US still has the worst, most expensive health care of any high-income country
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Oh yeah, whatever happens between insurance and hospitals is like financial Calvinball. Absolutely no fucking resemblance whatsoever to, like, fees for services rendered and goods consumed. My dad had a fairly major surgery in December and the hospital system basically demanded that insurance fill a room with all the gold bullion in their empire, insurance is like we'll give you tree fiddy, who the fuck knows what they'll settle on, Medicare is involved, the score is oogy to woogy.
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I do once per year. And I am paying through the nose for insurance that I can't afford to use. Why do I even bother? I couldn't afford treatment with the deductibles. The healthcare system in this country is hot garbage, like the lower education system, the freight rail system, ad infinitum.
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That's a big fucking problem for people who have chronic conditions. The government was asleep at the switch for decades as the opiod crisis developed, and now they've overcorrected and started to treat anyone who gets certain prescriptions as a criminal.
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"I'm sorry. Our earliest availability for God to hear your prayer is June 4."
"You'll take it? OK, what's your name, date of birth, and the last four of your social?"
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Fancy Internet Person
Ars Praefectus
That's a great reason to delete the unfair electoral advantages right wingers have in the US.
It's a dumb reason to give up.
Every other country on the list has had horrid conservative governments too. They are bad. They are not an insurmountable problem. They are not an unsolvable problem.
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Probably depends on the drug in question. You've covered a lot of it, but there are also things like seasonal illness waves (the COVID/RSV/Flu season in the northern hemisphere this year) that can cause unexpected surges in demand for certain medications like... painkillers/fever reducers/cough syrup in many places at once.
Or it can be supply-side. Manufacturers tweaking manufacturing processes, production allocation between different drugs, equipment down for maintenance or replacement, facilities failing health inspections... any of the above happening with a component supplier.
It's a recursive problem too - if there are outbreaks of the flu/COVID/RSV, etc. among staff at the drug factories, that could also impact productivity or yield if vital staff keep ending up too sick to work / not allowed to work due to being sick.
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Just because they are non-profit doesn't mean the individuals in the organization are not profiting.
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All fine and reasonable.
Starting to go off track with an attack on the credibility of a source, then continuing that trend by saying you don't believe the stats that are given, despite saying you want stats.
Casual racism. Nice.
Well which is it? First you say you want stats, but then you find some kind of fault with every stat provided. You can't just cherry pick the results you want. The US healthcare system is beyond fucked. Take your pick of analogies. It's either like a cartoon where a character sticks their finger in one hole on a dam, only for another one to take its place, and so on until the whole thing gives way. Or you could think of it as a car that's being held together with string, duct tape, and bubble gum and is one good bump away from literally falling to pieces. You're not going to find stats that paint a rosy picture, and if you do, you know they're full of shit.
I haven't read the book -- I tried, I just found it incredibly dry and full of useless details about people's childhoods -- but my late friend read one that was about the turnaround of Ford. He said how after some new CEO took over he held a meeting with all the department heads and said he wanted them to give him the unvarnished truth about how things were going within the company. Only one person was willing to do so, figuring if they presented anything other than a glowing report they'd get fired. IIRC, he fired everyone except the person who told him the truth. If you don't know what's wrong, you can't fix it, and you won't know what's wrong if you're unwilling to look at the potential horror show that is the situation ahead of you.
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And then your friend grew up to start the Twitch channel DarkSydePhil.
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A lot of people in the US have socialized medical care -- Medicare and Medicaid recipients. Are there similar statistics comparing just that group to the rest of the world? It would be a proxy for how completely socialized care might fare in the US.
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I was having a conversation years ago with a woman who's one of my sister's best friends, and who I've also known just as long. She's a mother of three and the kids at the time were elementary school age.
One of them had to go to the doctor for whatever reason, and this person was decrying how expensive health care is. I made the standard comment about how it's nuts that Americans have to make choices like "Do I buy food for the kids or take them to the doctor?" and the conversation just stopped.
She just stared at me for a moment, uncomprehending, and then said "I don't get what you're saying. That's what people have to do. What do you mean?"
It was my turn to be flabbergasted. She was frustrated yet completely okay with the idea that in America, health care should be considered a luxury.
I get pushback from this all the time. My sister taught a kid from Canada who supposedly was bad mouthing national health care there; Americans don't know the "real" story, it's not good at all, etc. When you point out that in Canada, Britain, etc., you don't lose access to decent healthcare if you lose your job, it's all "Well, this teen is from Canada and you're not, so therefore everything else you hear about how much better their system is ins't true."
And we're talking people who aren't MAGAts and actually vote Democratic. It's nuts. If you can't convince Blue State residents that maybe there's a better way than for-profit healthcare, I don't know what else to do.
One of them had to go to the doctor for whatever reason, and this person was decrying how expensive health care is. I made the standard comment about how it's nuts that Americans have to make choices like "Do I buy food for the kids or take them to the doctor?" and the conversation just stopped.
She just stared at me for a moment, uncomprehending, and then said "I don't get what you're saying. That's what people have to do. What do you mean?"
It was my turn to be flabbergasted. She was frustrated yet completely okay with the idea that in America, health care should be considered a luxury.
I get pushback from this all the time. My sister taught a kid from Canada who supposedly was bad mouthing national health care there; Americans don't know the "real" story, it's not good at all, etc. When you point out that in Canada, Britain, etc., you don't lose access to decent healthcare if you lose your job, it's all "Well, this teen is from Canada and you're not, so therefore everything else you hear about how much better their system is ins't true."
And we're talking people who aren't MAGAts and actually vote Democratic. It's nuts. If you can't convince Blue State residents that maybe there's a better way than for-profit healthcare, I don't know what else to do.
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You will see the same discrepancies in Australia as well. https://www.aihw.gov.au/reports/rural-remote-australians/rural-and-remote-health
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I used to know a DEA agent. They have quite a, shall we say, unique outlook on things.
Very "Blue Lives Matter" adjacent, to put it mildly, with all the baggage that implies.
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The way I see it, the US is basically a extremely rich and powerful nation that's run like a developing country. But not one of the good ones where the government is mostly trying to do its best with limited resources, it's more like one with an extremely corrupt and incompetent political and business class that exists mostly to enrich itself while constantly fucking up the rest of society.
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Yeah and mine isn't even an opioid! Oh noooooooo, the wrong person might get ADHD meds. How ever will we go on?
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Fancy Internet Person
Ars Praefectus
There may be, but I think it's the wrong comparison (too many other factors -- like Medicare can't make up for poor nutrition and housing availability).
What does exist is studies of comparable cohorts before and after ACA Medicaid expansion, and those show that it made things radically better.
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Fancy Internet Person
Ars Praefectus
No. You couldn't begin to explain the runaway profits of the pharmaceutical industry with that model.
You didn't think about this for a single moment and you should feel bad.
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Same in Sweden (and the other Nordics it seems), at least; record drug shortages. As far as I understand, it's mainly a problem with production. One area having a lot of problems is hormone based drugs, with things like estrogen patches not expected to be back in stock until May.
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You used this as a free taxi ride to and from the hospital. Not a joke, that was an argument I heard why insurance should not cover ambulance rides.
11 people around the bed? You only need 1 there, your free healthcare just cost 10 others a chance at getting better. If you had to pay for those other 10 doing nothing you would have not let them stand around.
And if you could walk 2 hours after getting out of narcosis then you could have gone home that day. Having you pay for the bed would have insured your left the moment you could instead of using the hospital as a hotel allowing that bed to be used by someone who really needed that spot.
I can go on and on about the reasons (what I just wrote down are some of the more reasonable arguments) why but it generally boils down to short sighted people trying to spite others by cutting of their own nose because how dare you do all this, this isn't why they spend money on healthcare, they spend that money on healthcare for themselves not you.
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Seems I underestimated the ability of people to reason.
I thought that the following bit would have been enough to set the tone of the rest of the post:
As in what is written down in this post reasons given by others to me why the [bleeeeeeep] state of the US healthcare system is just right. And yes those have been the more reasonable ones, that said since I stopped going to those forums (rampant alcoholism causes less loss of brain cells then trying to argue there) they might have gotten worse seeing the rise of the MAGA crowd.
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I have to push back on this somewhat - I've got family in Brazil, and the difference between their extremely corrupt and incompetent political and business class is like the difference between a B-21 Raider and a Sopwith Camel. It's not just a difference of degree; there's something broken in Brazilian society that's not broken in the US, yet. But there is, I admit, a similar total and massive contempt for the middle and working class among the oligarchs and kleptocrats, and a similar rapacious, blind greed that has the effect of kneecapping itself by limiting its own long-term prospects.
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I feel for you. They've become weirdly restrictive even for drugs with relatively low potentials for addiction/abuse. My mother has chronic pain and over the past few years is basically interrogated any time she has to deal with a new medical provider. She does have a prescription for an opiod at an extremely low dose for really bad days, but they've actually given her more shit about some of the non-opiods that she's on which are much more critical for her daily life.
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HISTORY OF MODERN NUTRITION:
First they added sugar...
Then they added processed fats...
Then they told you to stop eating real foods that naturally make you satiated...
Then they told you to snack all day & eat small meals...
Then they sold you diabetes medications
First they added sugar...
Then they added processed fats...
Then they told you to stop eating real foods that naturally make you satiated...
Then they told you to snack all day & eat small meals...
Then they sold you diabetes medications
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Federal law enforcement can be scary. But the real scary fuckers, the guys who'd stand by the oven doors and enjoy it, are fucking CBP.
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Money. Take the profit motive out. Problem solved*
*yes, it really is that simple and easy. Every other first world economy/country proved it.
*yes, it really is that simple and easy. Every other first world economy/country proved it.
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That's true of public health systems as well? Nurses and doctors (and technicians and contractors and all the other people) in socialized health care systems still get paid. Sometimes under the table from a recent study of pre-COVID Europe surveys
From: https://www.economist.com/graphic-d...uropes-health-services-is-surprisingly-common
Excerpted from the article:
The study, by Giulia Dallera and her colleagues, used surveys carried out in 2013, 2017 and 2019 by Eurobarometer, the EU’s polling organisation. Each survey asked more than 27,000 people from 28 EU countries (before Britain left the bloc) whether they had been asked to make unofficial payments or give valuable gifts to nurses, doctors or hospitals to secure treatment in the past year. In the most recent survey almost 4% of Europeans who used such services reported that they were asked to make an informal payment. This represented an increase of around 14% since 2013, despite public perceptions that corruption in health care is becoming less common.
Eastern Europe had the highest prevalence of bribes: 5.5% of the population was asked to make an informal payment in 2019. But the situation there is improving. Requests for such payments have fallen by around 8% since 2013, with the biggest drops coming from Lithuania, Romania and Slovakia. The more worrying trend is farther west. The surveys show that western Europe is seeing the largest increase in bribery, with every country except Germany reporting an increase between 2013 and 2019. Respondents in the west were 1.5 percentage points more likely to have been asked for unofficial payment by medical professionals than those in southern Europe, where the figure stands at 2.5%. Austria had the highest bribery rate of any European country in 2019; more than one person in nine was pressured by heath-care professionals. Belgium, Germany and Luxembourg all had rates above 5%.
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Fellow ADHDer - I feel your pain here. They won't even mail my shit to me, I've got to pick it up at the actual pharmacy.
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poke 532810
Ars Praetorian
My wife had a mammogram and some additional imaging done at the local hospital’s imaging clinic. The $1,400 bill was $118 after insurance, which we paid. Then yesterday we received another bill for over $100 from the imaging company. Apparently the clinic does the imaging, and then sends it to the imaging company to read it. Why the largest hospital in the whole region that owns over half the clinics in the region cannot read their own images, I don’t know. I do know that we get the privilege of paying twice, though.
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I do agree that American society isn't as broken yet as Brazil, but we're well on the way to getting there, especially with one party being openly fascist, a fascist police force, and constant gun massacres. The government is almost completely unresponsive to the needs of the people. And so far it seems like Brazil has had a much more effective response to their January 6 equivalent than we have.
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This is the baffling part. Doctors were against nationalized healthcare in Canada too before it was introduced but now love it because of guaranteed job security and the exact same pay or better (biggest argument against nationalized healthcare from doctors). I don't get it. Do Americans simply have zero knowledge about the rest of the world? It's like that comment from an American who was asking if other countries think they are the best in the world. We had this exact same conversation in the rest of the developed world more than 50 years ago. There are many lessons to learn if the US was only willing to look beyond its narrow borders.
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The US ranks 6th of 11 out of Commonwealth Fund countries on ER wait times on percentage served under 4 hours. 10th of 11 on getting weekend and evening care without going to the ER. 5th of 11 for countries able to make a same or next day doctors/nurse appointment when they're sick.
https://www.cihi.ca/en/commonwealth-fund-survey-2016
Americans do better on wait times for specialists (ranking 3rd for wait times under four weeks), and surgeries (ranking 3rd for wait times under four months), but that ignores three important factors:
- Wait times in universal healthcare are based on urgency, so while you might wait for an elective hip replacement surgery you're going to get surgery for that life threatening illness quickly.
- Nearly every universal healthcare country has strong private options and supplemental private insurance. That means that if there is a wait you're not happy about you have options that still work out significantly cheaper than US care, which is a win/win.
- One third of US families had to put off healthcare due to the cost last year. That means more Americans are waiting for care than any other wealthy country on earth.
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By being tired, distracted, and cranky, from personal experience
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