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Message
re: Healthcare cannot be fixed
Posted on 7/6/25 at 4:16 pm to TigerDoc
Posted on 7/6/25 at 4:16 pm to TigerDoc
quote:
We pay more to get no better or worse outcomes than dozens of countries around the world
This is complete for shite and not supportable Beyond very very cursory understanding
quote:
the population is less satisfied with our system
Well that's because our population is stupidly thinks that those other countries that have National Health Care have basically our system only free.
Here's the Dirty Little Secret. Americans don't want Canada's Healthcare System. They want our Healthcare System at Canada prices. Our country doesn't want Germans Healthcare System. We want our Healthcare System at German prices. It's complete fantastic bullshite
1
Posted on 7/6/25 at 4:23 pm to Grumpy Nemesis
I agree people have unrealistic expectations and that's what makes reform difficult - AND YET a number of other countries:
1. Pay far less than we do (almost all OECD countries do).
2. Get as good or better quality.
3. Are as satisfied.
Yes, there is a massive status quo bias when it comes to changing any major policy that affects a major aspect of life (public safety, health, pensions, education, etc.), so people are inclined to reject alternatives unless the situation completely melts down. Otherwise, path-dependent minor tweaks are all you can do.
But there are interesting counterfactuals where a country builds a healthcare system from scratch (like nations following absolute conflagration of WWII, major changes of govt type, ideology) where big changes get made and of course those can turn out well or poorly, but unless we get a failure of our constitutional system (not an insigificant chance) then we're stuck with incrementalism, in which chance we mostly keep the same system and most of the bad aspects with it, of course.
1. Pay far less than we do (almost all OECD countries do).
2. Get as good or better quality.
3. Are as satisfied.
Yes, there is a massive status quo bias when it comes to changing any major policy that affects a major aspect of life (public safety, health, pensions, education, etc.), so people are inclined to reject alternatives unless the situation completely melts down. Otherwise, path-dependent minor tweaks are all you can do.
But there are interesting counterfactuals where a country builds a healthcare system from scratch (like nations following absolute conflagration of WWII, major changes of govt type, ideology) where big changes get made and of course those can turn out well or poorly, but unless we get a failure of our constitutional system (not an insigificant chance) then we're stuck with incrementalism, in which chance we mostly keep the same system and most of the bad aspects with it, of course.
Posted on 7/6/25 at 4:31 pm to The Torch
quote:
Obama’s entire legacy is screwing up the health care system for working people and dividing the country along racial lines.
Posted on 7/6/25 at 4:39 pm to TigerDoc
quote:
Are as satisfied.
They are “as satisfied” because they don’t know any different.
Posted on 7/6/25 at 4:44 pm to the808bass
And because they get good as good care and get a better value. We will continue to piss money away.
This post was edited on 7/6/25 at 4:47 pm
Posted on 7/6/25 at 5:02 pm to Grumpy Nemesis
If SS and Medicare money collected going forward were invested in the stock market, anyone paying 15% of their income for 35 or 40 years wouldn't have anything to worry about.
Only those who worked off the books would be left out in the cold.
Only those who worked off the books would be left out in the cold.
Posted on 7/6/25 at 5:08 pm to Grumpy Nemesis
quote:
When are you that rather than Supply some emotional response. I mean you're wrong which is probably why you didn't make an actual argument so there's that. There is literally no such thing as a finite product of any sort ever in the history of humankind that everybody can have access to whenever they want it or need it. It's not only unsolvable it's completely fricking impossible
If you make up a ridiculous position then it is easy to argue it is impossible. Nobody is talking about getting access to whatever they want but I am not ready to dismiss out of hand that basic health is infeasible. Germany has basically been doing that since it came into being with Otto von Bismarck. FYI, Germany has tended to be a very fiscally responsible government too.
This post was edited on 7/6/25 at 5:09 pm
Posted on 7/6/25 at 5:14 pm to TigerDoc
quote:
2. Get as good or better quality
This ain't my wheelhouse, but which country(s) does this? I was always under the impression that our system was second to none, just horribly inefficient. I just don't hear of too many Americans engaging in medical tourism outside of plastic surgery.
Posted on 7/6/25 at 5:20 pm to onmymedicalgrind
quote:
I used to be part of a committee that advocated on our behalf. Met with congressmen and all that…but nothing would change so I just said screw it I’d rather spend my free time with the family.
Same. I'm still involved politically but no one gives a shite about physicians reimbursements. We don't really have a lobby and there isn't that many of us, so our vote is meaningless. I'm 51 and will quit taking insurance altogether soon. Especially after the Change Healthcare fiasco cut our insurance collections to zero for 2 months with zero notice and prior to that, taking it up the arse during COVID all while getting 5 straight years of cuts after 15 with no net increases.
Doctors are leaving the field to be device reps or leaving medicine altogether as other fields become more lucrative. I know 2 neurosurgeons that have been laid off. Most of my income comes from industrial medicine but 100% of my headaches and 85% of my overhead comes from seeing insured patients and dealing with them and their insurers.
Posted on 7/6/25 at 5:21 pm to TigerDoc
quote:
. Pay far less than we do (almost all OECD countries do).
True
quote:Compelling undupportable nonsense
. Get as good or better quality
quote:
Are as satisfied
Irrelevant measure since they have nothing to actually compare it to. It's like me saying I'm satisfied with my taste buds compared to yours even though I have no way of knowing how yours perceived food
If you told Americans tomorrow that they had to sustain the average wait time for an MRI that Canadians do they would burn Washington DC to the fricking ground
Most people when they are comparing their system to some other country system they assume that both countries are providing the same product. They have no way of knowing otherwise even though it's not even close
Posted on 7/6/25 at 5:27 pm to Flats
US citizens so engage in a lot of medical tourism for cost reasons, but yes, we perform well in advanced and innovative care, research (or at least we did - we're throwing this away), specialty & acute care, medical education, but things like preventable mortality, infant mortality, maternal mortality, continuity of care (leading to rehospitalizations, duplicate care, neglected issues leading to worsening, etc.) we're bad at. Canada, richer European countries, Japan, do at least as well, overall, etc.
Posted on 7/6/25 at 5:29 pm to TigerDoc
quote:
but things like preventable mortality, infant mortality, maternal mortality, continuity of care (leading to rehospitalizations, duplicate care, neglected issues leading to worsening, etc.) we're bad at.
The system isn’t bad at it. People are bad at it.
Posted on 7/6/25 at 5:29 pm to Grumpy Nemesis
The UK and the other Commonwealth nations have highly regulated largely state operated healthcare systems. They aren’t really a model worth emulating in the United States. There are other workable blended models like Germany. Germany is home to some of the most successful companies in pharmaceuticals, so it isn’t like they’re stunting their free market in medicine.
Posted on 7/6/25 at 5:30 pm to Grumpy Nemesis
The only thing we can do is make ourselves healthier to prevent from going to the doctors as much as possible. Anything else is just bullsh!t
Posted on 7/6/25 at 5:36 pm to Grumpy Nemesis
quote:
It's like me saying I'm satisfied with my taste buds compared to yours even though I have no way of knowing how yours perceived food
satisfaction is relevant because dissatisfaction is a major source of political pressure on governments, at least in places where their governments are responsive to electorates (if you want to find really bad health systems, go to kleptocratic autocracies...). Ours is headed in the direction of nothing happening if its not good for oligarchs and garchs get good health care no matter what and they don't want our system to get bad at the top to be able to attract or keep good talent, but I agree with you that our system doesn't have an incentive to improve our overall system at the moment.
Posted on 7/6/25 at 5:36 pm to TigerDoc
quote:
things like preventable mortality, infant mortality, maternal mortality, continuity of care (leading to rehospitalizations, duplicate care, neglected issues leading to worsening, etc.) we're bad at. Canada, richer European countries, Japan, do at least as well, overall, etc.
Less than half of patients keep their hospital follow up, even when cost is not an issue. We probably have the least compliant clientele in the world. People do not value healthcare or maintenance. They value comfort and convenience. They'll gladly pay out the arse for what they want ($200 IV's, botox, fillers, testosterone etc) yet balk at a $25 copay. Give us homogenous white, educated society and I will give you some fantastic arse numbers in healthcare. The vast majority of people that got their free Obamacare are no healthier than they were before. Nor are they more productive. They are on more meds. They do suck up more resources and time. But they refuse to get healthy.
Posted on 7/6/25 at 5:38 pm to TigerDoc
quote:
satisfaction is relevant because dissatisfaction is a major source of political pressure on governments,
It's politically relevant but it isn't factually relevant. The fact that uninformed ignorant people can influence uninformed ignorant policies doesn't negate them being uninformed ignorant policies
Posted on 7/6/25 at 5:38 pm to 4cubbies
quote:
People refusing to accept that only people with money deserve medical help.
Simply amazing.
Posted on 7/6/25 at 5:40 pm to the808bass
quote:
The system isn’t bad at it. People are bad at it.
People aren't just "good at" technical/advanced care. We train them well, attract talent, have lots of capital for investment, historically relatively good regulation. The system incentivizes people and they get good at things and it fails to incentivize people to be better at other things.
Posted on 7/6/25 at 5:41 pm to imjustafatkid
quote:
People refusing to accept that only people with money deserve medical help.
Simply amazing.
I keep waiting for all these "free healthcare" people to go to med school or nursing school...anything. Volunteer to do PA's and pre-certs at an office or be a receptionist. Anything will help. Be the change you want.
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