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[Rusty Shackleford]

The profit margin on healthcare is razor thin as it is - a 2016 study found that only 45% of hospitals make more money than they spend on a per-patient basis. This is with the absolutely absurd prices charged for many services. Malpractice insurance is a big factor in jacking the prices up, but an even bigger factor is the bare-minimum nature of so many insurance providers. It is far from uncommon for a patient to go through several rounds of testing that both the hospital and patient expect to be covered, only to realize after the fact that a small loophole in the insurance contract or a slight procedural error means that none of it is covered and the patient now has to eat a four or five figure bill that they cannot afford. Patient declares bankruptcy or just lives with the ruined credit, hospital eats the loss and has to charge everyone else more to stay afloat. If the cost of treatment was just salary+supplies+treatment, the prices would be far lower.

Personally, I think a good first step is to mandate that insurance -all forms of insurance- be legally required to operate as a not-for-profit organization, with all existing companies forced to comply or be forcibly dissolved. That might just get the situation into a state where meaningful reform is possible.

You made sense right up until 'forcibly dissolved' then I hope you were in jest or you realize this is a futile cause. There is no mechanism in the US government in any jurisdiction to accomplish what you say without radical changes to the legal system.

If we are making impossible changes to the legal system a really easy change would be tort reform. The plaintiff pays the legal fees of the defendant if their case is ruled against them. Like the legal system in the UK. That would make a huge, huge difference, but again, it's politically impossible. Lawsuits and tort add tremendously to the cost of healthcare, but it will never be changed.

[Descan]

Well I guess I have to apologize to SalmonGod for uncalling him millenial, but I still feel millenial refers more to post-2000 than pre-.

millenial was an assigned term from the early 90s for "people coming of age at the turn of the millenium" not "people born in the new millenium" :V

[Reelya]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3048809/

This study states the cost of medical liabilities (including preventative spending) at about 2.5% of total medical spending. Sure some groups want that, but when a typical year sees 4% inflation in medical spending, tort reform looks like it would only wind back growth in spending by about 6 months worth. It's clearly not the panacea.

[Rusty Shackleford]

If the internet existed at some point before you were out or college or well into a career you are 'Millennial'. The first generation with meaningful internet access is a you.

[Lord Shonus]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3048809/

This study states the cost of medical liabilities (including preventative spending) about about 2.5% of total medical spending. Sure some groups want that, but when a typical year sees 4% inflation in medical spending, tort reform looks like it would only wind back growth in spending by about 6 months worth. It's clearly not the panacea.

Tort reform is the last thing that is needed in this country - lawsuits are a potent weapon for the common citizen, the next-to-last of the Four Boxes, and false stories of frivolous lawsuits have already eroded it far too much. The problem is not in the lawsuits, but in measures taken to reduce the possibility of such a lawsuit, which in turn are protection against spikes in malpractice insurance costs. Even that is one of the smaller contributors to rising healthcare costs.

That said, the study linked admits to being extremely flawed due to poor data, and flatly states that a potentially significant portion of the costs in question are impossible to estimate. It is a useful benchmark, but it isn't something to base conclusions on by itself.

[Rusty Shackleford]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3048809/

This study states the cost of medical liabilities (including preventative spending) about about 2.5% of total medical spending. Sure some groups want that, but when a typical year sees 4% inflation in medical spending, tort reform looks like it would only wind back growth in spending by about 6 months worth. It's clearly not the panacea.

Tort reform is the last thing that is needed in this country - lawsuits are a potent weapon for the common citizen, the next-to-last of the Four Boxes, and false stories of frivolous lawsuits have already eroded it far too much. The problem is not in the lawsuits, but in measures taken to reduce the possibility of such a lawsuit, which in turn are protection against spikes in malpractice insurance costs. Even that is one of the smaller contributors to rising healthcare costs.

That said, the study linked admits to being extremely flawed due to poor data, and flatly states that a potentially significant portion of the costs in question are impossible to estimate. It is a useful benchmark, but it isn't something to base conclusions on by itself.

I understand that is the argument against tort reform and it isn't just frivolous lawsuits, its the constant threat of a lawsuit that drives up the costs of everything. Medicial malpractice tort and related insurance liability  is a major reason why Healthcare is so much more expensive in the USA than anywhere else in the world.

Anyone can file such a malpractice civil suit for reasons real or imagined for absolutely free because of the availability of attorneys willing to work for free on the chance of getting a portion of a settlement resulting from a claim, which are usually sums in terms of millions of dollars.

Yeah, sure the guy that gets an emergency tracheotomy that saves his life but leaves a scar is suing for millions is sticking it to the man and passing that cost to everyone else in the country.

[Lord Shonus]

Just keep attacking that windmill - such cases get thrown out of court almost immediately, when they aren't fabricated entirely. They exist only so that the gullible will try to give away a potent line of defense. Then there will be nobody to speak for those crippled, wounded, or dead because the doctor insisted that they were obviously faking chest pains to get Vicodin, or that they collapsed because they were paranoid after smoking half a joint two hours earlier.

[Rusty Shackleford]

Just keep attacking that windmill - such cases get thrown out of court almost immediately, when they aren't fabricated entirely. They exist only so that the gullible will try to give away a potent line of defense. Then there will be nobody to speak for those crippled, wounded, or dead because the doctor insisted that they were obviously faking chest pains to get Vicodin, or that they collapsed because they were paranoid after smoking half a joint two hours earlier.

Of course there are legitimate cases. I support 'loser pays' tort reform such as it is in Europe. If the victim is right than its free. anyways.

Otherwise everyone paying for healthcare is also paying for litigation insurance, which is astronomical anymore.

I suppose your solution is to make the government aka the taxpayer pay for this, right? Or more accurately taxpayers 20 years in the future that have to pay the assumed debt taken on by the government to finance this kind of shitshow?

[Neonivek]

Just keep attacking that windmill - such cases get thrown out of court almost immediately, when they aren't fabricated entirely. They exist only so that the gullible will try to give away a potent line of defense. Then there will be nobody to speak for those crippled, wounded, or dead because the doctor insisted that they were obviously faking chest pains to get Vicodin, or that they collapsed because they were paranoid after smoking half a joint two hours earlier.

Plus the most typical way of legal bastardry is usually using the legal system as a form of harassment. Suing someone so they spend a lot on legal fees or suing someone in a way that takes up an excessive amount of time and energy.

If a case is superfluous and had absolutely no leg to stand on, not only does it get thrown out but the person suing can end up with the legal fees.

Another aspect is... yeah you NEED the ability to sue hospitals and doctors in order to force liability. Trust me, doctors can get away with murder if no one challenges it. I mean is there a Hospital version of internal affairs?

[Max™]

Just keep attacking that windmill - such cases get thrown out of court almost immediately, when they aren't fabricated entirely. They exist only so that the gullible will try to give away a potent line of defense. Then there will be nobody to speak for those crippled, wounded, or dead because the doctor insisted that they were obviously faking chest pains to get Vicodin, or that they collapsed because they were paranoid after smoking half a joint two hours earlier.

Of course there are legitimate cases. I support 'loser pays' tort reform such as it is in Europe. If the victim is right than its free. anyways.

Otherwise everyone paying for healthcare is also paying for litigation insurance, which is astronomical anymore.

I suppose your solution is to make the government aka the taxpayer pay for this, right? Or more accurately taxpayers 20 years in the future that have to pay the assumed debt taken on by the government to finance this kind of shitshow?

You sound like you're operating under the assumption that government finances bear even the slightest resemblance to home finances, but I have no idea where to begin explaining how wrong that is, except to say that taxation pays for spending each year (with surplus/deficit being over/under respectively) and that tax income being used broadly or even exclusively to pay down government debt would probably fuck up all sorts of financial systems worldwide.

You compare national debt with gross domestic product to determine if there is a problem, not tax revenue.

[ChairmanPoo]

Anyway, Canada is a true Single Payer system (also Taiwan).
 

Also most of the EU.

 https://upload.wikimedia.org/wikipedia/commons/thumb/2/25/Universal_health_care.svg/863px-Universal_health_care.svg.png

[Sheb]

Just keep attacking that windmill - such cases get thrown out of court almost immediately, when they aren't fabricated entirely. They exist only so that the gullible will try to give away a potent line of defense. Then there will be nobody to speak for those crippled, wounded, or dead because the doctor insisted that they were obviously faking chest pains to get Vicodin, or that they collapsed because they were paranoid after smoking half a joint two hours earlier.

Of course there are legitimate cases. I support 'loser pays' tort reform such as it is in Europe. If the victim is right than its free. anyways.

Otherwise everyone paying for healthcare is also paying for litigation insurance, which is astronomical anymore.

I suppose your solution is to make the government aka the taxpayer pay for this, right? Or more accurately taxpayers 20 years in the future that have to pay the assumed debt taken on by the government to finance this kind of shitshow?

Just reality check: do you know that the US federal government already operate single payer healthcare for about 100 millions persons? Also, you don't seem to realise how bad the current US health system is. Not only is the US the only rich country without universal health care, but it's also ridiculously expensive. Just go and look it up in the world bank. It's litterally the most expensive in the world as a %age of GDP. Sure, making health public for all would re-route a lot of money through the state instead of insurer, but there is so much money saving potential than it could easily be done for a fraction of what Americans currently pays to insurer.

[scriver]

Spoiler (click to show/hide)

This is an entirely awful way of presenting information and I hate it. It hate it.

(aside: hate the phrasing "10 times less".  Consider what "1 time less" could possibly mean, as to why... (Never mind whether it should be "fewer", which is a different issue of pedantry on some occasions!) But please don't let this distract you.)

Since the quote was "Canada has 10 times less population", shouldn't it be Fewer only if Canada has more than one population, and since it only has one population  Less is correct because it measures the amount of that population? Sort of like the difference between "I'd like less sauce on my taters please" and "I'd like fewer sauces with my taters please".

...Yeah, I was distracted.

Well I guess I have to apologize to SalmonGod for uncalling him millenial, but I still feel millenial refers more to post-2000 than pre-.

millenial was an assigned term from the early 90s for "people coming of age at the turn of the millenium" not "people born in the new millenium" :V

But so much of my self image hinges on millenials being awful people that are younger than me!

[penguinofhonor]

snip

Can you really say it's politically impossible to tax things for being unhealthy in the US when every state and the federal government have special high taxes on alcohol and tobacco? I understand that you might personally oppose these taxes, but Americans in general seem pretty tolerant of them.

[Starver]

Anyway, Canada is a true Single Payer system (also Taiwan).
 

Also most of the EU.

 https://upload.wikimedia.org/wikipedia/commons/thumb/2/25/Universal_health_care.svg/863px-Universal_health_care.svg.png

What I said I meant. It is justified elsewhere, but if you're happy with Wiki:

Only Canada and Taiwan have true nation-wide single-payer systems.[2]

...and how that squares with whoever it was who said Canada wasn't Single-Payer, I don't know. (So left that uncommented at, but sounded sorta similar to the way the UK isn't.)

Spoiler (click to show/hide)

This is an entirely awful way of presenting information and I hate it. It hate it.

There are big problems with it (neither axis is zero-rooted, one has to assume what the unlabelled cost figure represents, there is no actual 'standard' conversion rate from one scale to the other save what one chooses and change the scales/offsets and the gradients can all be made positive/all negative, and without every country represented we can't be sure that the US is not just the "worst of the absolute best" like Norway would appear if one excluded the US and rescaled accordingly...  does that cover it all, or did I miss something? ) but it demonstrates useful things like the fact that the apparently pilloried "wasteful" NHS, in the UK, may or may not be imperfect (there are problems, and arguments rage over whether it is due to too little oversight or too much) but it clearly does better in cost-benefit ratio (if raw LE is considered a benefit) than yonder colonials at the lower latitudes...

(aside: hate the phrasing "10 times less".  Consider what "1 time less" could possibly mean, as to why... (Never mind whether it should be "fewer", which is a different issue of pedantry on some occasions!) But please don't let this distract you.)

Since the quote was "Canada has 10 times less population", shouldn't it be Fewer only if Canada has more than one population, and since it only has one population  Less is correct because it measures the amount of that population? Sort of like the difference between "I'd like less sauce on my taters please" and "I'd like fewer sauces with my taters please".

Ay, hence "on some occasions". Specifically, I'd have said "...fewer members of population" or just "...fewer people" to get "fewer" in here, but given the nonsensicality of the phrasing (Pop_US=X,  therefore Pop_Can=Pop_US-(10xPop_US)=-9xPop_US?) I thought it worth noting the usual next pitfall.

"Canada has a tenth of the population" works Ok, though. It is a simpler description and doesn't trigger questions such as "ten more 'lessnesses' than what?", like "OtherCountry has XYZ less people than the US, Canada has ten times [the figure XYZ] deficit to the population than the US".  Or, left without any XYZ to work with, "there are ten times fewer people in Canada than in thd US" sends the brain in a direction other than the more correct "there are 90% fewer people in Canada..." and only self-corrects because the possibility of a negative population figure (even for poor, desolate Canada!) is a nonsensical notion.

But "we had ten times less profit than RivalCompany" would easily allow for misunderstanding/misconveying of precise information that does not have a glass floor to clue one in on. Which has (if you care to count the inherent ambiguities) at least four alternate relationships with the (unstated) comparison figure, and probably even more.  (Even "a third as much less again" is less problematic, if colloquial.)

...Yeah, I was distracted.

For which I apologise, but (as you can tell) I was distracted first. With just enough wit to keep it as an aside in the first instance, but not enough to realise that I might have then added in a misunderstandable counterpoint argument (the less/fewer one) even whilst I was attempting to get that exact future discussion quickly disposed of before it even became an additional talking point.  Oh well...



On with the show!  "What Muslim ban?"  Whoops!