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Fat Ogre posted:There are a number of local places opening up medical care centers that specifically don't take health instance ( if you have it you have to do the filing yourself). They post the prices beforehand and are doing quite well people skip going to the emergency room when they can spend $50 and get a checkup and know that their antibiotics aren't going to go over $20 at most. The problem is that this isn't incredibly helpful for the expensive (but still routine) treatments which are the bread and butter of hospitals. Surgery for a broken back. Hip replacements. ACL repairs. Pretty much everything that involves an ongoing relationship with a specialist or extensive followup care. There are way too many procedures that are really important but also so expensive that someone making retail wages wouldn't be able to pay for them across a decade. There are already plenty of free-market solutions for low-cost stuff like urgent care. The things that aren't priced openly tend to be be in the above category.
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May 10, 2014 20:47
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VitalSigns posted:But if competition worked on hospitals then market demand should be compelling them to post prices already! You are contradicting yourself. What incentive does that hospital have to lower prices? You need to get this care somewhere, and there's no hospital glut. When the cheaper hospital has its MRI booked for the next month or is not open at 2am when you need it, you're not going to turn it down. The hospital does not need your business as much as you need it, full stop. Assuming you can even afford the somewhat cheaper hospital, which likewise has no particular need or incentive to individually bargain with you. That's why only large organizations like insurance companies or the government with a huge pool of customers can bargain with hospitals on even terms. They don't have to compete at all. So how on earth does competition work on them? I'm saying for hospitals to compete. Force insurance companies to compete against out of state companies. Unless you think that is a bad thing when it comes to home owners insurance, car insurance etc?  As to your idea of the cheaper one being booked for 2 months that means the other places aren't being used. Have fun explaining to the board of directors why you let the other place steal your MRI business.
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May 10, 2014 20:53
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We could look at studies on how price availability impacts healthcare decision-making; I assume Fat Ogre will have some useful sources since he's really insistent on this as something that should be done. I did a little searching and by no means is this the final statement on the topic, but here's a small-scale paper from Taiwan which uses a national insurance system combined with co-pays:quote:Decision making when accessing medical facilities There's some interesting stuff there about how little they knew about the actual difference in cost and how quality and doctors play a big role in decision-making. I'd also like to reiterate how this is a small scale paper about Taiwan and the cost differences are pretty narrow, and not the thousands to tens of thousands that could possibly result in the U.S. instead. Maybe we can move beyond anecdotes about how "prices are good / don't matter in emergencies / well but what about when my back is sore" and onto actual studies? Anybody have something more relatable to U.S. healthcare?
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May 10, 2014 20:56
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Fat Ogre posted:They don't have to compete at all. So how on earth does competition work on them? Do you think hospital directors get quizzed by a board of directors on why they let another hospital steal their MRI business, or have we completely converted the medical system into the wonders that are quarterly-profits driven business operation in this example?
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May 10, 2014 20:56
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I remember reading years ago that in India, hospitals actually did compete on price, and those with lower prices made profits via volume. That isn't a model that will work in the USA because insurance has been around for too long. When I had my kidney stone operations, I would have rather had the most expensive possible procedure, because that was the only metric I had to judge quality with. Assuming no coinsurance, the cost of the procedure is irrelevant once you hit your deductible, so more expensive procedure = better, and I'm not going to pay any of it anyways.
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May 10, 2014 20:57
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Pope Guilty posted:Behind every use of the phrase "personal responsibility" is the terror of a world in which bad things happen regardless of whether you're a "good person" or not. It is a talisman, an incantation, which can be repeated as a ward against having to acknowledge the reality of that world. Yeah, I think you've hit it on the head. Like everyone else who aren't the ultra-rich, he's a couple of bad breaks away from losing his comfortable middle-class lifestyle to something like a one-two combo of another economic crisis and an ill-timed family medical emergency, which is a pretty scary thing to contemplate when you have kids...but if you can think "I got where I am because I made Good Decisions, and as long as I keep making Good Decisions then nothing bad will happen" then you don't have to consider the possibility. It's sympathetic in and of itself, except that part of the justification requires seeing people in bad situations as having made bad decisions and thus unworthy of help. It's just sad that this fear leads them to gently caress over others, and ultimately works against their own interests as well. Nessus posted:The reason why people are not warmly embracing solutions such as that or "let me give you some pro career advice (become a coder)" etc. is, I think, a lot more because these are general discussion threads. If this was a medical discussion on the virology of the common cold, someone popping in to say "Just have some chicken soup! OK, some veggie broth if you're a vegetarian. What's wrong with that? Everyone can get chicken soup, what harm does it do? It's quick and easy so what's wrong with bringing it up?" etc. etc. would get told "gently caress off." What? How can you be against chicken soup? Good nutrition helps your immune system and it sure wouldn't hurt! Stop telling people not to eat chicken soup, that's insane. You just hate chicken soup because gently caress people with colds, right? 
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May 10, 2014 20:58
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Nessus posted:Do you have an answer for what would keep every insurance company from immediately moving its headquarters to Delaware or whatever other state has the laxest possible requirements? If they all do it, we don't get much of a choice, now do we? The federal government gets to handle interstate commerce requirements. Also is incorporating in Delaware or whatever a serious issue when it comes to car, renter's or home owners insurance currently?
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May 10, 2014 21:03
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Oh yeah, all that federal government regulation we're likely to get in the next few years. That seems pretty likely. Maybe in 2020 or something. VitalSigns posted:What? How can you be against chicken soup? Good nutrition helps your immune system and it sure wouldn't hurt! Stop telling people not to eat chicken soup, that's insane. You just hate chicken soup because gently caress people with colds, right? Why I remember on this very forum back in the before-times, someone said something to the effect of "Well because I don't live in COMMUNIST CANADA I'm going to go to the urgent care clinic tomorrow and get a Z-pack for this cold, because I can't afford to miss A SINGLE WORK DAY." To which I was like "So you're going to get antibiotics to treat your cold?" Someone half-heartedly chimed in, "well maybe he has an underlying infection--" and it was just like, come on, man.
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May 10, 2014 21:04
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Yeah, Fat Ogre, it comes back to this: In a discussion about fixes to a systematic problem, it's lovely to jump in suggesting individual solutions. Or things like public hospital prices to enable individual solutions. Your ideas may be genuinely helpful to an individual case, but it's still gonna be callous to push those ideas in a context trying to discuss a more comprehensive solution. You've done this with health care and with education and with employment, and it's like... look at your NFL analogy. "Not everyone can get into the NFL, but it's still a thing where hard work and skill matter", or something like that. But if someone's life and livelihood depend on getting into the NFL, that would be a major problem! We would want to make their life and livelihood not depend on something so unlikely and elite. Giving them advice on how best to become a pro football player would be missing the point. Ditocoaf fucked around with this message at 21:14 on May 10, 2014 |
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May 10, 2014 21:09
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Fat Ogre posted:They don't have to compete at all. So how on earth does competition work on them? The very fact that hospitals don't have to compete on things like whether they post prices or not should tell you why they won't be required to compete on price even if you do make them publish their prices. You are actually pointing to blatant, undeniable evidence that your elementary-school economics are wrong, can't you think about the implications of that for two seconds? Fat Ogre posted:As to your idea of the cheaper one being booked for 2 months that means the other places aren't being used. Have fun explaining to the board of directors why you let the other place steal your MRI business. I won't have to do that because there is not a glut of health care, and health care is not always delayable. The people who can wait two months can go to the cheaper hospital. The people who need it this week or right now can take my price or suffer. And of course, you ignore that many, many procedures are unaffordable regardless. Let's take my friend Chad who now owes the cost of a cheap house in medical bills. Hooray, as he writhed in pain on the floor, his boyfriend applied his savvy bargain-hunting skills and was able to find a hospital in the next town that would treat him for $40k all-inclusive. Luckily, Chad didn't get septic and die during a few hours of shopping and another couple-hour drive, and he now owes a $40k bill he can never repay rather than an $80k bill he can never repay. Progress! Or maybe as a savvy consumer he realized his credit score was too important to blow on some silly infection, told the hospital to come back when they had a better offer, and died at home while waiting for them to crumble. VitalSigns fucked around with this message at 21:14 on May 10, 2014 |
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May 10, 2014 21:10
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VitalSigns posted:And of course, you ignore that many, many procedures are unaffordable regardless. Let's take my friend Chad who now owes the cost of a cheap house in medical bills. Hooray, as he writhed in pain on the floor, his boyfriend applied his savvy bargain-hunting skills and was able to find a hospital in the next town that would treat him for $40k all-inclusive. Luckily, Chad didn't get septic and die during a few hours of shopping and another couple-hour drive, and he now owes a $40k bill he can never repay rather than an $80k bill he can never repay. Progress!
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May 10, 2014 21:16
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Pope Guilty posted:Behind every use of the phrase "personal responsibility" is the terror of a world in which bad things happen regardless of whether you're a "good person" or not. It is a talisman, an incantation, which can be repeated as a ward against having to acknowledge the reality of that world. This is clearly Fat Ogre's problem and a good reason why the skiing tangent and Fat Ogre's attitude in that discussion can be extrapolated to show why he's completely full of poo poo in this discussion also. Why would anyone go SKIING? That's a failure of personal responsibility!  What's that? Driving is something I do all the time yet is considerably more dangerous than skiing? LALALALALA *puts fingers in ears and continues to use the same fallacious reasoning when discussing healthcare in general.
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May 10, 2014 21:30
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Shakugan posted:Driving is something I do all the time yet is considerably more dangerous than skiing? LALALALALA *puts fingers in ears and continues to use the same fallacious reasoning when discussing healthcare in general.  Excuse me, he has a job and health insurance, so he's proven he has the Personal Responsibility required to take the family on a road trip to visit grandma for Thanksgiving.I can't imagine why people without insurance are so irresponsible that they drive to places they don't strictly have to be. Driving to work or the store, that makes sense, but if you're going to take needless risks like visiting the family, don't bitch and moan when you get in an accident that exhausts the personal injury coverage in your auto insurance policy. You were asking for it with all that superfluous pleasure driving.
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May 10, 2014 21:44
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VitalSigns posted:
Bonus points for simultaneously believing that choosing to ski is an act demonstrating poor responsibility due to (imagined and incorrect) high risk, and that the poors should bootstrap themselves into employment by creating businesses. One of these acts is incredibly difficult to do without enormous wealth or taking out a massive loan that could cripple someone for the rest of their lives, and is very likely to result in the loss or at best breaking even of all that money. Hint: it's not skiing.
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May 10, 2014 21:53
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Americans can't even vote for people who aren't lovely politicians, and they certainly can't balance their own checkbooks. What makes anyone think they could come up with individual solutions regarding our healthcare crisis?
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May 10, 2014 22:04
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Ahahaha I missed this post the first time aroundFat Ogre posted:Yeah or maybe figure out which place had the best price rating before an emergency. The goon in question did not know his wife would need an MRI before he took her in in the middle of the night. Even if you assume that there are plenty places to get an MRI in the middle of the night like it's loving Jack In The Box or something, and he's a walking dictionary of the various prices of every medical test at every hospital, how is he supposed to know which one to go to to get that sweet MRI deal that you claim is out there, if he doesn't know what she needs until a doctor looks at her? I mean, what an idiot that guy is, right? Not being able to diagnose that his wife may need an MRI that insurance may not pay for if nothing turns up, so he could pick the hospital with the best 1am MRI rates, because as a spherical frictionless consumer in a vacuum he has precompiled a list of price comparisons of all medical tests and hospitals depending on time of day. This is just more "This person was in a bad situation that I don't want to believe can happen to me, so there must be some way that it's really all his fault." You don't have to run out and get car repairs or a lawyer in the middle of the night. You can wait until business hours and then start comparison shopping, and if you can't afford the prices you have alternatives other than just lying down in the street and dying and...wait, did you just call people who don't pre-shop for lawyers stupid and irresponsible? A lawyer is like the definition of a service that you have time to shop for when needed. You don't get a court summons at 2am ordering you to appear immediately or have a judgment entered against you.  Okay Mister Well-Prepared Consumer, your wife just got fired for "bad conduct" a month after she refused to sleep with her boss. Quick, who is the best employment lawyer in your area, what are his billable hours, and what will it cost you to take this to trial? Who is the best accident lawyer, what does he charge to sue an uninsured motorist who did a hit-and-run on one of your kids as he walked to school? Who's the best traffic lawyer if you have to fight a bogus ticket? If you don't have a lawyer picked out and an estimate of the costs ready for every common legal eventuality, you're obviously too irresponsible to be trusted with anything. VitalSigns fucked around with this message at 23:36 on May 10, 2014 |
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May 10, 2014 23:31
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VitalSigns posted:Ahahaha I missed this post the first time around Keep on with the strawman arguments. It really proves your imaginary points.
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May 10, 2014 23:52
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My anecdote about not needing an ambulance is irrelevant but dudes wife needing an MRI totally is 
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May 10, 2014 23:56
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You're the one framing medical costs in this country as a problem of personal responsibility. Anecdotes are perfectly valid ways of providing counterexamples to a blanket claim. It's in fact extremely common for people to not know what procedures they need or how bad a condition is until they are already in the emergency room. That is, you know, one of the reasons we have doctors. Emergency room visits in the middle of the night are a common thing. So common in fact, that it's why we have 24-hour emergency centers. And even if emergencies are less than 10% of medical complaints, people live a long time and have multiple multiple medical issues throughout their lives so the rare person who gets through life without ever himself or a close family member having a medical emergency is actually quite the outlier! And if you're uninsured, it just takes one to wreck your finances! Not, of course, that it makes any difference to someone without insurance whether a week of hospitalization or a surgery can cost them $40k instead of $80k if we let the  free market reward their bargain-hunting responsibility, when they still can't afford either price.Medical bankruptcies are the largest cause of bankruptcy in the United States. How many medical bankruptcies would be prevented by requiring public prices, and by letting all insurance companies incorporate in Delaware and buy the legislature to write slack regulations? Show your work. I know Republicans hate that, but please do, for me? I really want to see the proof that medical bankruptcies happen because people don't bargain hard enough. VitalSigns fucked around with this message at 00:24 on May 11, 2014 |
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May 11, 2014 00:18
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Fat Ogre, you want this to be a first world country, right? I see the level of individualism you're prescribing as literally incompatible with that. A lot of people do. That's principally where the guff you're getting is coming from. You've picked up on that by now, right? If not, it should inform your thinking.
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May 11, 2014 00:24
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Accretionist posted:Fat Ogre, you want this to be a first world country, right? I see the level of individualism you're prescribing as literally incompatible with that. A lot of people do. That's principally where the guff you're getting is coming from. You've picked up on that by now, right? If not, it should inform your thinking. VitalSigns posted:You're the one framing medical costs in this country as a problem of personal responsibility. Anecdotes are perfectly valid ways of providing counterexamples to a blanket claim. It's in fact extremely common for people to not know what procedures they need or how bad a condition is until they are already in the emergency room. That is, you know, one of the reasons we have doctors. Emergency room visits in the middle of the night are a common thing. So common in fact, that it's why we have 24-hour emergency centers. And even if emergencies are less than 10% of medical complaints, people live a long time and have multiple multiple medical issues throughout their lives so the rare person who gets through life without ever himself or a close family member having a medical emergency is actually quite the outlier! And if you're uninsured, it just takes one to wreck your finances! It is like both of you missed what I said entirely. You're both arguing with a Straw-man you've created. I support UHC full stop. I also support universal secondary education. The current system disproportionately favors those with money, we are all agreed on this. Until that magical day when the USA gets UHC, which could be decades, how exactly should people work in the system that currently exists?  What small baby steps could you use to get a historically divided congress to work towards UHC? Especially when almost half of them want to destroy ACA already? All I hear is a bunch of people pissed at the current system bitching at someone on their side already.  Sorry to suggest that maybe self improvement or entrepreneurial spirit could help those currently mired in the lovely system we have in place. Instead they can use your solutions which are *crickets chirping*. Apparently blaming everything and being annoyed at anyone trying to work in the current rigged system to help others is the solution to crippling student loans and ruinous medical bills.  God drat. Why should anyone want to fix anything if they get yelled at for suggesting baby steps towards resolving something?
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May 11, 2014 00:50
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Because we're talking about policy. "Do what you can to avoid a bad situation" is great advice for your kid or whatever, but millions of people are in those bad situations, and "try harder so you're not unemployed" or "don't go skiing and you won't hit your head while skiing" or "you shouldn't have gotten that degree" are standard right-wing tactics to preserve the status quo by casting anyone who gets hosed over as losers who deserve it. At best it's just white noise (people aren't going to stop skiing, that is literally a less achievable goal than UHC. Getting people to stop doing anything fun because of the risk will never happen, ever. UHC actually has happened), and sometimes it crosses over into being ridiculous like: The unemployment rate is what it is. No matter how much resume-pounding people do, the unemployment rate will remain the same because the problem is there are not enough jobs. No one is opposed to posting prices. Sure, do that, if the Republicans offer to do it tomorrow, take them up on it, can't hurt. I'm objecting that it won't help those most hosed over by our health care system, because it doesn't address any of the underlying problems that make a health care market unworkable in the first place. Your case that it would make sense to divert resources and time from campaigns to expand the ACA or implement UHC would be a lot better received if you just stopped blaming people for getting injured or sick. If we could wave a wand, sure. But should we campaign on, essentially, the Republican Health Care Reform proposal (you only need tort reform for the trifecta)? How does that advance the goal of UHC? VitalSigns fucked around with this message at 01:45 on May 11, 2014 |
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May 11, 2014 01:41
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Fat Ogre posted:Sorry to suggest that maybe self improvement or entrepreneurial spirit could help those currently mired in the lovely system we have in place. Instead they can use your solutions which are *crickets chirping*. Apparently blaming everything and being annoyed at anyone trying to work in the current rigged system to help others is the solution to crippling student loans and ruinous medical bills.
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May 11, 2014 01:52
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There has actually been some movement at the state level to disclose price information publicly. Many states are creating "All-payer claims databases" in which claims information for some or all of the medical procedures performed in a state are anonymized and then placed in a central database, potentially allowing patients to find the 2 for 1 deals on brain tumor removal or whatever. http://www.apcdcouncil.org To summarize, proposals for the scope and funding mechanism for these sorts of things vary pretty widely by state. Some states intend to collect all data; others will exclude pharmaceuticals and outpatient procedures, and some rely on *voluntary* disclosure, which is utterly worthless. Some states are paying for these databases via taxes on insurance plans or out of general revenue, while others rely on private grants. This latter approach is particularly problematic for obvious reasons, and it appears that Colorado's effort has basically run out of money, which they hope to recoup by selling bundled claims data to private entities. However, Medicare does not allow this, although bipartisan support to rewrite the rules would probably be fairly easy to scrounge up, assuming Congress concerns itself with passing laws anytime soon: http://www.npr.org/blogs/health/2014/02/12/276001379/elusive-goal-a-transparent-price-list-for-health-care I have mixed feelings about these sorts of things. On the one hand, I firmly believe that the healthcare market is so fundamentally different than the one for consumer goods or even property insurance that standard price signals are unlikely to accomplish all that much on its own. Patients will still lack the expertise to properly determine if they really need a procedure, the demand for end of life care will continue to be nearly infinite, and large hospitals and insurers will still exert tremendous oligopolistic power, especially outside of big cities. On the other hand, these databases are pretty cheap in the grand scheme of things and probably won't make anyone worse off, so even if expanded price information probably won't have the magical effects Econ 101 would indicate they might be worthwhile pursuits. A uniform, standardized federal system that leveraged Medicare's power in order to force price disclosures would be even better. But really, I'm hoping that Vermont figures out a funding mechanism and gets their effort off the ground soon. DeceasedHorse fucked around with this message at 09:00 on May 11, 2014 |
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May 11, 2014 08:55
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I know a person who talks so similar to Fat Ogre that I eerily wonder if they are the same person or if just all "personal responsibility" -retards sound so stupidly similar?
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May 11, 2014 10:00
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Vahakyla posted:I know a person who talks so similar to Fat Ogre that I eerily wonder if they are the same person or if just all "personal responsibility" -retards sound so stupidly similar? I used to believe the exact same poo poo (much of my family still does). A lot of it functions like a paint-by-numbers 'Assemble your Own Conclusions Kit.' You take culturally supplied concepts, terms, definitions, frames, etc. and run with em' and you end up in roughly the same place with the same language as everyone else.
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May 11, 2014 10:20
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https://www.jacobinmag.com/2014/04/the-neoliberal-turn-in-american-health-care/ I don't know if this article was posted here, but in case any of you are wondering why healthcare has taken such a rightward turn in this country since World War II, give it a read. Among other things, it does a great job in refuting the "healthcare as a consumer good" talking point that was successfully (and sadly) used as academic proof that universal healthcare can't work in America. What are the chances that Vermont will actually implement this with the OK from the Obama administration? I can't help but feel some paranoia over them actually letting Vermont go ahead.
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May 11, 2014 20:18
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Y-Hat posted:https://www.jacobinmag.com/2014/04/the-neoliberal-turn-in-american-health-care/ The biggest challenge is getting over the funding hurdle since the waiver requires the plan to be deficient neutral to the federal government,
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May 11, 2014 21:03
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Slobjob Zizek fucked around with this message at 00:03 on May 12, 2014 |
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May 11, 2014 23:13
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Slobjob Zizek posted:Everyone here is getting caught up in the minutiae of the configuration of insurance companies, but you are all tacitly agreeing that you LOVE DEATH AND ILLNESS. That is the system that we have -- one that dumps money into treating chronic disease and old age without considering the value of such treatments to the patients and to everybody else. Granted that perhaps we waste money on heroic measures in some cases. Are you just advocating Logan's Run or something? It sounds like you're specifically advocating cutting expensive treatments and things in favor of much cheaper (and good!) things like "gym memberships" and "bikes." You also seem to be introducing this whiff of "life unworthy of life" which has, uh, poor historical connotations.
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May 12, 2014 00:01
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Nessus posted:What? I think he is just highlighting the depressing fact that there is an insane amount of profit for physicians in maintaining a solid consumer base of chronically ill, but not critically ill patients. Polypharmacy is bad enough as it is, but with enormous kickbacks, it incentivizes dependencies, most physicians will treat adequately but not comprehensively. There is no financial reward in this system for good outcomes. LeeMajors fucked around with this message at 02:43 on May 12, 2014 |
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May 12, 2014 02:25
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That's why I only go to my naturopath; institutional "doctors" and "medical science" make  by keeping you sick. They don't want you to know the real secret to staying healthy.
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May 12, 2014 02:29
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VitalSigns posted:That's why I only go to my naturopath; institutional "doctors" and "medical science" make I know you're being a smartass, but I work in healthcare and see this frequently. MOST individual doctors are not guilty of this, but it is an overall institutional flaw. Yet another reason that treating healthcare as a consumer good is ethically hosed.
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May 12, 2014 02:43
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Fat Ogre posted:Yeah or maybe figure out which place had the best price rating before an emergency. Good luck trying to find out how much something will cost to treat even if it is not an emergency. Hospitals and clinics are some of the most opaque when it comes to prices, with some exceptions. Or you know, we can dodge the issue entirely by having single payer collective bargaining power like every other country but noooo. That would impoverish publicly traded firms with powerful lobbyists.
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May 12, 2014 03:06
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Toning down the weird, eugenicist overtones, here's the crux of my argument: we spend most of our healthcare dollars on the chronically ill and the elderly. These people are not flukes, they do not suffer from freak genetic diseases or barely survive horrible car accidents. The quadriplegics and those with cystic fibrosis are who traditional insurance is meant for. They, randomly, suffered bad luck and now, we as a society provided for them (via insurance of some sort, public or private), because we, too, could suffer from bad luck. Those with non-severe mental illnesses, chronic cardiovascular diseases, diabetes, cancer (in some cases), or old age do not suffer from bad luck, but from social diseases. People are overworked, overfed, overexposed to carcinogens, or simply too old. If we could absolutely cure the aforementioned conditions, great, I'm all for it. We solved the problem we created. Hopefully we came out even. However, we usually can only merely treat the aforementioned social diseases, instead of cure them. So, more and more people develop chronic conditions and get older as social conditions are not addressed, and we keep dumping money into the medical-industrial complex. It's practitioners are all too happy to take it. And patients are "happy" that they can take a pill instead of change their life or think about the reality of death. This would all be fine if people had to pay for their own healthcare when really sick. They don't, though (and couldn't afford it anyway). So, if we give carte blanche to every chronically ill/elderly person for their treatment, and stick the tab to those paying insurance premiums (private) or the taxpayer (public), we are essentially making a social decision. And instead of providing universal daycare, subsidizing college tuition, or raising the wages of younger workers, we are dumping ever-increasing amounts of money into healthcare. Is this really the future of the welfare state? Everyone holding on so desperately to life that it isn't actually lived? That's depressing.
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May 12, 2014 03:25
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GomJabbar posted:Good luck trying to find out how much something will cost to treat even if it is not an emergency. Hospitals and clinics are some of the most opaque when it comes to prices, with some exceptions. To be fair here, he knows that opacity is the status quo, and his proposal is that hospitals be legally required to post one-size-fit-all prices. I don't know how the proposal is supposed to work if there are complications (say in a pregnancy). ... I'm just gonna quote all of this Slobjob Zizek posted:Toning down the weird, eugenicist overtones, here's the crux of my argument: we spend most of our healthcare dollars on the chronically ill and the elderly. These people are not flukes, they do not suffer from freak genetic diseases or barely survive horrible car accidents. Quality-adjusted-life-years are a thing when evaluating the cost-effectiveness of a treatment, as is cost-saving with preventative measures. I mean, yeah it would obviously be better if we had nutrition programs and so on to help people live a healthy lifestyle, but it's pretty bizarre to make that an argument against universal health care. If you're worried about the budget, let's talk about how we undertax the rich and blow trillions on wars before we start worrying if caring for old people is bankrupting the country. VitalSigns fucked around with this message at 03:36 on May 12, 2014 |
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May 12, 2014 03:28
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^^^^ Yeah, QALYs are great, but we are prohibited by law to in using them as of now to recommend/not recommend treatments. My point is that "universal healthcare" is merely insurance and only addresses one side of the healthcare trilemma (access). Cost and quality are ignored. Cost and quality are also mostly ignored by most politicians/political groups for some reason. GomJabbar posted:Good luck trying to find out how much something will cost to treat even if it is not an emergency. Hospitals and clinics are some of the most opaque when it comes to prices, with some exceptions. What do you mean? Medicare already unilaterally sets prices and private insurers usually reimburse some percentage of that price (usually more). Slobjob Zizek fucked around with this message at 03:39 on May 12, 2014 |
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May 12, 2014 03:35
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Slobjob Zizek posted:Toning down the weird, eugenicist overtones, here's the crux of my argument: we spend most of our healthcare dollars on the chronically ill and the elderly. These people are not flukes, they do not suffer from freak genetic diseases or barely survive horrible car accidents. There are two criticisms I have of this argument of yours. The first is: Where, exactly, are you going to decide someone has a 'social disease' and is therefore implicitly unworthy of treatment? At what point does my unforeseen disease become something that was not due to a deficiency of bootstraps, but rather an honest accident? As an ancillary question, how are you defining "old age" - is there some point at which you just stop receiving medical care? What is that age threshold, how did you arrive at it, and is it subject to amendment in light of later improvements? I would also point out you are basically saying that someone who has a mental illness outside of a certain threshold needs to just deal with it, and society isn't interested in assisting them (which, in that case, is basically the current situation - but now you've made it explicit!) The second is the question: Do you believe that the savings from cutting the former, would be applied to the latter? For that matter, do you think that they are mutually exclusive? The resources are there, just not the political will, at least in America.
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May 12, 2014 03:40
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If the problem is expense, really as a country we are not short on the money to pay for this end-of-life care. It's just all going to an extremely small slice of the populace right now. This problem sort of sits at the head of all or at least most of our national ills.
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May 12, 2014 06:14
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Redeye Flight posted:If the problem is expense, really as a country we are not short on the money to pay for this end-of-life care. Coming in and saying "we have plenty of money" as a way to downplay high healthcare costs is monumentally stupid. Healthcare is close to 20% of the economy currently. Exactly how much more would you like diverted to cancer treatment for the last 4 weeks of life? In our technological era the amount of money we can spend on healthcare is practically limitless. I'm sympathetic to your point of view. What's a more positive way to frame things, I.E. what policies should we support in order to achieve some of those ends. I was health proxy, and thus making some of the decisions when my father was dying of cancer. So I know the momentum behind the end of life care. When the doctors asked if we wanted radiation for the brain tumor that spread, I just sort of nodded and said ok. They were recommending it, despite that fact that he was terminal, so how could I no. I didn't really think it was needed, but was the rest of the family going to judge me? God knows what it cost (the ambulance bills for transportation alone were $5k) and he died 3 weeks later so it didn't do any good. The point is that besides being systemic on the caregivers side I also think the idea of fighting to the end is cultural. No one wants to give up, and is afraid of being judged if they might want too. But again, what we're doing in general with end of life care just makes no sense whatsoever.
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May 13, 2014 01:30
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