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As our vulnerabilities are made opaquer by this unprecedented health crisis, will USA healthcare post 2020 be radically different than it might have been prior to this stress on our system? Below are a few articles with some conventional thoughts on the topic.
Democrats, Republicans, and Your Health Insurance
The Trump and Republican 2020 Health Care Plan
A group of Republicans has unveiled its healthcare plan. Here is what's new and what isn't
Ha, the Trump administration won't re-open the Obamacare exchanges during this crisis. Republicans didn't want to expand Medicaid either, which really hurt nursing homes and rural hospitals. They fiddle around the edges with protections for pre-existing conditions, too. Can't imagine what BS they'll come up with after people recover from covid19 but have permanent lung damage and lose 20-30% lung function....but lost employer-insurance when they got laid off, and had a "gap" in coverage. :rolleyes:
They don't have a plan other than Freeeee Market private insurance and Health Savings Accounts, with lobbyists having regulatory control in 50 states. Just today VP Pence announced that no one will have to pay for covid19 tests or treatment. Blatant lie. :down:
SSSocialism is bad. Freee Markets are good. Government IS the problem. Nothing will change so long as these outdated memes continue to drive political (Republican) policies, and people continue to vote by party affiliation. We don't need Russia or China to prove that Propaganda works. :(
Only when it isn't used as prescribed...Quote:
Originally Posted by GGT
https://www.commonwealthfund.org/blo...responder-workQuote:
What steps could the Centers for Medicare and Medicaid Services (CMS) take with respect to Medicaid and the coronavirus emergency? On March 5, the agency issued a brief factsheet on Medicaid coverage. Not only is it distressingly incomplete, it appears to have been drafted with an eye toward discouraging beneficiaries from seeking care by, for example, pointing out that although care cannot be denied to very sick people unable to pay cost-sharing, “enrollees may be held liable for unpaid copayments.”
Quote:
The health crisis is also highlighting the potential virtues of a more comprehensive and connected approach to healthcare. The U.S. system’s fragmented fragility has been laid bare, as has the danger of viewing health as an individual matter. Universal coverage of some kind now seems far more likely –
Too much to hope for?Quote:
Sanders’ greatest legacy may be that he widened the Overton window – making space for Covid-19 to push America through it.
https://www.reuters.com/article/us-u...-idUSKCN21Q31A
I don't think socializing healthcare helps with pandemics any more than living in dictatorships that lie about the numbers. Pandemics are pandemics because they easily overwhelm health care systems of any type.
Dread, once there's a corona virus vaccine....should it be patented and trademarked to protect intellectual property and profits for certain pharmaceutical entities? Or should it be available to everyone regardless of their insurance status, or ability to pay OOP, or even which country they live in?
You're too young to remember polio patients using the "Iron Lung" https://en.wikipedia.org/wiki/Iron_lungQuote:
Originally Posted by Dreadnaught
You didn't go to school with kids who needed crutches because of polio paralysis. You probably don't even know the origins of the March of Dimes, let alone FDR's polio experience. https://www.marchofdimes.org/mission...of-dimes.aspx#
You benefit from the Polio vaccine but can't admit that was SSSocializing healthcare during a pandemic? :donkey:
Ah I see - best way to make sure people research a cure is to ensure no one can make money off of it. Sigh... how can you be so naive as to what drives people? It isn't Love, it isn't Hate, it isn't Fear, GREED is the most powerful motivator of all time. We know this historically and we know this in just observing people's behavior.Quote:
Originally Posted by GGT
https://www.youtube.com/watch?v=OrH_9aBFbyQ
You're right, greed is a very powerful motivator. And it's why the "for-profit" sector isn't interested in researching cures in the first place. It's not because the big bad government won't let them or is interfering with their ability to make a profit. It's because there isn't much profit in cures. The profit lies in disease "management." Ongoing eternal treatment. To compete with that kind of profit potential you have to charge an arm and a leg, which limits your patient pool, which again limits how much potential profit there is the cure for you.
I think the Germans would disagree.Quote:
Originally Posted by Dreadnaught
It never stops them from putting their snouts in the trough of publicly funded research though. It's close to crazy that people still fall for that claim of huge investments that need to be recovered before they make a cent of profit.Quote:
Originally Posted by LittleFuzzy
I might to an extent buy the idea that they need to recoup their investments. But if that's going to be the case, it does need to be THEIR investments, not public funding. The public gets to recoup its investments as well, and the way it does so is ready access to the results.Quote:
Originally Posted by Hazir
Off topic for this thread, but this is bullshit.Quote:
Originally Posted by Lewkowski
This would only work if there was a global monopoly on medical research.Quote:
Originally Posted by LittleFuzzy
Clearly not. Because it's what almost all for-profit research is focused on already. They compete on incremental improvements in drug regimens and such for disease management, with very little effort paid to beating their competitors by curing a condition completely. Because to be competitive profit-wise with disease-management over a lifetime a cure needs to be priced in the tens to mid hundreds of thousands per individual, depending on the rarity. They understand opportunity cost, even if you don't.Quote:
Originally Posted by Lewkowski
Its one reason there's such a difference between eg the UK and USA healthcare systems too. Here a lot of work by the NHS is on prevention - because prevention is much cheaper than treatment. I belive in the USA a lot more gets spent on treatment, because treatment is more profitable than prevention.Quote:
Originally Posted by LittleFuzzy
Let nobody pretend the US system is "free market" it is anything but, it is deeply linked to its politics and very restricted by regulations. Free market makes it easy for new companies to come into the marketplace if existing ones are profiteering, regulations prevent that. Plus the American taxpayer pays more on healthcare than the British taxpayer does - so its absolutely Socialised, just incompetently so.
I'd say the fact that people had to pay for their own Corona test in the beginning (not sure if that's still the case) is already a clear example of the shortcoming of that system. Without (proper) insurance, people will avoid going to the doctor unless they have to, and this crisis shows very well why that's a bad idea from public health perspective.
Not to mention the fact that practically everybody's insurance is linked to employment, so what if you lose your job due to a health crisis...
Testing sites still require a primary referral. And even with employment our HDCPs can easily cause a visit to cost $100+ just to get permission to get tested.
If you end up in the hospital before getting a positive test result they still run a battery of tests on you to rule everything else, I've seen bills range from 9 to 35 grand.
The fundamental problem with the US health-care system isn't whether or not it's a 'free market' it's that it's done for profit. You could, hypothetically, have several not-for-profit healthcare providers competing with one another (I don't think this an especially good idea, but you could do it). Under capitalism, things aren't done because they're useful, they're done because they make money. In some spheres, things that are profitable and things that are useful are more or less the same, and at least for a time the capitalist system actually does some good.Quote:
Originally Posted by RandBlade
Health-care is not one of those spheres, for the reasons Fuzzy just explained.
For profit works too with a free market (though it doesn't deal with the fact preventison is better than cure too well) and there are many other nations with private companies in healthcare that are without America's system.
America is worse than just being for profit. Its corrupt. Systemically corrupt.
That's what you get when you deregulate the shit out of everything and speed decades telling everyone 'government isn't the solution, government is the problem'.Quote:
Originally Posted by RandBlade
The problem isn't that it's deregulated, its too regulated and its corrupt because people pay politicians to make and keep regulations that suit them.
Deregulation would be better than what they have. America's politics and government is a problem.
It seems extraordinary unlikely that deregulation would improve the American health-care system one iota. I would look forward to health-insurance becoming basically unobtainable for anyone but those with the most profitable illnesses, who would then be told to go die in a ditch the second they stop becoming profitable.Quote:
Originally Posted by RandBlade
Secondly, I obviously agree about politicians being basically paid to introduce or change laws beneficial to the health-industry (and others), which is why I advocate and have always advocated for not allowing politicians to receive donations from those they make laws about, and that political parties and election campaigns should be publicly funded but everyone loses their shit when I suggest that. This a 'violation to free speech'. Apparently.
I'm not willing to go so far as saying that the healthcare sphere as a whole works that way, Steely. Various other sectors operate in ways where other factors (like cost containment or prioritizing limited capacity) are far larger motivators. For-profit pharmaceutical R&D though, a distinct subset of the healhcare sphere? Yeah.Quote:
Originally Posted by Steely Glint
Well, I am.Quote:
Originally Posted by LittleFuzzy
R&D doesn't deal directly with patients, so only reason something would be profitable for them is if it's profitable within the market they're doing the research for.
I mentioned polio because Salk didn't patent his vaccine and considered it a 'gift to mankind'. Early research funding (thru March of Dimes) came from private donations, so the vaccine belonged 'to the people'. The government used private entities to manufacture and distribute the vaccines (and regulated against profiteering) because it was an investment in Public Health.Quote:
Originally Posted by Lewkowski
https://www.forbes.com/sites/quora/2.../#19b490d69b83
https://www.history.com/news/8-thing...-polio-vaccine
https://slate.com/technology/2014/04...o-vaccine.html
(The Slate article is interesting since it mentions the legal confusion between an invention and a discovery, and SCOTUS decisions.)
And you're wrong about GREED as the most powerful motivator of all time. Especially in Public Health. What's greedy is clinging to private insurance models that don't work, paying millions of middle men (like you) that only add to costs, and exclude entire groups of people from getting care. :donkey:
How many Trillions of (borrowed) dollars have been spent on the economic fallout of this pandemic? Imagine if we'd spent just half of that a couple of decades ago....funding universal healthcare, public health initiatives, pandemic planning, and R&D.
The deficit hawks and anti-tax ideologues don't mind much that our military budget is bloated beyond belief, so it's not really about money, taxation, or even deficit spending. They just don't want to fund anything that benefits people -- SS, Medicare, Medicaid, CHIP, SNAP, Obamacare, etc. -- those are entitlement programs and/or "welfare". SSSocialism! They don't want to fully fund the CDC or NIH, let alone international agencies like USAID, or even WHO.
The sad irony is that Trumpism and "America First" is just a propaganda tool for crony capitalism and plutocratic populism. :(
*And if Trump wins re-election, healthcare in the US will continue its course toward failure. Bigly*
Papa Johns is running a commercial about "feeding the community" with their pizzas during the covid-19 pandemic. Keeping us safe with 'hands-free' delivery. So magnaniminous, they really care, pfft what a crock.
This is the same corporation that complained about providing its employees with health insurance....because it would raise the price of a pizza by TEN CENTS.
:rolleyes:
Health economy does not follow the rules of popular wisdom and popular microeconomics. Competition does not bring efficiency. Customers cannot evaluate quality of service and price is inelastic because people pay whatever price to stay alive. Those two conditions cause everything you know about markets to not work. This is why health economy is for a higher degree at universities, very complex problems to solve.Quote:
Originally Posted by Dreadnaught
Freee Market Capitalism does a crap job in the healthcare sector. Vaccine R & D is included in that mess. Even if/when a vaccine for Covid-19 makes its way to "the market"....the delivery won't be based on need, but power. Just like the N1H1 vaccine that went first to Wall Street executives, because they were considered "essential workers", above healthcare providers. SSDD. :(
BTW, I'm still waiting for the GOP healthcare plan that replaces the ACA (Obama Care). To date, it still sounds like trading a chicken for a check-up. :rolleyes:
The incentives of the market will produce a vaccine, not the socialist ideologues of the faculty lounge. Pricing and delivery are a natural debate to have, but the underlying fact of what conditions drive the innovation remains.
Right. That's why a bunch of non-profit or state entities are shoving resources into the research of a vaccine themselves. Is it going to be done by Horatio Alger who will catapult themselves from poverty into the ranks of the wealthy with the singular titanic act too, Dread?
China will develop a vaccine before the "freeworld" does. China already having it may be what quelled Hong Kong protests.
You mean the US actually cares about people, and public health policies? Citation needed. :bored:Quote:
Originally Posted by Dreadnaught
More than 5 million Americans lost health insurance during the covid-19 pandemic. Early numbers thru May; full stats won't be available until mid-late 2021. (Some studies put the numbers between 10 and 27 million.) :eek:
https://www.nytimes.com/2020/07/13/u...nce-trump.html
https://www.familiesusa.org/resource...rican-history/
https://www.kff.org/coronavirus-covi...wing-job-loss/
Note that states who didn't expand Medicaid (including Texas, Florida and North Carolina) had *double* the rates of uninsured.
IMO the US will never get out of this morass until we break the chain of employer-based-health insurance, and/or decouple healthcare from the private for-profit Insurance Industry. If we *truly* care about people and their health, we should have policies to reflect that principle. If the biggest economy in the world can't do this, we're not really USA #1! :cheerleader:
:(