Author Topic: A Better Healthcare System  (Read 2655 times)

Desert_Rat

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Re: A Better Healthcare System
« Reply #10 on: May 09, 2017, 10:12:30 AM »
Every universal healthcare system I've read of, even those countries whose military budget is almost zero because it leaches its neighbors or NATO's protections, is a healthcare system far worse than what I had available to me 8 years ago. I understand the dilemma with the poor and pre-existing with job loss but I think that should be resolved with Medicaid or SS, even as busted as the two are. What we once had was fine though.
MAGA

Singaporeans live 3 years longer than Americans, spend less than 1/3rd of what Americans spend on healthcare and express very high levels of satisfaction with their healthcare. Wait times in Singapore are also vastly superior to the US. BTW, Singaporeans spend as much on their military in proportion to GDP as the US and also force their young into mandatory service where some of them actually die in training (they run themselves to death).

Healthcare is an input. HEALTH IS AN OUTPUT. You are confusing the two. You can have a space age healthcare system and yet because you order needless tests, over treat, over medicate and don't wash your hands (poor operational effectiveness)...actually make peoples health worse.

Well, I just spent a few minutes seeking a downside to Singapore but can't.

3rd richest country in world
tax rate of 0-22%
corp tax 17%
minute # of poor
apparently, a pretty damn good healthcare system

No clue. Good for you, Singapore!


Desert_Rat

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Re: A Better Healthcare System
« Reply #11 on: May 09, 2017, 10:22:23 AM »
I don't think there's a bad healthcare system in the US. It's just really expensive. But I don't think there's much hope of improving it because of economic and political reasons.

Firstly economic. Healthcare cost is at 17.1% of GDP. But your cost is someone's income. At 17% it's pretty much the biggest sector of the economy and makes a lot of money. This gives it a lot of money and influence. In turn it will use this influence in order to defeat cost controls so it/they can keep making the money.

Secondly political. This is where the public/private ideologies come into play. Because of this when you try to pass something like Obamacare or any other reform it will be heavily flawed from the start because they have to make a lot of compromises just to get it passed. Then the other side will will try its best to make it even crappier so they can get up on a soap box and say "see it doesn't work". Basically healthcare reform fails because nobody wants it to work.

Think about it for a second how messed up the ideologies are. Basically from a pure self interest perspective poor states like Alabama and Mississippi should be all in for cheap gov't healthcare and rich states like New Jersey, California, and Maryland should prefer fancy, expensive private care. However in reality their preferences are completely opposite from their self interest.

Probably because, first and foremost, AL and MS want gov out of citizens business, while in CA and MD it's the opposite.

rukawa

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Re: A Better Healthcare System
« Reply #12 on: May 09, 2017, 11:10:15 AM »
I don't think there's a bad healthcare system in the US.

People are not very good at judging the quality of healthcare. They tend to judge it based on inputs: access to doctors/specialists, medications, sophisticated diagnostics.

I have a very hard time believing that the US healthcare system is a good one. I define good not based on access to the healthcare, number of MRI machines but rather on its ability to actually improve human health. My reason for believing this is that in the US system there are no monetary incentives for anyone to actually improve health of patients. And additionally there appears to be little concern by anyone as to whether treatments actually work or are effective. The vast majority of things done by doctors don't have scientific evidence backing them up.

There is also very little money devoted to operational effectiveness. For instance, a doctor meets a patient and he doesn't wash his hands. He then touches the patient. The patient contracts C. Difficile from contact with the doctor. In the American system there are zero incentives to prevent the scenario I just described from happening and in fact doctors generally are resistant to hand-washing programs. Why are they resistant .... because they don't have time. They get paid by the number of procedures they do and patients they see, not time spent washing hands. When you also consider the fact that many of the procedures doctors perform are contraindicated by research you realize that the system often incentivizes poor health outcomes. The Canadian system is not that different in this regard.

The other thing that make me doubt the effectiveness of US healthcare is the fact that the number of iatrogenic deaths (deaths due to the medical system) is estimated at around 200k and interestingly no one appears to care. In a truly good system, that cared about health outcomes, this should be an absolute scandal.
« Last Edit: May 09, 2017, 11:13:09 AM by rukawa »

CorpRaider

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Re: A Better Healthcare System
« Reply #13 on: June 20, 2018, 06:35:14 AM »
BRK + AMZN + JPM hire Atul Gawande as CEO of their new combined healthcare effort!  Wow, what a get!  He is an amazing thinker in my estimation.

Cigarbutt

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Re: A Better Healthcare System
« Reply #14 on: June 20, 2018, 12:35:58 PM »

scorpioncapital

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Re: A Better Healthcare System
« Reply #15 on: June 20, 2018, 02:16:19 PM »
The US system is far superior in technology, access, and options than the Canadian one. I would not wish the limited features of the Canadian system, the wait times, the state appointed and overworked doctors on anyone. I think something like UK or other parts of Europe have the best system. A hybrid system, with more private clinic options. You can pay cash or get referred via the public system. Faster if you pay cash. Also I'd like to see more options like in the US systems. More technology, more research, more cutting edge treatments. UK has an interesting hybrid mix, Germany and Switzerland too. I quite like these systems.


Cigarbutt

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Re: A Better Healthcare System
« Reply #16 on: June 20, 2018, 03:56:21 PM »
To be different does not automatically mean being inferior as it may just reflect underlying values and historical path-dependency.
From data, it appears that clinical outcomes for the US population are diverging from rising health expenditures.
Looking at what others are doing successfully may be a source of inspiration.
Being great means different things to different people. I submit that a component is the ability to learn from others.

There will be reform and this may impact, for better or for worse, private sector firms. Worth thinking about.
If you think of the "system", it may be relevant to discuss the care that will be given to "these people" or what others refer to as ordinary folks.
https://www.newyorker.com/magazine/2009/01/26/getting-there-from-here


RichardGibbons

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Re: A Better Healthcare System
« Reply #17 on: June 20, 2018, 05:43:54 PM »
The US system is far superior in technology, access, and options than the Canadian one.

Well, yeah, if you don't actually care that Canada has better outcomes at 2/3rds of the price, doesn't have the massive numbers of underinsured people that USA does, doesn't have the huge number of deaths resulting from underinsurance, and doesn't have nearly the number of medical-related bankruptcies that USA does.

That said, if you're really wealthy, then the American system is better for you. If you're playing the genetic lottery (i.e. being randomly assigned into the body of someone that needs healthcare), then the Canadian system is so superior that it's laughable that anyone would suggest otherwise.