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from the But-I-*like*-getting-50-different-invoices-for-one-hospital-stay dept.
There is an instinct among political pundits to confuse caution for practicality — an assumption that those who advocate for incremental change are being reasonable, while those pushing for bold reforms aren’t. This is seen most starkly in the debate around health care reform, despite the fact that the “practical” pushers of limited reform fail to address the real problems in our health care system.
We all recognize that the status quo isn’t working. We spend more per person than any other country on health care, but we aren’t getting any bang for our buck. We have lower life expectancy, higher infant mortality rates and more preventable deaths, and too many personal bankruptcies are due at least in part to medical bills.
[...]Time to get real. As an economist who has spent decades studying our health care system, I can tell you that Medicare for All advocates are the only ones who are being reasonable, because theirs is the only plan that will control health care costs while finally achieving universal coverage.
The problem with incremental plans, whether they are public options, buy-ins to Medicare or Medicaid, or pumping more money into subsidies in the Affordable Care Act's individual marketplace, is that they preserve the private health insurance system weighing down our health care. [...]they are leaving the main reason for our system’s dysfunction in place: the multipayer, for-profit financing model.
Commercial insurance companies are nothing more than middle men. They add no value to our system, but they do drive up costs with their bloated claims departments, marketing and advertising budgets and executive salaries. We pay for all of these things before a single dollar is spent on the delivery of care.
They also create extra costs for providers who need large administrative staffs to deal with billing systems, accounting for as much as $100,000 per physician.
Any plans short of Medicare for All leaves these costs in place. In other words, they leave hundreds of billions of dollars a year in savings on the table.
[...]Gerald Friedman, a health care and labor economist, is an economics professor at University of Massachusetts Amherst and the director of The Hopbrook Institute.
[Related]:
Democrats' promise of Medicare for All is remarkably misguided and unrealistic
Trump wants to drop a neutron bomb on Obamacare. Over to you, 2020 voters.
Take it from me, tweaks won't fix health care. Dems should focus on Medicare for All.
(Score: 5, Insightful) by Thexalon on Tuesday April 09 2019, @02:14PM
The status quo is working in the US if your goal is to siphon as much money as possible from the working and middle class folks to the shareholders of insurance, pharmaceutical, and medical device companies, and consider the working and middle class folks to be completely disposable in pursuit of that goal. From that perspective, those silly systems like the UK's NHS are just wasting a valuable opportunity.
"Think of how stupid the average person is. Then realize half of 'em are stupider than that." - George Carlin
(Score: 2, Redundant) by Snotnose on Tuesday April 09 2019, @02:16PM (14 children)
The government looks like it can't run shit. On the state level look at your local DMV. A fricken nightmare to deal with (at least here in CA). Look at the recent problems with the VA system. Once some outside inspectors came in they decided things were so bad they shut down at least 1 hospital, rather than try to fix the problems.
I agree, the current system is badly broken. The health insurance industry is nothing but a huge middleman, soaking up $$$ from both providers (in the form of paperwork and red tape) and patients (who would really prefer to get their chemo now, instead of middle of next year).
I don't know what the solution is, but I don't want to trust my health to the government.
It was a once in a lifetime experience. Which means I'll never do it again.
(Score: 1, Insightful) by Anonymous Coward on Tuesday April 09 2019, @02:29PM (9 children)
You gotta trust someone. Why not trust a single entity that all eyes are watching, and who, by law, has to be transparent with its constituency?
(Score: 1) by khallow on Tuesday April 09 2019, @02:32PM (8 children)
Like a business? Government has plenty of ways it can be non-transparent, legally and not. And I don't buy that "all eyes are watching" an entity like the US government. It gets away with way too much for that to be true.
(Score: 2) by Thexalon on Tuesday April 09 2019, @02:51PM (1 child)
Like what, exactly? And if the answer is "I don't know because it's classified", how do you know that the US government got away with it, rather than didn't do it?
If you're wanting to understand what's going on in civilian agencies, you can follow any of them on https://www.regulations.gov/ [regulations.gov], and you'll start to get a pretty good handle on what they're doing. It's not like they're allowed to keep most of that stuff secret.
"Think of how stupid the average person is. Then realize half of 'em are stupider than that." - George Carlin
(Score: 1) by khallow on Tuesday April 09 2019, @03:51PM
Such as the US government repeatedly insisting it's not spying on its citizens and allies and then repeatedly revealed via high risk leaks doing so without consequence?
Most businesses have websites too that allow you to understand in a similarly superficial manner what they do as well.
(Score: 1, Insightful) by Anonymous Coward on Tuesday April 09 2019, @02:53PM (2 children)
With the US government, at least the population has *SOME* opportunity for control and oversight. The reason folks don't trust the government is because they eventually find out what is going on. Likewise, they have the opportunity to vote people in or out, and make issues of things such that elected officials take action in order to save their jobs.
With a private company, 9 times out of 10, you never even find out about something until something catastrophic happens. Do you remember Equifax? That's a private company. How much stuff do you think goes on there that we STILL, to this day, do not know about? Do you want them in control of this country's health care? With a private company, the customers, have no insight and no say whatsoever. At best, they are left to vote solely with their feet if something goes amiss, and we've already seen what that is like.
When is comes to people's health and well-being, there needs to be strong accountability, transparency and plenty of oversight from folks who know what to look for when spotting problems. This is why the US gov makes the news almost daily. people are watching and getting the word out when things aren't as they should be. I agree that something like that is only the first step, but simply knowing is half the battle with these things.
(Score: 1) by khallow on Tuesday April 09 2019, @04:02PM (1 child)
You don't need control and oversight of a business. You just need a pot of money to sue. They can't hide behind sovereign immunity.
(Score: 0) by Anonymous Coward on Tuesday April 09 2019, @06:02PM
Was that actually intended to be ironic? Ah, justice for the rich and well-connected. Or were suggesting you can just hire a lawyer to do some ambulance chasing for you? Of course, you yourself won't ever see any of the money your lawyer manages to win from that big pot. Lawyers like to win big money for themselves by suing other big pots of money; they don't typically like sharing the won settlement with their clients though. Gotta love it!
(Score: 0) by Anonymous Coward on Wednesday April 10 2019, @11:11AM (2 children)
https://www.foia.gov/ [foia.gov]
Good luck filing a FOIA request with a private business.
You're such a piece of shit, Khallow.
(Score: 1) by khallow on Friday April 12 2019, @12:06AM
This happens during the discovery process during the lawsuit. No need to file anything like an FOIA.
(Score: 1) by khallow on Sunday April 14 2019, @03:14PM
Also, let us keep in mind the many accounting restrictions that a private business undergoes. For example, if the US government were following GAAP-based law as it is followed in the US, somebody would be going to jail for the crap accounting that is done.
These accounting rules means also that businesses have a much harder time hiding assets from lawsuits and sometimes even reveal the wrongdoing itself.
OTOH, governments don't even need to try.
(Score: 0) by Anonymous Coward on Tuesday April 09 2019, @03:07PM
CA DMV is much better than it used to be. Most routine paperworks can be done online, and even office visits are much more efficient than it used to be.
(Score: 2) by DeathMonkey on Tuesday April 09 2019, @04:59PM (1 child)
(Score: 0) by Anonymous Coward on Tuesday April 09 2019, @05:29PM
You can take a behind-the-wheel test online? Did you get a ticket for using your cell phone while driving?
(Score: 2) by MostCynical on Tuesday April 09 2019, @10:51PM
Maybe hospitals should be inspected more often?
https://www.safetyandquality.gov.au/ [safetyandquality.gov.au]
Oops...more government "interference"
"I guess once you start doubting, there's no end to it." -Batou, Ghost in the Shell: Stand Alone Complex
(Score: 2) by Entropy on Tuesday April 09 2019, @03:48PM (3 children)
Statistics are something quite easy to manipulate. I do wonder if in calculating health care costs for people in countries with mandatory/government health coverage they included the taxes they pay? At times they pay over 50% taxes for people in a normal income bracket, afterall.
(Score: 0) by Anonymous Coward on Tuesday April 09 2019, @04:07PM
Yes. They did.
That was easy.
(Score: 1) by khallow on Tuesday April 09 2019, @05:00PM (1 child)
(Score: 2) by opinionated_science on Tuesday April 09 2019, @05:16PM
the US Govt spends 3 Trillion on Medicare and Medicaid.
That's more than the GDP of the 5th richest country (United Kingdom) in the worldSource [wikipedia.org]
That doesn't include what all us suckers pay *in addition* to that...
(Score: 0) by Anonymous Coward on Tuesday April 09 2019, @04:04PM (1 child)
We will never ever get medicare for all, not without a bloody revolution first.
The existing system is excellent at extracting wealth from the working class while giving them the illusion of choice and the oh-so-important Personal Responsibilty, and so it will never change by a parliamentary process.
(Score: 0) by Anonymous Coward on Wednesday April 10 2019, @03:52AM
At the present, Medicare appears to be a lower cost system than the various options for people that are not able to use Medicare.
My idea of ~20 years ago was to slowly lower the age at which people are eligible for Medicare. Every year we lower the age by a year -- this year I can get Medicare when I'm 65, next year it's 64, etc. Change the rate if you want to go slower, wait two years before lowering the age by a year.
The advantages of a slow phase in include: Slowly increase the workload on the Medicare bureaucracy, with a good manager (there are some in gov't), automation and other productivity improvements could keep the head count from growing as fast as the increased number of people covered by Medicare. Meanwhile, the insurance companies would have plenty of time to figure out how to get into another business, or close down gracefully, no need to put all those workers out on the street all at once.
(Score: 2) by RamiK on Tuesday April 09 2019, @05:20PM (9 children)
and I'll show you a tyranny.
I'm not sure who coined the original phrase, but while I support medicare for all, it will concentrate a lot of power in the hand of some really untrustworthy individuals so some considerable checks and balances would be required for it to not get abused
compiling...
(Score: 1) by khallow on Tuesday April 09 2019, @06:11PM (8 children)
And really, if one thinks about it, the large government is the one more likely to be a tyranny because it has more people dependent on it and has a much easier time hiding misdeeds behind layers of complexity.
(Score: 0) by Anonymous Coward on Tuesday April 09 2019, @06:54PM (6 children)
Hahaha the Native Americans and minirities would like a word.
The company town denizens would like out of their makeshift debtor's prison, and a host of other issues. Not all the abuses were done by government, but it required government intrrvention to stop the abuse. Get a fucking clue already mr. Series of Contracts.
(Score: 2) by RamiK on Tuesday April 09 2019, @11:15PM (1 child)
I tend to agree. I'd also add women didn't have voting rights so not only was it a tyranny of the majority (which some argue to be a form of democracy), but it was in fact a tyranny of a minority. Add to that rail road tycoons and oil barons runnig around doing whatever they'd like and it's pretty clear that representation was completely dysfunctional even for that minor section of the population that had a voting right.
The easiest way to qualify what's a democracy is to look at what got passed by the legislators and ask "Was it for the public good?" or at least, "Was it for the ruling majority's good?". Though lets face it, very few so-called-democracies pass this test.
compiling...
(Score: 2) by NotSanguine on Wednesday April 10 2019, @11:15AM
How does the old saw go?
The true measure of any society can be found in how it treats its most vulnerable members [azquotes.com]
No, no, you're not thinking; you're just being logical. --Niels Bohr
(Score: 1) by khallow on Tuesday April 09 2019, @11:24PM (3 children)
Still true. Things didn't get better for them just because the US federal government grew bigger.
Also irrelevant.
It doesn't require an order of magnitude growth in the size of government to do that. The original government was big enough.
And what of the abuses that can only be caused by large governments such as a worldwide military invasions or a global surveillance program?
(Score: 2) by NotSanguine on Wednesday April 10 2019, @11:16AM (2 children)
The true measure of any society can be found in how it treats its most vulnerable members
No, no, you're not thinking; you're just being logical. --Niels Bohr
(Score: 1) by khallow on Wednesday April 10 2019, @01:22PM (1 child)
Unless, of course, that isn't true. France in 1938 treated its most vulnerable much better than France of 1941 did. But the latter came from the corruption and divisiveness of the former. Virtue in this one narrow area turned out useless to the future survival of France.
And since I Godwined this thread a little, I'll note that the US handles hate speech much better than Europe does. The latter creates a large class of vulnerable people who are persecuted merely for their speech and beliefs, which is much more serious IMHO than merely treating the physically and mentally handicapped somewhat less well.
(Score: 0) by Anonymous Coward on Wednesday April 10 2019, @03:32PM
You nailed it brother! We need to protect freedom of speech and freedom of religion!
Free Robert Bowers! Protect freedom of speech!
Free Dylann Roof! Protect freedom of religion!
We will create the America we deserve, and *no one* will replace us!
(Score: 0) by Anonymous Coward on Wednesday April 10 2019, @12:47AM
The way capitalist libertarians measure the size of government tends to either miss the point¹ or is totally asinine².
¹ I don't think anybody is seriously suggesting that more bureaucrats is a good thing. However, the libertarian analysis tends to be blind to corporate bureaucracy, so it is incomplete.
² Measuring the size of government by the amount of wealth it "redistributes" while totally ignoring that the wealth the worker produces has already once been redistributed away from him by capitalism itself before the government can redistribute it again into social programs.
The problem with capitalism is alienation from the worker of the value he produces. Marxism (or some synthesis of Marxism with anarchist mutualism) is a better way to implement what capitalist libertarians are always claiming minarchist capitalism will deliver.
Brush aside the wishful thinking of the Libertarian Party, Republican Party, and Democratic Party and actually analyze the emergent behavior of capitalism. If you're not certain how to begin your analysis, I'd suggest starting a game of Monopoly. Observe what happens as the game progresses from early stage at the beginning, through the middle game, to the late stage with the endgame.
The Libertarian Party blames the emergent behaviors of capitalism on a "big gubmit" bogeyman. The Republican Party blames the emergent behaviors of capitalism on a "immigrants! darkies! mooooooslims!" bogeyman. The Democratic Party blames the emergent behaviors of capitalism on a "white men oppressors!" bogeyman. None of them get it right because they cannot admit that capitalism, for all the good it's done the world, is a fundamentally flawed system when it reaches the endgame.
(Score: 4, Informative) by jmorris on Tuesday April 09 2019, @07:59PM
Instead of the usual pointless debate, lemme instead question the premise of the post?
To say "an economist said" is as useless as saying "a religious person said"; without a qualifier the word "economist" is just as null. So lets click the linky thing and find the Hopbrook Institute only has articles about the joys of socialized medicine and everything there seems to point to it be being a PR front for one unknown academic to look bigger than he is. The stated purpose of the "Hopbrook institute" is "..to provide a forum for the development of progressive policy in collaboration between activists and academic researchers." That is from their/his own "About" link. So we are posting partisan political operatives PR releases and having a pointless debate about a topic that has been beaten to death already.
Pass.
(Score: 0) by Anonymous Coward on Tuesday April 09 2019, @08:16PM
We are not a nation, we are warring tribes, like Lebanon in the 80s.
Long live the revolution. Long live the republic. Long live the empire.
(Score: 1) by lcall on Tuesday April 09 2019, @08:40PM
(Sorry this is verbose...it is what I can best do for now.)
States are laboratories of democracy that can learn from each other.
If we leave it to the states, we have a better shot at preventing federal scope creep, and finding better ways to do things, and having a choice.
I have personal experiences that say medicare for all is a HORRIBLE idea, at http://lukecall.net [lukecall.net] (that link is partway down the page; the site is meant to be lightweight and skimmable: read a page and click the links where you want details).
And my state DMV etc etc work pretty well in my experience. Don't force the worst experience on everyone! This is one part of preserving our freedoms: don't let the federal govenment take care of everything for everyone, which leads to excessive rules for everyone.
If the federal government does it, we don't have a chance to have a choice; with states deciding these things, we do.
And, IMO, forced charity (forced participation in Federal "take-care-of-everyone" schemes) is clearly unconstitutional and a very bad idea for cost-effective outcomes. I have spent years studying communism (college, family, travel, etc etc--more details under my web site somewhere, under about my beliefs)--and socialism and other "force things to work out for everyone" things just ... aren't a good idea for progress or the wealth & health of society. If individual states want to try such things, that is different, but we really should preserve freedom at the federal level, and not have it control so much of our lives. We can do a better job at locally, with the money we send to the government for these things. And in my area, I think we do (with our time, and with what available money the IRS doesn't take).
--
Things I would like to say to more people:
http://lukecall.net [lukecall.net]
(Score: 0) by Anonymous Coward on Wednesday April 10 2019, @12:21AM
The basics of better price is thus
Higher supply
Lower demand
Instead we have lower supply and higher demand.
But yes lets throw more money on that dumpster fire. Obamacare is working SO well. It has not needed any changes in 10 years!
(Score: 2) by chewbacon on Wednesday April 10 2019, @04:11AM
If you laid all of the economists in the world end to end, you still wouldn’t reach a conclusion.
(Score: 0) by Anonymous Coward on Wednesday April 10 2019, @08:44AM
Australian - Everyone pays 1% extra tax but get rebated for doctor visits (35%) and pharmy items on a schedule (pbs) and up to the point of cancer drugs or similar are generally covered if they can wait in the queue
UK - Like the Aussie system but scrappier
Swedish system - Walk in, be treated, walk out
UAE system - Top level great cover so long as you are rich
South American system - Buy a ticket to the US