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Thread: Post 2020 Healthcare in the USA

  1. #1

    Default Post 2020 Healthcare in the USA

    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
    .

  2. #2
    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.

    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.

  3. #3
    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 Nothing will change so long as these outdated memes continue to drive political (Republican) policies, and people continue to vote by party affiliation.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.

  4. #4
    Quote Originally Posted by GGT View Post
    SSSocialism is bad.
    Only when it isn't used as prescribed...

    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.”
    https://www.commonwealthfund.org/blo...responder-work
    .

  5. #5
    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 –
    Sanders’ greatest legacy may be that he widened the Overton window – making space for Covid-19 to push America through it.
    Too much to hope for?


    https://www.reuters.com/article/us-u...-idUSKCN21Q31A
    .

  6. #6
    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.

  7. #7
    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?

  8. #8
    Quote Originally Posted by Dreadnaught View Post
    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.
    You're too young to remember polio patients using the "Iron Lung" https://en.wikipedia.org/wiki/Iron_lung

    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?

  9. #9
    Quote Originally Posted by GGT View Post
    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?
    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.

    https://www.youtube.com/watch?v=OrH_9aBFbyQ

  10. #10
    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.
    Last night as I lay in bed, looking up at the stars, I thought, “Where the hell is my ceiling?"

  11. #11
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    Quote Originally Posted by Dreadnaught View Post
    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.
    I think the Germans would disagree.
    Greece shows us that there is a kind of politician worse than the ones that break their election promises; the ones that keep their election promises.

  12. #12
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    Quote Originally Posted by LittleFuzzy View Post
    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.
    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.
    Greece shows us that there is a kind of politician worse than the ones that break their election promises; the ones that keep their election promises.

  13. #13
    Quote Originally Posted by Hazir View Post
    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.
    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.
    Last night as I lay in bed, looking up at the stars, I thought, “Where the hell is my ceiling?"

  14. #14
    Quote Originally Posted by Lewkowski View Post
    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.
    Off topic for this thread, but this is bullshit.
    Take the suffering and plague away now, let the madness become the truth, cause it's never too late for mercy when the red tides rise to you
    As power tends towards violent ends, I'll choose to give up nothing, cause it's too late to be the hero, and it's too late to see the truth
    I'm exempt of absolution
    But it's never too late for you

  15. #15
    Quote Originally Posted by LittleFuzzy View Post
    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.
    This would only work if there was a global monopoly on medical research.

  16. #16
    Quote Originally Posted by Lewkowski View Post
    This would only work if there was a global monopoly on medical research.
    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.
    Last night as I lay in bed, looking up at the stars, I thought, “Where the hell is my ceiling?"

  17. #17
    Quote Originally Posted by LittleFuzzy View Post
    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.
    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.

    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.
    Quote Originally Posted by Ominous Gamer View Post
    ℬeing upset is understandable, but be upset at yourself for poor planning, not at the world by acting like a spoiled bitch during an interview.

  18. #18
    Senior Member Flixy's Avatar
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    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...
    Keep on keepin' the beat alive!

  19. #19
    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.
    "In a field where an overlooked bug could cost millions, you want people who will speak their minds, even if they’re sometimes obnoxious about it."

  20. #20
    Quote Originally Posted by RandBlade View Post
    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.
    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.

    Health-care is not one of those spheres, for the reasons Fuzzy just explained.
    Last edited by Steely Glint; 04-20-2020 at 07:17 PM.
    Take the suffering and plague away now, let the madness become the truth, cause it's never too late for mercy when the red tides rise to you
    As power tends towards violent ends, I'll choose to give up nothing, cause it's too late to be the hero, and it's too late to see the truth
    I'm exempt of absolution
    But it's never too late for you

  21. #21
    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.
    Quote Originally Posted by Ominous Gamer View Post
    ℬeing upset is understandable, but be upset at yourself for poor planning, not at the world by acting like a spoiled bitch during an interview.

  22. #22
    Quote Originally Posted by RandBlade View Post
    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'.
    Take the suffering and plague away now, let the madness become the truth, cause it's never too late for mercy when the red tides rise to you
    As power tends towards violent ends, I'll choose to give up nothing, cause it's too late to be the hero, and it's too late to see the truth
    I'm exempt of absolution
    But it's never too late for you

  23. #23
    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.
    Quote Originally Posted by Ominous Gamer View Post
    ℬeing upset is understandable, but be upset at yourself for poor planning, not at the world by acting like a spoiled bitch during an interview.

  24. #24
    Quote Originally Posted by RandBlade View Post
    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.

    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.
    Take the suffering and plague away now, let the madness become the truth, cause it's never too late for mercy when the red tides rise to you
    As power tends towards violent ends, I'll choose to give up nothing, cause it's too late to be the hero, and it's too late to see the truth
    I'm exempt of absolution
    But it's never too late for you

  25. #25
    Quote Originally Posted by Steely Glint View Post
    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.

    Health-care is not one of those spheres, for the reasons Fuzzy just explained.
    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.
    Last night as I lay in bed, looking up at the stars, I thought, “Where the hell is my ceiling?"

  26. #26
    Quote Originally Posted by LittleFuzzy View Post
    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.
    Well, I am.

    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.
    Take the suffering and plague away now, let the madness become the truth, cause it's never too late for mercy when the red tides rise to you
    As power tends towards violent ends, I'll choose to give up nothing, cause it's too late to be the hero, and it's too late to see the truth
    I'm exempt of absolution
    But it's never too late for you

  27. #27
    Quote Originally Posted by Lewkowski View Post
    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.
    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.

    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.

  28. #28
    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*

  29. #29
    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.


  30. #30
    Quote Originally Posted by Dreadnaught View Post
    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.
    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.
    Freedom - When people learn to embrace criticism about politicians, since politicians are just employees like you and me.

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