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Shakugan posted:If you go outside your house, there's a risk you might come to harm. Why would anyone take the risk of going outside?! People who choose to go outside are to blame if they get mugged, hit by a car whatever. It's their own stupid fault for leaving their basements. Yeah and if someone else hurts you, you get to sue them to pay for your injuries. Like if you get hit by a car the insurance picks up the bill, or your own uninsured motorist, or you get a judgement against them and the hospital goes after them. Please make more strawman arguments. Fat Ogre fucked around with this message at 21:56 on May 4, 2014 |
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May 4, 2014 21:53
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Fat Ogre posted:It isn't like people don't understand healthcare is expensive in this country. The injury rate for skiing is below 2.5 per 1,000 skiers; in 2012 the injury rate on the roads was 11 per 1,000 licensed drivers. Maybe you should hassle him for being driven to the ER instead, what sort absolutely loving insane person would take that risk without health insurance?
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May 4, 2014 21:56
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Mo_Steel posted:The injury rate for skiing is below 2.5 per 1,000 skiers; in 2012 the injury rate on the roads was 11 per 1,000 licensed drivers. Maybe you should hassle him for being driven to the ER instead, what sort absolutely loving insane person would take that risk without health insurance? Yeah like I said car insurance covers that.... Or is there a skiing insurance you can get? Maybe something like health insurance?
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May 4, 2014 21:58
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Fat Ogre posted:Yeah like I said car insurance covers that.... Or we could have universal coverage and then people wouldn't have to worry about crippling debt for taking part in generally safe activities and you wouldn't have to blame them for being lunatics. Hence this thread about UHC in Vermont.
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May 4, 2014 22:01
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Fat Ogre posted:Yeah and if someone else hurts you, you get to sue them to pay for your injuries. Like if you get hit by a car the insurance picks up the bill, or your own uninsured motorist, or you get a judgement against them and the hospital goes after them. Plenty of car accidents happen with the other party speeding off before you can get their details. Muggers don't kindly provide their information to you after a beating. Many accidents don't involve anyone else at all and may be as simple as tripping down stairs and breaking bones. It's not a strawman argument at all, your argument is equivalent and just as stupid. Plus yeah, the skiing accident rate really isn't that high anyway.
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May 4, 2014 22:02
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Mo_Steel posted:Or we could have universal coverage and then people wouldn't have to worry about crippling debt for taking part in generally safe activities and you wouldn't have to blame them for being lunatics. Hence this thread about UHC in Vermont. At what point did I say we shouldn't have UHC?
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May 4, 2014 22:06
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I really don't understand your argument. Nowhere did he say that the American friend didn't have insurance, and as my own experience shows, you can easily rack up a crippling bill at the ER even with insurance. So what are you trying to say?
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May 4, 2014 22:08
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Shakugan posted:Plenty of car accidents happen with the other party speeding off before you can get their details. Muggers don't kindly provide their information to you after a beating. Many accidents don't involve anyone else at all and may be as simple as tripping down stairs and breaking bones. The straw man is saying people are to blame if they go out and get hurt by someone else or something else. I was talking about engaging in voluntary activities known to be dangerous without insurance. You brought up getting mugged etc. Last time I checked people don't volunteer to get mugged. Hence strawman.
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May 4, 2014 22:08
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Redeye Flight posted:I really don't understand your argument. Nowhere did he say that the American friend didn't have insurance, and as my own experience shows, you can easily rack up a crippling bill at the ER even with insurance. So what are you trying to say? 2000 is crippling now? Where do you live that 2000 is crippling but you don't qualify for state aid etc for being poor as gently caress?
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May 4, 2014 22:09
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Fat Ogre posted:2000 is crippling now? Where do you live that 2000 is crippling but you don't qualify for state aid etc for being poor as gently caress? Wherein I'm a graduate student. EDIT: Hell, just on a minimum wage job 2000 dollars is 1/8th of your entire yearly salary.
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May 4, 2014 22:11
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Fat Ogre posted:2000 is crippling now? Where do you live that 2000 is crippling but you don't qualify for state aid etc for being poor as gently caress?
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May 4, 2014 22:13
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Fat Ogre posted:Yeah like I said car insurance covers that.... That sort of depends on your car insurance contract , the other driver's car insurance contract, your health insurance contract, and whether either/all will try and punt you back to the other. It's a lot more complicated and there's a lot of vagaries depending on which states jurisdiction applies. As anyone who has dealt with any insurance company ever can tell you, they will take every opportunity to pass the cost onto another party in the event of a claim. Car insurance aside, when you have a country like the United States who spends nearly twice the OECD average on medical care for worse results in every single metric with the sole exception of medical care for those aged 75+ (mostly as a result of cancer treatments and the like- we do do pretty good in at respect if you an afford it ) it's kinds of a canard to argue that personal responsibility has any real relevance on a systemic problem that is literally devouring the American economy. Like, we can discuss other non-single payer models- the German/Swiss model is a decent alternative if you feel the private sector should play a role as a payer- but we really get pretty much the worst of all possible worlds right now and it's not because people are going skiing too often.
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May 4, 2014 22:14
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Redeye Flight posted:Wherein I'm a graduate student.  I had a full time job with health insurance when I went to college. I guess I just don't understand.
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May 4, 2014 22:14
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Fat Ogre posted:At what point did I say we shouldn't have UHC? I never said you did, I said you were blaming a victim of our lovely insurance system for being "insane" by taking part in a relatively safe activity. Which you are, and you continue to not comprehend why that's idiotic.
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May 4, 2014 22:16
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Fat Ogre posted:I was talking about engaging in voluntary activities known to be dangerous without insurance. No, you aren't. Jesus christ skiing in the general sense isn't "dangerous"(obviously there are trails where it can be). It's dangerous in the sense almost everything has some kind of danger. People generally don't bring their kids for day trips though to dangerous activities. I mean you may as well harp on me for riding my bike to work with no insurance when I could just take the bus. Then again you in fact did put out riding a stationary bike over an actual bike because it's less dangerous. Nessus posted:America, presumably. Yeah, like the entire 1/2 of the country that didn't expand Medicaid(and the other 1/2 only came into effect a few months ago, beforehand unless you were totally destitute or had kids, you weren't getting Medicaid)
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May 4, 2014 22:40
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Fat Ogre posted:2000 is crippling now? Where do you live that 2000 is crippling but you don't qualify for state aid etc for being poor as gently caress? 50% of Americans would be in deep trouble with a sudden $2000 expense.
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May 4, 2014 23:00
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I have a question I've been wondering about. In other countries with single-payer healthcare how do they treat brain-damaged infants and children that have almost no chance of walking or talking? In this US this will cost over a million dollars per decade that the child lives, but as long as the parent wants to keep them alive, they can.
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May 4, 2014 23:38
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Fat Ogre posted:Maybe, just maybe, you shouldn't go Skiing if you don't have insurance. It is illogical to put conditions on activities that would improve your chances at not receiving injuries when there are a host of common, everyday activities that are more likely to cause you injury. Many of these activities do not have the kind of compensation that driving does and litigation is a time-consuming and costly method of justice that isn't guaranteed to pay out enough to balance the loss of a normal life. Nobody has the ability to accurately balance each action in life with a proper reaction. To force people to live boring, protected lives is one of the worst ways to promote a health care system. Just because someone wants to ski (a perceived injury-prone activity which isn't as injury-prone as something normal like driving, as was pointed out earlier) doesn't mean they should be denied that activity through the threat of costly debt or even refusal for treatment of possible injury.
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May 5, 2014 03:40
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Fat Ogre posted:
He's just trolling now.
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May 5, 2014 03:42
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Isn't it also a little insulting to say "You silly proles shouldn't be doing something as high brow and expensive as skiing. Go back to your hovels before
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May 5, 2014 03:42
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anonumos posted:Isn't it also a little insulting to say "You silly proles shouldn't be doing something as high brow and expensive as skiing. Go back to your hovels before
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May 5, 2014 03:46
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http://www.vnews.com/opinion/11801131-95/column-heres-why-a-single-payer-system-wont-save-us-health-caresw Column in opposition to single-payer. Thoughts?
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May 5, 2014 03:50
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This has taken a stupid turn. Whether it's smart for an individual to ski with no insurence is utterly unrelated to whether the nation should have nationized healthcare or not. At this moment it doesn't, so people making choices have to make them based on that reality.
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May 5, 2014 03:52
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AYC posted:http://www.vnews.com/opinion/11801131-95/column-heres-why-a-single-payer-system-wont-save-us-health-caresw
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May 5, 2014 03:58
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Nessus posted:An unpersuasive argument trading heavily on "blooooo govmint bad" in my opinion, though I suppose she raises a point that even if we instituted quote:Holding down growth rates is feasible, but cutting spending is absurdly difficult because it means cutting people’s incomes. Incomes that they counted on to help make their mortgages and car payments. Maybe you don’t feel so bad for rich surgeons who have to sell the BMW, and I don’t, either. But America’s cost inflation is not just about fancy surgeons. It’s everything: surgeons, general practitioners, nurses, respiratory technicians, private hospital rooms, MRIs, CT scanners — and I haven’t even gotten to drug prices. This quote from the article captures what I think is the core of her argument. If health care is for instance 15% of the US economy and realizing per patient costs comparable to the Canadian system would imply bringing that down 40%, then realizing those gains over the short term would imply shaving about 6.5% off of GDP which would be a major disruption to the US economy. It's hard to see where the political will to do that could come from, and also hard to see how it would be technically feasible. Over the very long term it might be possible to hold the growth rate of health care spending down so that the sector becomes less important as a % of GDP, but the author is skeptical because she claims American healthcare is more expensive for reasons that are also expensive and difficult to fix. For instance, patient rooms in US hospitals are largely private and that means less beds per hospital, more duplicated equipment, more staff to monitor patients, etc. To fix that you have to build new hospitals and that takes a ton of money and time. So whether or not single payer is worth it after all the pain to get there (I suspect the author would say it's not) it would require taking an axe to the US economy in addition to putting a ton of money into the system up front to realize uncertain cost savings later and that makes the project politically impossible.
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May 5, 2014 04:32
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What the gently caress hospitals are these that are mostly private rooms? Has that been where all the new stuff has been? Every time I've been in a hospital to visit or for treatment it's been semi-private, except when I was in the ICU for a few days. I mean anecdote is not the plural of data, but there are clearly non-single hospital rooms out there.
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May 5, 2014 04:42
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As a Vermonter, I'm pretty pessimistic about the chances of single payer here. The state government is fairly effective at implementing incremental change but medium size changes (like property tax reform) have had a lot of negative knock on effects over time. The part time legislature is partially to blame for that, but I also worry about the depth of talent we have available in the state government. Outside of a few areas (semiconductor manufacturing, agriculture, and tourism) Vermont doesn't have a lot of world class talent. For something like roll out of single payer when you have an at best indifferent federal government for a partner, making sure you have the best and the brightest is pretty much required. You have Fat Ogre's issue of people crossing state lines to get free insurance, but even beyond that there are a bunch of issues that need to be resolved. We have a fairly large population of out of state students and tourists, so a lot of the administrative savings from dealing with just one payer are going to be lessened. How do large, multi-state employers that self insure going to be treated? Are their employees (who are likely going to have higher that normal incomes) going to be exempt? If so, we're adding more administrative complexity. If not, how to you ensure that the employees are not paying double? Beyond that, there are a host of logistical issues in standing up insurance operations for ~600,000 customers that will need treatment all over the world. None of the issues are impossible to solve, but as a pilot program for the country, I wish a state with more resources (both human and financial) was going first.
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May 5, 2014 04:47
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AYC posted:http://www.vnews.com/opinion/11801131-95/column-heres-why-a-single-payer-system-wont-save-us-health-caresw quote:The financing is impossible, in part because the politics is impossible. And the politics is impossible in part because the financial hit would be too big. Single-payer would have to be paid for at the extremely high prices that Americans pay, not the lower European prices that we’d rather have. And when you look at the taxes needed to finance a government takeover, you quickly realize that most people just aren’t willing to pay the price.
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May 5, 2014 05:21
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Nessus posted:What the gently caress hospitals are these that are mostly private rooms? Has that been where all the new stuff has been? Every time I've been in a hospital to visit or for treatment it's been semi-private, except when I was in the ICU for a few days. IDK how reasonable that strand of her argument is. It doesn't sound implausible, I guess? FWIW at public hospitals here in Chile you can expect to share an open bay with like 20 other people so maybe she has something like that in mind. I also have no idea if that's the norm in the systems she's drawing cost comparisons with. I think the cost overall cost reduction argument in general is sound - the way to wring cost savings out of the system without causing major problems is by curbing the growth of health care spending to diminish its importance over the long run, and using that approach it's not clear that single payer would be much cheaper than what we're doing with PPACA.
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May 5, 2014 05:32
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AYC posted:http://www.vnews.com/opinion/11801131-95/column-heres-why-a-single-payer-system-wont-save-us-health-caresw Shocking. Next thing you know she'll express admiration for Peter Peterson. Oh wait! http://www.philanthropyroundtable.org/topic/economic_opportunity/economia http://www.sourcewatch.org/index.php/Peter_G._Peterson_Foundation quote:How Pete Peterson's donations are helping Washington find budget balance
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May 5, 2014 14:18
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To add to the anecdotal pile. In 2011 I caught pink eye. My minimum wage retail job didn't have insurance. I missed a week of work hoping it heal on its own. The pain became so severe I had to suck it up and walk to the hospital. After about seven hours I was able to speak to a doctor who said "Yep, that's pinkeye." and signed a slip for some prescription eye drops. Then I walked to a 24 hour pharmacy, got the drops, and in three days the eye healed up. That visit cost $780 dollars, plus another $20 for the drops. I lost about $400 in wages during that time as well, so when I couldn't make rent on my sublease I had to quit my job and move from Brooklyn back to California to live with family.
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May 5, 2014 14:50
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forgot my pants posted:I have a question I've been wondering about. In other countries with single-payer healthcare how do they treat brain-damaged infants and children that have almost no chance of walking or talking? In this US this will cost over a million dollars per decade that the child lives, but as long as the parent wants to keep them alive, they can. This is kind of basic, but insurance works by spreading risk across the group of people covered by the plan, or the risk pool. When somebody covered by the plan has to make a claim they're paid off with money from the larger number of people who also paid premiums but don't make claims--with health insurance, the healthy subsidize the sick. In a single-payer system the entire population is in the risk pool, so people who require extremely expensive care are paid off by the healthy majority.
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May 5, 2014 15:14
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EvanSchenck posted:This is kind of basic, but insurance works by spreading risk across the group of people covered by the plan, or the risk pool. When somebody covered by the plan has to make a claim they're paid off with money from the larger number of people who also paid premiums but don't make claims--with health insurance, the healthy subsidize the sick. In a single-payer system the entire population is in the risk pool, so people who require extremely expensive care are paid off by the healthy majority. To expand on this single payer forces companies to play nice in many cases, for example stuff like replacement hips etc. If you're a company you're going to work to produce the lowest costing best quality replacement hip in the hopes that yours is the single payer of choice hip. As a pharmaceutical company you may not produce much of cheap anti-biotic XYZ because there is no profit in it for you. Thing is if everyone is going to be prescribed that anti-biotic because of single payer, the economy of scale makes it profitable for someone to pick up that slack unlike the current situation. Instead of companies only having to worry about tiny market shares they now have to focus on a large scale market share. This has the flip side issue of higher barriers to entry, in that it gets much harder to get your product to market because the established players will work regulations in that favor their products or company policies. Think military industrial complex.
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May 5, 2014 15:33
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Fat Ogre posted:As a pharmaceutical company you may not produce much of cheap anti-biotic XYZ because there is no profit in it for you. Thing is if everyone is going to be prescribed that anti-biotic because of single payer, the economy of scale makes it profitable for someone to pick up that slack unlike the current situation. Probably the best demonstration of this principle is Medicare Part D, which was added during the Bush administration to help recipients pay for prescription drugs. When the law establishing Part D was written, the program was specifically banned from using their mass purchasing power to negotiate better pricing. As a result the government overpays ridiculously. The VA health administration, which provides a similar service to veterans, pays something like half what Medicare Part D pays for the exact same drugs. Essentially, the pharmaceutical companies used their political influence to write a gigantic taxpayer subsidy for their industry into the law.
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May 5, 2014 15:55
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Fat Ogre posted:To expand on this single payer forces companies to play nice in many cases, for example stuff like replacement hips etc. I don't know about that. New innovations are already going to be expensive and not covered on most insurance. In any case they're only going to be available to the rich, who can still pay for them if they want.
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May 5, 2014 16:10
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EvanSchenck posted:This is kind of basic, but insurance works by spreading risk across the group of people covered by the plan, or the risk pool. When somebody covered by the plan has to make a claim they're paid off with money from the larger number of people who also paid premiums but don't make claims--with health insurance, the healthy subsidize the sick. In a single-payer system the entire population is in the risk pool, so people who require extremely expensive care are paid off by the healthy majority. I understand all that. However, I've heard people (who are not experts) say that this sort of care is rationed in single-payer countries. I'd like to know if that's actually true.
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May 5, 2014 16:11
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Kiwi Ghost Chips posted:I don't know about that. New innovations are already going to be expensive and not covered on most insurance. In any case they're only going to be available to the rich, who can still pay for them if they want. Yes they are expensive but if you can show that your new hip is X% better in every way that the currently produced hip, they'll switch to purchasing your expensive hip over the other one. It forces the market to be super competitive in that everyone wants that controlled piece of the pie. The problem comes when they lobby to change the laws to keep it from working that way and stifling the competition, or they just make a poo poo ton of money and effectively become the only option in town because they ran everyone out of business or bought everyone and folded them into their own company.
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May 5, 2014 16:26
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forgot my pants posted:I understand all that. However, I've heard people (who are not experts) say that this sort of care is rationed in single-payer countries. I'd like to know if that's actually true. It's rationed to the same extent as care is rationed to insured people in the US. Take a look at exclusion lists sometime, they are quite long.
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May 5, 2014 16:42
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forgot my pants posted:I understand all that. However, I've heard people (who are not experts) say that this sort of care is rationed in single-payer countries. I'd like to know if that's actually true. Yes, it's true. The issue is that when Americans talk about rationing health care they often don't recognize that it happens everywhere. It has to, because resources aren't unlimited. The difference is in the criteria that are used to determine who gets care and when. In the USA we ration according to ability to pay rather than need, and we do it incredibly inefficiently. Having a child with a total permanent disability is a quick ticket to poverty in the USA. Under a single-payer system, their healthcare costs are covered in the same way as anybody else. For example, if your kid requires surgery to correct birth defects, that's covered. Care that isn't medical per se, for example if you want to put your child in a 24 hour residential care facility, is a little different. You can compare it to how in the USA right now, a disabled child can be covered either by the parent's health insurance or by medicaid if they're indigent, but then coverage for other costs resulting from disability are handled by the SSA. Anyway, your child would be assessed to determine what level of assistance he actually requires, and then the costs of that care would be subsidized according to your income. Generally speaking the amount of government funding directed to these programs is higher in countries with single payer, and the subsidies are more generous, than the same in the USA.
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May 5, 2014 16:59
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forgot my pants posted:I understand all that. However, I've heard people (who are not experts) say that this sort of care is rationed in single-payer countries. I'd like to know if that's actually true. It is. I wish I could find the source for this story. Maybe another Goon can find it. There was a family in Europe (Switzerland? Norway?) that had a child who was deaf but the hearing loss could be surgically fixed. Hearing loss at a young age can set you back years developmentally so getting this fixed is paramount to the future of the child. However, the government would only fix one ear now and fix the other a few years down the road. Why? Well, there are only so many ears that can be fixed at any given time. So the government can have one baby hearing with two ears and the other is deaf, or two babies hearing with one ear now. That's medical rationing. It's not necessarily evil. Sometimes it's what you have to do for society to function. Since the family was rich they went to another country and had both ears fixed because they could pay for it.
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May 5, 2014 17:00
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