Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Starver]

² Which would be "Without with 'ception'",

...what I was acknowledging there, with minor poetic licence.

[redwallzyl]

According to the bbc trump now says that he wants to keep the pre existing conditions and parents insurance thing from the ACA. So now we get both the things that cause most of the expense, although completely good and nessisary things, and the destruction of the measures that counter that expense. Not only will this explode costs but all this idiots calling for the compleat repeal are gonna suddenly see trump reversing his stance.

[Reelya]

Luckily America does actually have a decent single-payer system already, waiting for funding. Medicaid. Just expand eligibility for that and gradually push the private stuff out of the market. I remember reading somewhere that medicaid has administration fees of 2% of the costs. Whereas private plans have "administration" fees equally to about 30% of the costs. Basically the private plans are excessively corrupt and inefficient because they've worked out ways to attach leeches everywhere to sucking all that excess money out. That is why they're so scared of single-payer programs even if they are optional. It's the reason that GOP state politicians who get campaign money from the pharma companies don't want to expand medicaid in their states, even though it's objectively federal money flowing into the state. Basically they're screwing over their own state economies and people's health to line their own pockets.

[scriver]

Conception is the only cure for inception.

[RoseHeart]

Alight, my understanding is from personal experience that you have shared, universal healthcare, while potentially suseptible to failings of slowdown and less offerings, if underfunded, is potentially very good when funded properly.

On the other hand the open market has not produced affordable, quality service for the poorest.

[Reelya]

One issue is that privatized healthcare naturally creates levels of healthcare based on wealth - there's a need to create a carrot and stick to get people to pay more for the service. Even if it's possible to provide the service cheaply to everyone, that's not good business practice. You want people to be scared of what will happen if they don't buy the premium health plan. Which is not a problem for many services (such as first-class on an airline) but is a civil rights issue for something like health.

So of course a privatized market isn't going to create quality healthcare for the poor: their business model relies on you being desperate not to have that level of healthcare. Look at UK, Canada, Australia. In all those places people live on average about three years longer than Americans, even though those other countries spend a mere fraction of the amount of money that Americans spend on health.

But ... private health doesn't even create a good deal for the taxpayer. Australia's government, with a national health system, spends 6.4% of GDP on health, while America's government, with private health, spends 8.3% of GDP. That's just the government. Add on top of that the fact that America's government provides many fewer health services than Australia's so Americans are paying more in tax than Australians are, then paying again into a private system. America only has "better health care" because the "private" system is massively propped up by the government, at even higher spending rates than "national health" countries. Take away that 8.3% of GDP that the USA Federal Government spends and how highly do you think USA's "Private" System will rate?
http://theconversation.com/australias-unsustainable-health-spending-is-a-myth-26393

[ChairmanPoo]

It also has to do with the resources a national healthcare system is able to bring about, by sheer size: keeping a network of specialized hospitals, negotiating better deals with pharmaceutical companies (this one is very important), etc...

[Reelya]

Weird fact as I edited in, Australia's government spends 6.4% of GDP on health, and America's government spends 8.3% of GDP on health. Australians have lower health-related taxes overall, and we can go to the hospital when needed, Americans pay more tax and cannot go to the hospital without paying all over again.

People often point at "better outcomes" in the American system, but how much of that is due to the larger amount of tax dollars poured in to keep the "private" system afloat? It's proof that health is not an area suited to privatization.

Some of our conservatives want to copy the American "privatized" system, claiming it will save money. But that's not about saving tax money, it's about opening up a cash-cow profit center for their cronies.

[ChairmanPoo]

Let me tell you what they will try: someone will come out and say that the best solution is a mixed system, with private corporations managing public hospitals, possibly with a public contest, of varying degrees of sleaziness. After the contract is signed the managing corporation will try to make the most of it by cutting down wages, trimming patient expenses, and even rebounding the more complicates patients elsewhere. Then they will ask their buddies in the goverment for more money "cause managing this shit is expensive", so that they can keep running the hospital

[scriver]

Sounds exactly like what happpened with the apothecaries in Sweden.

Liberals: "We're privatizing the apothecaries! But don't worry, one of the conditions is that apothecary coverage/availability cannot decrease!"
 - Prices increase
 - Health safety decreases
 - Service quality decreases
 - Apothecaries start carrying previously unseen amount of non-medicine related bullshit goods
Capitalists: "Okay, so sorry, but now that we've lowered all standards to below what's allowed to increase our winnings we can't create enough growth any more. We're going to have to shut down all the rural apothecaries, they don't make enough money, and hardly anyone lives there anyway (and those who do probably smell bad).
Opposition: "But people need accessible medicine to live! Literally! And all those stores didn't had any trouble when state run, can't you just move money around from the more populated places to pay for the country-side ones like the public monopoly did?"
Capitalists: "LALALALA NOT LISTENING PLZ GIB MONEY"
Liberals: "Don't worry, people! We'll just pay the private business even more money for the privilege of keeping these apothecaries open!"

Because somewhere along the line capitalism became all about making tax payers cover all the costs while private businesses make all the profits.

[McTraveller]

So what are the checks and balances in various countries to help keep health care low? Is it just legal mandate, or is there actual balance of supply and demand in the countries?

One problem in the US is that there are significant barriers to starting new medical practices, so demand always outstrips supply. It also doesn't help that people in the US have this attitude about "I want whatever it takes to get better, I don't care how much it costs."  (Even though the bulk of the costs are put on other people.)

[Reelya]

The real poison is public funds => private hospitals. That's the #1 ticket for cost explosions. Private companies have unlimited appetites for money, and politicians have almost unlimited ability to produce money. It's a bad combination especially when you consider campaign donations from the companies getting taxpayers money.

When you have a massive government spending like America's Medicare, and that money is going into a "private" system, it distorts free-market pricing. e.g. if you work out the optimal free-market price of a procedure, then raising that price will lower the number of people who take it. But when Medicare is factored in, you can raise the price without lowering the number of people who take the option. This pushes up the prices for everyone, whether or not they are eligible for Medicare. So they raise prices to the optimum point to gouge medicare for every cent, this drives away a few customers who can't get medicare, but not enough to offset the big profit increase.

Whereas you can have two parallel systems operating much more efficiently. Have a private hospital system which is entirely paid for by the public through private insurance, and a non-profit public system which is funded directly by the state. The state naturally wants to keep costs down, but still get elected, so they will fund a reasonable amount to the public hospitals, neither high nor low, and it's the people paying the bills who appoint the hospital's executive staff: so they hire people who are aligned with the goal of keeping costs down, unlike the American system where hospitals are trying to maximize revenue from all sources.

Meanwhile, private insurers without access to public money will want to keep premiums low, but still claim to provide decent coverage, that will regulate their behavior, especially when they need to prove they're competitive against a non-profit state system.

[martinuzz]

Lol, Reelya, I thought I was a nefarious post editor, but you've made me click this thread 3 times now thinking there was a new post.

[Reelya]

If you're clicking on the same post 3 4 times in 5 minutes (that's the time span between my first post and last edit), expecting there to be new posts each time, perhaps you have a different problem than other people's posted being edited too much?

[martinuzz]

Whoa easy cowboy