Opinion polls have shown for decades that a majority favor a system more like those of Canada or Europe - here it's called "single payer". But the interests of the majority have little relevance here.
The "single payer" alternative is considered so radical in USA that it's mentioned in the corporate media only apologetically, as if it were advocacy of leprosy. When they can't avoid mentioning the obvious, the rejection of it is euphemistically explained by saying that it is "politically unrealistic" - before a quick change of topic. The "talking points" the owners provide for their followers call it "socialism", and the latter, in US political culture, is an epithet like "child molester".
The ugly reality this charade is designed to avoid acknowledging is that the US is ruled by what has lately been called "the one percent" - and there is nothing the majority can do about it. Voting for one of the practically identical, freak-show, major-party candidates is made useless by the two-party system; the increasingly hollow pretence of democracy mocks any thought of reform.
Of course it's barbaric. It is also perfectly rational on the part of the rulers: their families need not worry about getting first-quality treatment of any health problem, and from their view the rest are disposable labor whose costs are still too expensive.
What, exactly, would you propose we do about it? Protest in the streets? People can't afford to lose their jobs, nor even time away from their daily responsibilities. Write to Congresspeople? Pointless for those who can't afford lobbyists. Revolution? No one has a realistic plan. It's almost miraculous that Obama managed to (temporarily?) install a plan that even purports to help - and it forces citizens to pay the insurance industry, whose presence in the healthcare system is exactly what keeps 30-40 percent of the population an illness or injury away from destitution.
You're obviously in a better place (news of which does not penetrate the info-tainment here, BTW), but it's rather naive to suppose that we in the US chose this situation. For us, it will get worse before it gets better.
Adjective Savagely cruel; exceedingly brutal. Primitive; unsophisticated.
I fail to see how, when a group decide to take from the minority, it could be seen as anything else than barbaric.
It saddens me to see one of the last first world country coming closer to the universal health care trap. Sure, the US medical fees are insanely overpriced, but you don't solve a problem like this just by hiding the costs in a social program.
We're still quite a ways off and there's been quite a bit of pushback on the small steps Obama took. It's entirely possible the whole thing will be scrapped during the next presidency.
I personally don't see the "trap" you reference. I'd really like to understand your position there...
I only found out because I got 23andMe, and I actually know biology. It was dismaying to find out that very few of the tests on 23andMe are useful for Asians like me (fewer still if you're hispanic and if you're pure African, the affymetrix chip they use is basically useless). As we move into an era of personalized medicine, we'll be subsidizing better healthcare and better outcomes for some ethnic groups over others.
The faulty assumption behind universal healthcare is that a one-size-fits-all prescription is good for everyone, but there are some really ugly disparities that no one talks about; and these disparities serve to reinforce preexisting social inequality. While I'm lucky to be in a minority group that's likely to live a long time - if we have it, a lot of universal healthcare coverage will wind up being plowed into gerontological care costs, which tend to be super-expensive; so in a way, it's a subsidy for rich white people.
Now, I do think the american healthcare system is awful. In particular being able to be put into permanent lifelong debt from healthcare costs is only one small step above barbarism. But I don't think that universal healthcare is the solution we're looking for. Obamacare is even worse, it combines the worst parts of universal healthcare with the worst parts of the crony capitalist system we have, and I won't be surprised when it turns out to be an even bigger albatross on the shoulders of this country.
There was even a study that found on the whole, simvastatin is equally helpful across races: http://www.ncbi.nlm.nih.gov/pubmed/16709304
I think you miss the point of universal healthcare. It is not that one group has a higher utilisation of the healthcare system and therefore should pay more - the principle is that everyone is guaranteed the same provisions for healthcare, regardless of their risk factors.
Personalised medicine contributes nothing to the concept of universal healthcare; except for the noble aim of enabling better treatment of people through understanding individual responses. ' The idea that someone should be restricted in their level of healthcare utilisation under a universal system is absurd; As is the notion that someone should be forced to contribute extra (apart from the incremental addition of a high income earner through increased taxation) due to a perceived increase in risk.
>>The faulty assumption behind universal healthcare is that a one-size-fits-all prescription is good for everyone,
Again, I feel like you are trying to talk about personalised medicine inside of the concept of universal healthcare. Forget about personalised medicine. What the US needs first is access that won't bankrupt. The fact is we don't know enough about personalised medicine to give people different treatments based on genetic characteristics. And we won't for years. Sure, you can look at 1 or 2 isolated instances at the moment (ACE-inhibitors and ARBs in Black people for instance) - but none of this matters when it comes to life-saving care, for which the treatment is going to be the same for everyone anyway, unless you happen to have some rare blood disorder in which case racial profiling and blood tests at the time of intervention will dictate management.
>> so in a way, it's a subsidy for rich white people.
How so? Because they live longer anyway? Because they are less likely to indulge in the risk factors that result in early mortality? Again, Universal healthcare doesnt discriminate. But since rich black/brown/yellow/white/green people pay a higher proportion of taxes anyway, shouldn't your argument here be that Universal healthcare is a tax on rich people?
Additionally, just because you are on a high dose of a Statin, in a high risk population, doesn't mean you are developing myopathy. CK levels should usually be checked after a month or 2 of Statin therapy in line with followup for new lipid levels, and in the absence of symptoms it can be fairly safely ruled that you aren't experiencing a complication of a statin drug. But you probably already know this.
I'm not saying our system is perfect or can't be improved, but "Barbaric"? You win the prize for the most ridiculously hyperbolic statement I've read all today.
Elective procedures - that's a different story. But it is location specific, and in many countries with mixed public/private systems you can pay through your nose if you like anyway
There are 193 members states in the UN, of those 192 have a health care system that I would bet nearly 100% of americans would call "socialized medicine" in a poll. That includes countries like Sweden with completely state controlled top of the line healthcare, also England with state regulated prices for the private sector and also a top 5 in any reasonable metric health care system, or Panama/Argentina/Brazil with a mixed public and private not-top-of-the-line-but-reasonably-working system that includes very cheap private health insurance. It also includes Cuba, that has a very dfferent system than lets say Russia or Chile.
Your remark is as vague and irrelevant as saying "the only difference between HN readers and the rest of the world is that the former usually make vague and irrelevant remarks based on their personal beleifs".
This is only true if the law requires younger people to pay more than their cohort consumes on an average basis, so as to transfer even more wealth from the working young to the retired, wealthy elderly.
Hmmm http://www.forbes.com/sites/chrisconover/2012/11/27/young-pe...
The author of the article also says, "Young people are typically healthy. On average, they incur very low medical costs each year. In any social insurance system, most of them will end up paying in more than they get out during their early years"
It's not just the early years, it's all years. The way insurance works is that most people pay in more than they ever get out. You're insured so that in the unhappy event that you end up with a huge, abnormal, way above average expense, insurance will cover it. This is possible because, on average, most people pay in more than they ever get out. This fact in itself is not anything specific to insuring the youngest and healthiest people. The value of insurance is not measured by how much you "get out". It's measured by how much coverage you had, regardless of whether you used it.
I hope to never use my health insurance, or to use it (i.e., "get out of it") as little as possible. So far I've done great at that. Does not "getting out" what I've paid make me think I've been paying without getting value? Hardly. And my belief in that value is not conditioned on my expecting to get payments out of it in the future, any more than my belief in the value of my auto insurance is. I hope also to never get any money out of my auto insurance policy, this year or in any future years, yet it will still be worth every penny I pay.
The healthcare industry needs a lot more transparency. Every hospital should be required (if they choose to accept Medicare/Medicaid patients) to publish prices in an easily comparable format tied to standard medical codes for every service/procedure they provide, and should be required to charge individuals without insurance no more than the government or other large insurer pays. This would seem pretty simple to implement and would, over time, help keep prices lower simply by making them public and allowing people to compare them. The information asymmetry in the industry has created a situation where people are powerless to help themselves and make smart choices with regard to getting healthcare, and has led to the creation of another expensive program that we can't afford.
Sadly, we have a system in which the industries being regulated control the dialog, and they are all too happy to tiptoe past prices and on to who is footing the bill.
OK, yes. What it really needs is to be an open market both for care and insurance. Competition has amazing ways to both improve quality and affordability. This has been proven time and time again across a myriad of fields both within and well outside of medicine. Nothing beats open market competition. When providers and insurance companies truly have to compete for your business things change.
The ACA (Obamacare) is a disaster full of typical government-driven unintended consequences. We are just starting to see the tip of the iceberg. Funny that the very people who passed it will not have to live within this monstrous framework. And now the very unions who helped push it forward had an "oh-shit!" moment. They learned just how fucked it's going to be and want out.
I say, we are all on the same boat or shred the damn thing. If we are going to have socialized medicine the only equitable approach is that everyone, without exceptions, has to use it. All exceptions granted by POTUS need to be rescinded.
It applies to Congress.
I've been taking son analysis myself: ultrasound, x-ray, endoscopy, and had a surgery some time ago. All this amounted to $2000. And that's because I chose to go the private route in my country (Mexico). I have no idea how much would I have to pay in the USA for all that... it scares me.
Or in other words, it's not because the general concept of insurance can be wise that every implementations are interesting.
"One of the less obvious consequences of serious accidents is that victims often become uninsurable on the individual market as a result.... Obamacare really will change that."
Making this sort of insurance available amounts to a wealth transfer to people who have been victims of injuries. That's fine, if you're into wealth transfers and all that, but...
wouldn't it be better if we just admitted it was a big fat subsidy to the sick and injured, and paid for it out of the general fund, instead of paying for it by making insurance more expensive, especially the young healthy twenty-somethings who struggle to afford it? so that these twenty-somethings wouldn't be tempted to skip it, among other things, and would be less vulnerable to these $200,000+ risks (and further undermine the system)?
I mean, all else being equal, it is probably a good idea to be insured if you can, Obamacare notwithstanding, but the fact that it incentives people this way is a fundamental design flaw, not a feature or a fix.
Oh, wait, I know why we're paying for it this way. It's so we can pretend that it doesn't cost anybody any money. :P
I'm gonna go ahead and disagree with that. The residual value is every day afterwards that you get to live. (not that I disagree with the sentiment, just sayin)
