:

            A) They ain't doing what 99% of other Docs ain't already doing.
            B) Medicine isn't the profit center you think it is. INSURANCE is.
            B2) Medical reimbursements for Medicare and Medicaid have been STAGNANT or DECLINING for over ten years. Yet your insurer is consistently able to rack up record profits, quarter after quarter. EVERY quarter.

            So where do you think the real problem lies? Your greedy Doctor, or your greedy Insurance Company?

            • (Score: 0) by Anonymous Coward on Tuesday March 21 2017, @07:18PM (1 child)

              by Anonymous Coward on Tuesday March 21 2017, @07:18PM (#482325)

              I interpreted GP as being more focused on the lack of affordable care for the working class. The fact that everybody does this in the medical "industry" (or that medicine is even an "industry") is an even larger indictment of the system.

              GP can correct me if I'm interpreting wrong, but it seems that it doesn't particularly matter to GP whether it's the doctors or the insurance companies or who exactly is profiting off the exploitation of the working class.

              And yeah, I've kind of been wondering when declining payments from Medi* would start making headlines as larger facilities begin to refuse to accept it. Lower priority is a step up from certain practices around here that flat out don't accept those.

              Personally, I realize that doctors aren't exactly making out like bandits. However, the hospital administrators certainly are, and they're all too happy to have somebody else to point the finger at like insurance companies. Insurance companies, of course, are likewise happy to be able to point the finger at hospitals. It's just a big 1%er circle jerk, and too many people get distracted by it and miss the forest for the trees.

              Oh, that's not to mention the tax write-off other 1%ers get when they "donate" to the facilities where their friends are administrators. I put donate in scare quotes because how much of a donation is it really if it's just going to be siphoned up and sent back to them by way of their shares of insurance companies? Hell of a financial acrobatic act if you ask me.

              • (Score: 0) by Anonymous Coward on Tuesday March 21 2017, @07:57PM

                by Anonymous Coward on Tuesday March 21 2017, @07:57PM (#482353)

                I'll take that in reverse order. First, industry. Yeah, it's a little disheartening to realize that medicine has its share of industrial complexes. But wishing that it were not true is not going to make it false. Double negative aside the insurance companies, the hospitals, and the government all conspire to make it harder for an independent, non-hospital-or-megahealthcorp affiliated practice to stay in business. Every year. So, if you don't want a healthcare industry, what have you done to help dismantle it? I work in an independent practice, that's what I do. At least until I won't be able to afford to anymore - I guarantee I could be making a lot more money elsewhere. And that, things keep up the way they are, eventually my bosses will have to sell out to stay alive as practitioners.

                Physicans aren't without blame either. They drank the Kool Aid years ago of, "We'll give you more patients and more consistent reimbursement just for signing up with us!" And they don't *always* play the highest-dollar game - the sicker patient actually still wins most of the time. Whether that costs your physician or not. But two equally sick patients and one slot available for a patient visit... who do you think wins that? (If the doctor just doesn't double-book it....)

                But because it doesn't matter to the GP who's screwing him/her or making the profit off of the GP, the GP will just happily point the finger of blame at whatever person shouted at him last. And my point is that maybe the GP should be looking for where to correctly put the blame by doing a little more research instead of jumping on the "Damn Greedy Doctors" train.

            • (Score: 0) by Anonymous Coward on Wednesday March 22 2017, @01:44AM

              by Anonymous Coward on Wednesday March 22 2017, @01:44AM (#482496)

              Again the turds who support GOP policies fail basic reading. No where did anyone blame the doctors, the only thing I could find all the way up to the first post was "medical care is expensive". Yall need to go back to school.

            • (Score: 2) by JoeMerchant on Thursday March 23 2017, @03:17AM

              by JoeMerchant (3937) on Thursday March 23 2017, @03:17AM (#483061)

              Chew on this, sunshine: Insurers and Healthcare providers are merging into single integrated entities. It doesn't matter which one is making the profit, it all goes to the same owners.

              --
              🌻🌻 [google.com]
          • (Score: 2, Disagree) by Justin Case on Tuesday March 21 2017, @07:25PM (8 children)

            by Justin Case (4239) on Tuesday March 21 2017, @07:25PM (#482330) Journal

            If you can't make your point without screaming insults and profanity, you probably don't have one.

            • (Score: 0) by Anonymous Coward on Tuesday March 21 2017, @07:31PM

              by Anonymous Coward on Tuesday March 21 2017, @07:31PM (#482334)

              > If you can't make your point without screaming insults and profanity, you probably don't have one.

              Shit begets shit.
              Ed's just being upfront while VLM is being duplicitous.
              You do prefer an honest talker, a straight shooter, don't you?

            • (Score: 0) by Anonymous Coward on Tuesday March 21 2017, @07:44PM (1 child)

              by Anonymous Coward on Tuesday March 21 2017, @07:44PM (#482347)

              Well, you can have a point and still scream profanities. The problem is that the profanities and anger just dilute it all and no one gives a care about what you have to say, no matter how true it is.

              • (Score: 2) by VLM on Tuesday March 21 2017, @08:46PM

                by VLM (445) Subscriber Badge on Tuesday March 21 2017, @08:46PM (#482386)

                The problem is that the profanities and anger just dilute it all and no one gives a care about what you have to say, no matter how true it is.

                Ironically he got much factually wrong, probably because he's all worked up.

                The problem with getting worked up is its bad dialectic strategy. Trump didn't get meme'd into office by the GNAA saying the n-word a million times or whatever other example you'd like. /pol/ memes did help, but GNAA chanting never accomplished anything.

                I was tempted to "u mad bro?" him but if he stroked out from being worked up I'd feel bad because he's cool when he's not triggered. Also I don't know if there's a Cuban medical doctor nearby to save him LOL.

            • (Score: 0) by Anonymous Coward on Tuesday March 21 2017, @08:32PM

              by Anonymous Coward on Tuesday March 21 2017, @08:32PM (#482377)

              Piss off with your hurt feelings, there was plenty of "point". A lot of people are simply tired of being told we can't fix the system, or that poor people deserve their shitty situation. Here's a clue: it is a systemic problem not an individual problem.

            • (Score: 2) by LoRdTAW on Tuesday March 21 2017, @08:49PM (1 child)

              by LoRdTAW (3755) on Tuesday March 21 2017, @08:49PM (#482388) Journal

              Did you vote for Trump?

              • (Score: 0) by Anonymous Coward on Tuesday March 21 2017, @09:24PM

                by Anonymous Coward on Tuesday March 21 2017, @09:24PM (#482407)

                How'd you guess?

            • (Score: 3, Informative) by art guerrilla on Wednesday March 22 2017, @12:28AM

              by art guerrilla (3082) on Wednesday March 22 2017, @12:28AM (#482478)

              at justin case of cods liver oil -
              oh, fuck off, prissy prig of a milquetoast...
              1. if you are unable or unwilling to consider the views of someone else cause they said wee wee or doo doo, then the failure is yours: you value style over substance...
              2. further, that the poster lambasted the often lame-brained (but equally often informative) vlm, doesnt have anything to do with comity or civility; vlm has a passive-agressive smugness which deserves a good shellacking...
              3. in short, urine idjit...

            • (Score: 2) by Anal Pumpernickel on Wednesday March 22 2017, @05:54AM

              by Anal Pumpernickel (776) on Wednesday March 22 2017, @05:54AM (#482564)

              So you've arbitrarily decided that using insults and/or certain words that you deem bad means that someone probably doesn't have a point? I'm not sure where the logic in that is, but fine.

          • (Score: 1, Troll) by VLM on Tuesday March 21 2017, @07:54PM (1 child)

            by VLM (445) Subscriber Badge on Tuesday March 21 2017, @07:54PM (#482351)

            Personally I like Ferrari as a metaphor because the US govt will, can, and has bailed out the domestics. So if I made an example like "Imagine GM having to give away a truck to everyone for free, they'd go out of business" and the rebuttal is of course not, the .gov would bail them out (again). If Ferrari were forced to give a nice expensive car to everyone they would in fact go out of business.

            The fundamental problem that can't be hand waved away is a nice death in America costs about as much in medical costs as a nice Ferrari. Not a cheap Ford or my new Yaris or whatever. So... you can hand wave all you want about morals and ethics but if the cost of death is getting vaguely close to lifetime income, there's going to be problems paying for that very expensive death.

            You can imagine the Eqyptians pouting that everyone who dies should get to be buried in a great pyramid. Sure, our culture can't afford it but who cares they're entitled because, um... because its a human right to take someone elses money to have a really fantastic death ritual. And a bunch of us vs them class stuff about how everyone is entitled to burial in their own great pyramid regardless of social strata especially every poor person should have tax money build him a great pyramid of a death. Yeah there's some scaling issues.

            You have some peculiar beliefs about what I believe in. People of a national SOCIALIST tendency tend to have a rather right wing view of how to serve the american workers, often confused by those used to "worker=left wing" commie stuff. As you'll recall a rather famous quote by the God Emperor himself on the topic of the R party now being "the party of the American worker". Personally I don't like the NatSoc moniker as that was a last century German thing and this isn't Germany in the 30s. But I like "American Nationalist" label. Some folks say 12 of one, a dozen of another, I don't think the label is as important as the belief.

            A lot of american nationalists or alt right or pre-neo-con republicans or whatever you want to call them were formerly very cringe level libertarian so its sure not your fault for confusing them. Times change, and with them, beliefs.

            blame the poor for their lack of character and poor decision making processes

            Well, we agree on the latter two observations at least that's a start.

            OUR MEDICAL IS TOO FUCKING EXPENSIVE

            we seem to be arguing quite a lot over something we agree on.

            the White Nationalist bullshit

            You seem very confused about neocons vs alt right / american nationalist / american workers party type stuff, shouting at alt right people for having neocon beliefs and such. The neocons are the epitome of the ever so Christian values of "F you die in a ditch" wrt to poor people, sick people, pretty much everyone not living in Israel, and I more or less agree with your assessment of the neocons needing to go in an oven. Everyone to their left AND right wants them in the (metaphorical of course) oven. I don't think anyone likes the neocons very much other than the Israelis who really enjoyed their foreign policy... mistakes.

            You know, when you read in a history book about the Holocaust and how could the Germans have permitted it, but then back to the 2010s, when you look at the literal millions of 3rd world deaths, and tens of thousands of american deaths, and literally trillions of dollars wasted, and what we could have done with trillions of dollars (hmmm health care maybe?) and ask yourself if the neocons were being tossed into ovens today would I risk my life or my families life to save a neocon life? Hell no, I'd probably fund raise money for the gas bill.... I remember when the neocons kicked all the normies out of the R party, and I was blue pilled normie back then not happy about it at all.

            Give the God Emperor some time. Its one eternal godlike sandworm and 100 days against the entire cathedral for decades. Rome wasn't burned in a day, right?

            You might find you agree with some of the folks on the far right. Your rant can also get a simple cut -n- paste job for higher education and real estate too, for a good time.

            • (Score: 3, Funny) by Anonymous Coward on Wednesday March 22 2017, @12:12AM

              by Anonymous Coward on Wednesday March 22 2017, @12:12AM (#482470)

              How do you have the time to write all these tediously long self-justifying posts?
              Anyone with so much free time to waste on validating their own inhumanity can't possibly be a productive member of society.
              You've painted a picture of yourself as self-loathing NEET.

          • (Score: 2) by JoeMerchant on Wednesday March 22 2017, @01:13PM

            by JoeMerchant (3937) on Wednesday March 22 2017, @01:13PM (#482686)

            The profit in our medical only comes when they get paid, and they only get paid by people who lack "negotiating power." People on insurance pay their insurance providers, but then 90% of the value of insurance isn't that they pay for your healthcare, it's that they negotiate the cost of your healthcare down to a sane level.

            So, the insane profits come from private pay (uninsured) patients, who all too often are unable to pay, so the ones who can pay are hit with a huge bill to cover the ones who can't. Basically, if you are in the uninsured pool, you have agreed to either pay for those who don't pay, or become one of the "don't pays" yourself and lose your credit rating. It's a very broken version of self-insurance.

            --
            🌻🌻 [google.com]
        • (Score: 3, Insightful) by Gaaark on Tuesday March 21 2017, @07:11PM (11 children)

          by Gaaark (41) on Tuesday March 21 2017, @07:11PM (#482319) Journal

          Yes, the U.S. is an empire that is fading, like the British Empire and the Roman Empire. That's a given.

          Here in Canada, we may not all have Ferrari's, but we all have, say, Toyota Tercels: nothing fancy, but it is there when you need it (i rarely need it, luckily) and it is pretty good to boot.

          You break a leg, it costs you nothing (except what you paid in taxes already).
          Your life is on the edge and you will die unless you get expensive surgery? No problem: it is there, no cost.
          (I used to work at a group home for multi-handicapped children: we got a 'bill' (not sure we were supposed to see it) for $30,000.00 for this one kid we took into the hospital. My wife and i thought: 'shit: that would easily bankrupt us if we had to pay that and it was our child'). Nope: freee.

          You build a first world economy

          But is the U.S. really a first world economy? You have some very, very poor people in your country; people living BELOW the poverty level. Is that REALLY FIRST WORLD?

          Canada is starting to suck too: we used to have in place people and places for those with mental health issues. Now they are out on the street or in jail..... cause it's cheaper (REALLY? SERIOUSLY CHEAPER???).

          First world economies are non-existent: people are too selfish and greedy. All they want is to help themselves. It seems Americans are best at that.

          --
          --- Please remind me if I haven't been civil to you: I'm channeling MDC. ---Gaaark 2.0 ---
          • (Score: 0) by Anonymous Coward on Tuesday March 21 2017, @08:02PM

            by Anonymous Coward on Tuesday March 21 2017, @08:02PM (#482355)

            You echo my sentiments.

            Thank you sincerely,
            A fellow Canadian

          • (Score: 2) by VLM on Tuesday March 21 2017, @08:04PM (8 children)

            by VLM (445) Subscriber Badge on Tuesday March 21 2017, @08:04PM (#482358)

            Something I find infinitely amusing about your Canadian system is our politicians who have never been in the US military describe it as anti-american and commie and all that ridiculous stuff, at least the neocons used to. Yet having been in the .mil a long time ago, basically the Canadian experience is the US military active duty experience. Now you can get tremendous TV ratings by possibly truly or possibly falsely complaining about post-active duty VA medical care, but regular army medical care is basically your canadian system. You sick or hurt, we fix you best we can in the middle of nowhere. Bill? Whats a bill?

            But is the U.S. really a first world economy?

            I should have given dates. Say, pre 1970s. Before boomers came to power, roughly. I was just a kid. Imagine what it must have been like to be an adult in America in the 60s. Even the parts that sucked were across the board better than the same more sucky parts today.

            • (Score: 2) by GreatAuntAnesthesia on Wednesday March 22 2017, @12:45PM (7 children)

              by GreatAuntAnesthesia (3275) on Wednesday March 22 2017, @12:45PM (#482677) Journal

              Something I find infinitely amusing about your Canadian system is our politicians who have never been in the US military describe it as anti-american and commie and all that ridiculous stuff, at least the neocons used to. Yet having been in the .mil a long time ago, basically the Canadian experience is the US military active duty experience. Now you can get tremendous TV ratings by possibly truly or possibly falsely complaining about post-active duty VA medical care, but regular army medical care is basically your canadian system. You sick or hurt, we fix you best we can in the middle of nowhere. Bill? Whats a bill?

              Well that makes perfect sense. Leaving your soldiers to hobble around on broken legs when you have important military stuff to get done would be counter-productive, right? A inefficient use of your human resources - not to mention bad for morale. You've invested however much time and money in this soldier to enable him to do a job for you, it makes sense to invest a little more when he needs it to keep him working.

              Now let's switch back to civilian healthcare and apply the same principles. Your economy is the thing you have to keep running, think of it as a metaphor for the military. Workers in the economy (be they are burger-flippers or million-dollar CEOs - a front line grunt has as much of a role to play as a senior general, right?) are your soldiers. You want to keep those people working, keep them at high efficiency. That takes investment. Can you see how universal healthcare makes sense?

              • (Score: 2) by VLM on Wednesday March 22 2017, @03:53PM (4 children)

                by VLM (445) Subscriber Badge on Wednesday March 22 2017, @03:53PM (#482785)

                This is going to be one of those things where we agree on the goal but I know the counterexample will be that in a world of 75% obesity and hipster nu-males even a off the shelf bog standard 11B infantryman is a valued commodity. However that same world has like 320M people (and growing) and only 70 million full time jobs (and shrinking fast) and maybe only 30 million "real good jobs". So when your cannon fodder is kinda irreplaceable you take care of it, but when you have like 10 people or 3 college grads for every "really good job" then you don't have to worry so much about how to replace when there's a line out the door of unemployed or starbux mcjob workers.

                For example, you know why public school teachers are treated like trash? Because there's about 2 or 3 times too many of them. Now if the teachers union did the AMA thing and made certain there was just barely enough K12 teacher grads to barely make the system work, they'd have sane salaries and bennies and decent management, but thats obviously observationally not really necessary to staff a school now and generally is not provided anymore. Someday they'll be a shortage of teachers and market will fix it.

                I like where you're going, just I can see that specific rhetoric isn't going to work. You can't have a country with ten times as many people as "good jobs" and expect them to worry about the supply of workers.

                • (Score: 2) by GreatAuntAnesthesia on Wednesday March 22 2017, @05:26PM (3 children)

                  by GreatAuntAnesthesia (3275) on Wednesday March 22 2017, @05:26PM (#482840) Journal

                  The problem with that argument (and admittedly it's kind of my fault from the way I phrased my metaphor) is that you are dividing the population into "those who are part of the economy" (ie those with jobs) and "those who are not part of the economy" (the unemployed). This is simply not true. EVERYBODY, whether employed or not, is a part of the economy, and not just as a consumer. Many 'unemployed' people provide valuable services, for free. For example, how many people do you know who are only able to work the hours they do because their retired parents look after the kids a couple days a week? Loads, probably. Are those grandparents getting paid for their childcare services? Unlikely. Non-workers contribute all sorts of other 'services', (even simple friendship, community) that are less easy to put a price on but whose absence would soon have a financial impact. Everybody, whether contributing directly, indireclty or not at all is still part of the Big Equation. If someone can't afford the healthcare they need and as a result does something desperate (commits a crime, or self-medicates using illegal drugs) then how does that impact the economy? Who pays the cost? Remind me how much you guys spend on law enforcement / judiciary / incarceration / War on Drugs..? If some unemployed person dies because of a preventable but expensive illness, who loses out when their brothers and sisters have to take time off work to grieve? It can take months, years to fully get over something like that, maybe even lead to depression. How is a grieving, depressed employee any more effective than a soldier with a broken leg?

                  I guess what I'm saying is, you have to see the economy not simply as a giant spreadsheet of the incomes and expenditures of businesses and their employees, but as a function of society, because that's exactly what it is. It might sound trite but people are more than just numbers. Broken society == broken economy. And to keep your society running smoothly, one of the first things you need to do is to keep your citizens healthy and happy.

                  • (Score: 2) by VLM on Wednesday March 22 2017, @05:47PM (2 children)

                    by VLM (445) Subscriber Badge on Wednesday March 22 2017, @05:47PM (#482846)

                    That's a good argument. I've seen it, or similar to it, expressed as the purpose of welfare programs isn't to be nice to poor people but to permit rich people to live without fear of the guillotine and kidnapping.

                    Its a good argument because on the left side obviously you can sell morals and ethics as a justification and on the neocon-legacy-right you can sell you don't want your kids kidnapped type of argument. The national socialist point of view is when the people aren't getting their needs met, their jackboots get stomping as they should, and serving the people by nationalizing health care is an easy way to keep out of the oven. It sells well to everyone under the sun.

                    The main problems implementing are we got no money for the pie, their slice of the pie is bigger than our slice of the pie, I like my job of deciding who gets which slice of the pie, I paid that politician so my pie slice would be bigger now where is it, that type of squabbling.

                    • (Score: 2) by GreatAuntAnesthesia on Wednesday March 22 2017, @08:05PM (1 child)

                      by GreatAuntAnesthesia (3275) on Wednesday March 22 2017, @08:05PM (#482914) Journal

                      permit rich people to live without fear of the guillotine and kidnapping.

                      I'd say it's more than just lessening the chance of rich of poor-on-rich violence. It's about the fundamental productivity increases you can achieve if you allow your workforce to live relatively happy, healthy, balanced, stress-free lives rather than scrabbling to survive in some kind of urban dystopia as envisioned in a bad 80s science fiction film. For an extreme example look at Japan, where they squeeze their workers like sponges, but don't actually extract any more useful productivity per person than anywhere else.

                      The rest of your post is salient. The alt-right like to shout about how the left has steered discourse with political correctness to the point where people feel they can't talk about immigration without being labelled racists and all of that, but I think its sad that the right has brought us to a point where we can only talk about things like "improving quality of life for our fellow humans" and "showing basic compassion" if we can somehow tie it to an economic argument.

                      • (Score: 2) by VLM on Wednesday March 22 2017, @09:16PM

                        by VLM (445) Subscriber Badge on Wednesday March 22 2017, @09:16PM (#482946)

                        if we can somehow tie it to an economic argument.

                        I see it as a way of silencing beancounter opposition. If you can prove its revenue neutral or positive, thats a whole swath of arguments just gone.

              • (Score: 2) by Justin Case on Wednesday March 22 2017, @06:37PM (1 child)

                by Justin Case (4239) on Wednesday March 22 2017, @06:37PM (#482879) Journal

                Your economy is the thing you have to keep running... You want to keep those people working, keep them at high efficiency.

                You seem to think an economy needs someone to "run" it. Central (state) planned economies often fail because politicians are not gods who know everything and can wisely dictate who should produce how much of what.

                The economy will run itself if you just leave it alone. People will willingly trade what they can offer for what they want. About all you have to do is make sure thieves, cheaters etc. know there will be consequences.

                • (Score: 3, Insightful) by GreatAuntAnesthesia on Wednesday March 22 2017, @08:08PM

                  by GreatAuntAnesthesia (3275) on Wednesday March 22 2017, @08:08PM (#482917) Journal

                  False dichotomy: There is plenty of room between "fully controlled planned economy, comrade" and "no holds barred law of jungle economic free-for-all".

          • (Score: 1) by slap on Wednesday March 22 2017, @05:08AM

            by slap (5764) on Wednesday March 22 2017, @05:08AM (#482547)

            Of course, there are limits to the Canadian health care system. Not all treatments are covered, and you may have to wait to get treated. Wealthy Canadians can go elsewhere and get it treated, or with less waiting.

        • (Score: 0) by Anonymous Coward on Tuesday March 21 2017, @07:55PM

          by Anonymous Coward on Tuesday March 21 2017, @07:55PM (#482352)

          Everyone can't afford a Ferrari. You must give everyone a Ferrari regardless of their ability to pay or your ability to fund the giveaway program. OK we'll fire everyone and close instead. Net result everyone comes out behind. Nobody gets a Ferrari and nobody has a job anymore, but hey, at least we're all equal now?

          Not everyone can afford safe drinking water.

          Not everyone can afford equal protection by the police, fire, ambulance.

          Not everyone can afford to drive on safe roads.

          The list goes on...

        • (Score: 5, Insightful) by JoeMerchant on Tuesday March 21 2017, @08:16PM (2 children)

          by JoeMerchant (3937) on Tuesday March 21 2017, @08:16PM (#482367)

          The problem with healthcare in the US is precisely that: everyone expects Ferrari healthcare, handmade - lots of expert craftsmanship, expensive components made from exotic materials. Not only does everyone expect this, but the organization providing healthcare refuse to differentiate: Mayo Clinic has one set of doors, and all patients walk through the same ones.

          There is no option for Chevy healthcare, your choices at large company healthcare plans basically boil down to: how much of your deductable do you want to pre-pay in premiums? Not: do you want to pay for all the latest exotic cancer therapies, joint replacements, etc. or do you just want to get basic preventative and emergency health care when you need it?

          The Ferrari healthcare system is terrified that if people had a choice (with proportionate price tags), they'd choose Chevy, and that would de-fund the Ferrari healthcare development system to a point that it collapses. So, we're all left to struggle, attempting to pay for Ferrari healthcare, and being told that if we don't pay for the Ferrari, there's not a viable Chevy option.

          --
          🌻🌻 [google.com]
          • (Score: 2) by bradley13 on Wednesday March 22 2017, @07:22AM (1 child)

            by bradley13 (3053) on Wednesday March 22 2017, @07:22AM (#482584) Homepage Journal

            You're right: there needs to be an option for "Chevy" health care. We have a similar situation here in Switzerland: 15 or 20 years ago, the government decided to dictate the minimum coverage that *must* be included in any health care policy. This has since been added to, and added to, and now includes all sorts of stuff including various flavors of "alternative medicine". Funny, the insurance now costs (after inflation) 2-3 times as much as it did before the government got involved. Dear well-meaning politicians: thanks for your help.

            However, alternative medicine aside, there is another problem: Most people would love to save money by having a "Chevy" policy instead of a "Ferrari" policy...right up until they fall ill and only "Ferrari" health care can save them. I remember watching this play out in New Hampshire, about 30 years ago. There was a little girl whose family was on welfare. The state had clear policies of what health care they would pay for, and what they wouldn't. Organ transplants were not on the list, but this little girl needed a liver transplant. While not exactly routine today, 30 years ago that was even crazier. Anyway, the state said (correctly, imho) "nope, not covered". The public outrage was enormous, of course, because little kids are photogenic.

            Anyhow, the point is: If you are going to allow Chevy policies, you've got to also be willing to enforce them. And that, in turn, requires a public that is sufficiently educated to say "you made your bed, you lie in it" - i.e., a public that is willing to see people denied Ferrari health care when they chose to pay only for that Chevy. I don't think that's going to work...

            --
            Everyone is somebody else's weirdo.
            • (Score: 2) by JoeMerchant on Wednesday March 22 2017, @01:07PM

              by JoeMerchant (3937) on Wednesday March 22 2017, @01:07PM (#482683)

              As someone else posted, it works in Cuba. In Cuba, you get good Chevy healthcare provided by the state - if you want more, you pay for it out of pocket in Miami.

              I rode a commuter train from Zurich to Schafhausen once upon a time - that train had no problem with "two tier service" - if you wanted a quiet, uncrowded car with big chairs, you could pay for that, or you could ride something like a metro for much less money - makes sense, it costs much more money to provide the big cars.

              Of course, everybody is willing to sacrifice everything in matters of life and death. I think, perhaps, the answer to "two tier" healthcare is that insurance pays for the lower tier, and if you want "supplemental care" you save that money yourself - as you say: make your choices and live with them. The U.S. seems to be trying to train people to this with "high deductible" insurances that include individual savings accounts - but it still falls short, the "high deductible" insurance is still paying for all the Ferrari options up to some crazy high lifetime caps, and that's where the insane costs come in.

              It doesn't help that in the US all the bills are written to ~10x actual prices and "negotiated down" by a multiplier of ~0.08 to ~0.12 depending on your insurance, and thus not all providers take all insurances - and if you are private pay, your "negotiating power" is either x0.9 if you pay or x0.0 if you choose the (all too viable) bankruptcy option instead. So, we're getting a lot of Chevy healthcare with Ferrari price tags on it, and without insurance you are paying for a Ferrari, even though it's the same Chevy that the insured get.

              --
              🌻🌻 [google.com]
        • (Score: 2) by urza9814 on Wednesday March 22 2017, @04:13PM

          by urza9814 (3954) on Wednesday March 22 2017, @04:13PM (#482804) Journal

          Everyone can't afford a Ferrari. You must give everyone a Ferrari regardless of their ability to pay or your ability to fund the giveaway program. OK we'll fire everyone and close instead. Net result everyone comes out behind. Nobody gets a Ferrari and nobody has a job anymore, but hey, at least we're all equal now?

          ...I don't quite understand how you are misunderstanding this so severely that you think people paying for medical treatment is the same as giving out free Ferraris. These aren't uninsured patients, nobody is asking Mayo Clinic to treat people for free. It's public insurance vs private insurance. Saying you have to treat all of these patients is like saying you have to sell a Ferrari to anyone who shows up with an loan approved by their bank for the purchase of a Ferrari. And instead the dealer say they won't sell it to you unless you get a loan from their internal financing department because they don't want to accept loans from outside banks.

          They're perfectly free to choose which plans they want to accept. They don't have to accept Medicare or Medicaid or whatever else if they don't want to. They agreed to accept these plans, which means they agreed to provide their services to those patients. And now they're saying they don't want to fulfill their obligations under that agreement unless it happens to be convenient for them.

      • (Score: 1) by Ken on Wednesday March 22 2017, @08:52PM

        by Ken (5985) on Wednesday March 22 2017, @08:52PM (#482938)

        "(2) Improve efficiencies so the treatments are less expensive."

        Efficiencies sometimes are not enough to bring the cost down. Facilities are at the mercy of vendors. When something is new, there is no competition between vendors, so they have to pay the price or don't provide the service.

    • (Score: 0) by Anonymous Coward on Tuesday March 21 2017, @05:24PM

      by Anonymous Coward on Tuesday March 21 2017, @05:24PM (#482252)

      Same as it works in socialized medicine counties. They poor get basic healthcare and long waits. The rich pay for faster and better.

    • (Score: 5, Interesting) by SunTzuWarmaster on Tuesday March 21 2017, @05:26PM (21 children)

      by SunTzuWarmaster (3971) on Tuesday March 21 2017, @05:26PM (#482254)

      The problem, in short, is that healthcare is expensive in the USA. In addition to being expensive, it doesn't actually appear to *do* very much, considering life expectancy among the US and Cuba is effectively equal. The US spends ~18% of GDP on healthcare, and Cuba spends ~10%.

      In response to this, the US Government has launched a program where the mostly-for-old-people Government-paid healthcare (Medicare and Medicaid) will simply start paying less to healthcare providers. The system of how much less, on what services, under what circumstances, etc. is complicated, but the end result is the same: less. In response, private industry is sending those people to the back of the line, and it isn't hard to see the writing on the wall: eventually they aren't in line altogether and Government-paid healthcare recipients don't have access to the best care.

      The US has laws that no one can be refused emergency services (which has significant influence over our healthcare/insurance system/payments), but these laws do not particularly apply to complex operations such as those that the Mayo clinic performs (heart transplants, cancer treatments) and cannot be performed as emergency room procedures.

      Your response to this change is likely representative of your political ideology. Do you believe that all (especially elderly) citizens should have access to the best healthcare (regardless of price) ? Do you believe that the free market should determine who has access to healthcare (ie. only those with means) ? America is currently caught up in the debate over whether the Government should ensure the health of its citizens. Some believe that it is the responsibility of the Government (and people should be taxed in order to provide for the general health of the nation), while others believe in personal responsibility (people are free to make their own decisions, some of which will kill them slowly/painfully). Further - if the Government is responsible for its citizen's health, and it is dramatically cheaper to prevent than treat, where do you draw the line (mandatory root canals? ban soda? forced marches?) ?

      • (Score: 5, Interesting) by VLM on Tuesday March 21 2017, @05:41PM (16 children)

        by VLM (445) Subscriber Badge on Tuesday March 21 2017, @05:41PM (#482265)

        Further - if the Government is responsible for its citizen's health, and it is dramatically cheaper to prevent than treat, where do you draw the line (mandatory root canals? ban soda? forced marches?) ?

        Adding to the complexity "about half" of all health expenditures are in the last six months of life. Its pretty easy to keep an average 18 year old alive aside from misadventure trauma care, but when someone's in decline the health care vultures descend, because, hey, they gotta eat and old people are easy prey for money. I've seen some real shark like behavior on elderly relatives. Oh you dying of lung cancer? You have prescription vision coverage? I'll make sure you go out with perfect vision and new glasses. What else can I remember... I had a great great aunt-in-law (complicated, I donno maybe thats a cousin?) who was on her way out with terminal metastasized intestinal cancer so naturally they spent bazillions of dollars on fixing her lung failure with oxygen enrichment and lots of drugs, you know, so the lung failure from smoking for 60 years doesn't kill her before the cancer gets her, which seemed kinda dumb, brutal actually as it didn't appear very comfortable.

        That explains why the lifespan in Cuba and the USA are about the same, if the difference between "treating" pancreatic cancer and "not treating" is like $1M and about three months, in Cuba they just die 3 months earlier which is lost in the noise whereas in the USA the right people just became $1M richer.

        Meanwhile the government encourages high wages by supporting the AMA cartel, while providing most services to people about to die means you have like poor kids with tooth problems because there's no money for dentistry because a near majority of money goes to almost dead people. Hey you might have terminal brain cancer but at least your new dentures only have to last three months har har har. Thats the american way.

        • (Score: 0, Informative) by edIII on Tuesday March 21 2017, @06:31PM (15 children)

          by edIII (791) on Tuesday March 21 2017, @06:31PM (#482299)

          Stop lying mother fucker!!!!!!!!!!!!!!!!

          That explains why the lifespan in Cuba and the USA are about the same, if the difference between "treating" pancreatic cancer and "not treating" is like $1M and about three months, in Cuba they just die 3 months earlier which is lost in the noise whereas in the USA the right people just became $1M richer.

          THIS IS FAKE NEWS. THIS IS A FUCKING LIE. Cuba TREATS its citizens 1 trillion times better than the U.S, and NOOOOOOOOOOO, it does NOT let its citizens die of cancer.

          Cuba is recognized by the W.H.O for its great efforts, and pertinently, its cancer treatment programs. Stop saying Cuba doesn't do anything for cancer patients. It most certainly does.

          I know it's convenient for you White Nationalists to trot out a 3rd world pinko commie hell hole to use in your arguments, but Cuba didn't fucking cooperate for the last 50 years. They actually created a medical system that is the envy of the world.

          Deal with the truth mother fucker!

          --
          Technically, lunchtime is at any moment. It's just a wave function.
          • (Score: 0) by Anonymous Coward on Tuesday March 21 2017, @07:28PM (1 child)

            by Anonymous Coward on Tuesday March 21 2017, @07:28PM (#482331)

            Yeah, Cuba must be awesome. That's why so many US citizens defect there.

            • (Score: 1, TouchĂ©) by Anonymous Coward on Tuesday March 21 2017, @08:06PM

              by Anonymous Coward on Tuesday March 21 2017, @08:06PM (#482359)

              Yeah, you're right. They tend to go north to Canada instead.

              Now, I'm not an expert on Canada, but I assume that Americans not emigrating to Cuba and instead emigrating to Canada must mean that Canada also avoided the horrors of socialized medicine.

          • (Score: 1, Funny) by Anonymous Coward on Tuesday March 21 2017, @07:41PM (1 child)

            by Anonymous Coward on Tuesday March 21 2017, @07:41PM (#482344)

            And in this thread, we have VLM standing in front of edIII with the "edIII Programmer's Reference Manual" pressing edIII's buttons LIKE. A. FUCKING. BOSS.

            • (Score: 3, Informative) by edIII on Tuesday March 21 2017, @10:14PM

              by edIII (791) on Tuesday March 21 2017, @10:14PM (#482434)

              Spreading lies and misinformation from the White Nationalist playbook in order to further those lies for purposes against our greater interests is not pressing buttons. It is something that every good person should stand up and fight. I understand the juvenile, monkey-poo-throwin' entertainment you get from reducing it to a game of pressing emotional buttons, but this does not qualify.

              Those are outright lies. It's about time we start standing up and resisting in every way, shape, and form we can. That begins by not being complacent, and confronting lying bigotry

              VLM fucking knows better. He's let his hate and fear control him now in order to spew lies and misinformation. Oh, excuse me.... alternative facts.

              --
              Technically, lunchtime is at any moment. It's just a wave function.
          • (Score: 1, Troll) by linkdude64 on Tuesday March 21 2017, @08:11PM (2 children)

            by linkdude64 (5482) on Tuesday March 21 2017, @08:11PM (#482364)

            "Cuba does NOT let its citizens die of cancer."

            This is what leftists actually believe.

            • (Score: 0) by Anonymous Coward on Tuesday March 21 2017, @08:35PM

              by Anonymous Coward on Tuesday March 21 2017, @08:35PM (#482380)

              I guess you're one of those idiots that doesn't let facts get in the way of your beliefs...

              I'm gonna give you the benefit of a doubt and say that you were viewing the statement as "no one dies from cancer in Cuba" which would be a monumentally ignorant statement. However, that is not how it was meant and you should work on your critical thinking skills if that is your interpretation.

            • (Score: 2) by edIII on Tuesday March 21 2017, @10:36PM

              by edIII (791) on Tuesday March 21 2017, @10:36PM (#482439)

              You mean the truth? Uhhh, yeah. I tend to believe something that is backed up with evidence, and promulgated by credentialed and respected people.... Like the World Health Organization.

              I'm not Leftist fuckface, but let's go with that as your statement:

              "Leftists believe that Cuba has ability, and uses said abilities, to treat their citizens that have cancer"

              Yes. Many people believe this is true. Not just Leftists, but Chinese people, Russian people, people in Europe, people walking through Indonesia... because they aren't ignorant White Nationalist bigoted dickheads like you. They can read and comprehend reports like this, ingest information from medical journals, and basically learn the truth about medicine in Cuba beyond the ignorant butthurt glasses that American bravado and politics demands that you wear.

              Or.... were you just playing the Grammar Nazi today and taking my statement as an absolute in a weak and pathetic attempt to make a counter argument very similar to a monkey throwing poo? ;)

              --
              Technically, lunchtime is at any moment. It's just a wave function.
          • (Score: 2) by VLM on Tuesday March 21 2017, @08:34PM (3 children)

            by VLM (445) Subscriber Badge on Tuesday March 21 2017, @08:34PM (#482379)

            I believe we've sparred over this topic before.

            for you White Nationalists to trot out a 3rd world pinko commie hell hole to use in your arguments

            I don't think you're seeing the big picture.

            Say I paint a picture that if they suck, they're still much better than our system, overall. Then you get triggered again and point out they're not that bad, they're like 22% better than I claim, therefore I'm entirely wrong. But think about it, because if my pessimistic engineering estimate shows them superior, then your rather... optimistic engineering estimate will none the less continue to show them superior. Rather than disproving my point all you're doing is calling attention to my rather pessimistic estimate probably being more accurate than I claim. And you're pointing out your... displeasure with my politics, which you might think makes my idea look bad when all it does is make it look like bipartisan support. Why the only thing we can fight about is how much more efficient Cuba is as providing care per dollar, merely lots or a whole heck of a lot.

            I will admit its a mistake for me to use Cuban docs as a comparison because medical is Cuba's secret sauce its their "silicon valley" its their "nokia" or whatever. Cuban docs are pretty legendary and their medical field is a major export for Cuba. I should be comparing to a truly typical and random tropical medical community, El Salvadoran docs perhaps. My argument would still be pretty strong, just you wouldn't be as triggered.

            Stop saying Cuba doesn't do anything for cancer patients. It most certainly does.

            While spending about half the money. They're efficient. They don't have the same material supplies we do so clearly their best work can't be as good as our best... unaffordable... work.

            a 3rd world pinko commie hell hole ... Cuba didn't fucking cooperate for the last 50 years.

            You might find this hard to believe, but nationalist types kinda like Cuba. As a people they're tough and effective and put up with a lot of BS for decades and just keep doing the impossible year after year. You see, a neocon sees a place like that and wants military action. A leftie sees a place like that and wants them all to immigrate to the US to vote democrat. A nationalist sees a nation of tough effective cool people and as long as they stay in their nation and we (including our military) stay in our nation aside from recreational vacationing that's a pretty respectable country. They do their own thing and the rest of the planet can F itself and a neocon sees that as justification for drone bombing, a lefty sees that as justification for mass immigration, and a nationalist sees that as a respectable nation worth visiting someday. I like the idea of there being a strong Cuba nation over there that we're not bombing and they're not invading us. Only nationalists are live and let live like that. The neocon right and the american want to use them as pawns, I just want to take a vacation there, smoke a cigar or two, eat one of those cubano sandwiches....

            • (Score: 2, Insightful) by edIII on Tuesday March 21 2017, @10:27PM (2 children)

              by edIII (791) on Tuesday March 21 2017, @10:27PM (#482436)

              I don't think you're seeing the big picture.

              Say I paint a picture that if they suck, they're still much better than our system, overall. Then you get triggered again and point out they're not that bad, they're like 22% better than I claim, therefore I'm entirely wrong.

              No, fuck you. You own your bigotry today.

              What you SAID was that Cuba DID NOT treat cancer and LET THEM DIE, and this was the basis for whatever White Nationlists argument you were making today. You denigrated Cuba because it was useful to you, and spared the rest of us anything close to the truth. That truth being, medical is far too fucking expensive in the United States. Meaning, they're people who literally get rich off our suffering for no other reason, but to provide them profit. Not the costs of the drug/treatment being too high, but just the pure profit. You wish to lead us to believe that Cuba was spending less because it was delivering less. That's a flat out fucking lie, and I believe I've called you on it before, and put out links to the W.H.O to receive real information other than your bigotry.

              I will admit its a mistake for me to use Cuban docs as a comparison because medical is Cuba's secret sauce its their "silicon valley" its their "nokia" or whatever. Cuban docs are pretty legendary and their medical field is a major export for Cuba. I should be comparing to a truly typical and random tropical medical community, El Salvadoran docs perhaps. My argument would still be pretty strong, just you wouldn't be as triggered.

              You can stop at "I will admit its a mistake". Compare whatever the fuck you want, and my "trigger" is just you lying. That's it. Putting out misinformation like that in order to continue to prop up our medical system as valid. It's fucking bullshit, and you're a fucking liar.

              Compare away! Just use the fucking truth for once.

              You might find this hard to believe, but nationalist types kinda like Cuba. As a people they're tough and effective and put up with a lot of BS for decades and just keep doing the impossible year after year.

              Awww, the White Nationalist gets soft. Is part of the bullshit that these people deal with is people like you saying they don't care for their fellow brothers and sisters that get cancer? That just let them die to save money? That, while noble tropical savages, they still don't have the strength and moral fortitude to care for each other?

              THAT bullshit?

              --
              Technically, lunchtime is at any moment. It's just a wave function.
              • (Score: 0) by Anonymous Coward on Wednesday March 22 2017, @01:53AM

                by Anonymous Coward on Wednesday March 22 2017, @01:53AM (#482497)

                Special little snowflakes... when called out on their shit they reverse and say the opposite. They are mentally handicapped by a lifetime of paradoxical beliefs. Their education and training makes them smart, their sheer exposure to cultural bias and emotional beliefs (dey tooker jerrrbs) make sit impossible for them to use critical thinking. Their left brain is fighting with their right brain, and sadly it takes a monumental effort for logic to win against emotion.

              • (Score: 2) by VLM on Wednesday March 22 2017, @12:23PM

                by VLM (445) Subscriber Badge on Wednesday March 22 2017, @12:23PM (#482671)

                they still don't have the strength and moral fortitude to care for each other?

                LOL you seem to be implying all you need for medical care is the correct beliefs. It seems to take money and gear sometimes.

                If you need a MRI, and until recently the only way to export a MRI to Cuba due to weird US law was to commit a felony, well, you can wish all you want you aren't getting a MRI in Cuba. Or if they need $200K for some exotic cancer drug, and they don't have $200K, then they aren't getting the $200K cancer drug no matter how nice their intentions are. Things are slightly better now and there is the whole rest of the world willing to trade with Cuba even if the USA won't, but its still a problem.

          • (Score: 3, Informative) by SunTzuWarmaster on Tuesday March 21 2017, @08:45PM (3 children)

            by SunTzuWarmaster (3971) on Tuesday March 21 2017, @08:45PM (#482385)

            Fine - let's pick another country then (all countries are w/in 3 years of the US):

            South Korea (7%)
            Finland (9%)
            Slovenia (8.7% of GDP)
            USA (18%) ----------------
            Chile (7% GDP)
            Czech Republic (7.5% of GDP)
            Poland (6.8%)

            One of these things doesn't look like the other. Cuba appears to have a good medical system - roughly equivalent to Finland, Poland, Chile, and the US. The spend, as a percentage of GDP, a similar amount to the countries against which they are ranked. The US, per person, spends between double and triple what everyone else pays.

            • (Score: 2) by VLM on Tuesday March 21 2017, @08:59PM (2 children)

              by VLM (445) Subscriber Badge on Tuesday March 21 2017, @08:59PM (#482391)

              One of these things doesn't look like the other.

              The one thats 2 or 3 times higher has corn syrup.

              Think about the variety of diet, in that list you got people eating dogs (not hot, the "woof" type), soy, pickled fish, weird cheeses, tons of spicy delicious meat, American heartland trad sunday dinner stuff like pork roasts, lots of delicious beer, and interesting potatoe dishes. Thats like everything.

              Like is there anything not on that list that people eat... oh yeah... the one that has 2 to 3 times the medical cost consumes like a gallon of HFCS per week.

              I'm just sayin... yeah I know its not just food intake, but ...

              • (Score: 1, Troll) by Anonymous Coward on Wednesday March 22 2017, @12:19AM

                by Anonymous Coward on Wednesday March 22 2017, @12:19AM (#482472)

                > The one thats 2 or 3 times higher has corn syrup.

                And that is the quality of your thinking.
                The corn syrup conspiracy. lol

                You spend all that time spewing bullshit to puff yourself up but when it comes down to dealing with hard facts, you go with random bullshit because all you've got is sophistry. You nazis are all alike, completely vapid versions of all the things you hate.

              • (Score: 3, Insightful) by dry on Wednesday March 22 2017, @02:23AM

                by dry (223) on Wednesday March 22 2017, @02:23AM (#482502) Journal

                Lots of Canadian food is imported from the States, including stuff with HFCS. Unluckily maple syrup is just too expensive to consume regularly.

      • (Score: 0) by Anonymous Coward on Tuesday March 21 2017, @06:12PM

        by Anonymous Coward on Tuesday March 21 2017, @06:12PM (#482285)

        Some believe that it is the responsibility of the Government, while others believe in personal responsibility

        Note that the latter group are typically unknowing members of the former group.

        Just ask them if they are willing to start paying income tax on their employer-paid health insurance premiums, just like I have to pay on the income I use to purchase insurance on the open market. And don't even get me started about all the people who are on Obamacare and don't know it, "keep the government out of my medicare!" [slate.com]

      • (Score: 2) by JoeMerchant on Tuesday March 21 2017, @08:19PM

        by JoeMerchant (3937) on Tuesday March 21 2017, @08:19PM (#482370)

        Somebody watches too many Michael Moore films.

        However, you (and he) are right in this circumstance - the US healthcare system spends too much for too little benefit to the broader population. We've developed some miraculous technologies, but most of the time they're moot.

        --
        🌻🌻 [google.com]
      • (Score: 2) by linkdude64 on Tuesday March 21 2017, @08:28PM (1 child)

        by linkdude64 (5482) on Tuesday March 21 2017, @08:28PM (#482373)

        " Do you believe that all (especially elderly) citizens should have access to the best healthcare (regardless of price) ?"

        Completely willing to be the inhumane unforgiveable literally-worse-than-a-genocidal-mass-murderer and say NO, the best healthcare services, technologies, and other resources should be directed to populations which will most greatly benefit from them.

        Here's an elementary moral dillema: You have a choice: Kill 1 person or kill 100. You are advocating that they are equally bad, because you have no common sense.

        No, the extremely elderly do not deserve the best. They surely deserve to be in as little pain as possible, but remaining less than half-cognizant hooked up to million dollar a day machines drugged to hell and back only to keep them alive for another week (a cruel existence in itself) is not doing much for anyone.

        • (Score: 0) by Anonymous Coward on Tuesday March 21 2017, @08:37PM

          by Anonymous Coward on Tuesday March 21 2017, @08:37PM (#482381)

          See, you criticize a system you don't even have the most basic understanding of. Countries with socialized healthcare prioritize patients based on need, basically what you're advocating for. The current system in the US is the one where we save 1 person and kill 100.

    • (Score: 3, Informative) by Scruffy Beard 2 on Tuesday March 21 2017, @07:47PM (7 children)

      by Scruffy Beard 2 (6030) on Tuesday March 21 2017, @07:47PM (#482349)

      In Canada it is illegal to allow people paying privately jump the queue.

      Doctors either work in the public system, or as a private practice: not both.

      The reason is that the queuing is supposed to be triaged based on need. It you let people with money jump the queue, the poor end up not getting the treatment they need.

      • (Score: 4, Insightful) by Justin Case on Tuesday March 21 2017, @08:03PM (4 children)

        by Justin Case (4239) on Tuesday March 21 2017, @08:03PM (#482357) Journal

        the poor end up not getting the treatment they need

        You seem to be assuming that resources should be distributed (by some all knowing benevolent power, I suppose) according to need. There are people who share that view. Indeed entire nations have been sacrificed in pursuit thereof.

        Others think that resources belong to those who produce them, and can then be traded for other resources according to mutual agreement.

        These two viewpoints are not likely to be reconciled. Ideally we could have a state, or country, or several, where those of various views could gather with others of like mind. Then we'd see which one works and which one goes bankrupt.

        • (Score: 0) by Anonymous Coward on Tuesday March 21 2017, @08:10PM

          by Anonymous Coward on Tuesday March 21 2017, @08:10PM (#482362)

          by some all knowing benevolent power, I suppose

          Don't most hospitals use a triage nurse? Maybe that's part of why American medicine is so expensive. Maybe as a first step, Americans should look into using triage nurses instead of all knowing benevolent powers and/or entities in hospitals.

        • (Score: 2, Insightful) by Anonymous Coward on Tuesday March 21 2017, @08:25PM

          by Anonymous Coward on Tuesday March 21 2017, @08:25PM (#482371)

          And its always the biggest beneficiaries of that redistribution who yellow loudest for non-distribution.
          Tax deductible mortgages. Tax-free insurance premiums. Police. Firefighters. Public roads. Oil defended by military spending.
          The value the rich derive from that redistribution dwarfs the value that the poor do.

          The US has always been overtly libertarian but covertly redistributionist.

        • (Score: 0, TouchĂ©) by Anonymous Coward on Tuesday March 21 2017, @08:43PM

          by Anonymous Coward on Tuesday March 21 2017, @08:43PM (#482384)

          Fuck you buddy, "Others think that resources belong to those who produce them, and can then be traded for other resources according to mutual agreement."

          I get where you're coming from, it is a selfish and inhumane approach that ignores the concept of society / community.

          Ironically, your statement is actually advocating that the resources be distributed to the workers and not some owner sitting in his office doing jack shit for millions of dollars a year. You commie bastard :D

        • (Score: 2) by dry on Wednesday March 22 2017, @02:44AM

          by dry (223) on Wednesday March 22 2017, @02:44AM (#482506) Journal

          Well if you just consider debt, America is winning that war. When was the last time America balanced its budget? Canada went 8 years with balanced budgets until the right wingers, those who "Others think that resources belong to those who produce them, and can then be traded for other resources according to mutual agreement" got into power and started racking up the debt, $65 billion (add an order of magnitude to compare to America) the first year while arguing that since they were conservatives, they knew how to manage money and then ran a deficit for a decade and finally balanced the budget by not spending money earmarked for the veterans.
          Now that America has swung even further right, the debt will really climb, though just like the guy who owes a few billion to the bank, you won't be forced into bankruptcy.

      • (Score: 1) by slap on Wednesday March 22 2017, @05:14AM (1 child)

        by slap (5764) on Wednesday March 22 2017, @05:14AM (#482550)

        "In Canada it is illegal to allow people paying privately jump the queue.

        Doctors either work in the public system, or as a private practice: not both."

        So to jump the queue you just switch doctors and go to a private one.

        • (Score: 2) by Scruffy Beard 2 on Wednesday March 22 2017, @05:23AM

          by Scruffy Beard 2 (6030) on Wednesday March 22 2017, @05:23AM (#482553)

          Can't stop that anyway: people can always got to another country for treatment.

          What the policy does is cut down on cherry-picking. You can't just force all the difficult cases to the public hospital down the road, unless you forgo all public funding.

    • (Score: 0) by Anonymous Coward on Wednesday March 22 2017, @01:41AM

      by Anonymous Coward on Wednesday March 22 2017, @01:41AM (#482495)

      Well since you're not from the US you don't have a valid excuse for being an idiot... Stick to your own country plzthxbye.

  • (Score: 5, Interesting) by jmorris on Tuesday March 21 2017, @05:35PM (7 children)

    by jmorris (4844) on Tuesday March 21 2017, @05:35PM (#482263)

    Medicare reimbursement pays a fraction of what private insured patients does and Medicaid pays a fraction of what Medicare does. People who work for a living like getting paid, people who run up half a million in debt getting through the most elite medical schools to get to work at a high prestige place like the Mayo Clinic really want to get paid. They will do a percentage of charity work here in the U.S. exactly like many doctors do charity work overseas, but it can't be the majority of their work.

    It is about time we face some brutal math facts. Medical science is inventing all sorts of wonderful procedures and drugs that have helped extended our average lifetime and is inventing ever more, but they tend to be expensive and growing more so, especially at the most elite places like Mayo. It is simply impossible to expect everyone, especially charity cases, to receive equal care to someone with unlimited resources to pay for their care. Their ability to pay for new and exotic treatments do drive the cost down though and they eventually become commonplace and cheap, we see this in the tech world daily. This means charity cases should not expect others to pay for new and exotic treatements and even normal insured people should expect limits as well.

    Yes math is real, yes we live in a world of limited resources. Grow the hell up buttercup, you aren't special, you aren't irreplaceable and demanding your neighbors spend themselves into poverty to buy you another year or two is dumb. Everybody dies in the end, most simply aren't worth a million plus in medical care trying to push the exit date back a bit, and these days it is all too common to run up that kind of bill, usually in the last couple of years.

    Personally, if I were rewriting the rules in this rip and replace of 0care I'd put anyone with a preexisting condition (i.e. those who couldn't or wouldn't buy insurance before they got sick) into government subsidized high risk pools along with the indigent where they got good but not great care. Access to doctors and common procedures but for example most branded drugs would simply be forbidden, generics only. Yes that means you wait ten years for a new drug to go generic, oh the horrors of getting care a decade out of date. But knowing this would be the fate of those who weren't insured would be a big motivator to get covered. It isn't politically viable to leave the sick untreated so formalize it and design it such that it provides the required market incentives.

    • (Score: 3, Insightful) by VLM on Tuesday March 21 2017, @05:56PM

      by VLM (445) Subscriber Badge on Tuesday March 21 2017, @05:56PM (#482272)

      This means charity cases should not expect others to pay for new and exotic treatements and even normal insured people should expect limits as well.

      Something to consider is that sounds not so nice out of context but my observation of dying elderly relatives is that the only thing less fun than paying for someones $1M of care in their last six months is being the recipient of $1M of care in their last six months and almost universally they all had their fill of doctors toward the end and just wanted to go home or hospice and die in peace. Enough pills and injections and therapies that don't work and ...

      I mean $1M of medical treatment sounds like a nice way to go out if its six months of endless sponge baths by a smoking hot 10/10 nurse. But the reality is that last $1M is usually not that much fun.

      It brings up weird market ideas. Imagine terminal diagnosis comes with an offer like "Sign this medical release that basically says 'nothing but bottomless bottle of free painkillers' and instead of spending $1M on aggressive intervention and you're gonna die anyway, we hand you a check for $100K and tickets to Amsterdam while you can still enjoy it. Or you can transfer $2 of refused medical care into $1 of life insurance for your family."

      There is an interesting capitalist type of problem were decades ago some cancers meant "you gon die" for sure, but spending an infinite amount of money for decades results in "you almost certainly not gonna die as long as you come in early enough" like skin and breast cancer. Eventually they'll figure out how to fix that outpatient maybe with an OTC pill. But how to figure out which diseases are eventually curable vs not, thats the mystery.

    • (Score: 3, Informative) by DeathMonkey on Tuesday March 21 2017, @05:58PM (4 children)

      by DeathMonkey (1380) on Tuesday March 21 2017, @05:58PM (#482274) Journal

      It is about time we face some brutal math facts. Medical science is inventing all sorts of wonderful procedures and drugs that have helped extended our average lifetime
      The brutal fact is that US life expectancy is actually slipping. Life Expectancy In U.S. Drops For First Time In Decades, Report Finds [npr.org]

      • (Score: 1, Flamebait) by Anonymous Coward on Tuesday March 21 2017, @06:05PM (3 children)

        by Anonymous Coward on Tuesday March 21 2017, @06:05PM (#482282)

        Note that the drag downwards in life expectancy is due to poor people dying early.
        Rich people are doing better than ever.
        Policies like Mayo's are part of that problem.

        • (Score: 0) by Anonymous Coward on Tuesday March 21 2017, @06:16PM (2 children)

          by Anonymous Coward on Tuesday March 21 2017, @06:16PM (#482288)

          Flamebait?
          Looks like once again some snowflake can't deal with the fact that reality has a well-known liberal bias.

          the richest 1 percent of men lives 14.6 years longer on average than the poorest 1 percent of men, while among women in those wealth percentiles, the difference is 10.1 years on average.

          This eye-opening gap is also growing rapidly: Over roughly the last 15 years, life expectancy increased by 2.34 years for men and 2.91 years for women who are among the top 5 percent of income earners in America, but by just 0.32 and 0.04 years for men and women in the bottom 5 percent of the income tables.

          https://news.mit.edu/2016/study-rich-poor-huge-mortality-gap-us-0411 [mit.edu]

          • (Score: 0) by Anonymous Coward on Tuesday March 21 2017, @08:40PM (1 child)

            by Anonymous Coward on Tuesday March 21 2017, @08:40PM (#482383)

            Conservative retards are retarded. They can blame some brainwashing, but once they are past their early 20's they have only themselves to blame. I'm so mad about some of the shit I'm reading I have to say "FUCK YOU CONSERVATIVE PIECES OF SHIT! LEARN TO READ OR MAYBE GET A BRAIN IMPLANT THAT CAN LOGIC FOR YOU!!!"

            • (Score: 4, Insightful) by Azuma Hazuki on Tuesday March 21 2017, @10:48PM

              by Azuma Hazuki (5086) on Tuesday March 21 2017, @10:48PM (#482440) Journal

              Don't bother. Since Reagan if not before, "Conservative" has been shorthand for "selfish sociopath" and everyone knows is. Their problem isn't usually lack of intelligence, it's lack of common humanity.

              --
              I am "that girl" your mother warned you about...
    • (Score: 3, Interesting) by sjames on Tuesday March 21 2017, @06:38PM

      by sjames (2882) on Tuesday March 21 2017, @06:38PM (#482304) Journal

      Another reality, health care costs 4 times as much in the U.S. as in the U.K. Fix that and a hell of a lot of problems will just go away.

      Forget the insurance scam and the up and coming replacement insurance scam and follow the money if we want to solve the problem.

      Also ban evergreening and paying companies to NOT produce a generic. EVERYONE should probably start with a generic and only switch to the new shiny if the problem isn't adequately addressed. Ban the FDA from pretending that the pill with a B stamped into it is any different than the same pill with an A stamped into it. We already know B is safe and effective because A is and it contains the same stuff. Also ban the FDA from handing out exclusivity on generics when companies do an adequate job licking their boots.

      Actually teach the art of clinical diagnosis. A good clinician can diagnose the patient without a battery of overpriced tests. And yes, the tests are over-priced. Most of them consist of diluting the sample (anyone who took chemistry in high school can manage that) dipping a $0.10 test strip into it, and then reading off the color chart. Most even have a machine that takes care of all of that including a coloremeter (much like the paint matching thing at the hardware store).

      The reason Medicare pays less is that they know what the actual costs and profits are for the various tests and procedures. They demand val;ue for the dollar because they can. Everyone else is left flapping in the breeze.

  • (Score: 2) by fraxinus-tree on Tuesday March 21 2017, @05:50PM (6 children)

    by fraxinus-tree (5590) on Tuesday March 21 2017, @05:50PM (#482268)

    1. The hospital is a business. It has to make ends meet (whatever in their case meeting the ends means, up to and including attracting enough investments).

    2. The headline implies that government pays (for generally the same service) less than commercial insurance. So the commercial insured patients cross-subsidy gov ones.

    3. 1+2 = hospitals compete for a better patient pool. Whatever it takes.

    Well, 0. Insurance drives prices up. No one cares to improve that so issues like in the RTFA will become more and more "normal".

    • (Score: 3, Insightful) by fishybell on Tuesday March 21 2017, @07:58PM (3 children)

      by fishybell (3156) on Tuesday March 21 2017, @07:58PM (#482354)

      Hospitals don't really compete. You usually have the option of going to one or two different ones depending on your insurance and your location, and even then they won't/can't tell you what you have to pay beforehand.

      Until you can go anywhere, and see what it will cost you and your insurance up front, hospitals and all care-providers in the US are going to be expensive.

      • (Score: 2) by VLM on Tuesday March 21 2017, @09:12PM (2 children)

        by VLM (445) Subscriber Badge on Tuesday March 21 2017, @09:12PM (#482399)

        You usually have the option of going to one or two different ones depending on your insurance and your location

        In the major urban areas like NYC. Most places an ambulance scrapes up an unconscious person they don't have to ponder which ER because there's roughly one choice, the closest.

        Given that hospitals mostly serve their neighbors, the best way to fund them is prop tax. You want a good hospital in your city, you'll pay. You want a not so good hospital, well then you won't.

        To some extent we already do this and areas with the best schools and best people have the best insurance program and get the best neonatal care or best cardiac center or best cancer treatment center just following the dollars.

        Explicitly paying via prop tax is an interesting way to formalize it. May as well cut a zillion middlemen out of the billing process and just pay out of prop tax, just like we do garbage collection or public schools or road maintenance here. You benefit from the library you pay for the library. 99% of the time the hospital you visit is the one by your house, so may as well pay out of prop tax just like trash pickup or police service or the library.

        • (Score: 0) by Anonymous Coward on Wednesday March 22 2017, @12:22AM (1 child)

          by Anonymous Coward on Wednesday March 22 2017, @12:22AM (#482474)

          Property taxes have been one of the greatest causes of inequality in this country.
          Its why the schools of the poor suck, making it 2x as hard for the poor to climb out of poverty.
          And now you are arguing that the poor should get shitty healthcare too.
          Fuck that shit you creep.

          • (Score: 2) by VLM on Wednesday March 22 2017, @04:09PM

            by VLM (445) Subscriber Badge on Wednesday March 22 2017, @04:09PM (#482798)

            Its why the schools of the poor suck, making it 2x as hard for the poor to climb out of poverty.

            I thought it was pretty well statistically proven that only significant determinant in education outcome was demographics. Money doesn't matter. I wonder if health care is the same way. Or would be the same way if funded by prop tax.

            It seems pretty normal to have a "top district in the country" in a burb near a "bottom district in the country" in a city where the city spends more money than the burb. Where I live the local inner city spends $14K per pupil and scarcely half bother to graduate and the test scores are dismal some of the worst in the nation, 20 miles away in the burbs we only spend $12K per pupil in a district about the same size, and come in near the top in many national rankings for standardized tests and academic competitions and stuff like that. There's a slight demographic difference between the inner city and where I live but human biological differences don't exist so the results must just be solely due to luck.

    • (Score: 0) by Anonymous Coward on Tuesday March 21 2017, @08:51PM (1 child)

      by Anonymous Coward on Tuesday March 21 2017, @08:51PM (#482389)

      1. The hospital is a business.

      And that, right there, is the heart of the problem.

      • (Score: 2) by fraxinus-tree on Wednesday March 22 2017, @02:11PM

        by fraxinus-tree (5590) on Wednesday March 22 2017, @02:11PM (#482708)

        You want some kind of access to healthcare, right? It is either business or government. Both options have problems.

  • (Score: 2) by ngarrang on Tuesday March 21 2017, @06:30PM

    by ngarrang (896) on Tuesday March 21 2017, @06:30PM (#482298) Journal

    ...help to cover the costs of those that cannot. The reimbursement rates for Medicare and Medicaid are very low. The fact of life is...money makes things go. It pays for electricity. It pays people's salaries. Nothing is free, not even medical care.

  • (Score: 1, Informative) by Anonymous Coward on Tuesday March 21 2017, @06:44PM (1 child)

    by Anonymous Coward on Tuesday March 21 2017, @06:44PM (#482307)

    Mayo Clinic is a premier US healthcare outfit, and that means a premier care provider in the world. And almost half of its patients are medicare/medicaid patients.

    Mayo Clinic should be lauded for that.

    The real problem is the structural problem of the US healthcare industry where we spent way more than most other countries but the outcome/coverage is that of third-world country.

    The US has gotten so ossified we can't address any truly significant and difficult issue in any meaningful, substantial way. So we opted for something different in desperation, anything out of ordinary to get out of the rut, but all we were able to manage is Trump presidency.

    Sad.

    • (Score: 1, Informative) by Anonymous Coward on Tuesday March 21 2017, @06:51PM

      by Anonymous Coward on Tuesday March 21 2017, @06:51PM (#482313)

      Wanted to add this. Obama, who made it his presidential legacy to reform the medical care in the country, could only come up with the Rube Goldberg contraption called Affordable Care Act aka "Obamacare" - too damn many powerful vested interests to come up with a genuinely affective meaningful reform. Sure, it increased coverage to many more people, but it turned out not to be sustainable nor affordable after only a few years.

  • (Score: 2) by Justin Case on Tuesday March 21 2017, @06:45PM (3 children)

    by Justin Case (4239) on Tuesday March 21 2017, @06:45PM (#482310) Journal

    Shoppers with 15 items or less get priority service!

    We need more "scandals" like this. It is called choice. Not heavy handed bureaucratic red tape government regulated monopolies where everything is exactly the same everywhere. Options, so you can choose what matters most to you.

    Perhaps your time is valuable, and you're willing to pay a premium.

    Perhaps another person has lots of time, not so much money, they would rather wait than pay more.

    If you don't like the way Mayo Clinic does it, you should have 100 others to choose from. Or for that matter the freedom to start your own clinic and serve people better.

    Like grocery stores.

    • (Score: 0) by Anonymous Coward on Wednesday March 22 2017, @02:00AM

      by Anonymous Coward on Wednesday March 22 2017, @02:00AM (#482499)

      You must be fresh out of high school or college, the naivety doesn't make sense otherwise.

    • (Score: 2) by dry on Wednesday March 22 2017, @02:59AM

      by dry (223) on Wednesday March 22 2017, @02:59AM (#482512) Journal

      Grocery stores around here are pretty straight forward about prices and that 15 or less lineup has prominent signs. Are hospitals or the Mayo Clinic as straight forward about prices. I assume that the Mayo clinic along with most hospitals don't benefit anymore then the average grocery store from tax dollars.

    • (Score: 3, Interesting) by VLM on Wednesday March 22 2017, @04:18PM

      by VLM (445) Subscriber Badge on Wednesday March 22 2017, @04:18PM (#482813)

      Shoppers with 15 items or less get priority service!

      Interesting idea to think about, the local grocery store express lanes have all converted over the last 5-10 years to self-checkout. So instead of having 1 express lane with a human operator there's perhaps 8 self checkouts and no lines and no one cares if you scan an entire shopping cart at self check.

      The point being that some kind of kiosk / expert system type thing might develop in health care such that as long as I'm willing to sit in a booth, an AI chat bot will discuss medications until I'm tired of talking for a much lower fee than talking to a GP / PA / RN.

      Also on the topic of cheaper easier to access care, I live in a state where they allow PAs (I don't think all do?) and I think I've only met my GP once, I always end up talking to the PA. The PA is pretty cool so I don't mind. Supposedly it costs my insurance (aka your pocketbooks) much less to talk to the PA. I'm a paleo diet guy so I'm pretty healthy so I've never been sick enough to need my GP although law of averages will catch up to be in the coming decades I'm sure.

  • (Score: 0) by Anonymous Coward on Tuesday March 21 2017, @07:07PM

    by Anonymous Coward on Tuesday March 21 2017, @07:07PM (#482318)

    The Mayo Clinic is a non profit organization. Their income margin is about 5% [mayoclinic.org] of their revenue. What they're earning is almost in its entirety going back into the system to improve it.

    Consequently it's easy to see that the reason they would do something on a scale of greed-pragmatism-necessity is push far more towards the right than the left side of things. Consequently I think it's also a given that most of every hospital is also engaging in similar behavior. It'd be nice if companies could be more honest about things without people going on some name and shame justice crusade. I think the things we should be asking are how is that we spend so much on public healthcare (medicare+medicaid amount to more than $1 trillion a year alone) yet so apparently little of that money actually goes to healthcare providers. Seems bizarre. Another idea might be wondering why it even is that insurance companies are the ones that decide how much doctors get paid instead of doctors. The problem here is that when a doctor treats a patient it's not like they take your insurance and then charge them the rate they would have charged you. The insurance instead picks how much the doctor is paid for various services. And private insurance tends to pay doctors substantially more than medicare which pays subtantially more than medicaid. It's a nonsensical system that clearly is not working.

    I completely agree it's 'unfair' but trying to shame people accomplishes absolutely nothing, and whining even less. It's like punishment vs rehabilitation. Hurting people who do things we decide are bad things makes us feel morally superior, but somehow never seems to make headway against the problems. What is the cause here? And is there a way to remedy it?

  • (Score: 0) by Anonymous Coward on Tuesday March 21 2017, @07:33PM (1 child)

    by Anonymous Coward on Tuesday March 21 2017, @07:33PM (#482338)

    Of course the hospital will treat you better if you pay more. Other countries are the same. In German hospitals for example you'll see more senior Doctors if you have "private" insurance rather than "public".

    • (Score: 0) by Anonymous Coward on Tuesday March 21 2017, @08:54PM

      by Anonymous Coward on Tuesday March 21 2017, @08:54PM (#482390)

      but in Germany you will never get in front of the queue because you have private insurance (at most, you will be able to go to more places because some of them only work with private insurance).
      I'd say that's a significant difference.

(1) 2