2016 Economic Crisis Thread - Duck and Cover?

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Will the global economy implode in 2016?
	We're hosed - I have stocked up on canned goods
	My private security guards will shoot the paupers
	We'll be good or at least coast along
	I have no earthly clue

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LorneReams: Jun 27, 2003; I'm bizarre

The only moral free market, is my free market (i.e. a free market that protects me).

Back a libertarian into a corner with their own ideals, and you basically get to this point.

# ? Jan 4, 2017 20:02

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# ? May 8, 2024 17:25

Eggplant Squire: Aug 14, 2003

LorneReams posted:

The only moral free market, is my free market (i.e. a free market that protects me).

Back a libertarian into a corner with their own ideals, and you basically get to this point.

It's funny when STEM idiots smugly say that more people should get STEM degrees if they wanted to be paid a living wage. They should look at lawyers to see what happens to a field when people have little job prospects and see another occupation as something that guarantees a certain lifestyle.

# ? Jan 4, 2017 20:04

Covok: May 27, 2013; Yet where is that woman now? Tell me, in what heave does she reside? None of them. Because no God bothered to listen or care. If that is what you think it means to be a God, then you and all your teachings are welcome to do as that poor women did. And vanish from these realms forever.

Radish posted:

It's funny when STEM idiots smugly say that more people should get STEM degrees if they wanted to be paid a living wage. They should look at lawyers to see what happens to a field when people have little job prospects and see another occupation as something that guarantees a certain lifestyle.

"Yeah, but STEM naturally filters out the 'undesirables' and 'natural stupid' so we don't have to hire women, blacks or other weak minded. That way, we're never overflooded by 'lower quality' workforce." is how the racist STEMlords at my old university would respond.

The rare non-racist (see: not openly racist) STEMlords would go "Yeah, but STEM naturally filters out idoits so we'll never get flooded by lower quality workforce and lose our jobs. Not like companies would replace us with dumber engineers and computer programmers because they were willing to work for less: I'm too important!"

# ? Jan 4, 2017 20:08

disjoe: Feb 18, 2011

Helsing posted:

Doctors are actually a pretty good example of how "free" trade works in America. Right in the mid 1990s at the height of free trade mania and when other, especially blue collar, industries had been hit hard by economic changes, doctors and their organizations started freaking out about how the government was training too many physicians:

So, of course, the government tightened licensing restrictions to reduce the supply of doctors and thus protect the wages of the existing physicians. By the exact same logic that justifies free trade in manufactured goods, this is a huge cost to the rest of the economy. If American doctors were compensated at the same rates as European doctors the result would be -- again, using the exact same logic that justifies gains from trade in other areas -- tens of billions of dollars saved every year. Indeed the cost savings would be much greater than many of the trade deals that are relentlessly advocated for by "free trade" advocates.

It's ironic because this should have been applied to law schools and lawyers a long time ago but instead the legal profession did nothing while doctors worked to ultimately restrict access to healthcare for the sake of their paychecks.

# ? Jan 4, 2017 22:03

Covok: May 27, 2013; Yet where is that woman now? Tell me, in what heave does she reside? None of them. Because no God bothered to listen or care. If that is what you think it means to be a God, then you and all your teachings are welcome to do as that poor women did. And vanish from these realms forever.

disjoe posted:

It's ironic because this should have been applied to law schools and lawyers a long time ago but instead the legal profession did nothing while doctors worked to ultimately restrict access to healthcare for the sake of their paychecks.

Their ironic thing is that, if these instances were reversed, it wouldn't be so bad as not everyone needs healthcare and the government appoints lawyers to people who can't afford them. Huh, funny they can appoint lawyers to people who need them and not the government. Why don't we have "public doctors" like we have "public defenders?"

# ? Jan 4, 2017 22:05

SeaWolf: Mar 7, 2008

Covok posted:

Their ironic thing is that, if these instances were reversed, it wouldn't be so bad as not everyone needs healthcare and the government appoints lawyers to people who can't afford them. Huh, funny they can appoint lawyers to people who need them and not the government. Why don't we have "public doctors" like we have "public defenders?"

This is an absolutely terrible analogy. Especially since there's a glut of law school graduates and a dwindling number of public defenders available taking on an ever increasing number of cases.
The systems are broken and assigning "public doctors" to people the same as defenders to defendants is not A Thing.

# ? Jan 4, 2017 22:18

Xae: Jan 19, 2005

Helsing posted:

I'm sure that you also oppose the implementation of any kind of labour saving technology or international trade that potentially displaces workers as well. This is certainly not special pleading on behalf of your specific industry. After all, it's not as though the rest of the first world has managed to provide comparable or superior healthcare outcomes with lower spending through single payer systems.

That is a non-sequitur if I ever saw one. Automation and Labor savings has gently caress all to do with the current clusterfuck.

quote:

What I really find interesting about this post is that from the beginning I've been very obviously focused on how prohibitively costly health care is for actual people, and yet you literally cannot conceive of anyone being concerned about anything except cost inflation. Here's a headline: the lack of adequate care and the financial burden the current system is placing on people is a far bigger issue than cost.

And here is the backstory:
Healthcare wasn't always unaffordable. It became unaffordable due to medical inflation. It has been sitting there growing at 7-10% a year for decades. The inflation has to be stopped because 7-10% growth is just not sustainable under any payer system.

quote:

The United States is at the epicenter of the wealthiest and most powerful global civilization that has ever existed. It is completely capable of providing decent and affordable healthcare to its population. Switching to a public system modeled on the Canadian single-payer insurance model or even the British system would save a lot of money that is wasted on administrative overhead in the current highly inefficient system.

It isn't just "administrative overhead". Look up OECD figures for things like MRI per capita or procedures per capita. Right now the USA performs almost twice as many MRIs per person as the UK (55/107). The US performs dramatically more procedures per person than places like the UK. Simply changing the payer system does nothing to address that.

quote:

As far as reducing costs there are many options and all they require is the political will to implement them. Hey, I'm just spitballing here but perhaps it's time to let medical professionals enjoy the same stimulating blast of free trade that manufacturing workers have been enjoying since the 1980s. Crack down on unnecessary medical procedures, take a harder line in negotiations, purge the lobbyist parasites, and perhaps if the doctors kicks up a fuss bring in Chinese and Indian doctors to undercut their wages.

See these are good ideas because they address the core problem: The cost of providing care. Paying for care is ultimately secondary if it is affordable in the first place. Cracking down on the tech arms race is a huge one too. Hospitals are getting into dick measuring contests over technology and patients are demanding the latest and greatest things, particularly in imaging, even if they don't need it. You don't need a state of the art MRI scan for a routine broken bone, but you'll probably get one in the USA.

quote:

Like any disruptive economic or regulatory change some people would stand to benefit and others would stand to lose, but in this case it would clearly be a net gain. I personally would like to see a much stronger safety net and an economic policy geared around ensuring people get and keep high wage jobs, even if they have to transition from industry to industry. But insofar as some economic disruption is necessary and inevitable I think it's loving hilarious when some neoliberal shithead singing the praises of the American healthcare system suddenly starts crying over job losses.

It's one of those examples of a historically arbitrary and path-dependent outcome that sort of made sense in the past (though even then it left a lot to be desired) and which now can literally only be justified by appealing to how disruptive it would be to change it. Even this thread's resident apologist cannot quite bring themselves to argue that the system is working fine -- all they seem capable of doing is insinuating that somehow any change would make it worse.

Just nationalizing the payers is literally the dumbest thing you can do. It is the one thing worse than doing nothing. Because the only thing that happens is shifting a cost that is growing uncontrollably onto the public books. With no cost control and at the current growth rates Medical Care will be 30% of the US economy in 10 years. It is projected to start to drop in ~15 years due to "natural demographic changes". It will be something like 40-45% of the US economy at its height.

Single Payer is a lovely hill to die on in the United States. CO, a blue state, put single payer on the ballot in 2016. It lost by 80 points. There are plenty of countries that have non-single payer systems that work well. Implementing a system that mimics one of those is a winnable fight that can improve people's lives.

And as a side note, Medicare isn't the panacea everyone who doesn't have it thinks it is. Its claims get denied much more than private insurers do. It is just that when they get denied the provider fixes the problem and resubmits to medicare instead of trying to bill the patient. I spent my last couple of years in the industry dealing with the Re-submission poo poo. If I hammered home one thing it was that providers are loving poo poo at paperwork. We had a project that was billed as this miraculous RULES ENGINE (tm) that could determine if a providers claim would get rejected. It was just a bunch of stupid poo poo "Hey, if you diagnose a broken left arm make sure the treatment is coded for treating a broken left arm. Not a broken right arm or a broken left leg. ". One of the smarter things Obamacare did was mandate the ICD10 changeover, which hopefully kills off all these lovely homegrown coding systems hospitals used then tried to transcribe to ICD9.

Xae fucked around with this message at 23:53 on Jan 4, 2017

# ? Jan 4, 2017 23:50

The Insect Court: Nov 22, 2012; by FactsAreUseless

Xae posted:

Feel free to address the point that Medicare reimburses at or below cost and shifting the entire population to it would put providers out of business instead of attempting to deflect.

Gladly. The point is wrong because if Medicare reimbursed below "cost"(which is usually vaguely and arbitrarily defined by people who make this argument) is wrong, because if it were true then providers would not contract with Medicare.

Hospitals are not being forced at gunpoint to accept Medicare patients by jack-booted statist thugs, like in some Paulite fantasy. Nor are hospital administrators all idiots who decided that it's ok if they lose money with every patient because they'll make it up on volume.

# ? Jan 5, 2017 00:16

Xae: Jan 19, 2005

The Insect Court posted:

Gladly. The point is wrong because if Medicare reimbursed below "cost"(which is usually vaguely and arbitrarily defined by people who make this argument) is wrong, because if it were true then providers would not contract with Medicare.

Hospitals are not being forced at gunpoint to accept Medicare patients by jack-booted statist thugs, like in some Paulite fantasy. Nor are hospital administrators all idiots who decided that it's ok if they lose money with every patient because they'll make it up on volume.

21% of doctors are no longer accepting new Medicare patients. 3% Do not accept any Medicare patients.

http://kff.org/medicare/issue-brief/primary-care-physicians-accepting-medicare-a-snapshot/

# ? Jan 5, 2017 00:19

ToxicSlurpee: Nov 5, 2003; -=SEND HELP=-; Pillbug

Xae posted:

It isn't just "administrative overhead". Look up OECD figures for things like MRI per capita or procedures per capita. Right now the USA performs almost twice as many MRIs per person as the UK (55/107). The US performs dramatically more procedures per person than places like the UK. Simply changing the payer system does nothing to address that.

When I hosed up my knee the first time the bone doctor I went to was a super friendly guy with a pretty thick Southern accent. When he heard that my primary care doctor ordered an MRI for it he pretty bluntly said "if you were ever wondering why medicine is so drat expensive in America that's why. $5,000 for an MRI or $50 for an X-ray. 95% of the time I can tell you what's wrong with either of them. Which would you rather pay for?" I later came to find out that the doctor I was seeing at the time just did MRIs for basically everything that was wrong with you.

I quit seeing that doctor. MRIs are good and cool for diagnosing certain things but they don't need to be done every single time you go to the doctor.

# ? Jan 5, 2017 00:24

Xae: Jan 19, 2005

ToxicSlurpee posted:

When I hosed up my knee the first time the bone doctor I went to was a super friendly guy with a pretty thick Southern accent. When he heard that my primary care doctor ordered an MRI for it he pretty bluntly said "if you were ever wondering why medicine is so drat expensive in America that's why. $5,000 for an MRI or $50 for an X-ray. 95% of the time I can tell you what's wrong with either of them. Which would you rather pay for?" I later came to find out that the doctor I was seeing at the time just did MRIs for basically everything that was wrong with you.

I quit seeing that doctor. MRIs are good and cool for diagnosing certain things but they don't need to be done every single time you go to the doctor.

The other thing is that you aren't just getting an MRI, you're probably getting some crazy rear end fancy poo poo with 100x the resolution needed.

http://www.npr.org/templates/story/story.php?storyId=120545569

TL;DR in Japan they have price controls for imaging. So even though they have a ton of MRI machines they are mid range work horses that are still good enough for 99% of uses. In the US every hospital wants a research grade one for the 1 in a million patient that needs a super high tech one.

# ? Jan 5, 2017 00:33

Dr. Fishopolis: Aug 31, 2004; ROBOT

Xae posted:

Just nationalizing the payers is literally the dumbest thing you can do. It is the one thing worse than doing nothing. Because the only thing that happens is shifting a cost that is growing uncontrollably onto the public books. With no cost control and at the current growth rates Medical Care will be 30% of the US economy in 10 years. It is projected to start to drop in ~15 years due to "natural demographic changes". It will be something like 40-45% of the US economy at its height.

Nationalizing the payers inherently controls costs. Medical price inflation is largely a function of the relationship between hospitals and insurers, not the actual cost of care. Why do you think the American system has grown 10 points since 1980 as percent of GDP when every other first world nation has seen 2-3%?

You're arguing from the perspective that a medicare-for-all system would keep everything currently wrong with the system, and change only the insurance mechanism. It would not.

# ? Jan 5, 2017 00:38

asdf32: May 15, 2010; I lust for childrens' deaths. Ask me about how I don't care if my kids die.

Helsing posted:

Like any disruptive economic or regulatory change some people would stand to benefit and others would stand to lose, but in this case it would clearly be a net gain. I personally would like to see a much stronger safety net and an economic policy geared around ensuring people get and keep high wage jobs, even if they have to transition from industry to industry. But insofar as some economic disruption is necessary and inevitable I think it's loving hilarious when some neoliberal shithead singing the praises of the American healthcare system suddenly starts crying over job losses.

It's one of those examples of a historically arbitrary and path-dependent outcome that sort of made sense in the past (though even then it left a lot to be desired) and which now can literally only be justified by appealing to how disruptive it would be to change it. Even this thread's resident apologist cannot quite bring themselves to argue that the system is working fine -- all they seem capable of doing is insinuating that somehow any change would make it worse.

Well there is a huge difference between between cost cutting at the system level and a change from private employer based to private individual based policy. The second is disruptive in an administrative sense not an economic sense. Personally, given that single payer isn't on the horizon I think it would be smart reform in the right direction for a few reasons and should theoretically be feasible (though I don't see much movement in that direction).

It's just a bit noticeable when someone like yourself who otherwise supports various government subsidies for workers and employment speaks of cuts to a huge (the largest?) middle class employer. Again, I agree the system needs reform and disruption has to come along with that but messing with healthcare is potentially more than 'disruption'.

Helsing posted:

Doctors are actually a pretty good example of how "free" trade works in America. Right in the mid 1990s at the height of free trade mania and when other, especially blue collar, industries had been hit hard by economic changes, doctors and their organizations started freaking out about how the government was training too many physicians:

So, of course, the government tightened licensing restrictions to reduce the supply of doctors and thus protect the wages of the existing physicians. By the exact same logic that justifies free trade in manufactured goods, this is a huge cost to the rest of the economy. If American doctors were compensated at the same rates as European doctors the result would be -- again, using the exact same logic that justifies gains from trade in other areas -- tens of billions of dollars saved every year. Indeed the cost savings would be much greater than many of the trade deals that are relentlessly advocated for by "free trade" advocates.

Bad policy but doctor salaries, even if inflated (it's not clear what the result of this was), are nothing in the context of the cost inflation we've seen.

# ? Jan 5, 2017 00:57

Lote: Aug 5, 2001; Place your bets

Doctor salaries also aren't growing at 7-10% year over year.

# ? Jan 5, 2017 01:06

Raenir Salazar: Nov 5, 2010; College Slice

asdf32 posted:

It's just a bit noticeable when someone like yourself who otherwise supports various government subsidies for workers and employment speaks of cuts to a huge (the largest?) middle class employer. Again, I agree the system needs reform and disruption has to come along with that but messing with healthcare is potentially more than 'disruption'.

Again though, don't the majority of these people have unemployment insurance and decent credit? Can't they find other positions? Also wouldn't realistically any such plan be phased in over a decade or something anyways giving them time to change over?

# ? Jan 5, 2017 01:07

rscott: Dec 10, 2009

Xae posted:

The other thing is that you aren't just getting an MRI, you're probably getting some crazy rear end fancy poo poo with 100x the resolution needed.

http://www.npr.org/templates/story/story.php?storyId=120545569

TL;DR in Japan they have price controls for imaging. So even though they have a ton of MRI machines they are mid range work horses that are still good enough for 99% of uses. In the US every hospital wants a research grade one for the 1 in a million patient that needs a super high tech one.

This is due to market forces acting on people's inability to make rational decisions about their healthcare. Of course they want the da vinci robot and the top of the line mri machine and the most cutting edge medicine. What good is avoiding being in debt if your kid or wife is dead or crippled? I mean gently caress have you seen the commercials for Apdivo? A CHANCE TO LIVE LONGER is the opening line. How much money is another 6 months with grandma worth to you? I mean I had a doctor recommend me an epidural between my T7 and T8 for chronic upper back pain despite the risk/reward ratio in terms of paralyzing me and providing lasting relief. I got a nice bill for $1200 after insurance decided whatever they were going to cover. Doctor sold it to me by playing up the efficacy while completely neglecting to mention any of the risks involved.

# ? Jan 5, 2017 01:08

Doc Hawkins: Jun 15, 2010; Dashing? But I'm not even moving!

MiddleOne posted:

Nationalized healthcare is actually a pretty great corporate subsidy as every country to ever try it has found out. Also, unlike weapon production and 3rd world bombing which is for the most part glorified plate-spinning healthcare actually does produce some efficiency in the economy.

If people I don't know or care about die, that's efficiency. If they live, that's clutter and waste. Clearly expenditure on the former is preferred.

Or hell, George said it better:

quote:

The essential act of war is destruction, not necessarily of human lives, but of the products of human labour. War is a way of shattering to pieces, or pouring into the stratosphere, or sinking in the depths of the sea, materials which might otherwise be used to make the masses too comfortable, and hence, in the long run, too intelligent.

# ? Jan 5, 2017 01:12

Futuresight: Oct 11, 2012; IT'S ALL TURNED TO SHIT!

Xae posted:

It isn't just "administrative overhead". Look up OECD figures for things like MRI per capita or procedures per capita. Right now the USA performs almost twice as many MRIs per person as the UK (55/107). The US performs dramatically more procedures per person than places like the UK. Simply changing the payer system does nothing to address that.

I wonder if the private, profit-seeking nature of the American health system has anything to do with this?

# ? Jan 5, 2017 01:22

asdf32: May 15, 2010; I lust for childrens' deaths. Ask me about how I don't care if my kids die.

Xae posted:

That is a non-sequitur if I ever saw one. Automation and Labor savings has gently caress all to do with the current clusterfuck.

And here is the backstory:
Healthcare wasn't always unaffordable. It became unaffordable due to medical inflation. It has been sitting there growing at 7-10% a year for decades. The inflation has to be stopped because 7-10% growth is just not sustainable under any payer system.

It isn't just "administrative overhead". Look up OECD figures for things like MRI per capita or procedures per capita. Right now the USA performs almost twice as many MRIs per person as the UK (55/107). The US performs dramatically more procedures per person than places like the UK. Simply changing the payer system does nothing to address that.

See these are good ideas because they address the core problem: The cost of providing care. Paying for care is ultimately secondary if it is affordable in the first place. Cracking down on the tech arms race is a huge one too. Hospitals are getting into dick measuring contests over technology and patients are demanding the latest and greatest things, particularly in imaging, even if they don't need it. You don't need a state of the art MRI scan for a routine broken bone, but you'll probably get one in the USA.

Just nationalizing the payers is literally the dumbest thing you can do. It is the one thing worse than doing nothing. Because the only thing that happens is shifting a cost that is growing uncontrollably onto the public books. With no cost control and at the current growth rates Medical Care will be 30% of the US economy in 10 years. It is projected to start to drop in ~15 years due to "natural demographic changes". It will be something like 40-45% of the US economy at its height.

Single Payer is a lovely hill to die on in the United States. CO, a blue state, put single payer on the ballot in 2016. It lost by 80 points. There are plenty of countries that have non-single payer systems that work well. Implementing a system that mimics one of those is a winnable fight that can improve people's lives.

And as a side note, Medicare isn't the panacea everyone who doesn't have it thinks it is. Its claims get denied much more than private insurers do. It is just that when they get denied the provider fixes the problem and resubmits to medicare instead of trying to bill the patient. I spent my last couple of years in the industry dealing with the Re-submission poo poo. If I hammered home one thing it was that providers are loving poo poo at paperwork. We had a project that was billed as this miraculous RULES ENGINE (tm) that could determine if a providers claim would get rejected. It was just a bunch of stupid poo poo "Hey, if you diagnose a broken left arm make sure the treatment is coded for treating a broken left arm. Not a broken right arm or a broken left leg. ". One of the smarter things Obamacare did was mandate the ICD10 changeover, which hopefully kills off all these lovely homegrown coding systems hospitals used then tried to transcribe to ICD9.

Wait so basically every other first world country has single payer and drastically lower cost inflation and these things arn't linked?

# ? Jan 5, 2017 01:39

Proud Christian Mom: Dec 20, 2006; READING COMPREHENSION IS HARD

Itss almost like US healthcare is more about enriching doctors, hospital groups, insurers and all their various executives and shareholders, rather than actually providing healthcare, let alone affordable(or good) healthcare.

# ? Jan 5, 2017 01:59

Dr. Fishopolis: Aug 31, 2004; ROBOT

Xae posted:

There are plenty of countries that have non-single payer systems that work well. Implementing a system that mimics one of those is a winnable fight that can improve people's lives.

If you're talking about an insurance mandate with a public option, sure. You're still talking about a vast, vast expansion of medicare that the entire existing industry would fight tooth and nail against. It would still shrink private health care profits by more than half. I'm not sure it would be any easier than buying out the entire system at once.

If you're talking about a private-only mandate, well that's not working out that great for us now, is it?

# ? Jan 5, 2017 02:59

Raldikuk: Apr 7, 2006; I'm bad with money and I want that meatball!

Xae posted:

That is a non-sequitur if I ever saw one. Automation and Labor savings has gently caress all to do with the current clusterfuck.

And here is the backstory:
Healthcare wasn't always unaffordable. It became unaffordable due to medical inflation. It has been sitting there growing at 7-10% a year for decades. The inflation has to be stopped because 7-10% growth is just not sustainable under any payer system.

It isn't just "administrative overhead". Look up OECD figures for things like MRI per capita or procedures per capita. Right now the USA performs almost twice as many MRIs per person as the UK (55/107). The US performs dramatically more procedures per person than places like the UK. Simply changing the payer system does nothing to address that.

See these are good ideas because they address the core problem: The cost of providing care. Paying for care is ultimately secondary if it is affordable in the first place. Cracking down on the tech arms race is a huge one too. Hospitals are getting into dick measuring contests over technology and patients are demanding the latest and greatest things, particularly in imaging, even if they don't need it. You don't need a state of the art MRI scan for a routine broken bone, but you'll probably get one in the USA.

Just nationalizing the payers is literally the dumbest thing you can do. It is the one thing worse than doing nothing. Because the only thing that happens is shifting a cost that is growing uncontrollably onto the public books. With no cost control and at the current growth rates Medical Care will be 30% of the US economy in 10 years. It is projected to start to drop in ~15 years due to "natural demographic changes". It will be something like 40-45% of the US economy at its height.

Single Payer is a lovely hill to die on in the United States. CO, a blue state, put single payer on the ballot in 2016. It lost by 80 points. There are plenty of countries that have non-single payer systems that work well. Implementing a system that mimics one of those is a winnable fight that can improve people's lives.

And as a side note, Medicare isn't the panacea everyone who doesn't have it thinks it is. Its claims get denied much more than private insurers do. It is just that when they get denied the provider fixes the problem and resubmits to medicare instead of trying to bill the patient. I spent my last couple of years in the industry dealing with the Re-submission poo poo. If I hammered home one thing it was that providers are loving poo poo at paperwork. We had a project that was billed as this miraculous RULES ENGINE (tm) that could determine if a providers claim would get rejected. It was just a bunch of stupid poo poo "Hey, if you diagnose a broken left arm make sure the treatment is coded for treating a broken left arm. Not a broken right arm or a broken left leg. ". One of the smarter things Obamacare did was mandate the ICD10 changeover, which hopefully kills off all these lovely homegrown coding systems hospitals used then tried to transcribe to ICD9.

Seems most nations with a single payer system solve this by only paying for necessary things and then not allowing providers to bill patients directly for anything not covered. Seems like that would drastically curtail such practices if doctors/hospitals know they won't get paid for it or even be able to declare it as a loss unless they wish to justify the gouging. It seems this would work across the board too. We could also force the bundled payments you were talking about. The practice of having different doctors visit a patient and bill them individually for it, sometimes with that doctor being out of network is shameful gouging and needs to stop. And they could stop if there was only a single payer and they decided to say "cut the bullshit and charge this fairly" while also making it so the hospitals can't bill patients and try to make them responsible for it.

Not only that but with a single payer reform we can go and start mandating cost cuts and such from the providers, and again with only a single payer they'll have to toe the line. It seems by doing that we could cut out a lot of the waste and graft.

# ? Jan 5, 2017 03:45

Rated PG-34: Jul 1, 2004

Don't doctors drown in debt and then make peanuts for the longest time as residents, whereas administrators make massive bank without doing much of anything.

# ? Jan 5, 2017 04:21

silence_kit: Jul 14, 2011; by the sex ghost

Doctors make a lot of money and in the current system are basically guaranteed well-paying jobs for life by virtue of being accepted to medical school. Practically no one fails out of medical school--it isn't that hard. I can't think of any profession where you are guaranteed that much money by virtue of being accepted into school.

# ? Jan 5, 2017 04:30

Futuresight: Oct 11, 2012; IT'S ALL TURNED TO SHIT!

You do start off very poor though with massive debt and mediocre income. Which is pretty bad because it's a big part of why doctors are able to justify their massive salaries later. Or the massive later salaries are justification for the otherwise crippling debt. Either way it's a messed up way to have the profession work.

# ? Jan 5, 2017 04:57

ToxicSlurpee: Nov 5, 2003; -=SEND HELP=-; Pillbug

Higsian posted:

You do start off very poor though with massive debt and mediocre income. Which is pretty bad because it's a big part of why doctors are able to justify their massive salaries later. Or the massive later salaries are justification for the otherwise crippling debt. Either way it's a messed up way to have the profession work.

The thing nobody talks about is the pile of people who go >$100,000 of debt and then fail to become a doctor. There are also people who would make fine doctors that don't even try because the debt is just too terrifying. Entering medical school is a huge rich if you aren't at least upper middle class by birth.

# ? Jan 5, 2017 05:02

Raldikuk: Apr 7, 2006; I'm bad with money and I want that meatball!

Higsian posted:

You do start off very poor though with massive debt and mediocre income. Which is pretty bad because it's a big part of why doctors are able to justify their massive salaries later. Or the massive later salaries are justification for the otherwise crippling debt. Either way it's a messed up way to have the profession work.

Once a doctor reaches residency they're already going to be making a decent amount (50kish) and loans can be potentially deferred or put in forbearance while in residency. Doing such can be expensive, it does allow one to manage the debt they have to pay down while they finish up their residency and become a big boy doctor. And many states do have loan forgiveness programs if you work in an underserved community. The debt burden is a lot but I am not sure it is fair to characterize it as mediocre income.

I am all for making college free for everyone who is able to show they are successful in their studies, and that would include for med school. I'm not sure med school would be the first place to start with it since if you are accepted you are basically guaranteed to graduate and if you graduate you're guaranteed a pretty decent career.

# ? Jan 5, 2017 05:06

Ardennes: May 12, 2002

Yeah, then there is the issue of drug prices which will probably completely meltdown the thread.

That said, I think the ultimate issue is simply a combination of a lot of inefficiencies and profit-making coupled together. Doctors, medical groups, hospitals, insurance companies, and drug companies (among others) all take their cut and most work to make sure the revenue they are making is significantly above inflation. Profit taking is completely logical from their perspective but in reality it effectively acts like a involuntary tax for most of the population. Admittedly you made the system more efficient, doctors would have to be paid less, many hospitals maybe would have to be nationalized, federal drug research funding would have to be increased but you would effectively shifting much of the cost burden from the general population.

It is also why it may make sense for many younger Americans to think of a "plan B" in a country with a UHS if they actual go through with fully privatizing Medicare.

# ? Jan 5, 2017 09:40

Orange Devil: Oct 1, 2010; Wullie's reign cannae smother the flames o' equality!

Helsing posted:

Doctors are actually a pretty good example of how "free" trade works in America. Right in the mid 1990s at the height of free trade mania and when other, especially blue collar, industries had been hit hard by economic changes, doctors and their organizations started freaking out about how the government was training too many physicians:

So, of course, the government tightened licensing restrictions to reduce the supply of doctors and thus protect the wages of the existing physicians. By the exact same logic that justifies free trade in manufactured goods, this is a huge cost to the rest of the economy. If American doctors were compensated at the same rates as European doctors the result would be -- again, using the exact same logic that justifies gains from trade in other areas -- tens of billions of dollars saved every year. Indeed the cost savings would be much greater than many of the trade deals that are relentlessly advocated for by "free trade" advocates.

Keep in mind that this isn't unique to the US.

In the Netherlands a couple years back one of the top political issues was waiting lists for medical procedures, especially operations. Currently one of the top issues of the election campaign (elections in March) is rising healthcare costs. This stuff has been a top political issues for decades is what my point is.

Meanwhile, since forever (literally at least 3 or 4 decades by now) the amount of qualified students wishing to enter a medicine programme in Dutch universities exceeds the amount of students those universities will accept each year. What our universities do is make a first selection based on average grades of the applicants, and then for the remaining slots they have a lottery. If you don't make it through the lottery three times, you will never in your life be allowed to study medicine at a Dutch university.

This is happening while a lack of doctors is leading to waiting lists and where obviously the lack of competition leads to high wages for medical professionals which contribute to the high healthcare costs. As far as I am aware no political party has ever even suggested mandating the universities (all of which receive a bunch of funds from the state) to increase the amount of students they will train to be doctors to deal with these issues. It's farcical as gently caress.

# ? Jan 5, 2017 12:46

Dr. Fishopolis: Aug 31, 2004; ROBOT

Ardennes posted:

you would effectively shifting much of the cost burden from the general population.

Not really, you're just making it a progressive tax vs a regressive one. The general population pays for health care no matter what system you use, it's just a question of who pays the most. In a private system, it's the poor.

# ? Jan 6, 2017 00:52

ToxicSlurpee: Nov 5, 2003; -=SEND HELP=-; Pillbug

Dr. Fishopolis posted:

Not really, you're just making it a progressive tax vs a regressive one. The general population pays for health care no matter what system you use, it's just a question of who pays the most. In a private system, it's the poor.

Which is the right option because personal responsibility, Jesus, 'murica.

# ? Jan 6, 2017 03:06

Ynglaur: Oct 9, 2013; The Malta Conference, anyone?

rscott posted:

Money is a social construct

Yes. Aaaand.....

# ? Jan 6, 2017 04:02

Goa Tse-tung: Feb 11, 2008; ;3; Yams Fan

Ynglaur posted:

Yes. Aaaand.....

your premise is wrong, taxes don't slow economic growth

# ? Jan 6, 2017 11:38

VitalSigns: Sep 3, 2011

Ynglaur posted:

And that deficit is paid with: taxes. Which will slow economic growth (all other things being equal.) Money does not come from thin air. Or rather, fiat value doesn't.

Surely this depends on what that tax money is spent on.

If you want to convince me that streets, bridges, highways, airports, coast guard, schools, courts, health inspections, disease control, uniform weights and measures, standard timekeeping, pharmacological research, or water purification slow economic growth purely because they're paid by taxation, you're going to have to show more work than this.

Even if you're making a more narrow argument, I'd like to see something to support that a healthy and productive population is bad for the economy.

VitalSigns fucked around with this message at 14:40 on Jan 6, 2017

# ? Jan 6, 2017 14:16

anonumos: Jul 14, 2005; Fuck it.

VitalSigns posted:

Surely this depends on what that tax money is spent on.

If you want to convince me that streets, bridges, highways, airports, coast guard, schools, courts, health inspections, disease control, uniform weights and measures, standard timekeeping, pharmacological research, or water purification slow economic growth purely because they're paid by taxation, you're going to have to show more work than this.

Even if you're making a more narrow argument, I'd like to see something to support that a healthy and productive population is bad for the economy.

He's reducing taxation to just the first step: taking money out of the economy. And it would shrink the economy of its journey ended there.

# ? Jan 6, 2017 15:00

MiddleOne: Feb 17, 2011

anonumos posted:

He's reducing taxation to just the first step: taking money out of the economy. And it would shrink the economy of its journey ended there.

Nation states, famous for hoarding cash.

# ? Jan 6, 2017 15:11

VitalSigns: Sep 3, 2011

It's funny because apparently taking double the money that public health care would cost 'out of the economy' to pay for private health care and the insurance industry is just fine.

But private profits get gainfully reinvested in yachts, cocaine, and lobbying, whereas if I pay a government doctor he just burns it in a dumpster out behind his office.

# ? Jan 6, 2017 15:32

MiddleOne: Feb 17, 2011

VitalSigns posted:

It's funny because apparently taking double the money that public health care would cost 'out of the economy' to pay for private health care and the insurance industry is just fine.

But private profits get gainfully reinvested in yachts, cocaine, and lobbying, whereas if I pay a government doctor he just burns it in a dumpster out behind his office.

Hey now, you better watch your tongue before the god of supply-side economics strikes you down.

# ? Jan 6, 2017 15:36

anonumos: Jul 14, 2005; Fuck it.

It's time for the Second Coming of Supply Side Jesus.

# ? Jan 6, 2017 16:03

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# ? May 8, 2024 17:25

cheese: Jan 7, 2004; Shop around for doctors! Always fucking shop for doctors. Doctors are stupid assholes. And they get by because people are cowed by their mystical bullshit quality of being able to maintain a 3.0 GPA at some Guatemalan medical college for 3 semesters. Find one that makes sense.

VitalSigns posted:

It's funny because apparently taking double the money that public health care would cost 'out of the economy' to pay for private health care and the insurance industry is just fine.

But private profits get gainfully reinvested in yachts, cocaine, and lobbying, whereas if I pay a government doctor he just burns it in a dumpster out behind his office.

The ultimate make-work program, except that nothing other than the work gets made, and that a nice fat chunk of that make-work money goes to the very wealthy. Its the dream system.

# ? Jan 7, 2017 20:38

The Something Awful Forums > Discussion > Debate & Discussion > 2016 Economic Crisis Thread - Duck and Cover?

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