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This is the US health system

The book, The Healing of America, (T.R Reed) describes first hand how several European countries and Japan deal with healthcare. Most Americans assume they are "government run and socialistic" because most cover 100% of the population. Not true. Germany and Switzerland, for example, use private insurers, but they are regulated like utilities and trade like utilities on the stock market. There are many more ways to inject private sector into healthcare other than the way the US is doing it.

Everyone needs health care just was everyone needs water, power and light. Yet no one expects power and water utility stocks to provide the same kind of growth and profitability as Apple, Nividia or Google.
 
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watu05 said:
The book, The Healing of America, (T.R Reed) describes first hand how several European countries and Japan deal with healthcare. Most Americans assume they are "government run and socialistic" because most cover 100% of the population. Not true. Germany and Switzerland, for example, use private insurers, but they are regulated like utilities and trade like utilities on the stock market. There are many more ways to inject private sector into healthcare other than the way the US is doing it.
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The Dems tried initially to institute something similar to this in the lead up to Obamacare The healthcare / insurance industry managed to payoff a sufficient number of Dems resulting in zero price controls or regulations being included in the final law. I feel like we are further away today from a real solution than we’ve ever been. Healthcare in this country is such a cluster
 
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watu05 said:
The idea that health care insurance/deiivery can produce AI/tech stock returns without cutting quality and services is beyond silly, yet it's a mantra for the Republican/MAGA crowd. These denials should be no surprise, remember the John Grisham movie about how health insurance companies deny coverage? That was 20 or 25 years ago. The Rainmaker?

Private equity's embrace of assembling smaller practices into national networks is headed down the same path. For example, most hospital ER's were subcontracted out to small groups of ER docs. Private equity has been buying those practices, replacing MD's with nurses and adding in unnecessary services to charge for. That's just one example. Cardiac care and hospice are others.

My (now retired) private equity friends tell me that the prices private equity groups now have to pay to acquire properties has gotten so high that the pressures to ruthlessly cut costs and quality to meet debt service and earn a positive return is many, many times higher than it was a decade or two ago. But there is so much money in PE now that PE firms just continue to play the same game.

Guess who the losers are?
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It’s the same concept as food price gouging…. You can only do so much before people in berets start knocking down the doors of palaces with torches and pitchforks.
 
Weird. I was told that the ACA law which mandated additional demand and reduced consumer choice would lower costs.

 
URedskin54 said:
Weird. I was told that the ACA law which mandated additional demand and reduced consumer choice would lower costs.

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You can’t say what the cost would have been without it…. You just believe that competition breeds price decreases….

Problem is, there is still plenty of competition in the market.
 
The ACA was never going to reduce costs. The lobbyist made sure of that. Little to no cost restraints are found in the entire law. Aston tried to argue health care providers would lower prices due to not having to cover as many uninsured patients. I maintained he was full of crap and those cost savings even if they came to fruition would never be passed on by those large corporations to the end consumer. Guess what….i was 100% correct. We had an opportunity to at least address costs…and our politicians were once again paid off.
 
astonmartin708 said:
You can’t say what the cost would have been without it…. You just believe that competition breeds price decreases….

Problem is, there is still plenty of competition in the market.
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You assuming too much. I just know there are things that will obviously not reduce costs and it was noted by many people at the time.
 
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astonmartin708 said:
You can’t say what the cost would have been without it…. You just believe that competition breeds price decreases….

Problem is, there is still plenty of competition in the market.
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Competition usually keeps prices lower, but the private sector abhors competition. Completely open markets always move toward monopoly to reduce competition and increase profits. Healthcare is a target for all the reasons that Poke outlines: no info, hard to switch, and hard to measure quality.
 
watu05 said:
Competition usually keeps prices lower, but the private sector abhors competition. Completely open markets always move toward monopoly to reduce competition and increase profits. Healthcare is a target for all the reasons that Poke outlines: no info, hard to switch, and hard to measure quality.
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100% Competition only lowers prices if consumers are able to price and service shop. Why healthcare providers aren’t required to publish price lists is beyond me.
 
lawpoke87 said:
100% Competition only lowers prices if consumers are able to price and service shop. Why healthcare providers aren’t required to publish price lists is beyond me.
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Try service shopping when you break your leg skiing, or your daughter falls off a horse….
 
astonmartin708 said:
Try service shopping when you break your leg skiing, or your daughter falls off a horse….
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Wonder what percent of yearly health care expenditures in this country result from broken legs while skiing and horse accidents? Look….Im not claiming this is the definitive answer. I am saying that neither party is going to address health care costs. Thus if we are going to continue to operate the same in a capitalistic model then force the industry to operate within those constraints. The lack of accountability in our healthcare industry is pure insanity.
 
lawpoke87 said:
The ACA was never going to reduce costs. The lobbyist made sure of that. Little to no cost restraints are found in the entire law. Aston tried to argue health care providers would lower prices due to not having to cover as many uninsured patients. I maintained he was full of crap and those cost savings even if they came to fruition would never be passed on by those large corporations to the end consumer. Guess what….i was 100% correct. We had an opportunity to at least address costs…and our politicians were once again paid off.
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It is more complicated. They needed young people to sign up. They didn't.

Healthcare is a cluster. You have ever-increasing amounts of private equity involved all over the place. Here is just one example: check out what happened with ambulances in the 2000s.


 
lawpoke87 said:
Wonder what percent of yearly health care expenditures in this country result from broken legs while skiing and horse accidents? Look….Im not claiming this is the definitive answer. I am saying that neither party is going to address health care costs. Thus if we are going to continue to operate the same in a capitalistic model then force the industry to operate within those constraints. The lack of accountability in our healthcare industry is pure insanity.
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What percentage of yearly health expenditures are emergency or specialty is what you should ask yourself. In most of those cases you have few if any options… also, healthcare shouldn’t be like shopping for a car. “Well, I wanted the 90% chance to survive the surgery, but if I go down the street I can afford the 60% chance”
 
astonmartin708 said:
What percentage of yearly health expenditures are emergency or specialty is what you should ask yourself. In most of those cases you have few if any options… also, healthcare shouldn’t be like shopping for a car. “Well, I wanted the 90% chance to survive the surgery, but if I go down the street I can afford the 60% chance”
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Not sure exact percentages Over half of all healthcare expenditures are out patient though. I’m not arguing our healthcare system isn’t a cluster. I am arguing our politicians are bought by the industry and cost reform through government action is almost impossible.
 
lawpoke87 said:
Not sure exact percentages Over half of all healthcare expenditures are out patient though. I’m not arguing our healthcare system isn’t a cluster. I am arguing our politicians are bought by the industry and cost reform through government action is almost impossible.
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Yeah, I wouldn’t be surprised at the outpatient number. The emergencies I listed wouldn’t require a hospital stay. Many surgeries don’t require it these days…. I feel like the only things that require in patient care are severe illnesses, severe emergency trauma (burns, car crashes, gunshots, etc…) or emergency malfunctions like heart attacks, strokes, etc…

Everything else is either treated piecemeal with multiple appointments, or is a one off visit.
 
lawpoke87 said:
The ACA was never going to reduce costs. The lobbyist made sure of that. Little to no cost restraints are found in the entire law. Aston tried to argue health care providers would lower prices due to not having to cover as many uninsured patients. I maintained he was full of crap and those cost savings even if they came to fruition would never be passed on by those large corporations to the end consumer. Guess what….i was 100% correct. We had an opportunity to at least address costs…and ourpoliticians were once again paid off.
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aca was supposed to provide HI for the 40million uninsured. Today, there are 45million on aca, less than 10million that it was supposed to help and over 35million that lost their HI because of aca.
 
aTUfan said:
aca was supposed to provide HI for the 40million uninsured. Today, there are 45million on aca, less than 10million that it was supposed to help and over 35million that lost their HI because of aca.
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Your numbers don’t make much sense.

The percentage of uninsured people in the country was 16% in 2010. It’s 7% now.
 
Exploding health care costs is not the fault of the ACA. I think it's more complicated than that, bro. Your analysis is about as deep as the homeboys regurging russian bull:crap: that we started the Ukraine war.
 
astonmartin708 said:
Your numbers don’t make much sense.

The percentage of uninsured people in the country was 16% in 2010. It’s 7% now.
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Why didn’t we ever see the drop in healthcare costs like you predicted? Are you willing to concede my premise that healthcare providers wouldn’t pass any savings on to the consumer but instead would pocket the profits?
 
I have been out of a particular prescription for over a month. It's been phoned in several times, and held up by various things like a "prior authorization". I have no pharmacy in town that works with my insurer (for real), so I have to do the mail version as it is a kinda expensive script ($600/month).

I was relieved to hear last week that they were finally shipping my prescription! And then, no. I got an email the next day that they "needed additional information from me and would withhold shipping until I reached out".

I called about a half dozen times. One of the calls I finally got the stupid AI agent to refer to the correct prescription in dispute and it just literally repeated the email to me about how I needed to contact them. After spending an hour on the phone trying to do just that, that was the last thing I needed to hear.

Finally, I got it to connect me to a real person. I had to sit on hold for about an hour and a half waiting, with no options to schedule a callback or any updates on how long the wait would be or how many people were ahead of me.

But finally, finally, I was able to talk to someone and ask, "What information do you need from me that is preventing shipping?"

The only thing they wanted was to confirm that I still needed the script, and if I had a preferred ship by date. That's it. Hours of my day for that. Thankfully, it is not a life-dependent medication, but they still wasted my time and made me go without for almost a month while they dithered.


I also had an issue where the insurance company denied a claim when my daughter was born. As a newborn, she had to be life-flighted to Albuquerque and admitted to UNM for a major life-saving emergency surgery. The insurance company denied the claim for the flight saying we could have ambulanced her there for cheaper (two hours away). They apparently wanted me to second-guess the doctors who were telling me my 20-hour year old needs attention NOW and could die in an ambulance (because yes, I did actually ask about an ambulance instead). I had to go back to the hospital and collect a statement from the attending physician and dispute their denied claim and it again took a whole lot of time that I shouldn't have to spend. They eventually paid up, but they first made me deal with a ton of crap at a very stressful time in my life.



When stories like the above are so commonplace and can involve life-saving medications and treatments, it's only a matter of time before someone unstable enough to do something crazy is tipped over the edge and goes out and does something crazy. I know practically everyone in the country has at least one story like the above.

Might not be a popular take, but my thoughts are actually with the family of the CEO.
 
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watu05 said:
The combination of dependable demand with both private and government funding has made healthcare a playground for private equity abuse. Like water, power and other daily necessities, health care should not treated like a utility--not like crypto or an AI stock. Utilities are privately run and compete but have requirements for fairness that healthcare should copy.
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The biggest problem is one of the political parties has convinced some of the poorest Americans that this private health care insurance is the best way to go instead of it being a public "utility" and they make them afraid of the public option by using the big scary word "socialism".

But everyone is right, until we get lobbyists (i.e. legalized bribes) out of Congress and other elected positions), it will never change.
 
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TU_BLA said:
The biggest problem is one of the political parties has convinced some of the poorest Americans that this private health care insurance is the best way to go instead of it being a public "utility" and they make them afraid of the public option by using the big scary word "socialism".

But everyone is right, until we get lobbyists (i.e. legalized bribes) out of Congress and other elected positions), it will never change.
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Socialist medical care is the biggest insurance in America.

Medicare, the VA, and Medicaid.
 
Clong83a said:
I have been out of a particular prescription for over a month. It's been phoned in several times, and held up by various things like a "prior authorization". I have no pharmacy in town that works with my insurer (for real), so I have to do the mail version as it is a kinda expensive script ($600/month).

I was relieved to hear last week that they were finally shipping my prescription! And then, no. I got an email the next day that they "needed additional information from me and would withhold shipping until I reached out".

I called about a half dozen times. One of the calls I finally got the stupid AI agent to refer to the correct prescription in dispute and it just literally repeated the email to me about how I needed to contact them. After spending an hour on the phone trying to do just that, that was the last thing I needed to hear.

Finally, I got it to connect me to a real person. I had to sit on hold for about an hour and a half waiting, with no options to schedule a callback or any updates on how long the wait would be or how many people were ahead of me.

But finally, finally, I was able to talk to someone and ask, "What information do you need from me that is preventing shipping?"

The only thing they wanted was to confirm that I still needed the script, and if I had a preferred ship by date. That's it. Hours of my day for that. Thankfully, it is not a life-dependent medication, but they still wasted my time and made me go without for almost a month while they dithered.


I also had an issue where the insurance company denied a claim when my daughter was born. As a newborn, she had to be life-flighted to Albuquerque and admitted to UNM for a major life-saving emergency surgery. The insurance company denied the claim for the flight saying we could have ambulanced her there for cheaper (two hours away). They apparently wanted me to second-guess the doctors who were telling me my 20-hour year old needs attention NOW and could die in an ambulance (because yes, I did actually ask about an ambulance instead). I had to go back to the hospital and collect a statement from the attending physician and dispute their denied claim and it again took a whole lot of time that I shouldn't have to spend. They eventually paid up, but they first made me deal with a ton of crap at a very stressful time in my life.



When stories like the above are so commonplace and can involve life-saving medications and treatments, it's only a matter of time before someone unstable enough to do something crazy is tipped over the edge and goes out and does something crazy. I know practically everyone in the country has at least one story like the above.

Might not be a popular take, but my thoughts are actually with the family of the CEO.
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Yup. I really am surprised it hasn't happened sooner. Doctors friggin hate them too.
 
aTUfan said:
my son lost his company sponsered HI to aca, and it wasn't as good and cost more.
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My companies HI was cancelled due to the ACA as well due to non-compliance. HI almost doubled for every employee on the plan as did deductibles. Obviously wasn’t ideal. I posted a copy of the actual plan as well as the “forced” new plan under the ACA on this site when it occurred with corresponding premiums. The old plan had a $20 co-pay for office visits and a $1000 deductible. The co-pay wasn’t compliant. The new plan had a $3000 deductible and almost twice the premium. Takes a lot of $20 co-pays to make up that extra $2k.
 
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aTUfan said:
medicare is not socialism, it is PREPAID
VA is not socialism, it is EARNED
Medicaid is socialism, it is a HANDOUT
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Regardless of whether medicare and VA are earned or prepaid, they are still socialist. Do you not think medical care in countries like the Soviet Union had taxes that were paying for their medical care. They did, 60% taxes. Their taxes were similar in rate to most socialist countries. When you don't choose your healthcare, and it is paid for by taxes, rather than your earnings, that is socialist.
 
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Trump comes out in favor of the polio vaccine but not mandates. That is how you make sure a disease like polio doesn't come back. So he won't mandate it, and we have polio outbreaks from people who don't take the vaccine. A mandate is how we come as close to eliminating a disease as is possible. That mandate is for the health of the general populace. You don't take it, and you risk others health as well as your own. SMH
 
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Gmoney4WW said:
Trump comes out in favor of the polio vaccine but not mandates. That is how you make sure a disease like polio doesn't come back. So he won't mandate it, and we have polio outbreaks from people who don't take the vaccine. A mandate is how we come as close to eliminating a disease as is possible. That mandate is for the health of the general populace. You don't take it, and you risk others health as well as your own. SMH
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Sounds like a policy similar to those found in Canada, United Kingdom, Spain, Australia, etc. I personally would prefer a mandate to attend school.
 
lawpoke87 said:
Sounds like a policy similar to those found in Canada, United Kingdom, Spain, Australia, etc. I personally would prefer a mandate to attend school.
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??? Canada & UK require it. Australia & Spain strongly recommend.

Now that there is a large swath of Maga folk who question all Vaccines, it needs to be required. Before all these anti vaxxers became prevalent, (originating around the turn of the century, and increasing in popularity from 2015 to today) a strong recommendation was all that was necessary to get 99.9999% to do it.

The # of people who believe vaccines are safe fell from 77% to 71% in 2 1/2 years, ending in late '23. During that period, those who think approved vaccines are safe went from 9% to 16%. It is becoming unsafe to depend on the populace's opinion on vaccines. In 2000 95% of children were vaccinated, which is the recommended minimum goal by health experts. The latest % is 92.7 and dropping annually for the last several years. I am certain that it will continue dropping at the same rate or likely an increased rate with Trump/Kennedy in the government. I believe there is a mandate to attend school, if not in public/private, then in home schooling.
 
aTUfan said:
medicare is not socialism, it is PREPAID
VA is not socialism, it is EARNED
Medicaid is socialism, it is a HANDOUT
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Two years of active duty is rather generous for an entire life of free healthcare bruh.

Medicare is socialist insurance. Sorry dude.

I don't know what you people think socialism is. Lots of socialism involves payments and returns. Like the national healthcare system in Britain and the rest of the world.
 
lawpoke87 said:
Is my information incorrect ?

Is immunization mandatory in Canada? | immunizecanada

immunize.ca immunize.ca

ourworldindata.org

Which countries have mandatory childhood vaccination policies?

How do policies on childhood vaccinations vary across the world?
ourworldindata.org ourworldindata.org
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I was relying too much on AI on my search, I guess. Won't do that again w/o checking. Was having problems with the definition as well. Required and mandatory apparently are two different entities. Mandatory includes penalties I assume, and required may not, but that is really hazy when it comes to vaccines. I looked at your documentation and also some more stuff I hadn't looked at, and found you were right on Great Britain. They still haven't dipped below 95% like we have though, or if they have it is really recently, and not well documented yet. It gets a little bit ponderous in Great Britain about policy, but they aren't mandatory. That is a total screw up on AI.

Canada like what you were showing, the policies are different in different territories. So I'd call them mixed. That's a bit more understandable how AI could make the mistake.

Either way, the countries that are mandatory generally follow a pattern of less and more developed countries.(there are exceptions like France, Italy, Germany) But with our large contingent of anti vaxxers, we need to follow the pattern of a less developed country, due to this growing disbelief in science. Too many people are putting out badly researched data and the masses are buying it because they want to for some unknown reason? Most of the people putting it out have no real qualifications, but it is believed nonetheless. I guess it follows the trend of homeopathic medicine. There is great stuff in homeopathic medicine, and there is utter crap. Difficult to sift through the crap.
 
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TulsaRulzOSUdrools said:
Two years of active duty is rather generous for an entire life of free healthcare bruh.

Medicare is socialist insurance. Sorry dude.

I don't know what you people think socialism is. Lots of socialism involves payments and returns. Like the national healthcare system in Britain and the rest of the world.
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socialism is the government doing for people, what they should do for themselfes
 
Increasingly healthcare insurers and national service providers have shifted their priority from serving patients to earning profits from customers. The latter shifts the focus to reducing costs and increasing profits over delivering quality care. For example, I have a close friend who is an MD/MBA with a career in hospital management. After running two different hospitals, he finally left because of fatigue over fighting corporate pressure to reduce access to services.

This article may be behind a paywall, but describes the issues well.

Socialism had nothing to do with it.
 
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