GIRTHQUAKE said:
Beer Baron said:
gearheadmb said:
I think the problem with healthcare is the same problem with higher education, and that is mixing socialism with capitalism. When the Gov tells a business to send them the bill things go off the rails cost wise.
If that is true, then why do European nations with systems like you are describing have a lower per-capita cost for health care and education?
The best argument I have heard similar to what you appear to be making is that one of the U.S.'s big problems is that where other nations have this style system or that style system, the U.S. has a patchwork of at least three major systems for providing healthcare. It's not that we have a system that is a "blend of socialism and capitalism" but that we have one system that is far more capitalist than most other developed nations and another system that is far more socialist, both are broken on their own and the issues each has compound upon each other rather than fill in the gaps.
As someone who works in this- this is completely true. The simplest expression I can give of the USA's healthcare system, is that it's built and meant for the 70s running the worst of both capitalist and socialist ideologies.
I am not a fan of Medicare for All because it has serious faults... but I'm not a fan of people dying more, and a lot of americans die needlessly.
We can do the easy thing and just pick winners and losers by shifting the cost burden around or we can do the hard thing and build a comprehensive model of the process, identify the inefficiencies, and intelligently reduce / eliminate them.
This is also true. I hate the trend of band-aiding onto the current system, because there's no control over insurance systems when it comes to the level of work they demand for proper bureaucracy. That in fact, is how insurance agencies fight against us- after the ACA passed they increased the amount of paperwork so much that it took an average of 3 minutes to over 20 for one doctor's visit, which is part of why NPs and PA-Cs are seeing such an expansion.
Want to understand why costs for private insurance are so high? 35% of $100 aspirin is $35 but 35% of a $2 aspirin is 70 cents.
Ironically, Medicare/Medicaid can be one of the key reasons why prices on medications is so high in hospitals. The reason is because economically, since Medicare draws a line in the sand saying "We won't pay more than $X for a pill", in doing so these corporations are incentivized to only combat that number and not each other- and since it's daddy US government and the cash flow is guaranteed, why change? It's basically a check that hasn't been banked yet, and because of that there's also no impetuous to change.
From here corpos will eventually shove each other out, but that's more in a duopoly/tetarchy way, a partnership more than anything. They do this because it eventually makes more sense for one company to focus on X products and simply... agree to not step on each other's toes. They'll purchase and swap plants and lines and personnel until two or three companies make all of one product, and the price remains static. You see this in the modern telecom industry as well; here in the USA, we still only have Baxter producing all our saline for infusion out of Puerto Rico, and ... you get it.
It is not uncommon for people WITH INSURANCE in the U.S. in need of major surgeries to take a month off work, fly to Europe, pay out of pocket for an operation, and sit around recovering on vacation for a couple weeks before flying back to the U.S. sooner and for lower out-of-pocket cost than using their insurance to cover the same procedure in the U.S.
E36 M3 dude, our insurance is starting to sponsor it even. It's called "Healthcare Tourism" 
Spain is a major destination for hip and knee replacements now.
That has been going on for more than 2 decades. Regularly reported in the news magazines.
I drive home delivery for a small pharmacy, and while I'm not sure about larger places like CVS or Walgreens, I can say that we are at the mercy of our suppliers. We can order stuff, but if they don't have it, or if they've got a limited supply and someone has priority over us, we're S.O.L. I don't have that much firsthand knowledge with things outside of my deliveries, but I hear secondhand frustrations from the owner/lead pharmacist, and the techs, and they seem to have been on the rise lately.
I'm honestly feeling about ready to quit, it's just too disheartening seeing opioids that cost $0.37 for a 30-day supply, and life-sustaining medicines that cost upwards of $5,000 for a month. And that's not the customer price, that's what the insurance pays for them. If these people didn't have insurance, they'd be utterly boned, but that also leaves them at the whims of the bean counters. It's honestly terrifying to me.
RacetruckRon said:
M2Pilot said:
There have been some advances in insulin over the past few decades and there's been inflation, so some of the price increases are justified.
But, I was selling insulin in the 60s for $1.99 a vial. That was my cost from the wholeseller and we added no mark-up.
The patent was sold 100 years ago for $1, so it could be affordable for all who needed it. Please tell me how it's justified that I spend $500 a month for medicine that keeps my wife alive. I'd love to know.
Okay, I will tell you.
They come up with new formulations of old drugs so they are proprietary and patented, and they can charge full boat, rather than generic prices. Same thing with colchicine or the epi pens. Why do they do this? Two reasons.
1.Because they can
2.Because money
I would tell you to write a letter to your member of Congress and complain, but I guarantee that whoever it is, that MFer is getting paid and not interested in your opinion.
I'm 32. I'm healthy, so far as I know. I've never had to rely on the medical system in the US for anything. That's probably the only reason that I have a house and a car right now, as anything serious may cost me my job (absence) and would then happily bankrupt me. Maybe I'd be able to get a sob story on the local news with a link to my GoFundMe. This may not be the reality, but it's definitely the perception among a lot of normal, younger folks. We have a kid now (terrible decision, 2 thumbs down) and the deductible required to get an HSA is 10k. We could get an FSA for a third of that so long as we don't waste any of my money that, and I looked this up, is refunded to my employer if unused at the end of the year. I'm going to try and steer way clear of that fuzzy line and just say that I challenge anyone to convince me that there aren't some shenanigans there where, if you make enough money, you get a pre-tax and investable fund to pay healthcare costs with but, if you make less than an arbitrary number, you're incentivized to underestimate your full year of medical costs or the surplus funding from your own paycheck is lost. Why is the cost of insulin so high? 1) Because it can be. What else are you going to do? 2) The profit goes, firstly, to shareholders and politicians, then it goes to finance the next pill that you, Big Pharma, are trying to get Americans hooked on. After all, it's good for business and you can always point the finger and blame the disadvantaged for not being responsible enough.
I make good money, I have decent insurance, and a serious medical emergency would stand a good chance at ruining me in America. Or I look over the water at people paying comparable taxes with less stress, a healthier environment, better voting practices, that go to a doctor when they're sick instead of when they can't wait any longer for it to get better on its own. In the Corps they gave us E36 M3 for going to sick call but no one would stop you or get in your way (at least in my experience), even at PI. I can't say that about my experiences after EASing. Is this really the way we want to live?
Edit: If this is over th efuzzy line or really rubs someone the wrong way just let me know, not gonna die on this hill. (Can't afford it) I'm not in a charitable mood after my bosses' latest shenanigans so it may have come out a bit here.
