A short rejoinder to Gordon's nonsens about healthcare
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    Default A short rejoinder to Gordon's nonsens about healthcare

    The front page of today's Wall Street Journal has a rather well supported article which can be summed up as "The Indian Health Service is a tragic disgrace, and indeed embarrassment"

    If you grovel around the web for stories on the veteran's administration, there's no shortage of stories of their issues, and it's a recurring political crises.

    Various studies of medicaid suggest most recipients value it at far less than it costs.

    (Medicare does have very broad support from those it covers.)

    So of the 4 "single payer" health care systems in the US (one of them among the largest in the world, medicaid for example covers more people than the population of Canada or the UK), 2 of them "single provider" - one can say:

    1 of the 4 is tragic disgrace and embarrassment - and since it's a program meant to serve some of the poorest residents, who have at least some rights due to treaties dating back a very long time, why would anyone have any faith at all that a national program would serve the poor or disadvantaged?

    1 of the 4 serves veterans, a generally esteemed group in our society, and its still quite problematic.

    1 of the 4 in theory covers the poor, but with rather mixed effect - and alarmingly, at least one large study suggests it has no positive effect at all on health or mortality.

    So, basically batting 0.250 and we can start arguing about medicare too if you want - WHAT SANE PERSON GOES BACK TO SUCH AN AWFUL PROVIDER FOR A NEW SOLUTION TO A PROBLEM?

    US government has DEMONSTRATED OVER DECADES that it is utterly incapable of doing at least some of the things advocates for single payer health care wish for.

    If you bought 4 tools from a supplier and 3 of the 4 broke or caused a lot of problems, would you look to them for the next batch?

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    Quote Originally Posted by bryan_machine View Post
    The front page of today's Wall Street Journal has a rather well supported article which can be summed up as "The Indian Health Service is a tragic disgrace, and indeed embarrassment"

    If you grovel around the web for stories on the veteran's administration, there's no shortage of stories of their issues, and it's a recurring political crises.

    Various studies of medicaid suggest most recipients value it at far less than it costs.

    (Medicare does have very broad support from those it covers.)

    So of the 4 "single payer" health care systems in the US (one of them among the largest in the world, medicaid for example covers more people than the population of Canada or the UK), 2 of them "single provider" - one can say:

    1 of the 4 is tragic disgrace and embarrassment - and since it's a program meant to serve some of the poorest residents, who have at least some rights due to treaties dating back a very long time, why would anyone have any faith at all that a national program would serve the poor or disadvantaged?

    1 of the 4 serves veterans, a generally esteemed group in our society, and its still quite problematic.

    1 of the 4 in theory covers the poor, but with rather mixed effect - and alarmingly, at least one large study suggests it has no positive effect at all on health or mortality.

    So, basically batting 0.250 and we can start arguing about medicare too if you want - WHAT SANE PERSON GOES BACK TO SUCH AN AWFUL PROVIDER FOR A NEW SOLUTION TO A PROBLEM?

    US government has DEMONSTRATED OVER DECADES that it is utterly incapable of doing at least some of the things advocates for single payer health care wish for.

    If you bought 4 tools from a supplier and 3 of the 4 broke or caused a lot of problems, would you look to them for the next batch?
    Okay, 3 of 4 are bad. What is the fourth? Does the fourth work? If it does, why not use it as a starting point for a new system?

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    In other words,

    "If you like the way they deliver your mail, you'll LOVE the way they deliver your baby."

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    I think we should leave the system alone. Except for the out of control cost, the further consolidation of the hospitals into larger and larger systems (while not paying taxes, non-profit)so as to dictate pricing (which puts us at a price disadvantage when manufacturing compared to the rest), absurd drug costs, and worst expected lifespan in the developed world, we are #1!

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    Ah, I had to read that twice, Mebfab.

    Gordon's latest off-topic adventure is less overtly provocative than some previous ones, but he's essentially asking "Gosh, guys. If you just ignore all these real problems, not to mention your crippling political partisanship, that are standing in the way of crafting a serious solution, why can't you just craft a serious solution? Tell us what you think the solution looks like."

    It is HARD to imagine a less productive question at this particular point in time, in this specific political climate. I am pleasantly surprised that we have not yet reached 37 pages of righteous forum raving, but then, it's only been 48 hours...

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    Quote Originally Posted by sfriedberg View Post
    Ah, I had to read that twice, Mebfab.

    Gordon's latest off-topic adventure is less overtly provocative than some previous ones, but he's essentially asking "Gosh, guys. If you just ignore all these real problems, not to mention your crippling political partisanship, that are standing in the way of crafting a serious solution, why can't you just craft a serious solution? Tell us what you think the solution looks like."

    It is HARD to imagine a less productive question at this particular point in time, in this specific political climate. I am pleasantly surprised that we have not yet reached 37 pages of righteous forum raving, but then, it's only been 48 hours...
    I stopped reading any threads started by Gordon, someone that thinks the complexity and problems of running a hotdog-stand are the same as that of running, say General Motors has little credibility IMO (cf Denmark (pop <6 million), and US (pop >320 million))--notwithstanding many other reasons.

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    Who is Gordon?

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    My old account rep at msc was gordon. Good kid. They fired him for not selling enough, So he claims. Apparently when they jacked the price to outrageous a lot of people stopped buying and they took it out on him.

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    Quote Originally Posted by car2 View Post
    I stopped reading any threads started by Gordon, someone that thinks the complexity and problems of running a hotdog-stand are the same as that of running, say General Motors has little credibility IMO (cf Denmark (pop <6 million), and US (pop >320 million))--notwithstanding many other reasons.
    I'm quite curious, I keep hearing this shit.. But NEVER any actual reasons.

    Why CAN'T, and you are VERY VERY sure it CAN'T work, a system that works for a smaller population, not be
    scaled to work for a larger population????

    Is it because 320 is bigger than 6? Gordon isn't saying that a health care system that covers everybody
    HAS to be exactly like Denmark's. Actually he has been very vocal that they are all different.

    Brazil has 200 plus million people and they have a national health care system.. How do they do it??

    Well over a third of the US population is already on Medicare/Medicaid, and those are the OLD, the SICK and the poor.
    People that use THE MOST healthcare.. Basic systems are ALREADY IN PLACE.. Adding the YOUNG, the HEALTHY and
    the employed, you wouldn't double the size of it..

    Or am I missing something.. Is there something magic about 320 million written in scripture that says you can't
    have a functional system for 320 million people..

    So what is so different??? 320 is not 6.. I think we all know that... I think that's a bull shit reason..

    Then you'll say "the US isn't a homogeneous population".. Grabbing a Black guys balls, or a Mexican's balls, or
    a white guys balls and asking him to cough isn't any different.. I'm sure its exactly the same as grabbing
    Michelle Obama's balls

    So what exactly does the population thing have to do with it?? Are we here in the US such pathetic worthless pieces
    of shit that we can't upscale a system? Are we so fucking stupid that we can't come up with a system? We have
    plenty of examples, EVERY OTHER FIRST WORLD COUNTRY has done it...

    Why can't the US do it??? "Well the US has 320 million people, can't be done.. End of sentence."

    Bull shit.

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    Brazil has 200 plus million people and they have a national health care system.. How do they do it??
    Bob, unless the Copacabana isn't really polluted and the Zika virus is fake news and those slums in Rio are some kind of Potemkin village in reverse, I'm not sure they are doing it, actually. Yes, Brazil is definitely a first-world country (after, of course, Denmark!) but I just don't see a need for that kind of system transplant.



    C'mon people, let's go for the customary 812 pages of pissing vitriol...

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    I had a job and got benefits...isn't that how it's apossa work?

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    A substantive reply to BobW's reasonable question, and some of the snarky but quite on point comments of others.

    TL;DR - a powerful plurality, indeed majority, of the electorate actually prefers the current system, in part because ANY "more fair" system will cost them something (a lot) - and the part of the population that the ACA was even intended to address was a small fraction, many of whom ignored it anyway. For probably a majority of the population, "single payer" or some alternate is almost certain to be *worse* for them personally by their evaluation metric. ("If you like your doctor you can keep your doctor" is a by now very famous lie that won't work again.) Making about 2/3 of the population get less or pay more so the other 1/3 can have a better deal has never actually worked very well in the US.

    Longer:

    First, do keep in mind that no matter what your view, you are likely in a minority. It's quite clear there is a huge collection of people who opposed the ACA (obamacare) and oppose any single payer plan. You may reasonably think they're all daft, but the reality is they outnumber you. Do recall that after force passing the ACA, the democratic party got the worst (both absolute and relative) shellacking in the US House in the history of the United States. You can talk about how Republicans are botching up the ACA, but notice that passing it cost the Democrats the house, and to some extent, the presidency.

    You will hear a lot of understandable complaining from the people who got something from the ACA - but they are per force a small part of the population - per force because most people are either covered by employer health insurance, or by medicare.

    Second, OK, you'd like a system where employment by some large entity wasn't required to have health insurance. Something more like Germany where as I understand it people are compelled to sign up for some policy and there several choices - but it's not from your employer - so your insurance costs aren't dominated by whether you have a day job with a big company.

    Why would that be so hard in the US? (The core of Bob's question, and a key thing to understand.)

    I think the number ONE reason is that employer provided health insurance is one of the largest tax subsidies in the world, is a competitive weapon for companies in some markets, and is tied to union support in others. Turns out that a large fraction (numbers very, but think order 50%) of the population of the US is covered by employer provided health insurance. If you add this to medicare, VA, etc., you find that the whole argument about obamacare and the mandate, etc., is actually over a small fraction of the population. Employers don't pay taxes on (most) of the costs of offering health insurance to employees. Employees don't pay taxes on what amounts to compensation (though their salary is lower.) Unions negotiate for this, and nationalizing it in some way would remove a reason for Unions to continue to exist at all.

    The scale of this is bigger than people realize. When I left MSFT I was a bit surprized to find that I could not buy comparable health insurance in the private market. At. Any. Price. If you are MSFT, and at least in 2006 or so were hoping I would come back, this is a feature not a bug. And given the price I pay for not as good insurance (with post tax dollars!) it turns out that gold plated policy was a lot of money, whether I realized it or not. Tax free. At this late date, everybody realizes it.

    So in a very real sense, the *current* system is handing out federal money to companies and their employees in the current system - trying to regularize or nationalize that amounts to taking a large subsidy away from what is basically an electoral majority in the US.

    AND THIS BOTCHES UP THE RISK POOL. Because almost anybody with employer provided health insurance was at one point healthy enough to hold a job. Many independents are too, but statistically all of the "too sick to ever get hired in the first place" folks are in the individual market. Which means statistically very many of the high cost high risk patients are excluded from the employer group pools. And the employer group plans are not part of the ACA risk pools.

    That alone dooms most any other system, because it removes a large, relatively well off, healthy, influential, segment of the population from the risk pool. This is a large part of why premiums for the rest of us are so high, why the mandates on people and employers have been so bitterly fought, and so forth.

    You might sensibly think "OK, we'll just arrange that everybody, employer-covered or individual-covered, are part of the same global risk pool" - that would help, but AMOUNTS TO A TRANSFER OF WEALTH FROM A MAJORITY TO A MINORITY.

    The actual structure of the US, more like the EU than any single Euro state, complicates things even more. The Federal Government doesn't actually have general police power. Note that your Dr. is licensed by your state, not the Feds.

    And so, you could say "we want machined medical implants for knees and hips to be closer to actual cost" - and probably 48 or 49 states would agree with you. And Indiana would ask where the solvency fund is to cover the giant hole you just put in their budget. By the way states cannot go bankrupt....

    It does not help the cause that some of loudest voices for "single payer" are either obviously self interested (the CA nurses association - in effect arguing everybody should pay a lot of taxes so they all have higher paying jobs), or less obviously self interested (folks who like Big Government because they and their friends get jobs, because they know how to lobby, etc.)

    One question was "OK, what about Medicare, that seems to work better" - fun things to realize about Medicare. It's NOT universal - you are only eligible for free part A medicare if you paid a certain level of taxes, or were/are married to somebody who did. If you have been unemployable your entire life, and/or ducked employment taxes your entire life, Medicare doesn't cover you (for free.) What Medicare does cover, and what enrollees pay for some parts of it, is rather complicated, subject to complex laws, and in the end is not in ANY sense "free" or "automatically provided by the government". By the way it will be broke in the next couple of decades. And some fraction of doctors don't accept it. And it's the most successful program...

    So "why not Medicare for all" is actually "a more general not-as-good-as-today policy for everybody who pays taxes" - not actually a solution to the whole issue. And it faces "a majority of the voting age population would find it a bad deal."

    Finally - I personally don't think there will be real "cost cutting" in our lifetimes. Rather, I think that emotional, social, and political pressures will force the fraction of GDP spent on health care past the point of diminishing return, and keep it there.

    Please note that nowhere above did I suggest that the current US system isn't rather weird, or perhaps even fucked up. I am merely explaining why actually changing it in a way that really matters borders on the impossible.

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    Quote Originally Posted by bryan_machine View Post
    The front page of today's Wall Street Journal has a rather well supported article which can be summed up as "The Indian Health Service is a tragic disgrace, and indeed embarrassment"

    Various studies of medicaid suggest most recipients value it at far less than it costs.

    (Medicare does have very broad support from those it covers.)

    So of the 4 "single payer" health care systems in the US (one of them among the largest in the world, medicaid for example covers more people than the population of Canada or the UK), 2 of them "single provider" - one can say:

    1 of the 4 is tragic disgrace and embarrassment - and since it's a program meant to serve some of the poorest residents, who have at least some rights due to treaties dating back a very long time, why would anyone have any faith at all that a national program would serve the poor or disadvantaged?

    1 of the 4 in theory covers the poor, but with rather mixed effect - and alarmingly, at least one large study suggests it has no positive effect at all on health or mortality.
    Bryan,

    I would really like to read the WSJ article about IHS you quote. Unfortunately, it's premium content and I'm not a WSJ subscriber. I was able to read the first paragraph or so, but that's all.

    I'm particularly interested in the article and your post because I am a Native American and I rely on IHS for medical treatment. I use the WW Hastings Indian Hospital in Tahlequah, OK. It's one of the largest, busiest of the IHS treatment centres.

    I suffer from several life threatening conditions and I require quite a lot of care. The worst of these is decompensated liver cirrhosis with ammonia encephalopathy and constantly recurring varices. I need a liver transplant and I'm being seen for that at University of Oklahoma Medical School and Hospital in Norman, OK. This, at IHS expense.

    With all of this said, I must tell you that my care has been excellent. My primary care is a fine doctor and a terrific human being. The Emergency Room, lab, diagnostic imaging, and other departments all do a very good job. So, my experience has been perfectly satisfactory. Of course, there is always room for improvement, but all things considered they are better than private hospitals I've encountered in the past.

    If I were to guess, I'll bet that the problems mentioned in the article were centered around Northern Plains tribes such as the Lakota at Pine Ridge maybe Sisseton and Rosebud. Chippewas also have a rough go of it as do San Carlos Apaches, parts of the Navajo Nation, and some of the California "Rancherias". These are areas that are economically depressed to a horrible extreme. The tribes have never been able to establish viable tribal enterprises that would enable them to contribute of their own funds to healthcare for their tribes. This is in sharp contrast to the Choctaw, Chickasaw, Cherokee, Seminole and Creek tribes as well as many others. These have all created vibrant tribal enterprises and they contribute a very significant portion of total cost expended in the provision of healthcare to their tribes. This is key to the success of IHS programs.

    IMHO it is incorrect to say that IHS is a total failure. They could certainly do better in the geographical areas I mentioned. I know that there have been problems. I frankly don't understand why IHS works well in some parts of the country and not in others, aside from tribal contributions to the program. I think the best programs are those in which IHS and the tribes act as partners to deliver good healthcare.

    In any case I wouldn't label IHS a failure.

    As for the rest, Medicare is a popular program. Medicaid is the primary funding mechanism for nursing home care in this country. Without Medicaid families would be obliged to pony-up the cost of nursing home care for their elderly relatives. Most families simply can't afford a burden like that. So I wouldn't be too harsh on Medicaid.

    Of course none of these plans are perfect. If the government programs were replaced with purely private market insurance there would certainly be problems with that. Namely much higher cost and a lower level of service. Insurance companies exist to make a profit. They really don't give a crap about our well-being. I think we all know that. So before we toss out government Healthcare we should consider the private market alternative and really ask ourselves weather such an alternative would really be better. I really don't think so.

    Anyway, that's my two-cents worth.

    Squire


    Sent Using Tapatalk - Cherokee Nation of Oklahoma, Tahlequah OK

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    A somewhat more direct reply to BobW (for what's it worth.... from some guy on a machining board...)

    1. "every other 1st world country has it" - uh, apparently, that's not actually true. In particular the healthcare systems in Germany and France appear to be quite different from the UK, and from what I saw recently, it's possible to fall through the cracks in France.

    2. The current complicated set of plans actually covers a very large part of the population, and the uncovered part is remarkable for lack of political participation and/or ineffective political participation.

    3. Adding the young to Medicare would require they pay more taxes (they're already mostly paying taxes to cover old people) - that would cost them - or somebody - money. Push back would be unpleasent.

    4. Extending medicaid (rather than medicare) amounts to giving a lot of people a somewhat substandard coverage - and would cost a lot of money and have limited effect. (Something like 40% of Drs don't take medicaid patients. There are apparently entire counties were medicaid is useless.)

    5. Note that the US already has the most progressive net income tax in the world, and it's very difficult to get more net wealth transfer out of that system. Which means that "medicaid for all" let alone "medicare for all" will cost YOU BobW (and everybody else) real money. You are not going to pay for it by taxing Bill Gates, you are going to pay for it by taxing YOU. You personally may be OK with that, but society as a whole is not (so far.)

    6. The arguments about being a hetergenous society are about explaining social and political effects. To understand why it matters think about his. Sweden has apparently a quite rich national healthcare system, which covers residents of Sweden. It explicitly does not cover Germans, and they are not eligible to apply for it, even if they were to pay for it. Why? Why isn't there a single Euro system? The answer from sociologists is that people want to protect and groom relationships with their "in group" - which is at most something like their nation state. They explicitly do NOT want to protect or care for people in their "out group" which is everybody else. It's relatively easy to make everybody in Denmark, or even the UK, feel that their countryfolk are "in group" members who should be cared for. That is, tax themselves to cover them. But I don't think anybody expects Swedes to pay higher taxes to offer healthcare to French people. Or Germans to pay higher taxes to over healthcare coverage to Italians. If Danes are so awesome, why doesn't their health insurance plan include the residents of China?

    Now, think of the US as being akin to the EU rather than Germany or the UK, and you have the same issue. If the US were populated by 320 million German Lutherans, national healthcare would be a much easier case. But since, say, people in Idaho may realistically feel that people in Kentucky are "other" - part of an "out group" rather than an "in group" - doing something all inclusive is more complicated. (And only a large federal government, building programs directed at the middle class rather than the poor, could achieve what has been achieved. Savvy advocates for the poor OPPOSE means testing medicare, for fear turning into a program for just the poor will destroy it. They are right.)

    It's much more about social (and ethnic and let's be real racial) heterogenity, rather than about 320 million per se.

    The population of the EU is quite comparable to the US. The heterogenity is probably on the same order. There is NOT a universal scheme, nor even universal coverage, for the whole EU.

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    Squire -

    I'm glad to hear you think you are getting a better shake from the IHS. Good luck with the liver thing.

    Note that in health care and health insurance discussions, it's the lapses and failures that drive the debate. If that weren't the case, the topic about single payer in the US wouldn't come up at all - after all the current system works well for more than 100 million people! (Including me.)

    You hit at least the main geographic areas, and as almost always, Pine Ridge is the poster child for inadequate results.

    Note too that the "failures" are things like people dying from lack of ordinary care. Things that if they happened in a private or non-profit or public hospital in say WA state would cause a public crises and some heads to roll. (Indeed, there were some bad botches at a local hospital last year and several people got fired, one got his license pulled and the fallout continues.)
    The auditors quoted were talking about an ongoing pattern of really poor care, endangering patients, at multiple IHS hospitals, over years. NOT the sort of thing you can sweep under the rug and say "well it works better in OK"

    And the root causes are surely money and isolation.

    Squire - your observation about local economics make sense - but again, the whole debate is about coverage for single payers, poor people (medicaid recall), people in poor areas. In short, we're arguing about a system that would do a better job for, say Pine Ridge. Given that the revealed outcome of the political system has had these failures (along with some success) for 100+ years, why should we think some nationalized general system would suddenly be free of the political and economic constraints that lead to the current failures? If we were to switch an NHS like system, and it still ended up that the folks in Pine Ridge got screwed while the folks on Park Avenue got a great deal, what have we solved?

    Having government do it does not mean it will necessarily be better, fairer, or cheaper.

    Note that I do NOT advocate terminating medicaid, or the IHS, or VA (maybe better to voucherize it though.)

    I am merely trying to explain what I think I've learned to my fellows who ask. (I've given up on Gordon, he will never get it.)

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    Quote Originally Posted by Bobw View Post
    I'm quite curious, I keep hearing this shit.. But NEVER any actual reasons.

    Why CAN'T, and you are VERY VERY sure it CAN'T work, a system that works for a smaller population, not be
    scaled to work for a larger population????

    Is it because 320 is bigger than 6? Gordon isn't saying that a health care system that covers everybody
    HAS to be exactly like Denmark's. Actually he has been very vocal that they are all different.

    Brazil has 200 plus million people and they have a national health care system.. How do they do it??

    Well over a third of the US population is already on Medicare/Medicaid, and those are the OLD, the SICK and the poor.
    People that use THE MOST healthcare.. Basic systems are ALREADY IN PLACE.. Adding the YOUNG, the HEALTHY and
    the employed, you wouldn't double the size of it..

    Or am I missing something.. Is there something magic about 320 million written in scripture that says you can't
    have a functional system for 320 million people..

    So what is so different??? 320 is not 6.. I think we all know that... I think that's a bull shit reason..

    Then you'll say "the US isn't a homogeneous population".. Grabbing a Black guys balls, or a Mexican's balls, or
    a white guys balls and asking him to cough isn't any different.. I'm sure its exactly the same as grabbing
    Michelle Obama's balls

    So what exactly does the population thing have to do with it?? Are we here in the US such pathetic worthless pieces
    of shit that we can't upscale a system? Are we so fucking stupid that we can't come up with a system? We have
    plenty of examples, EVERY OTHER FIRST WORLD COUNTRY has done it...

    Why can't the US do it??? "Well the US has 320 million people, can't be done.. End of sentence."

    Bull shit.
    In point of fact, there are no successful single payer systems......anywhere! To think that the size of a program has no influence in its effectiveness is ridiculous. The larger the system, the more people are involved, the more complex the logistics, the more difficult coordination and intercommunication becomes among many more attributes. All these things adds program inertia. Program inertia adds delay, inefficiency and the lack of flexibility to service exceptions. Every project manager worth his salt knows this. When it comes to a health care system, these things are deadly.

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    Quote Originally Posted by steve-l View Post
    In point of fact, there are no successful single payer systems......anywhere!
    Bullshit. List the single payer systems be country and explain - with references, not something you pulled out of your arse - why they aren't successful.

    The USA system ranks No 1 on cost per capita and around No 32 on outcomes. It's such a marvelous system that every other First World country in the world looks on in amazement.

    Whether you can fix/improve it is, fortunately, your problem, but don't delude yourself about its efficacy on a cost basis.

    PDW

    PDW

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    Quote Originally Posted by PDW View Post
    Bullshit. List the single payer systems be country and explain - with references, not something you pulled out of your arse - why they aren't successful.

    The USA system ranks No 1 on cost per capita and around No 32 on outcomes. It's such a marvelous system that every other First World country in the world looks on in amazement.

    Whether you can fix/improve it is, fortunately, your problem, but don't delude yourself about its efficacy on a cost basis.

    PDW

    PDW
    All the single payer systems everywhere suffer the issues stated in my last post. The real issue, cost, is not being addressed. The actual cost of direct medical care is only a small fraction of the costs incurred in the USA. The fault is the Government and their regulations. Compliance is expensive, liability protection is expensive. Insurance companies operate a numbers game. They know the risks. They know how much their obligations cost and their premiums simply reflect that reality. They are in competition with each other and if the cost reality were to drop, so would their premiums. In defense of my position, do your own world-wide cost survey, for a set of medical procedures and drug cost. I have to assume you are not stupid. No bureaucracy wants to make themselves irrelevant, so getting rid of it is extremely difficult. So, nobody wants to address it, but only that will resolve the cost issue.

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    the cost issue will not be resolved because in a deep sense people do not want it to be resolved

    the coverage for all issue will not be resolved because americans as a group do not want it to be - you can take the view we are assholes if you want - but the very long term ill treatment of minority groups seems a proof

    the results for cost issue is more complicated, and it turns out lots of 1st world countries have these problems, but the only people in the us who really care are the ones losing elections...

    so maybe the better answer to foreigners is this:

    we are the americans, we are crazy barbaric assholes, get over it.

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    Quote Originally Posted by bryan_machine View Post
    If Danes are so awesome, why doesn't their health insurance plan include the residents of China?
    Thank you for injected some much needed levity into this thread.


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