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[Starver]

... what do you think "to source something" means? It means to check the cited source for a claim. This is an incredibly common usage. Maybe it's more academic than I think it is?

Not wishing to add to the confusion, here, but to me, "to source something" is to establish (or present) the sources for facts (or 'facts') given by yourself, not to check those sources already cited by another in their own work, which it did bot seem obvious to me that you were asking to be reviewed (even though it would be a normal thing to ask).

But then it might be an Americanized/Anglicised divide thing. (Like asking to "write me"[1] instead of "write to me", something similar compared to being "set on fire" that I can't currently recall your version of, or the famous problem with the term "to table [some issue or other]".)


(So, anyway, by that count the sources were already pre-sourced, as I take it, whether or not they were verified. And as I've not dove into this argument's specifics[3], I don't even know if/by how much even it was sourced in that way, I'm just watching the arguments fly and (until now) keeping out of it. It being Not My Business.)


[1] To be written implies one is to be the subject of writings (e.g. to write a character into existence by authoring a novel with them in; or "write me sympathetically", one might implore of your biographer/ghost-autobiographer), not the object. In normal[2] Br.Eng usage, anyway.

[2] Nearly wrote "regular", despite definitely not meaning anything like "periodic"... But these things do keep creeping across the Atlantic!

[3] The only big point I would make is that clearly some people in the UK government have been striving to make the UK health-system more US-like (rolling back the whole social healthcare system by continuous interference and repolicying and effectively defunding it even while establishing more wasteful sinks to soak up all 'honest' funding increases that they can then use to try to debunk it). It makes me groan every time anyone (of any political colour) pushes for "healthcare reform", as often this is going to be hot on the heals of a prior (possible opposite-hued, but even ones that are nearly identical!) 'reform' that never even got the chance to settle down and establish its efficacy in solving the prior problem-of-the-week before being branded irrelevent/not-the-answer/counterproductive. That said, while I may have felt it best not to bother the doctor with an ailment (pre-Covid, never mind post-Covid/during) I have never felt that I could not afford to do so (or not even afford to take a day off work, if applicable), and have not hit such limits of care that seem to be the one big issue for so many under the 'Merkin system... But this point is so often rehashed. And it seems almost as much "there's no simple way to get to <sensible system> from <current system>" as the other big issues[4], but not actually so much if done sensibly.

[4] Like the old "Guns! Yahoo! Everybody and their dog has them!" being transitioned to one in which that's pretty much a negligable chance that most people need/have/desire a gun (police, honest citizens, even criminals... each group not having to contest with either/both of the other two groups being armed by default, so "you go first" attitudes all round.

[scriver]

you employ the same number of people at the same costs, in which case you can't expect any cost savings or efficiency gains

This is entirely untrue, though. Employing the same number of people at the same wages, but under a single (or even divvied up on a state level, for that matter, it'd still be a massive improvement over the current state of things), relatively unified administration is pretty much guaranteed to cause massive cost savings and efficiency gains, just by dint of simplifying the paperwork process and ejecting bad actors (i.e. the vast majority of the health insurance industry) that are actively attempting to make the process more time consuming and expensive in ways far above and beyond just the wages and livelihoods of the employees involved.

The US health industry is pissing away gigantic amounts of money, time, and effort dealing with the sheer number of disparate processes our mess of a private industry inflicts on healthcare administration in an attempt to deny coverage and maximize profits. You can throw a rock at discussions among healthcare workers that actually have to deal with that shit and hit someone complaining about it, and for damn good reason.

Employing the exact same amount of people at the exact same wage would still see massive fiscal improvements, because having those under a much smaller amount of employers would enable the folks involved to cut out a genuinely tremendous amount of bullshit currently sucking all sorts of life out of the healthcare industry.

Not to mention that insurance companies will still exist for all things non-healthcare, and yes, even private health care.

[Lidku]

Biden is way too old.

[Schmaven]

Biden is way too old.

True, but as the saying goes, "cocaine is a helluva drug"

I'm sure he's got some presidential tier supplements to compensate for his age. 

Edit: The economic issues, healthcare, insurance, etc. seem very complicated.  Small improvements might easily be possible (like reducing the paperwork burden on coordinating care), but their overall effects on the larger system would likely be a drop in the bucket.

[McTraveller]

So when it comes to an economy, remember that a dollar saved is a dollar not spent. Economy-wide savings is not in terms of money, but is in terms of a combination of requiring less resources per unit output and producing more than you consume.  If you think of economy-sized "saving" instead as "storing" then it makes sense - either storing goods in warehouses, storing "ability to do work" as excess production capacity or education of the workforce, or as resources still in the ground.

I'm going to repeat it again: you cannot improve society by merely reducing the amount of money spent on (say)healthcare.  You have to spend less on healthcare and simultaneously spend the money previously spent on healthcare on something productive.  Extra credit: remember, paying down debt is not productive use of money because it doesn't make anything. In order to pay down the debt, you want to invest in something productive, then use the increased returns to pay down the debt.

[Frumple]

I mean, I can guarantee you folks not sucking on the barrel of medical bankruptcy, or the threat of it, aren't going to have trouble finding something else to spend the money on. It's genuinely not a major issue to worry about, and those millions or billions of dollars not spent fellating the health insurance bandits wouldn't cause people to run around like idiots unable to figure out what to do with it all.

We're 100% aware it's even generally something useful, for that matter -- money saved, particularly among the less economically well off that are most abused by the parasitic fucks, tends to go to things like food, shelter, etc. Necessities more than anything, which does just fine so far as encouraging useful spending on the money not being pissed into a corpsevulture's gullet.

[McTraveller]

I think there is confusion between personal savings with economy-wide savings.  Yes if personally your bills go down, you'll have extra money to spend on something else.  But it also depends on if your bills go down because there are less expensive options versus you just deciding you don't need dessert every day but only once a week, so you cut demand for dessert by 80%. Now say everyone cuts dessert by 80% - you just put a bunch of dessert makers out of work.

That's what makes it difficult at the entire-economy scale.

I think there's also some hand-waving over any hypothetical transition period, in which all these former insurance clerks magically find some new jobs. Or are we basically going to just turn all the savings in health care expenditure to welfare instead?

[Frumple]

Or are we basically going to just turn all the savings in health care expenditure to welfare instead?

Hell, there's worse ideas. The ROI on a number of welfare measures is quite good, and it'd pretty certainly benefit a lot more people at the end of the day.

[McTraveller]

Sorry I didn't mean "general" welfare - I meant basically just keep paying the people you just laid off, a large chunk what they were making before because they're no longer employed and there just isn't enough other job demand instantaneously to employ them.

[hector13]

I mean… what makes you so certain there’s going to be a huge amount of unemployed anyway?

Universal healthcare is going to require more people to do clerical work and things like that given the higher demand in healthcare, so if the private healthcare insurance business is expected to go tits up you ask the companies to restructure a little bit to employ some of those people, you offer re-training programs to allow people to move from the insurance market to the healthcare market (or indeed other markets or industries) and after that if anyone is still unemployed it’d be on them.

Could do it systematically so any snags in the plans can be identified and solved early and not become problems later on. Go hybrid so not everyone gets unemployed all at once.

There are things that can be done, and probably a lot of time to figure out given the scale of what universal healthcare will have to be.

[MrRoboto75]

tbf if you had government backed healthcare... wouldn't some of them just work for the government?

[Frumple]

Sorry I didn't mean "general" welfare - I meant basically just keep paying the people you just laid off, a large chunk what they were making before because they're no longer employed and there just isn't enough other job demand instantaneously to employ them.

It'd probably still be a net gain to the health of the country, economic or otherwise, so... again, there's worse ideas. Keeping private insurance in its current state is probably one of them :V

I mean… what makes you so certain there’s going to be a huge amount of unemployed anyway?

Universal healthcare is going to require more people to do clerical work and things like that given the higher demand in healthcare

It's entirely possible I'm misremembering things, but that may not even be true. It's really, really hard to understate how badly private insurance is fucking the US's healthcare system just in regards to clerical work, nevermind all the rest of it.

I can't remember if there's been explicit projections on it, but it's pretty damn possible the savings in terms of all the goddamn shit hospital staff has to deal with to work with insurance companies actually ends up greater than whatever workload gets added by higher demand (though iirc that demand's fairly likely to plateau and then drop back down, as the benefits from folks actually getting help before issues become acute start kicking in).

[hector13]

Well you say that demand will plateau eventually, pretty sure the NHS in the UK was launched in 1948 and demand has increased since.

[McTraveller]

Wait what? How are you going to save money if you have the same exact people employed by the universal plan instead of the private plans?  They're just going to accept lower salaries out of the goodness of their hearts?

You're not going to get enough cost savings by just getting rid of the insurance CxOs.

the savings in terms of all the goddamn shit hospital staff has to deal with

Again - what savings? The only way you can save money through this is if you fire the people and pay them some kind of stipend for their trouble, or cut their salaries and hope they quit and find a lower-paying job elsewhere (because if they find another job that pays the same, there is no net savings, the money just comes from a different account).

Or are we talking about cost savings over time, because the rate of increase of health spending will slow down? That I can see being a mechanism.  What I can't see working is just a wholesale drop in the amount of spending - only a relative drop in spending over time.

[hector13]

A workforce that stays healthy is a workforce that keeps working. That’ll be much cheaper in the long-run if people can actually afford to go to get healthcare.

Equally so you seem to be assuming that the only saving that can be made is via wage costs. In a single payer system, particularly when that single payer is the government, you won’t get the likes of Shkreli buying orphaned drugs and jacking up the price 50,000%, and even otherwise it will have a depressing effect on the price of drugs because manufacturers woukd have the choice of selling their drugs at a fair price, or not selling their drugs at all.

Edit: what you also seem to be forgetting is that if people aren’t paying for private insurance, they can be taxed (like National Insursnce in the UK) to help pay for universal healthcare.