Celebrating 10 years! 2007-2017

There are only two logical “solutions” to healthcare

The goals of most healthcare policies are to make high quali trickydick02/09/19
There is no option such as "healthcare available to as many drglennrichie02/09/19
This guy’s post is what stupidity looks like. trickydick02/09/19
Liberal meets reality. Not pretty. LOL! drglennrichie02/09/19
Idiot meets internet. The result? Your posts. trickydick02/09/19
Namecalling is the last resort of defeated troll. drglennrichie02/09/19
Gibberish is the first resort, to judge by your posts. trickydick02/09/19
Seems like. Since you started this thread with that impossib drglennrichie02/09/19
Then how come most of the developed countries in the world a dingbat02/09/19
The quality of "free" healthcare is usually crappy. Plus tax drglennrichie02/09/19
why on earth do you think the healthcare is crappy? there's dingbat02/09/19
WOW. Brainwashing is strong. drglennrichie02/09/19
on your part. want to try a retort based on facts, logic, dingbat02/09/19
Facts logic and reasoning are not the best weapons if arguin drglennrichie02/09/19
because they tend to prove you wrong? dingbat02/09/19
Not really. My opinions are always based on facts drglennrichie02/09/19
and yet you spout utter bullcrap dingbat02/09/19
So far I only called your intense delusions what they are. R drglennrichie02/09/19
what exactly is delusional? You said "The quality of "fre dingbat02/09/19
Yaaaaaaaaawn. And you also said taxes are lower there I c drglennrichie02/09/19
https://stats.oecd.org/index.aspx?D ataSetCode=TABLE_I6 Av dingbat02/10/19
OMG, you actually believe this crap. LOL. I lived in Swed drglennrichie02/10/19
I've lived in several countries, and my experience was obvio dingbat02/10/19
Also, do not forget that cost of HealthCare is much lower in drglennrichie02/09/19
The irrelevant red herring argument. Nice one. Yes, we c gladigotaphdinstead02/10/19
universal single payer system will not improve anything. Its drglennrichie02/10/19
Yeah and the climate is getting colder. Whatever u say bubba gladigotaphdinstead02/10/19
Thats not true. The average temperature rises drglennrichie02/10/19
You could deny health care to only those that could pay and anotherjd02/09/19
I don’t think any real solution is going to be pretty. The trickydick02/09/19
The real answer is the "New Green Deal". We just need to get drglennrichie02/09/19
More illegal aliens might fix things anotherjd02/09/19
check out Switzerland or the Netherlands, which has mandator dingbat02/09/19
No offence but why does everyone, including you, dance aroun theimmigrant02/09/19
There are a lot of structural issues. I'm familiar with som dingbat02/09/19
“New meds are only tested against placebos, and not agains gladigotaphdinstead02/10/19
I'm gonna say most people in the healthcare industry are in dingbat02/10/19
Medicare for all. Thats is NOT like britains NHS. dopesmokeresquire02/09/19
Can we regulate insurance industry heavily? Maybe cap their superttthero02/09/19
that actually already happens. The problem is that insuranc dingbat02/09/19
If we take all of the assumptions in your op as true, why ar persius02/09/19
while generally our politics are quite different, here we se dingbat02/09/19
exactly. Medicare for all, but if you want to buy supplement midlaw02/09/19
Anyone can already get free healthcare. Just move to NY. K david6198302/09/19
Can we have a two-tier system? So gov't subsidized and/or si batman02/09/19
Yep. This drglennrichie02/09/19
Garbage in, garbage out/junk in, junk out...that’s the ele daleycenter02/11/19



trickydick (Feb 9, 2019 - 2:14 pm)

The goals of most healthcare policies are to make high quality healthcare available to more people at a lower cost. The problem with these goals is that they are increasingly mutually exclusive the greater you come to fully achieving either goal.

You can either subsidize healthcare through some form of government action, which will increase its actual cost, or you can reduce cost by forcing people to pay market price for healthcare and thereby make it less available to people because fewer people will be able to afford it.

Put another way, you can either impose some sort of universal single payer plan whereby everyone is covered by a health plan funded by taxes or you can completely privatize healthcare and force people to pay only for whatever healthcare they can afford out of pocket. In the former scenario, everyone will be covered by an inefficient, overburdened system that struggles to meet the high demand for healthcare and in which actual costs increase as demand increases. In the latter system, those who can afford healthcare will get all the healthcare they can pay for while everyone else will die slow, agonizing deaths or fall under high debt burdens as they become older and become increasingly less healthy.

One method makes healthcare available to as many people as possible. The other keeps the actual cost of healthcare under control.

You can look for a middle ground in all this, of course, but in any trade off you will face both the problem of high healthcare costs (because to some degree healthcare has to be subsidized) and reduced availability of healthcare (because the artificially increased costs of healthcare means medical resources need to be rationed).

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drglennrichie (Feb 9, 2019 - 3:30 pm)

There is no option such as "healthcare available to as many people as possible". Its AOC style utopia.

You can get very crappy healthcare to be more available, and even that doubtful.

Why should I sacrifice the quality of my healthcare?

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trickydick (Feb 9, 2019 - 3:40 pm)

This guy’s post is what stupidity looks like.

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drglennrichie (Feb 9, 2019 - 4:01 pm)

Liberal meets reality. Not pretty. LOL!

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trickydick (Feb 9, 2019 - 4:02 pm)

Idiot meets internet. The result? Your posts.

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drglennrichie (Feb 9, 2019 - 4:06 pm)

Namecalling is the last resort of defeated troll.

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trickydick (Feb 9, 2019 - 6:53 pm)

Gibberish is the first resort, to judge by your posts.

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drglennrichie (Feb 9, 2019 - 7:30 pm)

Seems like. Since you started this thread with that impossible drivel of yours

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dingbat (Feb 9, 2019 - 4:11 pm)

Then how come most of the developed countries in the world are able to manage it?

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drglennrichie (Feb 9, 2019 - 4:14 pm)

The quality of "free" healthcare is usually crappy. Plus taxes are high there. Why should I sacrifice quality of my HealthCare and pay more taxes?

Kinda goes against my interests.

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dingbat (Feb 9, 2019 - 4:44 pm)

why on earth do you think the healthcare is crappy?
there's very good healthcare available throughout most of Europe, and more Americans go to Canada for medical treatment than the other way around.

Taxes are a separate discussion, but plenty of those countries have lower tax rates than the U.S., and those with higher rates aren't that much higher. Plus, the average family pays over a thousand dollars a month in health insurance premiums; abolishing that would result in more money in your pocket, even with higher taxes

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drglennrichie (Feb 9, 2019 - 4:49 pm)

WOW.

Brainwashing is strong.

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dingbat (Feb 9, 2019 - 5:19 pm)

on your part.

want to try a retort based on facts, logic, and/or reasoning?

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drglennrichie (Feb 9, 2019 - 6:35 pm)

Facts logic and reasoning are not the best weapons if arguing with liberal

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dingbat (Feb 9, 2019 - 7:17 pm)

because they tend to prove you wrong?

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drglennrichie (Feb 9, 2019 - 7:27 pm)

Not really. My opinions are always based on facts

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dingbat (Feb 9, 2019 - 7:46 pm)

and yet you spout utter bullcrap

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drglennrichie (Feb 9, 2019 - 7:52 pm)

So far I only called your intense delusions what they are. Results of brainwashing. Just goo back to @AOC tweeter and enjoy yourself.

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dingbat (Feb 9, 2019 - 8:09 pm)

what exactly is delusional?

You said "The quality of "free" healthcare is usually crappy.". I've lived in several countries, and received quality healthcare at affordable costs there. I therefore stated the fact that " very good healthcare available throughout most of Europe, and more Americans go to Canada for medical treatment than the other way around"

your retort was "brains" like you're some kind of mindless zombie
When I tried pointing that out to you, you just go "AOC", because she's the latest foxbot boogieman (boogiewoman?)

I hereby posit that you are not capable of logic or reasoning.

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drglennrichie (Feb 9, 2019 - 10:55 pm)

Yaaaaaaaaawn. And you also said taxes are lower there

I call BS on all of that and yes, I also lived in Europe for prolonged periods of time (Scandinavia and western Europe, just to clarify)

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dingbat (Feb 10, 2019 - 12:02 pm)

https://stats.oecd.org/index.aspx?DataSetCode=TABLE_I6

Average person income tax rate:

Single Person No Children:
U.S. 26%
Sweden 25%
U.K. 23.4%
Spain 21.1%
Switzerland 16.9%

One Earner Married Couple Two Children:
U.S. 14.2%
Spain 13.9%
Ireland 10.4%

Suck it
Switzerland 10.4%

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drglennrichie (Feb 10, 2019 - 2:19 pm)

OMG, you actually believe this crap. LOL.

I lived in Sweden and I can tell you that the reality is different as I know swedish tax laws pretty well.

You are brainwashed. SAD!!!. Liberal propaganda affects weak brains.

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dingbat (Feb 10, 2019 - 6:02 pm)

I've lived in several countries, and my experience was obviously different than yours.

But, facts are facts. that's a pretty respectable source, and while my Swedish isn't as good as yours, it appears to match up with what the swedish tax authority has published
https://www.skatteverket.se/funktioner/svarpavanligafragor/privat/beloppochprocent/privatbeloppfaq/narskamanbetalastatliginkomstskattochhurhogarden.5.10010ec103545f243e8000166.html

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drglennrichie (Feb 9, 2019 - 10:56 pm)

Also, do not forget that cost of HealthCare is much lower in Europe as they do not pay 150K a year to nurse

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gladigotaphdinstead (Feb 10, 2019 - 3:33 pm)

The irrelevant red herring argument. Nice one.

Yes, we can drop health care costs substantially by admitting more students to medical school and not creating an intentionally manufactured shortage of MDs. We can also just have a universal single payer system that doesn’t pay half of what we currently pay for services and MDs will take a mandatory and long overdue pay cut.

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drglennrichie (Feb 10, 2019 - 3:36 pm)

universal single payer system will not improve anything. Its a Hoax perpetuated by liberal media. Weak brains are falling for that. SAD!

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gladigotaphdinstead (Feb 10, 2019 - 3:51 pm)

Yeah and the climate is getting colder. Whatever u say bubba

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drglennrichie (Feb 10, 2019 - 4:35 pm)

Thats not true. The average temperature rises

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anotherjd (Feb 9, 2019 - 3:46 pm)

You could deny health care to only those that could pay and reduce their costs.

Wouldn't be pretty

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trickydick (Feb 9, 2019 - 4:00 pm)

I don’t think any real solution is going to be pretty. The ACA fell flat on its face and Republicans have no alternative on the table. Looks to me like we’re going to get either a bloated bureaucracy like Britain’s NHS or a bunch of people going without. If anyone has a real answer, I’d like to see it.

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drglennrichie (Feb 9, 2019 - 4:02 pm)

The real answer is the "New Green Deal". We just need to get like 50 trillion to pay for it. No biggie. Just pay for it.

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anotherjd (Feb 9, 2019 - 5:54 pm)

More illegal aliens might fix things

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dingbat (Feb 9, 2019 - 4:10 pm)

check out Switzerland or the Netherlands, which has mandatory private insurance, with legally mandated price caps.

The biggest problem with healthcare in the U.S. is a lack of price control. The cost of just about every aspect of health care is significantly higher than in other developed countries that provide relatively similar care.
There are a lot of structural reasons for this, but, until we tackle cost, the rest is just b.s.

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theimmigrant (Feb 9, 2019 - 6:12 pm)

No offence but why does everyone, including you, dance around this issue? The reason that healthcare is expensive is because it Costs More? Has anyone ever talked about "structural issues" and actually known what those issues were?
Part of this is just how the business model works... Immense sums are made on particular drugs or procedures, and overhead is high as a whole, but it doesn't necessarily cost a fortune for an individual to have a medical issue taken care of. If it were literally just drug companies or hospitals making a fortune by charging more then Hosptial ETFs would skyrocket en masse, and Pfizer would make 90% EBIT. There are several issues that are constantly being obfuscated

1. There is a massive amount of overhead that exists because of self-perpetuating "reasons" that rivals that of a Soviet-era jobs programme. United Healthcare employs 250,000 Office-dwellers ffs. 21,995,000 Americans work for some type of government, an indeterminate portion of which are meant to "support" "healthcare."
Not to mention, MedicalDoctors drive Porsches (but they are our betters so nbd).
2. The fact that severian2's family and other rent-seekers are multimillionaires is highly suspect. Tons of (((middlemen))) of all kinds.
3. Drug companies make immense profits on particular drugs that often constitute a smallish portion of their portfolio. They steal ideas from the public sector, and engage in other nefarious acts, but they also have actual overhead consisting of "complying" with various regulations and this requires Office-workers to work in offices.
4. Nurses make immense sums for no reason. In the private sector propre they would make $27k like every other work-doer.
5. It's expensive everywhere in the world irl and lol @ nationalising any of it as a means of controlling Cost; the average American makes $27k and doesn't even pay taxes, there are like 100 billionaires all Evading taxes, so where does the money come from irl?.. "Yes, let's borrow more money from Chinamen to pay for boomers' end-of-life care! Great idea! *shrewdly votes Democrat*"


Source: I am a Nurse

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dingbat (Feb 9, 2019 - 8:05 pm)

There are a lot of structural issues. I'm familiar with some, others not so much.
Source 1: my spouse works in medical admin
Source 2: years working in the insurance industry

Part of it is a lack of cost control, so that a pharmaceutical company can significantly increase its profits just by increasing the cost of the drugs (see daraprim and/or epipen for great examples)

Part of it is that there are doctors who own testing centers so they get paid for recommending unnecessary tests

Part of it is that insurance companies are required to pay for certain medication/procedures, so the providers will jack up the rates in the hopes that the insurance companies will pay more, which indirectly causes an increase in prices (this is a longer discussion than can fit here)
- even more fun is that a good admin can get insurance to approve elective procedures by making them appear mandatory. For example, "migraines" as justification for cosmetic Botox

Part of it is the disconnect between payment for service (coming from the insurance company) and use of service, so patients will demand the best service, the most testing, the most expensive drugs, etc., because they're not getting billed directly. Basically, we're overconsuming medical care here.

New meds are only tested against placebos, and not against older drugs that may be as effective, but less profitable. There's a whole cottage industry of drug reps (and pharma companies get to know which doctors prescribe their meds)


There are a lot of different things, a lot of it unique to America. If you go to Europe, most doctors don't make stupid money - they're not poor, but they don't make half a million dollars a year or more (like some doctors I've known). There's wage controls on the doctors, cost controls on pharmaceuticals, limits to how profitable hospitals can be, etc.
I've seen the total cost of a doctor's visit (first world country without socialized medicine) be less than my co-pay would be over here.

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gladigotaphdinstead (Feb 10, 2019 - 3:35 pm)

“New meds are only tested against placebos, and not against older drugs that may be as effective, but less profitable.”

This is patently false. I agree with everything else you’ve said but this is not true. I work in the pharmaceutical industry. It doesn’t even make sense. No pharma company is interested in developing a more expensive version of a less efficacious drug that’s already on the market. See Rova-T for very recent proof if you don’t believe me.

I know people hate big pharma and think we’re all scumbags looking to fleece people for meds that are totally free to mfg and require zero dollars to bring to market (sarcasm), but we are actually interested in helping our patients first and foremost. If we can make a buck doing that, why not? The fake shortage of medical doctors in our country is the reason healthcare costs are so exorbitant, not the drug costs, imho.

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dingbat (Feb 10, 2019 - 6:12 pm)

I'm gonna say most people in the healthcare industry are in it for the right reasons, but it's all open to abuse, both intentional and unintentional

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dopesmokeresquire (Feb 9, 2019 - 4:05 pm)

Medicare for all. Thats is NOT like britains NHS.

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superttthero (Feb 9, 2019 - 4:15 pm)

Can we regulate insurance industry heavily? Maybe cap their rate of profit per customer at a specific rate (kind of like some states do utilities) or reward them for a decreases in costs they can negotiate.

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dingbat (Feb 9, 2019 - 5:20 pm)

that actually already happens. The problem is that insurance companies are mandated to pay for certain treatments without regard for the cost. Cost needs to be decreased through other mechanisms

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persius (Feb 9, 2019 - 5:03 pm)

If we take all of the assumptions in your op as true, why are they mutually exclusive? What prohibits a two tier system like defense lawyers whereby lower quality health care is available to all but the ballers amongst us can still hire the dream team if they so desire. The lower tier would still benefit from the tricking down of innovation being paid for in the top tier.

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dingbat (Feb 9, 2019 - 5:22 pm)

while generally our politics are quite different, here we see eye-to-eye

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midlaw (Feb 9, 2019 - 6:08 pm)

exactly. Medicare for all, but if you want to buy supplemental insurance or pay out of pocket, go crazy.

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david61983 (Feb 9, 2019 - 7:09 pm)

Anyone can already get free healthcare. Just move to NY. King Andy will take care of you.

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batman (Feb 9, 2019 - 7:45 pm)

Can we have a two-tier system? So gov't subsidized and/or single payer for everybody that doesn't cover the more expensive/esoteric end of life stuff, and a private system that does.

I think this is the most cost-effective way to do things, but it's politically a no-go cause people will call it a de facto death panel for poors.

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drglennrichie (Feb 9, 2019 - 7:52 pm)

Yep. This

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daleycenter (Feb 11, 2019 - 12:20 am)

Garbage in, garbage out/junk in, junk out...that’s the elephant in the room you clowns aren’t discussing.

You wanna cut healthcare costs in this country? Then all ya gotta do is peg health insurance rates to BMI and/or HgB A1C levels.

This anti-fat shaming sh*t is outta control in this country. Take a walk around Switzerland or Norway, Sweden or Germany, and count the fat phucks you see...then take a walk around any city, town or village in this country and start counting...

And don’t even get me started on the Medicaid and Medicare land whale pseudo manatees. Good lord, it’s ridiculous.

Another giant sink hole here that you don’t have in Europe is ridiculous end of life care.

Hey, I’m sorry your grandpa is sick and I’m sure she was an awesome guy when he wasn’t flicking ashes on you, guzzling vodka and stuffing his face with fried chicken and waffles, but this is it, he’s self created burnt toast, yeah, I know you “want full code and everything done” but we’re tapping out. We’re not gonna waste another quarter million keeping this pseudo-suicidal geezer alive so you can feel good about yourself visiting him once a year on Father’s Day in the hellhole of a nursing home that we’re also paying for.

You wanna cut healthcare costs, there’s a few starting points.

And puhlease, Glad, gimme a phucking break, big pharma ain’t helping this matter one bit. At least the Vikings were straightforward about their intentions.

You pharma buffoons should be banned from advertising outside of peer reviewed journals as well as prohibited from using relative risk reductions anywhere in your promo material. It’s pathetic and a stain on our profession but so many of my colleagues fall for the trap and don’t really understand the difference between RRR and ARR...putting aside the fact that virtually none of the general population understands it. It’s tantamount to the legal text book definition of fraud.

Ok, I’m done for the moment, I gotta get some sleep because I’ve been busy earning my exorbitant salary, which is apparently a bigger problem than charging a patient 20x what the cost of taking say, separate generic ARB’s and HCTZ. Oh no, it’ll be easier for granny to remember to take one pill instead of two, and we can charge 20x as much for that convenience.

Gimme a phucking break. You guys do come up with some amazing sh*t at times but more often than not, my toolbox doesn’t look perform any differently, it just costs a whole helluva a lot more.

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