The US Healthcare Mass Debate

[laklak]

The problem with the ACA was it was written by career politicians, most of whom hadn't had a "real" job in years and were controlled by corporate masters. Neoliberalism FTW. You can't just decide how highly complex and interlocked industries are going to function by legislative fiat, you have to actually understand how those industries work in the first place. It's telling that the primary architect of the ACA, Jonathan Gruber, is an academic economist with no actual business experience. If you want to understand health care, talk to those at the coal face - doctors, therapists, nurses, hospital administrators, not economic theorists sitting in their insulated university towers. If you want to understand insurance and how it works, talk to the actuaries, the accountants, the insurance agents - not just the CEOs.

In my IT days the most common system failures were caused by NOT talking to the correct people during the early planning stages. You cannot jump into designing a system prior to determining what that system is actually going to do. You don't ask the CEO of an electric utility what they need, you talk to the people who actually use those systems. This is common knowledge amongst design professionals, but it is roundly and soundly ignored by those paying for the systems, with predictable and inevitable results.

[Joe]

Americans never see the point of that. It was always the argument put up by Seth. He never had any insurance. He just paid his way.

Please don't form your opinions of Americans based on Seth's extreme views. This is a much better representation of American views.

Heck, even Trump is reported to have asked, "Why can't Medicare simply cover everybody?"

But Seth's opinions do exist in America although it is a minority. Here for instance nobody would state those views. Certain things here are declared holy and above politics. Health and education being two. Like Britain after the war a UHC system was quickly realised to be a necessity as was a public education system. Both were quickly put in place. Both were government departments but by the end of the century health was turning into the mess Britain is now in. Too much creeping privatisation plus a dual system of private and public running through each other. So in 2004 the drastic step was taken and we have never looked back. Here is a CNN report:]

Thanks for the video. The US would benefit greatly from in depth study of what other countries are doing, since they do it better for less. We seem to have a real problem doing that, and I've never understood why. What good is a good idea, if you can't borrow it.

[Rum]

Americans never see the point of that. It was always the argument put up by Seth. He never had any insurance. He just paid his way.

Please don't form your opinions of Americans based on Seth's extreme views. This is a much better representation of American views.

Heck, even Trump is reported to have asked, "Why can't Medicare simply cover everybody?"

But Seth's opinions do exist in America although it is a minority. Here for instance nobody would state those views. Certain things here are declared holy and above politics. Health and education being two. Like Britain after the war a UHC system was quickly realised to be a necessity as was a public education system. Both were quickly put in place. Both were government departments but by the end of the century health was turning into the mess Britain is now in. Too much creeping privatisation plus a dual system of private and public running through each other. So in 2004 the drastic step was taken and we have never looked back. Here is a CNN report:

What mess in the UK? Headlines for sure, but my family has had cause to access out NHS services rather a lot this last three years - most recently major surgery for my mother for cancer back in November.

All the services are busy - running pretty much at full capacity I would imagine, but the treatment was excellent, the doctors were informative, offered plenty of time to her (and me), the nursing care was superb and the outcome very positive.

I'm no defender of Tory policy which is looking towards more privatisation, but the system works for me and mine well from what I have seen with my own eyes.

[Seabass]

Where's Seth been anyway? I haven't seen him on since I've returned. I hope he didn't accidentally shoot himself or something...

He hasn't. Someone who joined this forum very recently has quite inadvertently divulged his official name, whereupon I did a bit of googling to see if it checks out. It does, and Seth is still very much alive.

Well, that's mysterious. What, he's just lurking around on a sockpuppet account? Weird.

[Seabass]

Americans never see the point of that. It was always the argument put up by Seth. He never had any insurance. He just paid his way.

Please don't form your opinions of Americans based on Seth's extreme views. This is a much better representation of American views.

Heck, even Trump is reported to have asked, "Why can't Medicare simply cover everybody?"

But Seth's opinions do exist in America although it is a minority. Here for instance nobody would state those views. Certain things here are declared holy and above politics. Health and education being two. Like Britain after the war a UHC system was quickly realised to be a necessity as was a public education system. Both were quickly put in place. Both were government departments but by the end of the century health was turning into the mess Britain is now in. Too much creeping privatisation plus a dual system of private and public running through each other. So in 2004 the drastic step was taken and we have never looked back. Here is a CNN report:]

Thanks for the video. The US would benefit greatly from in depth study of what other countries are doing, since they do it better for less. We seem to have a real problem doing that, and I've never understood why. What good is a good idea, if you can't borrow it.

If by "we", you mean "Republicans", then yes, "we" have a problem doing that. Republicans live in an alternate reality. They can't even see that blue states outperform red states on just about every metric, nevermind other countries.

[JimC]

Where's Seth been anyway? I haven't seen him on since I've returned. I hope he didn't accidentally shoot himself or something...

He hasn't. Someone who joined this forum very recently has quite inadvertently divulged his official name, whereupon I did a bit of googling to see if it checks out. It does, and Seth is still very much alive.

Well, that's mysterious. What, he's just lurking around on a sockpuppet account? Weird.

He last posted here in July last year, at which time he was suspended for a period of 3 months. So, in theory he could be active again here, but he seems to have moved on to greener pastures...

[Joe]

Americans never see the point of that. It was always the argument put up by Seth. He never had any insurance. He just paid his way.

Please don't form your opinions of Americans based on Seth's extreme views. This is a much better representation of American views.

Heck, even Trump is reported to have asked, "Why can't Medicare simply cover everybody?"

But Seth's opinions do exist in America although it is a minority. Here for instance nobody would state those views. Certain things here are declared holy and above politics. Health and education being two. Like Britain after the war a UHC system was quickly realised to be a necessity as was a public education system. Both were quickly put in place. Both were government departments but by the end of the century health was turning into the mess Britain is now in. Too much creeping privatisation plus a dual system of private and public running through each other. So in 2004 the drastic step was taken and we have never looked back. Here is a CNN report:]

Thanks for the video. The US would benefit greatly from in depth study of what other countries are doing, since they do it better for less. We seem to have a real problem doing that, and I've never understood why. What good is a good idea, if you can't borrow it.

If by "we", you mean "Republicans", then yes, "we" have a problem doing that. Republicans live in an alternate reality. They can't even see that blue states outperform red states on just about every metric, nevermind other countries.

By we, I mean Americans and the terms in which we debate the problems, but plenty of Republicans live in an alternate reality. Sadly, they're the ones in power.

[Tyrannical]

Americans never see the point of that. It was always the argument put up by Seth. He never had any insurance. He just paid his way.

Please don't form your opinions of Americans based on Seth's extreme views. This is a much better representation of American views.

Heck, even Trump is reported to have asked, "Why can't Medicare simply cover everybody?"

But Seth's opinions do exist in America although it is a minority. Here for instance nobody would state those views. Certain things here are declared holy and above politics. Health and education being two. Like Britain after the war a UHC system was quickly realised to be a necessity as was a public education system. Both were quickly put in place. Both were government departments but by the end of the century health was turning into the mess Britain is now in. Too much creeping privatisation plus a dual system of private and public running through each other. So in 2004 the drastic step was taken and we have never looked back. Here is a CNN report:]

Thanks for the video. The US would benefit greatly from in depth study of what other countries are doing, since they do it better for less. We seem to have a real problem doing that, and I've never understood why. What good is a good idea, if you can't borrow it.

Yeah.......

Except other countries just leach off of US medical research, which is why their health care is so cheap. Invention and innovation is extremely expensive, copying it is fairly cheap. The US could cut health care costs dramatically if we just stopped 'wasting' money on medical/drug research and just relied on 'other' countries to invest, innovate and invent. Or at least 'fairly' tax other countries to contribute to medical research.

Take HIV research, the US spends Billions on it, and US health care providers spend billions on the drugs. But poor countries cant afford them, so then they are cheaply sold / copied by local drug manufacturers. So the US subsidizes the World.
But Trump is president now mother fuckers, and your free ride is over Get used to paying more for health care because your free ride is over, medical research is expensive and your health care system will start to pay it's fair share.

[Tero]

Er, the other countries do a big chunk of the research in drugs. They charge the same ripoff prices when selling the drugs in the US, often with a partner here.

When in Rome, do as the Romans do.

By law, Medicare is forbidden from negotiating drug prices the way European governments do.

I have a patent on an improved method to make a German drug of the 80s. The company partners with a bigger company in Europe and I think Johnson and Johnson to sell here. The brand name stays with the innovator. My patent expired, probably being used in China as it’s a good recipe avoiding a nasty solvent.

[Tero]

There is no need to think of drug companies, MRI machine makers etc as American or European. They should all be thought of as global companies. They operate in multiple markets, adjusting the sales to each country by law and culture.

It is true they make a big profit in the US. But the inventing could be in Japan or even India.

[Joe]

$27 billion is peanuts in the context of total healthcare spending. The US spent $2.9 trillion in 2013. Here's a breakout.

Bloomberg says our total research is $158 billion, and poo poo's the idea:

The numbers just don’t add up. Total U.S. biomedical research spending was only about $158 billion in 2015. Suppose, just for the sake of argument, that Canada, Germany, the U.K. and all the other countries where health care is dramatically cheaper than in the U.S. copied every last bit of U.S. R&D for free and didn’t do any of their own research. Even in that extreme case, they would only be saving $158 billion, which is a much smaller amount than what the rest of the developed world currently spends on health overall. So mooching off of the U.S. can’t explain the big gap between them and the U.S.

It sure looks like there's more to it than that.

[Tyrannical]

Er, the other countries do a big chunk of the research in drugs. They charge the same ripoff prices when selling the drugs in the US, often with a partner here.

When in Rome, do as the Romans do.

By law, Medicare is forbidden from negotiating drug prices the way European governments do.

I have a patent on an improved method to make a German drug of the 80s. The company partners with a bigger company in Europe and I think Johnson and Johnson to sell here. The brand name stays with the innovator. My patent expired, probably being used in China as it’s a good recipe avoiding a nasty solvent.

Oh, well thank God for Trump, he's smart enough to negotiate drug prices.

[pErvinalia]

Americans never see the point of that. It was always the argument put up by Seth. He never had any insurance. He just paid his way.

Please don't form your opinions of Americans based on Seth's extreme views. This is a much better representation of American views.

Heck, even Trump is reported to have asked, "Why can't Medicare simply cover everybody?"

But Seth's opinions do exist in America although it is a minority. Here for instance nobody would state those views. Certain things here are declared holy and above politics. Health and education being two. Like Britain after the war a UHC system was quickly realised to be a necessity as was a public education system. Both were quickly put in place. Both were government departments but by the end of the century health was turning into the mess Britain is now in. Too much creeping privatisation plus a dual system of private and public running through each other. So in 2004 the drastic step was taken and we have never looked back. Here is a CNN report:]

Are you saying the government does all this medical research? Isn't that socialism?

Thanks for the video. The US would benefit greatly from in depth study of what other countries are doing, since they do it better for less. We seem to have a real problem doing that, and I've never understood why. What good is a good idea, if you can't borrow it.

Yeah.......

Except other countries just leach off of US medical research, which is why their health care is so cheap. Invention and innovation is extremely expensive, copying it is fairly cheap. The US could cut health care costs dramatically if we just stopped 'wasting' money on medical/drug research and just relied on 'other' countries to invest, innovate and invent. Or at least 'fairly' tax other countries to contribute to medical research.

Take HIV research, the US spends Billions on it, and US health care providers spend billions on the drugs. But poor countries cant afford them, so then they are cheaply sold / copied by local drug manufacturers. So the US subsidizes the World.
But Trump is president now mother fuckers, and your free ride is over Get used to paying more for health care because your free ride is over, medical research is expensive and your health care system will start to pay it's fair share.

[Tyrannical]

$27 billion is peanuts in the context of total healthcare spending. The US spent $2.9 trillion in 2013. Here's a breakout.

Bloomberg says our total research is $158 billion, and poo poo's the idea:

The numbers just don’t add up. Total U.S. biomedical research spending was only about $158 billion in 2015. Suppose, just for the sake of argument, that Canada, Germany, the U.K. and all the other countries where health care is dramatically cheaper than in the U.S. copied every last bit of U.S. R&D for free and didn’t do any of their own research. Even in that extreme case, they would only be saving $158 billion, which is a much smaller amount than what the rest of the developed world currently spends on health overall. So mooching off of the U.S. can’t explain the big gap between them and the U.S.

It sure looks like there's more to it than that.

And, in the first paragraph the author you linked said he was full of shit.....

The economics of health care is a devilishly complicated subject. Between the complexity of the market, the degree of regulation and the unusual nature of the things being sold, the topic is so vast that any single economist is practically incapable of grasping the whole picture. That’s why I’m skeptical of arguments that rely strongly on economic theory. Unlike the market for oranges or blue jeans, health care defies simple theoretical analysis. Debates between advocates of government-centered and free-market systems tend, out of necessity, to focus on only a few points and leave much of the picture unaddressed.

But, I'd be perfectly willing to outlaw medical/drug patents and make medical research 100% open, unpatentable and publicly funded. Research would stagnate, but medical costs would plummet.

[pErvinalia]

Americans never see the point of that. It was always the argument put up by Seth. He never had any insurance. He just paid his way.

Please don't form your opinions of Americans based on Seth's extreme views. This is a much better representation of American views.

Heck, even Trump is reported to have asked, "Why can't Medicare simply cover everybody?"

But Seth's opinions do exist in America although it is a minority. Here for instance nobody would state those views. Certain things here are declared holy and above politics. Health and education being two. Like Britain after the war a UHC system was quickly realised to be a necessity as was a public education system. Both were quickly put in place. Both were government departments but by the end of the century health was turning into the mess Britain is now in. Too much creeping privatisation plus a dual system of private and public running through each other. So in 2004 the drastic step was taken and we have never looked back. Here is a CNN report:]

Thanks for the video. The US would benefit greatly from in depth study of what other countries are doing, since they do it better for less. We seem to have a real problem doing that, and I've never understood why. What good is a good idea, if you can't borrow it.

Yeah.......

Except other countries just leach off of US medical research, which is why their health care is so cheap. Invention and innovation is extremely expensive, copying it is fairly cheap. The US could cut health care costs dramatically if we just stopped 'wasting' money on medical/drug research and just relied on 'other' countries to invest, innovate and invent. Or at least 'fairly' tax other countries to contribute to medical research.

Take HIV research, the US spends Billions on it, and US health care providers spend billions on the drugs. But poor countries cant afford them, so then they are cheaply sold / copied by local drug manufacturers. So the US subsidizes the World.
But Trump is president now mother fuckers, and your free ride is over Get used to paying more for health care because your free ride is over, medical research is expensive and your health care system will start to pay it's fair share.

Are you saying the government pays for all that research? Sounds like socialism..