Shouldn’t heath care be a responsibility of the Department of the Interior?
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Certainly a war criminal having had a hand in the construction of what passes for the current American “system” is both not a surprise, and darkly humorous, on a level.
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The AMA is the reason healthcare is so expensive to begin with. Like insurance companies backing Obamacare, I’m sure the only reason the AMA might change their stance is that they see an angle for enriching its members. It essentially acts like a union for doctors, constricting supply and engaging in regulatory capture. I don’t trust them as far as I could throw a stethoscope. They are why we can’t have prescription drugs without a doctor visit like the rest of the civilized and most of the uncivilized world as well. They are why nurses can’t do certain things they could do just fine, and why foreign doctors’ training is worthless here.
Notice that none of the healthcare proposals to bring down costs in the last how many years have addressed expanding the supply side- it’s always about efficiencies and insurance, never about simply expanding the supply of doctors. Ptui
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Hum… pretty sure it’s 1945 for France…
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It’s not that American people are evil – people everywhere are self-interested – but I think the particular thing with American discourse is the conviction that, like, a $2 lottery ticket is worth more than a $2 bill.
Yeah, there will be longer queues for elective surgery if folks can’t just pay to jump the line.* If you’re richer than most people, that is a reasonable argument in terms of your self-interest. But most people aren’t richer than most people.
For a society that promises that everyone will be a millionaire if they do it right, the problem is that it becomes unpatriotic and insulting to suggest that anyone might not be in that group (for melanin-adjusted values of “everyone” and “anyone”).** You can be the third generation living in the same trailer, and still get offended at the notion of people like you having equal access to healthcare, because your whole focus is on the time any day now when you will be the rich guy cutting the line.
* Actually, in the UK (for example) you can still pay out of pocket for private medical treatment – and that’s still cheaper than in the US – but people mostly don’t, especially for important stuff, because the open-heart surgery provided to homeless people is plenty good enough for rich people.
** I think Americans are well aware that not everyone can be a winner. So when politicians make “positive” speeches about how everyone can be the richest, it’s implicit that they have someone else in mind to be the non-richest, and we can guess who they’re secretly thinking of, and by what name.
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I love this board. The level of snark, sarcasm, dark humor, and snickering is perfect for me. Brings a smile every time. 
But, I read it for the articles…
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The debate grew heated — older physicians warned their pay would decrease, calling younger advocates naïve to single-payer’s consequences.
Thing is, for our generation (people under forty), we’re already earning less in real terms, so this isin’t much of a threat.
Yeah, there will be longer queues for elective surgery if folks can’t just pay to jump the line.
As you point out, this isn’t a problem in the UK (and I assume everywhere else). Why would anyone ban doctors from providing their services at a cost if they want to? (Of course, they still have to be trained to the same standards). So I assume it would work the same way in a hypothetical US healthcare system. A basic level of treatment for everyone, and if you want to throw your money around, whatever extra treatment you can afford.
My mum uses private healthcare to get access to scans and diagnostics etc. that she then takes along to her NHS doctor, who uses them to make better informed decisions. That way she gets better healthcare than she might otherwise, and actually saves the NHS a bit of money along the way. Oh, and of course, being a pensioner she doesn’t even have to pay the £8.80 prescription charge. (Shit, I thought it was still £7ish, been a while since I needed meds).
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no thing is about how much money you/we have
The thing is, young docs are having the exact same problem that young Americans are having: the fucking Boomers tied the market up tight as a drum, climbed up the ladder and pulled it up after them.
Example: you want to be a neurosurgeon? Well, if you want to practice in a metro area (the only place you can make good money), you’re given a choice. You can sign on with the neurosurgical group that dominates the area (which means that they take all the profits and pay you whatever the fuck they like, keeping a huge cut for doing nothing except billing) or you can try and compete with them… Except that they will use the nastiest strategies possible to kick you out of the market, including undercutting you and threatening to not do business with any hospital/surgical center that lets you practice there. And of course these guys are highly connected at the top levels with hospitals, regulatory agencies, business and government - and if you think they’re not willing to maliciously abuse those connections to chase competing surgeons out of town, you’re incredibly naive.
And yes, of course the people that own/control these groups are old farts (or their kids, some of whom aren’t even doctors) that see their strangling of the free market as “gumption” and “hard work paying off”.
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Watching the healthcare debate in the US unfold, I’ve often struggled to pick out a rational argument against universal healthcare, however it might be provided. It seems like there’s plenty of case studies out there (see: every other developed country) that shows that universal healthcare, either provided by the government or through some other scheme managed by the government, produces better health care outcomes, for more people, for less money. I’ve struggled to understand what the argument against it really is, other than “it’s socialism and socialism is bad”.
But finally I understand why it can never work and why, in fact, I was a fool for thinking it ever did work: a small group of people might make less money.
The debate grew heated — older physicians warned their pay would decrease, calling younger advocates naïve to single-payer’s consequences
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It’s not very logical no.
But I can tell you what I’ve heard anecdotally for the biggest argument against a universal system employed by the civilized world. Basically, they invoke two things. One is that a government bureaucrat is going to get to decide if you get particular care - “death panels” they were called during the 2008 election. The second is that countries with a universal system (they love to point to GB and Canada) have long waiting periods for care. I’ll add one more: I guess they also complain about having to pay for others’ care (which they do anyway, because tax dollars support public hospitals that have to provide care for people who can’t afford it, at a much higher rate than it would be if we had a universal system).
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One small edit for additonal accuracy. They really don’t want to help insure the “undeserving”.
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The problem with their argument though is that they are paying for the “undeserving” poor already, at a much higher rate.
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And both those things are lies. Currently, private insurance companies decide what care you can get, and they decide through what one might rightly call “death panels”. Wait times in Canada for preventative and acute care are shorter than in the US. Wait times cited for elective care are on par or shorter than in the US. If you’ve ever needed to get an MRI in the US, you already know that the wait times are absolutely insane and your appointed time (which could be at 2:30 AM because there aren’t enough of these imaging machines in the US) can get bumped by a professional sportsballer.
Sadly, it wasn’t difficult to see what the issue was when Bill Clinton was president - single-payer represents less money getting siphoned into the pockets of a million different rent-seeking leaches.
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I… know. I’m just giving the justifications I’ve heard. I know they’re wrong.
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Yeah, I didn’t mean to imply anything about your thoughts, sorry if it seems like I did. I do believe that busting those lies repeatedly is necessary to make them less useful as talking points, though. Which is all I was trying to do.
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BlockquoteActually, in the UK (for example) you can still pay out of pocket for private medical treatment – and that’s still cheaper than in the US – but people mostly don’t, especially for important stuff, because the open-heart surgery provided to homeless people is plenty good enough for rich people.
I read thirty years ago that social programs are less depised in Britain because the benefits accrue to all regardless of financial need. IDK how true that is. Here in the US, we pretend benefits accrue to the needy. Do all we can to prevent benefits for any, and then surreptitiously give it all away to the wealthy and connected.
Blockquote My mum uses private healthcare to get access to scans and diagnostics etc. that she then takes along to her NHS doctor, who uses them to make better informed decisions. That way she gets better healthcare than she might otherwise
But shouldn’t everyone have access to scans and diagnostics that make the best decisions possible? Shouldn’t everyone get the same level of healthcare? Maybe I don’t understand how your mom is using private insurance and what isn’t covered by the NHS. Pay out of pocket to have a purely cosmetic nose job, snapchat filter, or liposuction if you want but tests and scans needed to make the best treatment decisions should be covered.
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Yes they should, but the NHS is pretty underfunded these days, so you might be put on a waiting list for (eg) an MRI scan. It could take months. There’s only so many MRI machines in the whole country to go round ( for starters they’re big, they require multiple rooms to be built around them). It’s better than the alternative of only the rich getting access though.
*edit It also depends on what you mean as ‘best’. If you break your arm, you’ll probably just get an X-ray, but an MRI provides much more information, so should everyone get MRI’ed for a broken limb? A doctor who was worried about getting sued by their customer might order an MRI just to be safe.
There is another thing going on, which is that from what I’ve heard, US doctors tend to order a lot more scans because they know that the insurance will pick up the cost. Whereas in the UK, a doctor will just order the scans that are quickly available whilst still effective.
As an example, when I had kidney stones I was given an ultrasound, rather than an MRI, presumably because it would still work just as well and wouldn’t tie up an MRI machine.
Another example, I have a lot of moles, but over the last few years I’ve had trouble getting any but the most cancerous looking ones removed. The NHS just doesn’t have the funds, I have to find a sympathetic doc. (I keep meaning to ask the teaching hospital if they want someone to practice on. I’ve got enough moles just on my back for a whole class to have a go).
Obviously I’d prefer it if they did, but given that the money they’re not spending on me can go towards helping someone much worse off.
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US insurance, more and more, picks up only a fraction of imaging costs. The increased number of ordered scans and tests by US doctors, particularly in corporate “health systems,” is to inflate the bill for the patient to increase profits for the company, not to improve the patient’s care.
To put it simply, if you can think of a cynical, perverse means to derive profit from health care, it’s already already employed in the US.
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My brother in law was a hospital administrator before he retired. What you describe is absolutely true in his experiences.
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