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Vulcan wrote: Which pretty much sums up the health care debate in America. One side demonstrates how much less it costs in socialist health care systems, and the other side throws their hands and says they don't care, it's DA EBIL SOCIALIZM!!!!!1!1!
Pretty much. Kings is just deflecting from the fact that a major claim his argument hinges on, the US healthcare is cheaper, isn't true. The healthcare you get will always be better than the healthcare you can't afford to get. Also harping on a tiny piece of anecdote that is outdated and irrelevant to the broader picture.
Vulcan wrote: Which pretty much sums up the health care debate in America. One side demonstrates how much less it costs in socialist health care systems, and the other side throws their hands and says they don't care, it's DA EBIL SOCIALIZM!!!!!1!1!
Left and Right, pretty much hate one another.
Only one side hates facts, though.
riight, sure ...you keep believing that last one, leftists are as big a liars as anyone I have ever seen, the rights lies are lies, the lefts lies are 'facts" sure. glad of you to cherry pick my arguments, I made quite a few claims not just cheaper, but thats ok show that bias strong. pretty safe to say there is no "deflecting" we do hate each other.
Devolving into generalizations, further deflection, and thinly-veiled insults really just proves my point. Also, I'm not liberal.
This message was edited 1 time. Last update was at 2018/05/14 01:42:18
Your quoted texts states that your two superior outcomes at lower than other countries. And every country spends less than us to get sometime comparable, but most often superior, outcomes. The US might have given you a Tylenol in the waiting room (from my EMS and ER experience and years as a triage nurse, not very likely), but they could just as easily charge you $50 for that pill.
With all your concerns about sources, I give you this:
From a person with 17 years experience in the US healthcare system in many different types of hospital structures, from someone trained at the Masters level in my profession, as someone holding a national board certification in my specialty, and as someone holding a commission in the United States Public Health Service: the US spends much more and gets much less than the vast majority of Western healthcare systems.
I don’t argue this to score a point. I don’t argue this to convince anyone that we should switch to super-socialism. I don’t argue this to push for single payer. I don’t care what particular solution we come up with to fix this issue. But to come up with any kind of solution, regardless of the ideology behind it, we need to stop ignoring the undeniable truth that our current system is failing us.
Vulcan wrote: Which pretty much sums up the health care debate in America. One side demonstrates how much less it costs in socialist health care systems, and the other side throws their hands and says they don't care, it's DA EBIL SOCIALIZM!!!!!1!1!
Pretty much. Kings is just deflecting from the fact that a major claim his argument hinges on, the US healthcare is cheaper, isn't true. The healthcare you get will always be better than the healthcare you can't afford to get. Also harping on a tiny piece of anecdote that is outdated and irrelevant to the broader picture.
Vulcan wrote: Which pretty much sums up the health care debate in America. One side demonstrates how much less it costs in socialist health care systems, and the other side throws their hands and says they don't care, it's DA EBIL SOCIALIZM!!!!!1!1!
Left and Right, pretty much hate one another.
Only one side hates facts, though.
riight, sure ...you keep believing that last one, leftists are as big a liars as anyone I have ever seen, the rights lies are lies, the lefts lies are 'facts" sure. glad of you to cherry pick my arguments, I made quite a few claims not just cheaper, but thats ok show that bias strong. pretty safe to say there is no "deflecting" we do hate each other.
Devolving into generalizations, further deflection, and thinly-veiled insults really just proves my point. Also, I'm not liberal.
you sound like a leftist to me. were was a thinly veiled insult, its pretty obvious I have no regard for you and several others I have been responding to. there is no deflection. or do you just want to bait me into saying something so you can run to the mods?
This message was edited 1 time. Last update was at 2018/05/14 01:54:42
thekingofkings wrote: "by every measure the US has worse outcomes and higher cost than the vast majority of Western healthcare systems"
"Five-year survival rates for certain cancers are higher in the U.S. than in comparable countries"
"Post-op sepsis are better in the U.S. than in some comparable countries, but not as low as others"
by direct quotes, the US does not have worse outcomes and higher costs than the vast majority, it is superior to them in the two categories I put in there. according to Forbes we are worse in both categories. So source does matter.
Just so everyone in the conversation is clear, one of the people involved in it posted this in another thread -
thekingofkings wrote: well we have really grown estranged from one another. I am fully guilty of taking likely more offense than is intended. I have found that over the years I generally have come to despise Europeans (except Russians, Poles, and Hungarians) and find it hard to even "talk" with them. Typing takes away so much of communication, someone here mentioned something about being in the room and talking might make a difference. That might be the case. I travel around the world a lot, but I find myself having less and less in common with westerners than the east.
In the US there is just a lack of trust and goodwill between growing segments of society. I generally assume (right or wrongly) that a leftist is a liar, and that a rightwinger is about 80% of the time lying.
Hope that's something the silent readers these debates are supposed to be for take into account. It's hard to have a good-faith discussion about facts when that's the attitude you're discussing with.
This message was edited 1 time. Last update was at 2018/05/14 02:04:54
d-usa wrote: Health outcomes don’t depend on a news source, and by every measure the US has worse outcomes and higher cost than the vast majority of Western healthcare systems.
The factor that is missing here, I think, is the American lifestyle.
We do not live a healthy lifestyle compared to UK/Europe.
As such, because we're a much unhealthier bunch of people, the numbers will be skewed in such a way that's not seen in other countries.
So, I think it's unfair to indict the US healthcare system, without acknowledging that the US lives a very unhealthy lifestyle.
This message was edited 1 time. Last update was at 2018/05/14 02:08:08
Spinner wrote: Just so everyone in the conversation is clear, one of the people involved in it posted this in another thread -
thekingofkings wrote: well we have really grown estranged from one another. I am fully guilty of taking likely more offense than is intended. I have found that over the years I generally have come to despise Europeans (except Russians, Poles, and Hungarians) and find it hard to even "talk" with them. Typing takes away so much of communication, someone here mentioned something about being in the room and talking might make a difference. That might be the case. I travel around the world a lot, but I find myself having less and less in common with westerners than the east.
In the US there is just a lack of trust and goodwill between growing segments of society. I generally assume (right or wrongly) that a leftist is a liar, and that a rightwinger is about 80% of the time lying.
Hope that's something the silent readers these debates are supposed to be for take into account. It's hard to have a good-faith discussion about facts when that's the attitude you're discussing with.
I see no reason to hide where my prejudices sit, and as fast as my initial post degenerated to personal attacks, there was no reason to believe in the "good faith" of the other side, there was none. I am not justifying my position, I don't feel in the slightest bit accountable to any of you for it, but I am explaining where I get my stance from.
A good healthcare system will take these things into account and address them. But I can see where something like “a good healthcare system addresses obesity and pushes policy to fix the problem” can be seen as a “get out of my personal health decisions” issue for many folks. Personally I think public policy and public interventions need to be a part of a comprehensive solution to our current crisis, but I’m a bit of a leftie there.
We also get into a chicken/egg discussion there: do our lifestyles and general unhealthiness drive our heath outcomes, or are our lifestyles and general unhealthiness a symptom of our approach to health maintenance and healthcare? Is our obesity a driver or an outcome? Is our general lack of seeming out preventative healthcare a symptom or a cause?
There is lots of good discussion we can have there, even if we won’t agree on anything, if the parties talking are honestly participating.
Spinner wrote: Just so everyone in the conversation is clear, one of the people involved in it posted this in another thread -
thekingofkings wrote: well we have really grown estranged from one another. I am fully guilty of taking likely more offense than is intended. I have found that over the years I generally have come to despise Europeans (except Russians, Poles, and Hungarians) and find it hard to even "talk" with them. Typing takes away so much of communication, someone here mentioned something about being in the room and talking might make a difference. That might be the case. I travel around the world a lot, but I find myself having less and less in common with westerners than the east.
In the US there is just a lack of trust and goodwill between growing segments of society. I generally assume (right or wrongly) that a leftist is a liar, and that a rightwinger is about 80% of the time lying.
Hope that's something the silent readers these debates are supposed to be for take into account. It's hard to have a good-faith discussion about facts when that's the attitude you're discussing with.
Yeah, I'm noticing he's in deep to the 'anything that disagrees with me is a lie' stance. Looking at the last two pages it's probably better to just ignore him an move on to more reasonable discussion, trying to deal with people debating in bad faith is what got the last thread closed.
d-usa wrote: Health outcomes don’t depend on a news source, and by every measure the US has worse outcomes and higher cost than the vast majority of Western healthcare systems.
The factor that is missing here, I think, is the American lifestyle.
We do not live a healthy lifestyle compared to UK/Europe.
As such, because we're a much unhealthier bunch of people, the numbers will be skewed in such a way that's not seen in other countries.
So, I think it's unfair to indict the US healthcare system, without acknowledging that the US lives a very unhealthy lifestyle.
Unfortunately that sort of statistic falls under the Preventable Illnesses statistic that I posted earlier. You can't just pin the whole mess on that.
Fate is in heaven, armor is on the chest, accomplishment is in the feet. - Nagao Kagetora
d-usa wrote: A good healthcare system will take these things into account and address them. But I can see where something like “a good healthcare system addresses obesity and pushes policy to fix the problem” can be seen as a “get out of my personal health decisions” issue for many folks. Personally I think public policy and public interventions need to be a part of a comprehensive solution to our current crisis, but I’m a bit of a leftie there.
We also get into a chicken/egg discussion there: do our lifestyles and general unhealthiness drive our heath outcomes, or are our lifestyles and general unhealthiness a symptom of our approach to health maintenance and healthcare? Is our obesity a driver or an outcome? Is our general lack of seeming out preventative healthcare a symptom or a cause?
There is lots of good discussion we can have there, even if we won’t agree on anything, if the parties talking are honestly participating.
We have to take culture into account, where obesity and diabetes are more common, look at the foods eaten, Indiana is known for Sugar Cream Pie for example. Food is the biggest issue to health IMO. But size is an issue too, 300+ million people scattered over a vast territory makes a good efficient food assistance program a logistical nightmare. foodstamps mean well, but far too often the healthier food is just too expensive and a parent would rather feed their child what they can then get much less in fruits and vegetables. Some areas still eat foods that were fine when the average job was more outdoors and physical but with more jobs being sedentary, its easier to microwave a hot pocket than make a fresh salad. I am not sure I like how it works now, but I am no less suspicious of the "Food box" idea either..I dont know enough about it, but it too seems like a potential logistical nightmare.
d-usa wrote: A good healthcare system will take these things into account and address them. But I can see where something like “a good healthcare system addresses obesity and pushes policy to fix the problem” can be seen as a “get out of my personal health decisions” issue for many folks. Personally I think public policy and public interventions need to be a part of a comprehensive solution to our current crisis, but I’m a bit of a leftie there.
We also get into a chicken/egg discussion there: do our lifestyles and general unhealthiness drive our heath outcomes, or are our lifestyles and general unhealthiness a symptom of our approach to health maintenance and healthcare? Is our obesity a driver or an outcome? Is our general lack of seeming out preventative healthcare a symptom or a cause?
There is lots of good discussion we can have there, even if we won’t agree on anything, if the parties talking are honestly participating.
We have to take culture into account, where obesity and diabetes are more common, look at the foods eaten, Indiana is known for Sugar Cream Pie for example. Food is the biggest issue to health IMO. But size is an issue too, 300+ million people scattered over a vast territory makes a good efficient food assistance program a logistical nightmare. foodstamps mean well, but far too often the healthier food is just too expensive and a parent would rather feed their child what they can then get much less in fruits and vegetables. Some areas still eat foods that were fine when the average job was more outdoors and physical but with more jobs being sedentary, its easier to microwave a hot pocket than make a fresh salad. I am not sure I like how it works now, but I am no less suspicious of the "Food box" idea either..I dont know enough about it, but it too seems like a potential logistical nightmare.
I love fried catfish, but that is horrible for me, and while I do run and exercise daily, how much activity is enough? food ingredients also, most soda I have had outside the US uses actual sugar and not corn syrup (though you can get sugar sodas that are called throwbacks)
This message was edited 2 times. Last update was at 2018/05/14 02:30:00
d-usa wrote: Health outcomes don’t depend on a news source, and by every measure the US has worse outcomes and higher cost than the vast majority of Western healthcare systems.
The factor that is missing here, I think, is the American lifestyle.
We do not live a healthy lifestyle compared to UK/Europe.
As such, because we're a much unhealthier bunch of people, the numbers will be skewed in such a way that's not seen in other countries.
So, I think it's unfair to indict the US healthcare system, without acknowledging that the US lives a very unhealthy lifestyle.
Unfortunately that sort of statistic falls under the Preventable Illnesses statistic that I posted earlier. You can't just pin the whole mess on that.
Not pinning it all on that... just an important factor.
It's a complex mess that needs improvement.
I'm still waiting for major hospitals to band together into larger entities... but, regulatory changes to facilitate that won't happen for quite some time. But, I'd suspect we'll see it in out lifetime as smaller systems/independent hospitals are having tougher times to weather the swings in the industry.
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d-usa wrote: A good healthcare system will take these things into account and address them. But I can see where something like “a good healthcare system addresses obesity and pushes policy to fix the problem” can be seen as a “get out of my personal health decisions” issue for many folks. Personally I think public policy and public interventions need to be a part of a comprehensive solution to our current crisis, but I’m a bit of a leftie there.
We also get into a chicken/egg discussion there: do our lifestyles and general unhealthiness drive our heath outcomes, or are our lifestyles and general unhealthiness a symptom of our approach to health maintenance and healthcare? Is our obesity a driver or an outcome? Is our general lack of seeming out preventative healthcare a symptom or a cause?
There is lots of good discussion we can have there, even if we won’t agree on anything, if the parties talking are honestly participating.
Yep. Exactly this... as it's not something that can be simply distilled as the root causes.
It's party why single-payer advocates have a hard time convincing skeptics that there's a better way.
This message was edited 1 time. Last update was at 2018/05/14 02:30:47
I'm still waiting for major hospitals to band together into larger entities... but, regulatory changes to facilitate that won't happen for quite some time. But, I'd suspect we'll see it in out lifetime as smaller systems/independent hospitals are having tougher times to weather the swings in the industry.
In Pennsylvania it already happened, UPMC and Allegheny Health Systems have split every hospital in the western half of the state between them. Now healthcare is even more expensive, deaths in the operating room are up, and insurance is unaffordable to the majority of people. The state government has had to step in twice, and the Hippocratic Oath isn't just dead, they've crucified it on a billboard.
God Bless America. That will be $1600 for that consultation.
This message was edited 1 time. Last update was at 2018/05/14 02:35:37
Fate is in heaven, armor is on the chest, accomplishment is in the feet. - Nagao Kagetora
A lot of the “food culture” issues also goes towards public policy issues because quite often “cultural” issues are driven by factors such as poverty and access to food resources.
As an example: Native American rates obesity and diabetes are not just driven by the fact that nomadic lifestyles have gone. Via packaged commodities we have provided them with a diet that drives health disparities through the roof.
I'm still waiting for major hospitals to band together into larger entities... but, regulatory changes to facilitate that won't happen for quite some time. But, I'd suspect we'll see it in out lifetime as smaller systems/independent hospitals are having tougher times to weather the swings in the industry.
In Pennsylvania it already happened, UPMC and Allegheny Health Systems have split every hospital in the western half of the state between them. Now healthcare is even more expensive, deaths in the operating room are up, and insurance is unaffordable to the majority of people. The state government has had to step in twice, and the Hippocratic Oath isn't just dead, they've crucified it on a billboard.
God Bless America. That will be $1600 for that consultation.
as much as I hate to say it, if there is a national consolidation then it needs to be nationalized, the biggest problem with the ACA is it did not go far enough. Doctors and the high cost of training them needs to be addressed. I cant imagine anyone wanting to go so deep in debt for a public sector salary, so thier education would have to be either paid for or massively subsidized. It is not a popular idea on the right (most of the folks I know and associate with) but it would be a step. I would also consider that "basic preventive care" could be done by PA's as opposed to full on doctors. But this would cost a lot of money and would need to be better regulated. It cant be sustained without a lot of give and take.
Going single-payer is more feasible than going the nationalization route.
Having one middleman (ala, Canada) is easier to negotiate price-points within the existing system.
I don't think we'll ever get to the level of UK, or even Canada, but it'd certainly help drive down costs as the administration managing the reimbursements would see what every provider is charging.
whembly wrote: Going single-payer is more feasible than going the nationalization route.
Having one middleman (ala, Canada) is easier to negotiate price-points within the existing system.
I don't think we'll ever get to the level of UK, or even Canada, but it'd certainly help drive down costs as the administration managing the reimbursements would see what every provider is charging.
maybe more of a state level hybrid? most of the university hospitals receive state funding..maybe match with federal dollars?
whembly wrote: Going single-payer is more feasible than going the nationalization route.
Having one middleman (ala, Canada) is easier to negotiate price-points within the existing system.
I don't think we'll ever get to the level of UK, or even Canada, but it'd certainly help drive down costs as the administration managing the reimbursements would see what every provider is charging.
maybe more of a state level hybrid? most of the university hospitals receive state funding..maybe match with federal dollars?
ALL university hospitals receive state/federal fundings. Most (if not all) also have massive charity foundations that funds building/development/training/free-care.
The problem, is that there's TOO MANY layers between the patient and the providers.
d-usa wrote: A lot of the “food culture” issues also goes towards public policy issues because quite often “cultural” issues are driven by factors such as poverty and access to food resources.
As an example: Native American rates obesity and diabetes are not just driven by the fact that nomadic lifestyles have gone. Via packaged commodities we have provided them with a diet that drives health disparities through the roof.
The reality is that healthy food is expensive, often too expensive for many to afford with any regularity. $5 can buy someone a single healthy meal, or a 3000 calorie pizza for the same price.
whembly wrote: Going single-payer is more feasible than going the nationalization route.
Having one middleman (ala, Canada) is easier to negotiate price-points within the existing system.
I don't think we'll ever get to the level of UK, or even Canada, but it'd certainly help drive down costs as the administration managing the reimbursements would see what every provider is charging.
maybe more of a state level hybrid? most of the university hospitals receive state funding..maybe match with federal dollars?
ALL university hospitals receive state/federal fundings. Most (if not all) also have massive charity foundations that funds building/development/training/free-care.
The problem, is that there's TOO MANY layers between the patient and the providers.
whembly wrote: Going single-payer is more feasible than going the nationalization route.
Having one middleman (ala, Canada) is easier to negotiate price-points within the existing system.
I don't think we'll ever get to the level of UK, or even Canada, but it'd certainly help drive down costs as the administration managing the reimbursements would see what every provider is charging.
maybe more of a state level hybrid? most of the university hospitals receive state funding..maybe match with federal dollars?
ALL university hospitals receive state/federal fundings. Most (if not all) also have massive charity foundations that funds building/development/training/free-care.
The problem, is that there's TOO MANY layers between the patient and the providers.
so how to cut layers...would it be worth it?
Going single payer? I think so... but, it's a massive shift in terms of "creative destruction" of an industry and in terms of taxation.
Prestor Jon wrote: So Trump is going to bring back coal jobs by shipping tons of coal to NK as a form of Danegeld to get KJU to play nice and abandon his nuclear weapons program. Trump is clearly the best 5 dimensional chess player ever.
It would probably be Chinese coal. That stuff is filthy and China is weening off it as it modernises, so instead they can truck it to NK and their own emissions would look like they improved.
The US would be providing grain and other agricultural stuff. This would suit Trump very nicely, solving the problem Trump has created for himself by starting a trade war with China, as the Chinese response has been on US agricultural goods. Trump could minimise that harm by government direct buying a lot of produce and shipping it to China. The only loss then would be to th deficit, and I think we've established that's something people like to talk about, not something they actually vote on.
Anyway, what that deal would have been is now just talk because Pompeo has already walked it all back. Now the US position is nuclear weapons for sanctions relief only, and we shouldn't ever mention that just last week the White House was talking about something completely different. Quite why they opted to walk back direct aid isn't known. Maybe Trump hadn't bothered to read the briefing notes so Pompeo's earlier statement was the first time Trump heard that suggested and he hated it? Maybe they saw the blowback to the suggestion of the US giving aid and dropped that. Or maybe they decided that any deal dependent on US aid will only last until the US no longer wants to give that aid, and so it would a temporary, false peace, like the 1990s deal, and so would be irresponsible to world stewardship to follow that course.
It probably wasn't the last one.
“We may observe that the government in a civilized country is much more expensive than in a barbarous one; and when we say that one government is more expensive than another, it is the same as if we said that that one country is farther advanced in improvement than another. To say that the government is expensive and the people not oppressed is to say that the people are rich.”
Adam Smith, who must have been some kind of leftie or something.
Prestor Jon wrote: So Trump is going to bring back coal jobs by shipping tons of coal to NK as a form of Danegeld to get KJU to play nice and abandon his nuclear weapons program. Trump is clearly the best 5 dimensional chess player ever.
It would probably be Chinese coal. That stuff is filthy and China is weening off it as it modernises, so instead they can truck it to NK and their own emissions would look like they improved.
The US would be providing grain and other agricultural stuff. This would suit Trump very nicely, solving the problem Trump has created for himself by starting a trade war with China, as the Chinese response has been on US agricultural goods. Trump could minimise that harm by government direct buying a lot of produce and shipping it to China. The only loss then would be to th deficit, and I think we've established that's something people like to talk about, not something they actually vote on.
Anyway, what that deal would have been is now just talk because Pompeo has already walked it all back. Now the US position is nuclear weapons for sanctions relief only, and we shouldn't ever mention that just last week the White House was talking about something completely different. Quite why they opted to walk back direct aid isn't known. Maybe Trump hadn't bothered to read the briefing notes so Pompeo's earlier statement was the first time Trump heard that suggested and he hated it? Maybe they saw the blowback to the suggestion of the US giving aid and dropped that. Or maybe they decided that any deal dependent on US aid will only last until the US no longer wants to give that aid, and so it would a temporary, false peace, like the 1990s deal, and so would be irresponsible to world stewardship to follow that course.
It probably wasn't the last one.
other than sactions relief, what real incentives do we really have to offer?
thekingofkings wrote: it depends on what you take as evidence, but Forbes (again depending on what you accept as evidence) has put out reports showing the US system being considerably more innovations in medicine and biology. That might be because a lot of our hospitals are linked to universities, but there are private hospitals like National Jewish in Colorado that are very highly regarded.
Uh, links between universities and hospitals is not some amazing thing that only happens in the US.
The reason the US trials a huge number of new treatments and medicines is simple - money, people and industry. Money - the US has more money splashing through its system than anywhere else, which means there is money funding per person for new trials. People - with more than 300m it is much easier to trial a lot of treatments across decent sized population groups, smaller countries, and ones with less diversity, would have to look at cross border trials, which adds a lot of cost and complexity. Industry - the US has the best venture capital system in the world, so promising medical research (which happens everywhere in the world) typically gets rolled in to testing and development in the US, just because that's where the capital is.
All of this is good, really, and it does mean the US drives a lot of medical advances. But none of it is changed by a change to the system that actually provides healthcare.
The reason you have middling healthcare results compared to what you spend is actually very simple - because some people get $100,000 care for minor afflictions, while other people can't access $500 treatments that might save their lives. It's great that a 78 year old can get an experimental treatment to prevent a disease that might extend his life by a year, but it's completely mad when the same system isn't able to provide juvenile diabetes screens for pregnant women, resulting in late term miscarriages and some really dangerous births.
When treatment is allocated based on wealth and insurance status rather than medical need, you end up with a system that costs a lot of money, while not doing the small stuff that really improves population health.
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BaronIveagh wrote: More Treason from Trump, he's promising to save Chinese jobs in an effort to create a rival for US tech firms.
This is so weird. ZTE have been fined billions for breaking sanctions on Iran, for stealing sensitive US secrets, and security agencies in multiple countries have stated ZTE is not to be trusted. So maintaining or even increasing the ban on ZTE would suit Trump's rhetoric on Iran and China, and let Trump talk about American jobs first. Instead Trump is tweeting about allowing ZTE back and how nice that would be for Chinese jobs?
I mean, obviously Trump's rhetoric on everything is total crap, but in everything else Trump has maintained the rhetoric in public while doing the crooked stuff behind the scenes. Here Trump is just saying that he's going to help a Chinese company for no explainable reason.
So weird.
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thekingofkings wrote: The leaning of the source is often used to discredit or disregard and both sides do it. If you were to cite say, Forbes, CNN, and Fox, and I cited The Enquirer, NY Times and CBS, and we had different opinions on something, all of those sources are cited, but not all of them would be taken as equals (some certainly shouldn't be).
You're getting close to an important truth here, but not quite. It is true that using sources only goes so far because peole can disagree on what a good source is. But what you miss is that a source shouldn't be accepted or attacked just because of the media company that produced it, it should be accepted or attacked based on whether the information given by that source is accurate and complete.
But people don't do that. In part because they're lazy, but mostly because US political debate has become so tribalistic that it doesn't even occur to many people to just read a source and think about whether what is being claimed is a logical conclusion based on the evidence provided.
But doing that would mean not just reading and actually having to think about stuff, it would also mean having to confront some beliefs we hold dear to. Hard work and humility. Not gonna happen.
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whembly wrote: Modern-day politics is just a giant game of soccer (that's football you European heathens!) with everyone falling down pretending to be hurt.
Interesting analogy.
What's telling to me is one side is pretending to gravely hurt because a comedian told a joke about using burnt facts as eye shadow, the other side is pretending to be gravely hurt because a White House staffer joked about a senator with a terminal brain cancer being dead soon.
Both sides are undoubtedly exaggerating the impact for political effect. But there is a massive difference in the scale of performance vs actual substance.
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whembly wrote: The factor that is missing here, I think, is the American lifestyle.
We do not live a healthy lifestyle compared to UK/Europe.
Australians are fatter than Americans, but we deliver a better healthcare system for less cost. And if we look across American states you see massive differences in lifestyle that don't line up with cost/effectiveness of that state's healthcare.
I'm not saying that's not an issue, obviously it's easier to treat a healthier population, but it is not even close to being an explanation for the US healthcare mess.
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whembly wrote: Going single-payer is more feasible than going the nationalization route.
Having one middleman (ala, Canada) is easier to negotiate price-points within the existing system.
Nationalisation is not possible in the slightest. That's the kind of scheme you have to build from the ground up, starting in a country with minimal existing health infrastructure. No country today can go about buying up all the hospitals and health clinics. And especially not the US.
Single payer is more viable, but its still near impossible. It would mean cutting out multiple billion dollar companies employing hundreds of thousands of people. Not going to happen short of Sanders leading a coup and setting up machine gun teams to capture the Washington Mall.
What is viable is last resort coverage, ie medicaid for all. Most would still be covered through private insurance, but people who missed that because their work doesn't offer it, or they have a pre-existing condition etc, would still get coverage through a government system. It'd have limited networks, but it would mean everyone gets a basic level of care and won't be bankrupted for accessing it.
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thekingofkings wrote: other than sactions relief, what real incentives do we really have to offer?
The 1990s deal had the US provide electricity generators, and subsidised fuel.
This message was edited 8 times. Last update was at 2018/05/14 04:36:42
“We may observe that the government in a civilized country is much more expensive than in a barbarous one; and when we say that one government is more expensive than another, it is the same as if we said that that one country is farther advanced in improvement than another. To say that the government is expensive and the people not oppressed is to say that the people are rich.”
Adam Smith, who must have been some kind of leftie or something.
sebster wrote: The reason you have middling healthcare results compared to what you spend is actually very simple - because some people get $100,000 care for minor afflictions, while other people can't access $500 treatments that might save their lives. When treatment is allocated based on wealth and insurance status rather than medical need, you end up with a system that costs a lot of money, while not doing the small stuff that really improves population health.
A good point, but IIRC another thing that drives up costs is uninsured ER visits. Hospitals are legally obliged to do what is reasonable to save your life if you are critically injured, and that's not free even if you can't pay it back ever. The only way to get that money is to charge it to the other patients, which gives you those $50 Tylenol pills and other outlandish bills. Then there's the lawyers mentioned, ofc, negotiating to lower these costs with the hospital on the insurance company's behalf. They have to be paid too.
So while it might sound like it only concerns you (or your employer) when you have a nice private health insurance you still get billed for those less well off. It's just that it's not done through those evil socialist taxes but good healthy capitalism! And somehow - all those lawyers maybe - it gets to be even more expensive...
I've mentioned a few times that few in the US really understand how US power worked, or why. This included Trump, who like many Americans seems to understand foreign policy through little more than a kind of fuzzy brained resentment than any actual idea of the alliances in place and what they meant for the US and the world at large.
The most shocking realization, however, is one that affects us directly: The West as we once knew it no longer exists. Our relationship to the United States cannot currently be called a friendship and can hardly be referred to as a partnership. President Trump has adopted a tone that ignores 70 years of trust. He wants punitive tariffs and demands obedience. It is no longer a question as to whether Germany and Europe will take part in foreign military interventions in Afghanistan or Iraq. It is now about whether trans-Atlantic cooperation on economic, foreign and security policy even exists anymore. The answer: No. It is impossible to overstate what Trump has dismantled in the last 16 months. Europe has lost its protective power. It has lost its guarantor of joint values. And it has lost the global political influence that it was only able to exert because the U.S. stood by its side.
A generation from now, when they talk about the end of the American order of the planet, people will ask why it happened, and the answer will be petulance and stupidity.
Spetulhu wrote: A good point, but IIRC another thing that drives up costs is uninsured ER visits. Hospitals are legally obliged to do what is reasonable to save your life if you are critically injured, and that's not free even if you can't pay it back ever. The only way to get that money is to charge it to the other patients, which gives you those $50 Tylenol pills and other outlandish bills. Then there's the lawyers mentioned, ofc, negotiating to lower these costs with the hospital on the insurance company's behalf. They have to be paid too.
So while it might sound like it only concerns you (or your employer) when you have a nice private health insurance you still get billed for those less well off. It's just that it's not done through those evil socialist taxes but good healthy capitalism! And somehow - all those lawyers maybe - it gets to be even more expensive...
True, though I'd say its two sides of the same coin. All the costs of unpaid emergency treatments get passed through the rest of the system, as you say, but it is a product of a system that doesn't have a simple means of getting necessary treatment and payment for everyone. Rather than treatment being cheaper preventative medicine with a single, simple settlement of the account, instead you get emergency treatment that can lead to a hugely expensive debt collection, legal dispute and final settlement.
The $50 Tylenol is impacted by that problem, but it has a bigger cause, which is a whole other problem of the US system. Because the the US system is a product of millions of deals between insurers and providers, with no transparency to those deals. Funnily enough some treatments in the US can be as cheap or cheaper than elsewhere, because on that one treatment a provider got a good deal, but then attached to that there'll be all kinds of hidden items with stupid mark ups to offset the price of that one discounted treatment. And heaven help you if you use US healthcare without access to an insurers negotiated treatment rates.
“We may observe that the government in a civilized country is much more expensive than in a barbarous one; and when we say that one government is more expensive than another, it is the same as if we said that that one country is farther advanced in improvement than another. To say that the government is expensive and the people not oppressed is to say that the people are rich.”
Adam Smith, who must have been some kind of leftie or something.
that magical "free" you guys keep lying about, its not "free" you pay for it each year ,your taxes are obscene.(you likely pay more in taxes than I pay for taxes and my premiums combined) thats what pays for it,
Well I actually did the math when I was offered a permanent position in the US instead of just spending 8-10 weeks a year there, and the results were the opposite.
My private plan here + taxes cost less than just the regular plan most colleagues in the US got (which was pretty comprehensive but nothing top tier)
I'm speaking about 10 years back but if anything the numbers will be worse now... plus now I have a son with a very expensive condition (ASD) that would cost upwards of 30K a year to properly treat un the US (schools, speech specialists, neuropaedatricians, etc) cost here is less than 100 euro a month for the extra private sessions, and I don't even have to worry about that affecting my own insurance policy.
depends, ACA has some really good plans. the thing is you would have options based on your needs. You might be better off not coming. Dont know how Poland's system is.
Apples to apples it's a no contest.
You can get affordable-ish, but only by compromising on high deductibles, high copays or patchy coverage. I did the math and to get anywhere close to what I got at home (private + public) I'd have to start looking at 4-figures a month, and that's with major compromises.
4-figures! compared to my zero deductible, zero copay, infinite allowable cost, subsidised meds public plan and my 60 euro a month private plan for the small stuff you want done quick and comfortable (such as your experience with the NHS).
And it's Spain actually, Poland is only a temporary location.
I think it's undeniable that the US has some very high quality care in specific areas - probably the best in the world in certain fields due to attracting large amounts of medical talent and spending a lot of money. If you want cutting edge treatment and high tech solutions the US is the place to be. If you've got a rare and complex disorder or require a complex and difficult to perform surgery, the US is likely the best place to get it.
However, this comes at the cost of general population health measures and efficiency in spending. So while those people with the really difficult complaints or those who can afford it are getting top of the line care, others are being ripped off on a huge scale and in some cases not recieving preventative care that could solve things before they get big and expensive.
These are all policy choices that any country can make. The UK has decided to have the most cost effective healthcare possible, which means limiting patient choice, accepting waiting lists, and having worse outcomes for some of the very expensive or difficult treatments. However, looked at overall, the general population gets a good standard of care and it does not cost them very much (I am not saying it's free, I'm saying it's efficient). You just have to look at Trump whinging that the NHS is ripping off US medical suppliers to see that collectivisation increases bargaining power and results in better deals. If I had a criticism of the UK system it would be that it is too open to interference for political gain and it is currently underfunded for the outcomes it is expected to deliver.
Personally, of the places I've lived in, I have to say I really like the German model. It seems like something that might be somewhat doable in the US too - a public insurance model that allows for some of the collective bargaining power of the NHS while allowing a bit more patient choice in terms of which doctor they get to see. Germany's secret weapon is having lots and lots of qualified medical personel though, something that requires a fix outside the healthcare system itself, but I don't think the US has a shortage of medically trained people and could just issue visas if they wanted more.
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sebster wrote: I've mentioned a few times that few in the US really understand how US power worked, or why. This included Trump, who like many Americans seems to understand foreign policy through little more than a kind of fuzzy brained resentment than any actual idea of the alliances in place and what they meant for the US and the world at large.
The most shocking realization, however, is one that affects us directly: The West as we once knew it no longer exists. Our relationship to the United States cannot currently be called a friendship and can hardly be referred to as a partnership. President Trump has adopted a tone that ignores 70 years of trust. He wants punitive tariffs and demands obedience. It is no longer a question as to whether Germany and Europe will take part in foreign military interventions in Afghanistan or Iraq. It is now about whether trans-Atlantic cooperation on economic, foreign and security policy even exists anymore. The answer: No. It is impossible to overstate what Trump has dismantled in the last 16 months. Europe has lost its protective power. It has lost its guarantor of joint values. And it has lost the global political influence that it was only able to exert because the U.S. stood by its side.
A generation from now, when they talk about the end of the American order of the planet, people will ask why it happened, and the answer will be petulance and stupidity.
It's really something to see. And it's terrifying and depressing. The only people who benefit from this spat are our enemies. Europe feels somewhat surrounded now - Russia to the East and an increasingly bellicose and irrational US to the West, with unstable and desperate neighbours to the south. I guess it really is time to start looking to our own defense and interests. It's a shame, because once you build a hammer you start looking for nails to use it on.
This message was edited 2 times. Last update was at 2018/05/14 07:55:54
hate one another. 
