[2017-12-08] Healthcare

Blame Quintushalls for this.

Moderator: Kimra

Re: [2017-12-08] Healthcare

Postby Sizlak Jones » Mon Dec 11, 2017 6:31 pm

We are spending about $5.6 billion in our province for core health services and infrastructure annually. 38% of the money our government spends each year goes to health care services (about 25% goes to education, about 9% to social services)

This is about $5,000.00 per person. However, since this is allocated out of government spending, it is actually weighted on an individual basis from personal contributions to the government coffers. About half of government revenues are from taxes. Individual and corporate taxes make up about 2/3rds of taxes, while sales taxes make up the other third. So it is tough to say on a personal basis how much your healthcare is costing you as an individual. For some people, they are paying almost nothing for healthcare (if they pay no income taxes, their cost of healthcare is only 38% of their annual sales taxes, I suppose).

There is certainly a lot to attack about the single-payer healthcare system we have in Canadia. However, despite the fact that, as a lawyer, I am going to pay a disproportionate amount of taxes (and therefore other people's healthcare costs), I would still rather have our system than the patchwork of systems you employ in the US.
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Re: [2017-12-08] Healthcare

Postby Guest » Tue Dec 12, 2017 8:59 am

zbbrox wrote:
magnetoo wrote:It's also disappointing to see so many comments focused on how to tinker with specific situations in order to try to continue to survive within a fundamentally and deeply flawed and unfair system.


Exactly right. This is a systemic problem that requires a systemic solution, not just individual action.


I am probably going to be the only one to say this as it may come across as a bit controversial, but I absolutely disagree that this is disappointing.

We all actually shouldn't want intelligent people or people around the middle class to be hit hard in favor of holding up all of our disadvantaged citizens. And/ or berate them for "not caring about the disadvantaged" when they try to take measures to save themselves. We want intelligent, successful people to have all the incentives and all the opportunity they can have in our country. Or else, think about it. These are the people who can afford to move out, over time, en masse. The economy and productivity of a nation would be hit severely by the loss of intelligent people, people with job skills, people with professional skills, business acumen, etc. Conversely, if they are living a good life and everything is going well you will draw in more intelligent/skilled people. Any excess productivity, wealth, and opportunity then go to the disadvantaged all along the way.

Think of it as this analogy - in a hunter/gatherer society the best hunters get the most portions of food. You still keep the poor hunters fed, but you never starve the best hunters in favor of the poor hunters.

In a third world country I would agree that the disadvantage is compelling, but in our society our disadvantaged people have had free public education, free libraries, access to nearly infinite and cheap knowledge on the internet nearly 2 decades. The main cause of poverty here is no longer a person's identity or even their location within the nation. We can be as charitable as we like with what we can spare, I especially think disadvantaged children are at no fault here and deserve all that they can have, but the reality is some disadvantaged adults got there because of poor life choices more than unavailable opportunities, and if we cause our most productive adults way too much grief by shouldering the burden of responsibility on them, we will only result in losing a lot of them, with the exceptional few who stay only suffering by losing everything anyway.

I say this from the perspective of a person well-educated but highly disadvantaged financially. I work har every day but I will have to work 5 years to help pay a family debt. I am in no way a preppy person with an in-group to protect, but I highly disagree with shaming them in this situation.
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Re: [2017-12-08] Healthcare

Postby Guest » Tue Dec 12, 2017 9:08 am

BB Shockwave wrote:I often wonder why you guys in the United States of No Healthcare even bother with health insurance when it is so deeply flawed and often by the time you need it, the provider decided you are no longer eligible "because".
Here in Hungary I pay the mandatory healthcare which is currently around 27$ a month. This means you are viable for service anywhere in the country for emergencies - and they usually respond on time when it is a life-and-death situation. When it is something less urgent like say, a fever or a tootache, you go to your assigned local general pracitioner doctor, they will examine you, prescribe meds (at discount), send you to various other labs and specialists if needed, etc. Now this is where the system slows down - often you have wait a month for even an ultrasound and even more for MRI or busy specialists like heart doctors, etc, and this is where I usually just skip the system and go to a private company. There are plenty, and they usually charge 45-55$ just for one examination, but they are fast and reliable. The caveat is, these private practices will want to milk you for all you have, so they will advise you to do all sorts of expensive tests. It's up to you what you choose. I generally stick to the public healthcare, but for dentists I always choose the private practices. It just takes a while - usually through recommendation from friends - to find a good and relatively cheap dentist whenever my current one retires or moves away.
As for you guys... I would just not pay healthcare at all, put the money you would spend on that away and invest it, and pay from that for a private company if you need it.


I live in the United States and all of the above you have described is the same here, save for one difference. If your income level is above the poverty line but you are not exactly wealthy either, you may be hit with the problem that Zach is describing. 400-800$ dollars a month for insurance, per person. If your income level is below the poverty line however you get cheap/no cost insurance. The caveat is if you had no insurance, under the ACA, come tax time once a year you were supposed to be fined around 2000$ per family, that part is thankfully rescinded but yeah the issue remains that a person of lower middle class/ working class cannot afford insurance. (Higher middle class/ higher class can afford better insurance, which is why I assume you do not hear them complaining, and only the demographic the weinersmiths speak about in this comic)
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Re: [2017-12-08] Healthcare

Postby zbbrox » Tue Dec 12, 2017 10:23 pm

Guest wrote:I am probably going to be the only one to say this as it may come across as a bit controversial, but I absolutely disagree that this is disappointing.

We all actually shouldn't want intelligent people or people around the middle class to be hit hard in favor of holding up all of our disadvantaged citizens. And/ or berate them for "not caring about the disadvantaged" when they try to take measures to save themselves. We want intelligent, successful people to have all the incentives and all the opportunity they can have in our country. Or else, think about it. These are the people who can afford to move out, over time, en masse.


I'm sorry, but I think this is deeply wrong. First of all, nobody is suggesting that small business owners should be made to suffer. The question is why someone would make a fervent plea for help on behalf of people who can, in fact, help themselves when only weeks ago millions of people who don't have the same resources were in much more direct trouble.

It's also ridiculous to suggest that helping the poor causes some kind of brain drain -- in reality it's exactly the opposite. A society where we help the poor is a society where, A: more intelligent and hard-working people find opportunity, B: it is much more pleasant to live because you don't have deprivation lining the streets, and C: even those people craven and callous enough that they're abandon their country because of the expectation that they help others will find that a strong working class presents a vastly better market for their services than an impoverished nation does

The economy and productivity of a nation would be hit severely by the loss of intelligent people, people with job skills, people with professional skills, business acumen, etc. Conversely, if they are living a good life and everything is going well you will draw in more intelligent/skilled people. Any excess productivity, wealth, and opportunity then go to the disadvantaged all along the way.

Think of it as this analogy - in a hunter/gatherer society the best hunters get the most portions of food. You still keep the poor hunters fed, but you never starve the best hunters in favor of the poor hunters.


Again, no one is being "starved" in this scenario, you're imagining a strawman fantasy where the poor and working class have all that they need and the upper middle class are being impoverished. That's so far from reality that it bears no relationship to the actual argument here at all. In fact, a small percentage of relatively well-off Americans are finding that health insurance is expensive, and somehow we're supposed to care more about that than recent attempts to take health insurance away entirely from tens of millions of people.

In a third world country I would agree that the disadvantage is compelling, but in our society our disadvantaged people have had free public education, free libraries, access to nearly infinite and cheap knowledge on the internet nearly 2 decades. The main cause of poverty here is no longer a person's identity or even their location within the nation.


This is absolute nonsense. What good are libraries to people who have to work 70 hours a week just to afford rent? Do you think everyone can afford high speed internet? Do you think that because everyone gets to go to a public school there are no comparative advantages to going to a private school over PS187? Come on.

We can be as charitable as we like with what we can spare, I especially think disadvantaged children are at no fault here and deserve all that they can have, but the reality is some disadvantaged adults got there because of poor life choices more than unavailable opportunities, and if we cause our most productive adults way too much grief by shouldering the burden of responsibility on them, we will only result in losing a lot of them, with the exceptional few who stay only suffering by losing everything anyway.


I honestly don't care what "poor life choices" may have led someone to not have any health insurance, they should have health insurance.

More than that, if you think rich people don't make "poor life choices", you really need to open your eyes. The fact is, some people in our society have the resources to screw up again and again without suffering any serious consequences and others do not. Even further, some people have to live in a constant defensive posture, passing by risky opportunities that the better positioned can take advantage of. Being poor had a way of keeping you poor.

And again, the idea that Americans are going to flee our excessive income redistribution is just laughable. We're the most unequal we've been since the gilded age, for a start, and Europe gets along just fine with vastly more redistributive policies. This middle school libertarianism isn't getting you anywhere.

I say this from the perspective of a person well-educated but highly disadvantaged financially. I work har every day but I will have to work 5 years to help pay a family debt. I am in no way a preppy person with an in-group to protect, but I highly disagree with shaming them in this situation.


Sorry, but anyone who has ignored the threat that ACA repeal has posed and the disaster of our healthcare system *right up until* they see people like them cost money should be ashamed of themselves. That's not how you develop a society.
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Re: [2017-12-08] Healthcare

Postby zbbrox » Tue Dec 12, 2017 10:25 pm

Guest wrote:I live in the United States and all of the above you have described is the same here, save for one difference.


What? It isn't remotely the same. What are you on about?
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Re: [2017-12-08] Healthcare

Postby Sizlak Jones » Tue Dec 12, 2017 10:51 pm

Guest wrote:We all actually shouldn't want intelligent people or people around the middle class to be hit hard in favor of holding up all of our disadvantaged citizens. And/ or berate them for "not caring about the disadvantaged" when they try to take measures to save themselves. We want intelligent, successful people to have all the incentives and all the opportunity they can have in our country. Or else, think about it. These are the people who can afford to move out, over time, en masse. The economy and productivity of a nation would be hit severely by the loss of intelligent people, people with job skills, people with professional skills, business acumen, etc. Conversely, if they are living a good life and everything is going well you will draw in more intelligent/skilled people. Any excess productivity, wealth, and opportunity then go to the disadvantaged all along the way.


On the other hand, at some point in time, the question is where are these intelligent and skilled people going to move to? Is there truly a place outside of the US that is just rapidly converting the elite US citizenry?

Yes, people will move from state to state, assuming the job market, the climate, the housing market, and many other factors permit, but how often do you see people in the upper half of economic advantage leave their country for such reasons. Yes, from time-to-time. I know a few people who left Vancouver to go live in LA, but these were actors trying to break into Hollywood. Hollywood has an exceptional location advantage, akin perhaps to a silicon valley. People would still move to Hollywood and Silicon Valley to make it in their respective industries.

Consider the NCAA division 1 system. Schools are essentially placed on an even field when it comes to recruitment, but some schools are consistently able to have a more successful program. They can recruit the top athletes more easily, despite offering essentially the same package of economic services as all of the other schools. One would think that a student athlete getting a full ride scholarship would be interested in going to the school that offers either: (a) the best education; or (b) the best opportunity to demonstrate athletic prowess so as to be drafted into the NBA/NFL. Other factors include coaching staff, living quarters, climate, proximity to home, other family members who played for a school or attended a school, etc.

It is the same shit with governments offering insane tax breaks to attract mega-corporations. Jon Oliver did a piece this last season about how states and cities were vastly overpaying for mega-corporations to bring their business. If all of the states agreed to raise taxes on the wealthiest earners, do you really think the wealthiest earning people will just say, "fuck it, I'm moving to the Middle East where I may not have the freedoms I'm accustomed to, but at least I get to keep a higher percentage of my earnings..."

I see your argument proposing trickle down. How has that worked out in the US? The wealthiest control a larger percentage of the wealth than ever before, yet the GDP isn't skyrocketing along with their personal wealth growth, and the cost of living is going up faster than the increase in wages. They don't pay their fair share. They make their money on the infrastructure built by the US, but they don't pay enough back in taxes to keep the infrastructure maintained. Their vast increase in wealth isn't then spent in the US and providing US jobs (which is one of the basic requirements of trickle-down). They are buying products made overseas, spending their money in tourist countries, moving their profits to tax havens, and the average American citizen isn't seeing but a small percentage of the wealth generation back into the country.

Wealth is not controlled by the smartest, the hardest working, or the most skilled. Wealth is generated by preexisting wealth. It is passed on to the next generation in life and through trusts. What is taxed on death in the US takes a relatively small amount of the actual spousal and generational wealth transfer.

Will Amazon just not have a US headquarters if no one gave them a huge tax break for moving there? Will Google stop running a search engine if the US changed their tax laws?

I was once younger and believed the simple economic models proposed by 80s Conservative governments. I still believe that you need to control government spending and provide your taxpayers with a reasonable bill for your government services (and that the highest income earners should pay a disproportionately higher amount of taxes)... but I have seen what happens when you provide deep discounts on taxes to attract business & wealth and what happens when everyone else starts matching or beating your discounts.
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Re: [2017-12-08] Healthcare

Postby Guest » Wed Dec 13, 2017 5:34 am

zbbrox wrote:
I'm sorry, but I think this is deeply wrong. First of all, nobody is suggesting that small business owners should be made to suffer. The question is why someone would make a fervent plea for help on behalf of people who can, in fact, help themselves when only weeks ago millions of people who don't have the same resources were in much more direct trouble.

It's also ridiculous to suggest that helping the poor causes some kind of brain drain -- in reality it's exactly the opposite. A society where we help the poor is a society where, A: more intelligent and hard-working people find opportunity, B: it is much more pleasant to live because you don't have deprivation lining the streets, and C: even those people craven and callous enough that they're abandon their country because of the expectation that they help others will find that a strong working class presents a vastly better market for their services than an impoverished nation does


I'm not saying anyone said small business owners should be made to suffer. I am saying that despite good intentions, there are issues with the current US healthcare system that hurt both the working class and the lower middle class. I'm not talking about the higher middle class or the rich, they are fine.

Small businesses are made to cover a worker's health insurance if they are full-time workers. This is not chump change, this could be a significant amount per worker. For big businesses this is affordable but for a small business it cuts into things. As a result a common practice is that they will keep multiple part time workers and many working class citizens are working 2-3 part time jobs instead of one steady full time job. Even big businesses that CAN handle it do this practice but that is another thing.

Also I am not saying anyone is starving. That was part of my analogy not meant to be taken literally.

However I do think the situation might be quite severe for a number of people. A lower middle class family of 4 paying 1600 for health insurance alone per month is ridiculous but it is happening and I know people who have suddenly had this drop on them this year. That may be similar to the situation Zach and friends are asking for help on.

Yeah we want the poor to have all the opportunity they can get, and they have it, again I want to reiterate the free education, job opportunities, free access to knowledge infinitely growing.

Health insurance is a different beast though. Imagine going to the doctor and doing a check up for 15 dollars. Your health insurance that you pay for covers it and you are good to go. Now imagine "free" health insurance paid for by the state. You go to get the same check up, you pay nothing, the "free" insurance covers it and decides to bill the state 30 dollars instead of the 15. Another person not getting the the check up then ends up paying for the whole thing through increased health insurance premiums. They keep getting away with it until they bill 40, 50, 60, etc. until we get the situation that we are at today.

I am not saying that a "brain drain" would happen instantly but yeah if this continues over the next decade, or the next generation, it could change things. Our country may be free but remember that the whole world competes with each other economically. It's not unheard of for an american today to move to another country for work. It could be to pay for a child's future education, or an individual wanting a better life. It could be for job skills, for example there are places in China, Japan, South Korea, where teachers are paid a lot higher than they are here. Don't let that become the trend for other careers or businesses.

Don't let the rhetoric of helping the poor be the excuse anymore.

The result is that, what? we help the poor, so long as they don't work/ barely draw in enough income to support themselves, and if they get a little bit better they hit a ceiling where they are worse off than when they had no income but free health insurance, food stamps, unemployment insurance? An intelligent person is going to get up there and break out no matter what, I agree. But there are people who are going to be incentivized by such a system to just be lazy and rely on the system and they are more numerous than it is comfortable to admit. If the incentive is to increase that group of people that will happen, and someone has to keep paying for them. Nothing is really free. Every dollar is a portion of somebody's hard work.

But we can be charitable, and we can decide to give up a portion of our hard work to be charitable. Let that be your focus instead of forcing people through the state system.

Also when you give millions of people health insurance, but there are not enough doctors or hospitals, the result is those people may still miss out on actual health care. A huge portion of that health insurance fund is instead going into a bureaucratic system of medical billing, a whole mess of trying to figure out who to charge, and a portion of that goes into the corrupt charge master system I described above which is contributing to the higher rates in the first place.
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Re: [2017-12-08] Healthcare

Postby Guest » Wed Dec 13, 2017 8:31 am

zbbrox wrote:This is absolute nonsense. What good are libraries to people who have to work 70 hours a week just to afford rent? Do you think everyone can afford high speed internet? Do you think that because everyone gets to go to a public school there are no comparative advantages to going to a private school over PS187? Come on.


Those two extremes are not the only options that exist. You can have less than private school education, less than high speed internet, and still get yourself higher education or trained in a trade skill. You can get free access to computers and the internet at the library. You can enrich your mind with free books and reading material as a child. I went to public school and later on worked my way through college. I am not the private school rich preppy person.

Besides that 70 hours a week for 10 dollars an hour is 700 dollars a week, 2800 a month, 33,600 a year. They can get a roommate or two to split the cost of rent , work less hours, and dedicate 30 hours of their week to get education and job training. They do not qualify for free healthcare and would still have to pay 160-400 dollars a month for health insurance, with government assistance, depending on their age and other factors. The 160 dollars a month situation is pretty much having to still pay for every doctor visit, lab test, medicine, full-price. The health insurance you are probably hoping they could have is at the 400 a month mark, even for them.
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Re: [2017-12-08] Healthcare

Postby zbbrox » Wed Dec 13, 2017 12:45 pm

Guest,

I'm sorry, but you seem to have some basic misunderstandings about the economics of healthcare.

First, when health insurance is provided by the government, health care costs go down, not up. Your idea that with "free" health care providers will start charging more is exactly backwards. What happens now is that providers negotiate reimbursement rates with individual insurers, allowing them to pick and choose only those that give favorable rates. Government health insurance has monopsony power -- they cover tens or hundreds of millions of people and so providers have a strong incentive to attract them and so charge luck lower reimbursement rates.

Taken to an extreme -- as sometimes happens with Medicaid -- this can lead to providers fleeing the market. But Medicare, for example, finds the happy medium where essentially every provider accepts it, but it's also dramatically cheaper than private insurance.

And, of course, what's even worse is having no insurance. If you have no insurance, providers charge dramatically higher prices than they do to insurance. When you hear about thousand-dollar bags of saline and shit like that, you're hearing the price that's charged on the bill -- a price insurance companies never actually pay because they have bargaining power that individuals don't. Meanwhile, providers are in a position to charge individuals as much money as they possibly can, both simply because they can do so (people are obviously extremely incentivized to pay whatever it costs to be healthy, and often literally have no choice in the matter as they're being carried away in an ambulance) and because already high prices mean they're are high rates of medical default for the uninsured and they need to make up the money somewhere.

So what you want is a system where everyone is insured (what we're trying to accomplish now), or, even better, single-payer, where everyone is insured by the government and fair prices can be set by negotiation (as happens with Medicare currently).

Now, another thing I want to point out is that when we talk about small business owners, we are in fact primarily talking about the upper-middle and upper classes. Particularly because Zach is referring to relatively successful small business owners -- these are generally people with incomes far above the national median (60k per household). In fact, because we're specifically talking about people who make too much money for their premiums to be capped by the ACA, we know they make substantially more than that -- a family of four has to make at least 90k not to have a premium cap.

So, no, the complaints here are not about the poor or the working class, they're about people in the middle class and higher who are unfortunately left out of the protections being granted currently to those who make less. But this is not the worst problem to have! There are working people who don't make enough to qualify for subsidies because the ACA intended then to be covered by Medicaid, but who can't get Medicaid because their governors rejected expansion. There are poor people who don't have the resources to navigate the health insurance process even now we're requiring it. There are still people whose medical debt is crushing them despite having insurance.

And, again, there are tens of millions of hard working people who get their insurance via the exchanges or Medicaid expansion who are in danger of losing that coverage of Republicans repeal the ACA.

So, seriously, being concerned first and foremost with people like Zach is shameful. And more than that, if you want to fix things, the solution is really clear: single-payer.
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Re: [2017-12-08] Healthcare

Postby Astrogirl » Wed Dec 13, 2017 2:19 pm

CorruptUser wrote:Haven't been on these forums in ages, but the latest comic brought me back.

I am a health actuary on individual (and commercial), and this very issue is something very close to my heart. I have actually done an analysis on this in the recent past. The subsidies Zach is referring to are the APTC, advance premium tax credit or something along those lines. What these subsidies do is basically say, if you make below 400% of the poverty line, you have your health insurance premium (for the second lowest cost silver plan) capped, at just under 10% for the people just making the cut, lower percent as you approach poverty. Anything above this, the federal government takes on.

The federal poverty level in 2018 is 12060 plus 4180 per dependent, so for a family of 5 the 400% cutoff is $115120 per year, and they would pay up to $11155 for the second lowest cost "silver" plan.

So now a bit more. The premium you pay is based on the sum of the age factors for the adults and the first 3 kids below 20, times the base rate. So if the family is a couple both age 46 (1.5 each) and the base rate is 200, the premium is 600 a month or 7200 a year. The age factors were fixed slightly for kids under 20, increasing them. Age factors increase with age to a 3 to 1 ratio of 64+ to a 21 year old, and there is talk of changing to a 5 to 1 since even with this steep factor the young still subsidize the old. But anyway.

So now let's take the doomsday scenario. Family of 5, parents age 64 and 64, kids all 17, so it's not like they can be kicked out. Their total factor is 8.655. If the base rate is our 200 a month, this family making 115120 should be paying 20772. But they are only paying 11155. Until they get a dollar raise, and now their health insurance goes up by 9617. And that's at the 200 base rate, which is comically low. In Albemarle county, it appears to be about 790. What does that mean? Well, in our doomsday scenario, plugging in 790 now gives 82049, or a spike of seventy thousand going from subsidized to unsubsidized. Oh and this doesn't include the extra factor for smokers, nor does it include the deductible or MOOP. That's like, everything they earn, tax deductions or not. To make 70k extra, this family is looking at requiring a raise from, ballparking here, somewhere around 110k-ish extra income assuming self employed just to break even.

Yeah it's a mess.

Is MOOP one of these things https://en.wikipedia.org/wiki/MOOP?
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Re: [2017-12-08] Healthcare

Postby Astrogirl » Wed Dec 13, 2017 2:51 pm

ACA was signed 2010. The last major provisions came into law in 2014. So at the latest the price increases should have happened then if it were really the ACA causing it. So why did it only happen in 2016? Because the Republicans defunded the risk corridor to sabotage the ACA, spike health insurance rates and make people vote for Trump.

Why healthcare is expensive in the US:
- Because there are so many poor uninsured people (even after the introduction of ACA still millions). Their only medical care is the emergency room. The most expensive medical care that is available. No access to preventive care and check-ups. Only going to the doctor when illnesses that could have been treated much better early on have already advanced. [US-specific problem]
- Before ACA and now after the mandate is removed: Healthy people can opt out of paying health insurance. [US-specific problem]
- Lots of old people. [Problem in common with all industrial/developed countries]
- Many many insurances, thus high administrative costs. [Problem in common with e.g. Germany, different from the cheap single-payer solutions of Canadia and the UK and I guess a bunch of other countries where I don't know the system]
- Pharmaceutical companies are robbers. [Problem in common with Germany, not sure how exactly other countries handle this, might be the same everywhere.]
- Fancy new machines like CTs and MRTs. [Problem somewhat in common with other industrialized countries, but the US might have the most or newest.]
- Large areas with low population density, need higher number of doctors per inhabitant to stay within a couple of hours reach. [Problem in common with Canadia, but their healthcare system still manages to be cheap.]

Not reasons why healthcare is expensive in the US:
- ACA
- Obesity

But I don't particularly care if health insurance rates go up for healthy adults with high income as long as this means that poor people get access to healthcare. Healthcare is a goddamn human right.
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Re: [2017-12-08] Healthcare

Postby AussieGuest » Wed Dec 13, 2017 4:05 pm

Astrogirl wrote:- Pharmaceutical companies are robbers. [Problem in common with Germany, not sure how exactly other countries handle this, might be the same everywhere.]

Australia has the [url=Pharmaceutical Benefits Scheme]Pharmaceutical Benefits Scheme[/url] (PBS), which predates our universal healthcare system (and can even be traced back to something instituted for Boer War and WW1 vets), basically means that anyone who wants to charge Australians for pharmaceutical drugs has to negotiate with Australians as a whole (via a community-representing system we call the "Federal Government"). Which is all a bit limiting for any companies wanting to exploit patents to pretty much give people a choice between a life of debt-servitude... or death. It's also why drug patents were a sticking point in TPP negotiations, as not only would longer patent protections be bad for the people the government represents, it would also have been impossible for them to dodge consequences due to the very obvious hit to the public purse (as opposed to offloading stuff to a private sector that then charges the public more money -- but not through the collective books, so it's better).

Australia's Medicare system (yay for distinctive names!) isn't exactly one-paragraph simple, but I feel there's a couple of things worth mentioning:

It controls costs by basically having a big list of what it will pay for various services (I assume it gets updated regularly), which is paid when someone gets (necessary) surgery or visits the doctor or whatever. There are practises which just take that money and leave it at that (referred to as bulk billing), but they are quite free to charge more on top of that (and plenty do, or do, but bulk bill for people with concession cards [old, disabled, etc.]). This means that a doctor who is happy with a decent living and wants to do good can basically give people free healthcare, while a doctor who thinks he's hot stuff and worth $2000 an hour can profit from people who are willing and able to pay what he demands (but he's unlikely to get it if he isn't that much better than the other doctor).

Also, it exists alongside private health insurance, which mostly provides advantages rather than basic services. For example, it may cover any fees above what Medicare covers, give access to some private hospitals, or guarantee private hospital rooms.

So Australia has a system where drug costs are kept in check, everyone is covered, and you can go to pretty much any medical professional you choose. And, per person, it costs about US$3000 per year. Also bear in mind that the minimum wage here is ~US$15 (with a standard week of 38 hours, above which overtime is to be paid), so if we assume the USA has an average of ~US$10 per hour and factor that into the relative cost... I think I could just about get away with calling it equivalent to US$2000 a year for comprehensive, no-excess*, full-cover health insurance.

*By which I mean the money one pays before the insurance kicks in (e.g. a car insurance excess of $500 means that if you do $501 of damage to your car, your insurance provider will pay for $1 of the repairs).
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Re: [2017-12-08] Healthcare

Postby AussieGuest » Wed Dec 13, 2017 4:26 pm

Wait, is it even fair to contrast the USA with first word countries? Should I be digging out information about other third world nations, since that would put it on a more level field? (o~o)
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Re: [2017-12-08] Healthcare

Postby Sizlak Jones » Wed Dec 13, 2017 7:31 pm

Astrogirl wrote:- Lots of old people. [Problem in common with all industrial/developed countries]


Homer: Marge, please, old people don't need companionship. They need to be isolated and studied so it can be determined what nutrients they have that might be extracted for our personal use.
Marge: Homer, would you please stop reading that Ross Perot pamphlet?
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Re: [2017-12-08] Healthcare

Postby Kit. » Thu Dec 14, 2017 5:43 pm

Guest wrote:I say this from the perspective of a person well-educated but highly disadvantaged financially. I work har every day but I will have to work 5 years to help pay a family debt.

If you have time to spend on becoming "well-educated", you don't work very hard. Unless you are a medic, but then you are "with an in-group to protect".

If you have time to spend arguing on the Internet, you definitely don't work really hard.
Kit.
 
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