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Still Dismal posted:Hospitals themselves don't get nearly enough flack honestly. Insurance companies are the main villains in most healthcare reform arguments (not at all saying they don't deserve this), but hospitals are a huge part of the problem as well. Hospitals have much better PR but are every bit as culpable for the insane runaway cost inflation that you see in American healthcare. I think the problem is that people generally like doctors, nurses, etc., and hospitals like to conflate attacking their predatory pricing and practices with attacking the workers providing healthcare themselves. Yeah, everyone in the system deserves some portion of the blame. Another reason for the fixation on the health insurance companies is because that is who people deal with when it comes time to pay for the healthcare. So problems created by other parts of the system get attributed to the health insurance companies. GABA ghoul posted:I'm not a big fan of how most of the pharma industry is run, but this is not a problem specific to the private sector. A public pharma industry would have to answer about spending limited resources just the same. Like, you can use available resources to bring drugs to market that could help millions or you can spend them to set up a production line for Glybera and help 31, but you can't do both at the same time. A public company might have faced a similar outrage, but for choosing to produce an obscure seizure medicine that helps 32 people a year over Glybera that would have helped only 31 people. Yeah, I don't get how a totally government-run health care system would create better outcomes for people with orphan diseases. I'd think that the government would just not make the investment to develop treatments for rare diseases, and instead would spend the government money on developing treatments which would benefit more people. edit: wins32767 posted:I've found this thought experiment to be a good illustration of many of the dysfunctions in the US healthcare system: Let's say a there is a magic box where if you feed in all of a patient's health records in and a proposed treatment (be it a prescription, surgery, whatever), it will tell you with perfect accuracy what the outcome for that patient would be (e.g. cancer in remission for 5 years, continues to smoke, dies on the operating table). Who would be interested in the magic box? Why would they want it? How much would they be willing to pay for it? And who has the information to feed into that magic box so it can operate? Thanks for sharing this thought experiment and your answers to it in a later post. silence_kit fucked around with this message at 21:14 on Aug 8, 2020 |
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Aug 8, 2020 21:04
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F_Shit_Fitzgerald posted:Question for those in this thread: how in the world do you respond to morons who tell you that universal health care is "slavery" because it's "forcing people to give charity"? I've run into this on another forum and its baffling, though I know it's a dumb way to reframe the issue. This person might be a lost cause, but I think that it might be a good idea to actually address what they are saying and get them to talk and explain their ideas, instead of just changing the subject on them. Let them do most of the talking, and ask questions and then you can use their own reasoning to reach conclusions that you hope they disagree with, and point out paradoxes in their thinking. I don't know how they will be able to expound a lot on the idea that UHC is the same thing as 'giving to charity' without saying a bunch of stuff that most people find morally monstrous. Their idea that UHC is slavery is predicated on the idea that taxation is slavery, but surely they don't actually believe that taxation is slavery because you can probably point to government programs that they like that wouldn't get funded if the government made taxes optional . . . etc . . . etc . . . edit: It is hilarious to me that this process of getting people to explain and reason about their beliefs and pointing out paradoxes in their thinking is considered to be bad on some online communities, and 'just asking questions' is a pejorative, but here we are. silence_kit fucked around with this message at 12:21 on Aug 15, 2020 |
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Aug 14, 2020 16:08
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knox_harrington posted:Adjacent to this, I occasionally read the medicine subreddit and it's surprising and disappointing how many doctors are libertarians. This is a little rich because doctors in the US might be the biggest beneficiaries of protectionist labor laws. Don't get me wrong--doctors make an incredibly valuable contribution to society, obviously, and should be able to live comfortably so they can focus on their jobs. knox_harrington posted:There's quite a lot of opposition to universal coverage in there, on the basis that they will earn less. I suspect that in order for a US UHC policy to actually deliver on its promises to greatly lower the cost of healthcare, it would have to force everybody in the healthcare industry to take a haircut, since everybody is partially responsible for driving up the cost of healthcare in the US. The high cost problem is not just localized to the health insurance companies. This would include doctors, who could easily make less money, and still be able to live comfortably and focus on their work. Doctors in the US make more money than doctors in other rich countries. knox_harrington posted:Doctors' salaries in the US are pretty insane, and the justification for the high pay is that medical school is expensive and residency is poorly paid. I'm not against doctors being well paid but it highlights to me that solving the problem of high healthcare cost in the US also includes solving the high university cost. The current system is not ideal, but doctors in the US tend to exaggerate the problem and the burden. Paying for an MD is still an incredible investment. You are guaranteed a stable, well-paying job for life when you get accepted into any US medical school. This is pretty unique for academic degrees. My cousin paid back his medical school loans in like 3 years after getting his first job. edit: I just Googled 'average residency salary' and it is $60k. Getting paid $60k per year for job training is pretty good, IMO. It is extremely low though, when compared to real doctor salaries. knox_harrington posted:Medicine should really also be an undergraduate degree Yeah, this is a no-brainer. This is how almost every other rich country does it. I suspect that the guild would not be a big fan of this though. silence_kit fucked around with this message at 18:00 on Aug 15, 2020 |
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Aug 15, 2020 17:47
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Still Dismal posted:“Heh, if you were a little more sophisticated, you’d realize this was Good, Actually. The Contradictions Have Been Heightened You See, furthermore,” I say as Trump defunds medicare in 2021. I don't understand how someone could pretend like they precisely know how the next 4-8 years of American politics would unfold under various hypothetical scenarios to be able to inform their utility calculus. It's a huge amount of speculation. It makes sense to me to just vote for the lesser evil, but I don't have a genius C-SPAM political brain. I guess if you live in a solidly blue state like CA or NY, your vote doesn't matter anyway, and voting third party probably won't make Trump win the election. Of course, that goes both ways--it also means that your third party vote won't really send much of a message to the Democratic Party Establishment. In reality, the political wisdom of the NoJoe King-Killing Super-Spreaders doesn't really matter anyway. They are a pretty small minority of the American public, and IMO the C-SPAM vote really isn't any sort of bellweather for how normal Americans would vote in the Presidential election. silence_kit fucked around with this message at 15:05 on Aug 18, 2020 |
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Aug 18, 2020 12:09
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KOTEX GOD OF BLOOD posted:buttigieg's campaign, for instance, had about zero substance, but he was ascendant largely because he waved the flag a bit. it's not that hard to do this while promoting democratic socialism, but the american left refuses to do this because they are such loving crybabies. Bernie liked patriotism and the American flag I thought? I think you might be projecting the AmeriKKKa posts on the SA political forums onto people who might actually have more of a chance of mattering politically.
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Aug 31, 2020 23:19
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Jaxyon posted:Literally no other nation in the world bases their UHC system around a for-profit system. But you don't think that's relevant? Health insurance profit margin is 3%. Health insurance profits alone aren't why US healthcare is so expensive. If UHC is to succeed in lowering the cost of American healthcare, the government will have to force everybody in the health care industry to accept less pay. silence_kit fucked around with this message at 02:32 on Oct 21, 2020 |
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Oct 21, 2020 02:19
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I think KingNastidon's posts are helpful and informative. SA Politics Posters have a problem where they are totally unwilling to acknowledge drawbacks to their favorite political policies, and in the few cases where they do acknowledge the drawbacks, they attribute the drawbacks to external factors, which at least in SA Politics Poster Ideal World, would not exist. I think UHC providing more equal access to health care at the cost of maybe fewer innovations in drug developments & medical treatments, and maybe worse quality of care for wealthy people is a worthwhile tradeoff.
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Oct 21, 2020 02:39
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Ytlaya posted:This not how politics should work, though. The most important thing to talk about politically is "what result you want." The important specifics aren't the specifics of implementation, but the specifics of outcome. In the case of healthcare, it would be things like "needs to be free at point of service" and "covers everyone." For a country like the US with no practical limit to resources/wealth, such a goal can be made to work (and the details of how to make it as cost effective as possible and how to offset its costs are something for others to work out). I want the US government to grant its citizens immortal life. Anybody who is emphasizing the complexities/difficulties of this goal is not on my side.
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Oct 21, 2020 02:58
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Jaxyon posted:US drug innovation is almost entirely funded by the government so why do you think it would change with single payer? There's a good chance it would go up. Aren't you conflating basic research and product development here? I can't speak personally about drug development, because I don't work in drug development, but in other kinds of technologies, there is a huge amount of effort & spending needed to translate a basic research idea to real technology. Technology development is most certainly not the following series of events: a university professor comes up with an idea and performs a basic proof of principle demonstration and companies just copy his formula and create a useful product one month later. Like the drug trial success rate is really low. You'd think that if all of the basic research ideas in medicine were well-formed ideas, drug trial success rate would be nearly 100%. silence_kit fucked around with this message at 03:11 on Oct 21, 2020 |
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Oct 21, 2020 03:06
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Jaxyon posted:Nope, you're confusing it. I don't think this is true. I think you are talking out of your rear end here. If it was really this easy, then why do so many drug trials fail? This is also totally opposite of my personal and professional experience with applied science & technology in other areas. There is a huge gulf between basic research and real technologies, real products. Going from successful research project to real product doesn't happen very often, and in the very rare cases where it does happen, still much work is needed to be done after the basic research phase. silence_kit fucked around with this message at 03:23 on Oct 21, 2020 |
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Oct 21, 2020 03:12
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Jaxyon posted:Who said it was easy? You did. If almost all spending was from the government, like you say, and if all drug companies do is slap a sticker on the government product, then why do most drug trials funded by drug companies fail?
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Oct 21, 2020 03:25
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Jaxyon posted:Nope, didn't say any of that. I said the innovation is accomplished by the government and the companies walk them through the approval process. That doesn't mean that the drug companies don't do work, I just aid they aren't responsible for the innovation. If what drug companies do is just a layup, then why do they miss all of the time, and why do they spend huge amounts of money on all of these misses? You are totally dodging the question. I think the answer is: silence_kit posted:Going from successful research project to real product doesn't happen very often, and in the very rare cases where it does happen, still much work is needed to be done after the basic research phase. silence_kit fucked around with this message at 03:39 on Oct 21, 2020 |
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Oct 21, 2020 03:34
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Jaxyon posted:Meanwhile the industry itself said that the taxpayers funded basically every new drug of the past decade It makes sense that basic research funding would comprise a (small) portion of the total funding needed to develop any new drug. All technology development first started out as basic research. I don't think the article you posted actually supports your claim which is that the government pays for almost all drug development costs. I think your claim is totally cut out of whole cloth. silence_kit fucked around with this message at 04:46 on Oct 21, 2020 |
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Oct 21, 2020 04:39
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Sharks Eat Bear posted:But if it doesn’t, then I do think, in a sense, drug development innovation would slow down. But personally I don’t actually think that’s a net bad thing for society given all the benefits of M4A, and the fact that US health outcomes are still extremely poor relative to the amount we spend on prescription drugs, and the fact that a lot of pharma “innovation” is pretty questionable in terms of benefit to patients (with some notable exceptions of truly incredible medical advances, but I do think those are the exceptions). Yeah, this is the argument to make. A lot of new medical technology might be kind of frivolous, and it might not really be that bad to not be able to fund it and to have to go without it. The argument not to make is: 'the government funds almost all of drug development costs, and all drug companies do is slap their logo on the government product and run the drug marketing campaigns.' There is absolutely no way that that is even close to being true. I can't speak from personal experience in the pharmaceutical industry, but micro-electronics technology development totally does not work in that way. Like, the hardware in an iPhone isn't Apple assembling some kit put out by government researchers, and packaging it in a shiny glass slab (this was VitalSigns' belief in the earlier healthcare thread). That claim couldn't be any further from the truth. The total funding needed to translate basic micro-electronics research ideas into real products dwarfs the basic research funding. Jaxyon posted:It should be noted that the original argument that was made here, among others, was that quality of care . . . would suffer under single payer. I said that quality of care might suffer for wealthy Americans. That is not the same claim that you are repeating here. You posted international stats on how US healthcare is so bad, but I don’t think they disprove my point. Average quality of healthcare in the US can still rank as mediocre in the int’l stats while quality of healthcare for wealthy Americans can be excellent. This is because most Americans aren’t wealthy Americans. silence_kit fucked around with this message at 16:11 on Oct 21, 2020 |
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Oct 21, 2020 11:27
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Jaxyon posted:And pretty much all drug innovation has come from basic research done on the public dime, including basically every novel drug in the past 10 years(see my earlier citation). R&D may be developing new products, but it's not developing innovation. When people receive medical treatment, they expect the treatment to work not just in principle, but in practice, in reality. Yes, the basic research is more creative and more novel than product development, but the basic research result doesn't really concretely mean much to society without being developed into a real product that people can actually use and is actually proven to work. The product development is especially valuable in medicine because the theory of medicine is not that great--the researchers can't make good predictions. If they could make good predictions, the drug trial success rate wouldn't be so low. silence_kit fucked around with this message at 00:58 on Oct 23, 2020 |
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Oct 23, 2020 00:56
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Jaxyon posted:Hey if you ever want to get around to supporting your argument with factual information like the other posters in this thread do, that would be great. What claim do you not believe in the quoted post?
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Oct 23, 2020 01:00
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WampaLord posted:Somehow, plenty of other countries have managed to solve this problem while still offering universal healthcare. I'm firm in my belief that America, the richest country on Earth, could figure out a way. This doesn't address my post at all. I'm just explaining the value of the later stages of technology development to Jaxyon. VitalSigns in the previous healthcare thread didn't get it as well. Yeah, in principle, for medicine, in D&D Poster Ideal World, this function could be performed by the government. In D&D Poster Ideal World, this function would still be very valuable though, unless somehow there was a giant breakthrough in medical understanding in D&D Poster Ideal World which would render the testing of medical ideas mostly useless. silence_kit fucked around with this message at 01:28 on Oct 23, 2020 |
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Oct 23, 2020 01:18
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