How Much Can US Health Care Progress If Donald Trump Allows More Money to Invest?

[Art Man]

Pretty much all my life I heard about how much better Canadian healthcare is than U.S. healthcare. In Canada every citizen is fully covered (there may be a line but you are guaranteed). While in the U.S.A. 91% of people are insured at least partially, I couldn't quickly find statistics on what percent are fully covered but I would imagine that number is much lower than 91%. An overhaul of the health system would greatly benefit seniors but before they can find a system that works they need to reduce the cost of healthcare per person. In Canada the cost of healthcare per person is $6,839 while here in the U.S.A. the cost per person is $10,739. Basically, if healthcare cost in the U.S.A. can drop in price to a number that resembles the Canadian expenditure then universal full coverage in the U.S.A. might be possible.

Edited August 29, 2019 by Art Man

[iNow]

43 minutes ago, Art Man said:

if healthcare cost in the U.S.A. can drop in price to a number that resembles the Canadian expenditure then universal full coverage in the U.S.A. might be possible.

You're putting the cart before the horse, here. The reason lower prices are possible in Canada (and other UHC countries) is because they have a much larger risk pool and greater bargaining power by coming together. With the private system in the US, prices cannot as easily be negotiated downward because the insurance companies can only ever represent a fraction of the populace. When every citizen in the country is part of a unified plan, the administrators of that plan have far greater leverage to lower costs.

In short, if we want our price to resemble prices in Canada, universal coverage needs to come first.

[Phi for All]

2 hours ago, Art Man said:

An overhaul of the health system would greatly benefit seniors but before they can find a system that works they need to reduce the cost of healthcare per person.

The health system runs pretty well, given that they're focused more on profit than service, like any other privately-run enterprise. What needs to change is the risk pool associated with it. It's extremely stupid to have private health insurance, for the reasons iNow mentioned, and also because you need a value before insurance makes sense. It's easy to figure out how much life insurance I'd need to cover my family if I died tomorrow, and I can insure a car for it's replacement value, but nobody knows how much good health is going to cost them. We need a national risk pool like Medicare for All so we can gain the most benefit from economy of scale.

[Art Man]

6 hours ago, iNow said:

You're putting the cart before the horse, here. The reason lower prices are possible in Canada (and other UHC countries) is because they have a much larger risk pool and greater bargaining power by coming together. With the private system in the US, prices cannot as easily be negotiated downward because the insurance companies can only ever represent a fraction of the populace. When every citizen in the country is part of a unified plan, the administrators of that plan have far greater leverage to lower costs.

In short, if we want our price to resemble prices in Canada, universal coverage needs to come first.

That would be an even greater risk and so would not be possible.

[iNow]

22 minutes ago, Art Man said:

That would be an even greater risk and so would not be possible.

What would be a greater risk, specifically?

[Art Man]

32 minutes ago, iNow said:

What would be a greater risk, specifically?

Granting universal coverage to all Americans before attempting to negotiate the market to a lower price. Which would effectively deepen the debt already there. I suppose that I should have shortened my quote. My mistake.

Using Canada as a model doesn't work anyways as someone already pointed out.

Edited August 29, 2019 by Art Man

[iNow]

You’re suggesting we cannot change the coverage model while negotiating prices downward in parallel.

Why do you believe these tasks must be done serially or that lowered costs are prerequisite for expanded risk pools?

Are you unaware that regulations and pricing rules get written by the same legislators who’d be writing these coverage bills?

Even from a purely political perspective, the people who think costs must come down BEFORE coverage is expanded tend not to be allies in the UHC push anyway. It’s a baseless rationalization to avoid improvements to a broken system which pays more to get less and cover fewer with worse outcomes. 

I’m not even gonna touch the comment about Canadian healthcare not working bc it’s absurd on its face and suggests you’re either terribly ignorant about the topic or not arguing in good faith. 

Edited August 30, 2019 by iNow

[Phi for All]

36 minutes ago, Art Man said:

Granting universal coverage to all Americans before attempting to negotiate the market to a lower price. Which would effectively deepen the debt already there.

Deepen which debt?

Medicare for All would quickly become the standard for paying healthcare professionals, simply because it could be offered at significant savings to everybody concerned. Doctors groups and hospitals would no longer have to jump through so many hoops to get approval and payment. It's actually MORE IMPORTANT to fix the risk pool before trying to bring down the other costs of keeping folks healthy. It would give us enormous clout to negotiate as the .gov (first step - take back the right to negotiate drug prices that Bush II the Businessman gave away).

 

[iNow]

16 minutes ago, Phi for All said:

Doctors groups and hospitals would no longer have to jump through so many hoops to get approval and payment.

This point is often under appreciated and bears repeating. 

 

https://www.cnbc.com/2018/03/22/the-real-reason-medical-care-costs-so-much-more-in-the-us.html

Quote

Administrative costs, meanwhile, accounted for 8 percent of total national health expenditures in the U.S. For the other countries, they ranged from 1 percent to 3 percent. Health care professionals in America also reported a higher level of "administrative burden." A survey showed that a significant portion of doctors call the time they lose to issues surrounding insurance claims and reporting clinical data a major problem.

 

[Art Man]

1 hour ago, iNow said:

Why do you believe these tasks must be done serially or that lowered costs are prerequisite for expanded risk pools?

A lower cost would be the selling point. You say hey, we get a deal on this and man, we'll sign everyone up! Otherwise, if another senator tries yet again for the 100th time to convince congress to sign a healthcare for everyone bill theyre going to say we cant afford it and we cant force anyone to sign up.

[iNow]

25 minutes ago, Art Man said:

A lower cost would be the selling point.

Indeed, it is. Lower outlays per patient per year. Paying less in taxes than we do in premiums each paycheck. Lower administrative costs for doctors and hospitals. No copays or deductibles. Lower services costs due to increased negotiating leverage and expanded risk pools. No more people avoiding doctors or tests or prescription refills bc they cannot afford them. No more ignoring illness until it worsens and results in an ER visit that costs tons more.

We agree that lower cost is a clear selling point. It’s funny that you miss/ignore the obvious point about how achieving those lower costs requires us to first update the current broken profit driven system. 

Edited August 30, 2019 by iNow

[Phi for All]

2 hours ago, Art Man said:

A lower cost would be the selling point. You say hey, we get a deal on this and man, we'll sign everyone up! 

It's not just lower costs, but I agree that will be the most obvious benefit. With everyone signed up, it's also a better national health database for medical research, a powerful political message that citizens matter beyond their vote, and frankly it's the bare minimum a citizen should expect from a society that requires them to give up so much freedom in order to live in such density. It's a step towards better education for everyone, learning how to take better care of ourselves physically and mentally. And universal healthcare is quite simply the smartest way to spend the money we have available to us for our health. 

I also predict there will be many innovative ways medicine will advance without the spectre of private insurance hanging over us. Remove the profit angle from the risk pool, and healthcare funding can take a more natural course. As it stands now, part of my medical insurance premiums goes to a guy who's paid to deny my claims any way he can. It's a warped, hamstrung system.

[StringJunky]

2 hours ago, Phi for All said:

It's not just lower costs, but I agree that will be the most obvious benefit. With everyone signed up, it's also a better national health database for medical research, a powerful political message that citizens matter beyond their vote, and frankly it's the bare minimum a citizen should expect from a society that requires them to give up so much freedom in order to live in such density. It's a step towards better education for everyone, learning how to take better care of ourselves physically and mentally. And universal healthcare is quite simply the smartest way to spend the money we have available to us for our health. 

I also predict there will be many innovative ways medicine will advance without the spectre of private insurance hanging over us. Remove the profit angle from the risk pool, and healthcare funding can take a more natural course. As it stands now, part of my medical insurance premiums goes to a guy who's paid to deny my claims any way he can. It's a warped, hamstrung system.

Or even just getting your records where they are needed in good time when it's urgent. Authorised UK medical professionals can get anybody's info anytime anywhere. It's one area of ones life, and societally, where it's important it's all connected for access. 

Quote

(Reuters Health) - Less than one in three U.S. hospitals can find, send, and receive electronic medical records for patients who receive care somewhere else, a new study suggests.

Just 30 percent of hospitals had achieved so-called interoperability as of 2015, the study found. While that’s slight improvement over the previous year, when 25 percent met this goal, it shows hospitals still have a long way to go, researchers report in Health Affairs.

“What this means is there is potentially a significant amount of waste and inefficiency in hospitals,” said lead study author Jay Holmgren of Harvard Business School in Boston.

Without access to patient records, doctors might re-order tests that have already been done somewhere else, or make treatment decisions without a full picture of any allergies or underlying medical conditions.  https://www.reuters.com/article/us-health-medicalrecords-sharing/few-u-s-hospitals-can-fully-share-electronic-medical-records-idUSKCN1C72UV

 

Edited August 30, 2019 by StringJunky

[John Cuthber]

7 hours ago, Art Man said:

That would be an even greater risk and so would not be possible.

You say "it is impossible."

The rest of the western world says "We did it".

Who is right?

[Curious layman]

51 minutes ago, John Cuthber said:

You say "it is impossible."

The rest of the western world says "We did it".

Who is right?

He'll see for himself when he moves to Europe. Having unbiased news will help too (depending on where he moves to of course).

If i get sick, I go doctors, get my prescription, go to chemist, and get my medication, if I need to go to the hospital then I do, simple as that, I don't pay anything (outside of taxes).

I feel sorry for Americans with their health care, they really do get f^^^ed over when it comes to health care, I've heard some Americans pay more for health insurance than they  pay for their mortgage.

To me, it's the same as the gun debate, I don't think they'll ever find common ground,  politicians don't work together anymore, too much trying to f^^k each other over, when the only thing they're really doing is fucking everybody else over.

Unfortunatly, I think Americans will have to wait a long time for decent health coverage.

 

Edited August 30, 2019 by Curious layman

[iNow]

9 hours ago, Phi for All said:

It's not just lower costs, but I agree that will be the most obvious benefit. With everyone signed up, it's also...

In addition to those items you listed, for me it's also central to supporting freedom of our citizens. A person cannot truly be free when facing a medical issue they cannot afford to treat. A person cannot be free when they're unable to leave a job they hate and which doesn't support them financially merely because it's the only way they can receive coverage for health. A person cannot be free when they're unable to leave an abusive spouse who instills fear and control merely because that spouse has the job which provides the insurance coverage for that family. 

There's an argument to be made more broadly about the affect of taxes on ones freedom, but we have and will continue to have tax burdens on us forever, and the question by default then becomes how we choose to spend that money. Once we accept the premise of a tax, the conversation of using those taxes to maximize our freedom and prosperity can ensue. 

Everyone needs healthcare at least once in their life, and the fact that quote unquote conservatives wish to force us to pay 3x or more for it through an inefficient system with unnecessary private insurance middle men who do nothing by scrape billions in profits from the sickest among us, bankrupting people merely for getting sick while adding no real value whatsoever to the system, just reeks of stupidity and heads lodged firmly up inside of asses.

[dimreepr]

10 minutes ago, iNow said:

just reeks of stupidity and heads lodged firmly up inside of asses.

The grapes of wrath.

No pun intended.

[StringJunky]

1 hour ago, iNow said:

In addition to those items you listed, for me it's also central to supporting freedom of our citizens. A person cannot truly be free when facing a medical issue they cannot afford to treat. A person cannot be free when they're unable to leave a job they hate and which doesn't support them financially merely because it's the only way they can receive coverage for health. A person cannot be free when they're unable to leave an abusive spouse who instills fear and control merely because that spouse has the job which provides the insurance coverage for that family. 

There's an argument to be made more broadly about the affect of taxes on ones freedom, but we have and will continue to have tax burdens on us forever, and the question by default then becomes how we choose to spend that money. Once we accept the premise of a tax, the conversation of using those taxes to maximize our freedom and prosperity can ensue. 

Everyone needs healthcare at least once in their life, and the fact that quote unquote conservatives wish to force us to pay 3x or more for it through an inefficient system with unnecessary private insurance middle men who do nothing by scrape billions in profits from the sickest among us, bankrupting people merely for getting sick while adding no real value whatsoever to the system, just reeks of stupidity and heads lodged firmly up inside of asses.

And that one time is going to cost tens of thousands, if not more. The Cons and their supporters are silly because you can't bank on not getting seriously ill. Very few people have an uneventful medical history. It is a lighter load for everybody if they share the burden in a pool and they can use it when they need it.

[Phi for All]

11 minutes ago, StringJunky said:

The Cons and their supporters are silly because...

So silly that I suspect it's all just a stall by wealthy interests who don't want their taxes paying to help support the masses in such a broad way. They've been delaying the common sense choices for quite a while now with their "too costly" and their "doesn't work", as well as their racism, and their bootstraps, and their snowflakes, and their 2nd Amendment, and their Welfare Queen, and their immigration fears, and all the other tactics they use to keep tax revenues focused on their private investment opportunities. The Cons pulling the strings over here live in private versions of museums with swimming pools on parks with roads and airstrips, and they resent paying taxes for public versions of the same things because they rarely need them. Working folks just don't deserve more than the pay the wealthy give us to work for them. We're such ungrateful bastards to demand good health on top of all the rest they allow us to have. 

[dimreepr]

24 minutes ago, StringJunky said:

And that one time is going to cost tens of thousands, if not more. The Cons and their supporters are silly because you can't bank on not getting seriously ill. Very few people have an uneventful medical history. 

They don't care because they can bank on their freedom to be unfair

26 minutes ago, StringJunky said:

It is a lighter load for everybody if they share the burden in a pool and they can use it when they need it.

That is the point of a tithe/tax. 

1 minute ago, Phi for All said:

 We're such ungrateful bastards to demand good health on top of all the rest they allow us to have. 

Yep, freedom  over fairness is an unbalanced equation when you own the land.

Did I get that the right way around?

[Sensei]

On 8/29/2019 at 5:02 PM, dimreepr said:

But, if I saved your life; would you be just as critical?

...if you would send me the bill, yes, I would be disgusted and disappointed...

It would not be "saving somebody's life".. It would be "just a business"..

 

[dimreepr]

3 hours ago, Sensei said:

...if you would send me the bill, yes, I would be disgusted and disappointed...

It would not be "saving somebody's life".. It would be "just a business"..

My point was, at an individual level there's no difference in the outcome despite the motivation (greed or philanthropy). And while I agree with Phi, but only very occasionally is a states primary motivation the well-being of it's citizens, and they tend to already be wealthy states.

Wealth/profit is the first step, it becomes disgusting when big pharma sells drugs to the healthy and insurance/casino's covers it's own bets.

 

[Mordred]

While I don't know squat about the American health care system. As a married man to a wife with serious health issues. I can appreciate the health care system in Canada. I priced out the medications my wife has to take daily to the tune of a little over 800.00 per month. With the medical plan I have through my company I pay a flat zero dollars for her prescriptions.

All I can say is I am thankful for that plan and the Canadian health care system without it I would likely be bankrupt trying to keep my wife healthy

 

[Curious layman]

A very good friend of mine has just been diagnosed with throat and chest cancer, you should see the amount of medication he has to take, not to mention the chemotherapy. He has no medical insurance, but because of the NHS it wont cost him anything. Instead of spending his money he's saved over the last 40 years on medical costs, he can pass it on to his grandchildren instead. Serious illness shouldn't bankrupt you.

[StringJunky]

5 hours ago, Curious layman said:

A very good friend of mine has just been diagnosed with throat and chest cancer, you should see the amount of medication he has to take, not to mention the chemotherapy. He has no medical insurance, but because of the NHS it wont cost him anything. Instead of spending his money he's saved over the last 40 years on medical costs, he can pass it on to his grandchildren instead. Serious illness shouldn't bankrupt you.

National Insurance contributions.