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Re:If wages are to rise, workers need more bargaining power by toomuchtodo on Wednesday June 06, 2018 @09:34AM (#17247005)
I spent $9k out of pocket (hospital stay and doctors) for my son’s birth in April after insurance. My friend paid 5£ in the UK. No, I am not getting substantially better care for what was paid.

It has been proven fact that we (Americans) pay more than every other developed country for healthcare with poorer outcomes. It’s a racket, plain and simple.

https://news.harvard.edu/gazette/story/2018/03/u-s-pays-more...

Re:If wages are to rise, workers need more bargaining power by paulpauper on Wednesday June 06, 2018 @09:48AM (#17247100)
this figure puts it at only $3,500 http://www.slate.com/blogs/xx_factor/2013/07/01/having_a_bab...

Women with insurance pay out of pocket an average of $3,400, according to a survey by Childbirth Connection, one of the groups behind the maternity costs report. Two decades ago, women typically paid nothing other than a small fee if they opted for a private hospital room or television.

But one must take into account the risk of complications; if something were to go really wrong, would you rather be in the US hospital or the UK one? I suspect the NHS is more affordable, but does not handle complications and individual patient cases as well as the US system.

Re:If wages are to rise, workers need more bargaining power by beat on Wednesday June 06, 2018 @10:20AM (#17247343)
Ah, the old "American exceptionalism" argument. Don't make that one, it's a bad argument.

How about this? Would you rather be in the US, or Japan, for such an emergency? Japan costs half as much as the US per capita (with even lower out of pocket costs), and beats us by every other measure. I'd rather be in the Japanese system than the American one for anything.

edit: The Japanese system, structurally, is very similar to the American system. It's not socialized, by and large. Private insurance through employers to private providers. Yet it costs half as much and works better. This points to something broken in the US system at a deeper level. Expanding on this, every civilized nation in the world has health care more or less on par with the US (fuck exceptionalism), for more or less half our cost. To the chagrin of liberals, "socialized medicine" isn't the obvious solution, because a lot of systems no more socialist than ours work well. And to the chagrin of conservatives, a lot of highly socialized systems also work better. The American system is uniquely fucked up.

Back to Japan. The key difference I can see between the two systems is that Japan has strict price controls. A government commission sets the prices for all medical products and services covered by insurance, with an eye to controlling costs while maintaining profitability. Insurers and providers have to control their costs internally, rather than jacking prices or doing many-to-many negotiations. Is this the key?

Re:If wages are to rise, workers need more bargaining power by mjevans on Wednesday June 06, 2018 @01:35PM (#17249205)
Centralized planning and standards sound like a non-free market to me; and also exactly what an inflexible demand market for critical utility services needs.
Re:If wages are to rise, workers need more bargaining power by beat on Wednesday June 06, 2018 @03:00PM (#17250016)
As Peter Thiel pointed out in Zero to One, in an idealized free market, profit is impossible. Pure competition drives profit margins to zero. This can be easily observed in highly competitive industries, like groceries or gas stations. They operate on razor-thin margins. The only way to make big money in competitive markets is huge scale, which explains consolidation and the drive of money to the top. All substantial profitability comes from friction or monopoly (including localized monopoly, like not having a full range of choices for your employee-based insurance).

But I digress.

At any rate, the Japanese system clearly works, while the American system is clearly broken. One is selling the same product for half the price of the other. Assuming I'm right about the key differentiator being the Japanese price controls (I could be wrong), then it really makes me wonder why we aren't trying that. Seems like a great way to get costs under control (even shrinking), while preserving much of the complex market and avoiding radical change to almost 20% of the economy.

I think "critical utility services" touches on the importance, but doesn't go far enough. I believe a health care system that denies care purely out of poverty is immoral. A health care system that is the primary cause of bankruptcy for the middle class is immoral. A system that traps employees in jobs they hate, for fear of losing (or even changing) their insurance is both immoral and un-American - what's more American than quitting your job to get a better one, or start your own business? So our system is not just an economic failure, it's a moral failure. It's a stain on our honor and an insult to our values.

In conclusion, I do not give a fuck about "free market" here. I am not putting economic ideology ahead of moral imperatives, and I'm not choosing ideology over observable facts. If I wanted to choose ideology over economic reality, I'd be a communist.

Re:If wages are to rise, workers need more bargaining power by toomuchtodo on Wednesday June 06, 2018 @09:54AM (#17247147)
I’d rather be in the UK one. I refuse to be held hostage by the medical industrial complex.

The hospital charges my wife for her stay, my newborn son for his “stay”, her OB charged for the procedure, and the neonatologist charged. Whatever isn’t paid by insurance automatically becomes our responsibility, with no recourse to dispute.

We are actively working to leave this country.

Re:If wages are to rise, workers need more bargaining power by CalRobert on Wednesday June 06, 2018 @10:12AM (#17247273)
Where are you headed? Wife and I left and have been delighted; happy to chat if you like.
Re:If wages are to rise, workers need more bargaining power by toomuchtodo on Wednesday June 06, 2018 @06:51PM (#17251790)
Germany (EU) or Columbia (SA). Would love to chat, will send an email intro if you don’t mind.
Re:If wages are to rise, workers need more bargaining power by CalRobert on Thursday June 07, 2018 @03:26AM (#17253954)
Don't mind in the least! But the ball's in your court since I don't see contact info for you in your profile.

Germany is, by all accounts, amazing. It's where my wife and I holiday and we've contemplated opening a B and B there a few years down the road. If I were coming to the EU fresh I'd be looking closely at Germany, Denmark, or the Netherlands.

http://www.bluecard-eu.de/eu-blue-card-germany/ is very relevant for a skilled migrant interested in Germany.

I can't comment on Colombia though.

Re:If wages are to rise, workers need more bargaining power by AstralStorm on Wednesday June 06, 2018 @10:03AM (#17247201)
Actually, it does. The other commenter gave credible child mortality figures, here's the other half from the reputable US CIA. Heck most EU countries rate better than the UK but USA is even further behind.

https://www.cia.gov/library/publications/the-world-factbook/...

Re:If wages are to rise, workers need more bargaining power by paulpauper on Wednesday June 06, 2018 @10:27AM (#17247394)
I've see that figure many times. One must take into account premature births and how stillbirths are reported. And also due to the racial makeup of America. Blacks have higher rates of infant mortality than whites.
Re:If wages are to rise, workers need more bargaining power by FireBeyond on Wednesday June 06, 2018 @12:00PM (#17248201)
Premature births correlate directly to advanced neonatal care, that thing you were arguing the US is the best in the world at. Now you're saying "oh, you can't count that"?

> [You] must take into account ... the racial makeup of America

Oh? Are black people not really counted for the purposes of birth stats? Why? Poorer genetics? Poorer healthcare access? Again, how would poorer healthcare access jibe with your "best in world" medical care?

Re:If wages are to rise, workers need more bargaining power by theplague42 on Wednesday June 06, 2018 @10:45AM (#17247539)
Do you think it's because of their race or socioeconomic status?
Re:If wages are to rise, workers need more bargaining power by bzbarsky on Wednesday June 06, 2018 @11:46AM (#17248069)
The effect is still there after controlling for SES. There may be other correlates of race that matter here, though. Diet comes to mind.

I would love to see a good study that tries to disentangle the various correlations here...

Re:If wages are to rise, workers need more bargaining power by boomboomsubban on Wednesday June 06, 2018 @10:57AM (#17247643)
How do any of those things impact the maternal mortality rate?
Re:If wages are to rise, workers need more bargaining power by pjc50 on Wednesday June 06, 2018 @10:55AM (#17247632)
There's some suggestion that the US system is more dangerous to the mother, although it's hard to compare the stats: https://www.economist.com/united-states/2017/08/05/is-pregna...

Again, if you've got great health cover you can probably do better in the US. If you haven't, then you might not.

Re:If wages are to rise, workers need more bargaining power by FireBeyond on Wednesday June 06, 2018 @11:57AM (#17248181)
> maternity costs ... complications ... if something were to go really wrong, would you rather be in the US hospital or the UK one? I suspect the NHS is more affordable, but does not handle complications and individual patient cases as well as the US system.

As someone who has lived in the UK, Australia, and the US, probably not the US?

Also, "Infant Mortality Rates of Countries, deaths per 1,000 live births[1]":

* Australia - 4.7

* United Kingdom - 4.8

* United States - 6.2

Apparently the statistics say we're not as good at "[handling] complications and individual patient cases" as you believe we are.

[1] https://www.infoplease.com/world/health-and-social-statistic...

Re:If wages are to rise, workers need more bargaining power by s73v3r_ on Wednesday June 06, 2018 @12:58PM (#17248828)
"I suspect the NHS is more affordable, but does not handle complications and individual patient cases as well as the US system."

Provide evidence for this claim, or stop trying to disparage an entire nation's healthcare system.

Re:If wages are to rise, workers need more bargaining power by nunya213 on Wednesday June 06, 2018 @09:57AM (#17247159)
https://data.worldbank.org/indicator/SH.DYN.MORT?view=map&ye.... Infant mortality is nearly 2x higher in the US. I know where I'd want to be.
Re:If wages are to rise, workers need more bargaining power by bzbarsky on Wednesday June 06, 2018 @11:57AM (#17248176)
The problem with infant mortality figures is that different countries measure them differently. There are cases (e.g. very premature births) that the US considers a live birth (with a high risk of mortality) while other countries consider them miscarriages and hence don't count them in infant mortality.

There have been attempts made to correct for these discrepancies. They end up accounting for a large fraction (but not all) of the difference in infant mortality rates, if I recall correctly.

Most of the rest of the effect is that premature births that everyone considers "births" have a higher prevalence in the US (for various reasons, not all of which are clear). Premature births have higher mortality, obviously.

https://uk.reuters.com/article/us-health-infants-mortality/u... is actually trying to look at an apples-to-apples comparison, and a few things jump out at me:

1) Birth defects. I wonder how much of this has to do with differences in abortion availability and again differences in definition of "birth". Many other countries count a child that dies within some number of days after birth from birth defects as a stillbirth, not an infant mortality event.

2) SUID (aka SIDS) is a huge contributor in the US. In the US this is highly concentrated in ehthnic groups that are largely missing in the comparison countries. Why that is is a good question, but makes this comparison less apples-to-apples.

To know where you'd want to be you want to know the outcomes for your specific demographic in the different countries, which is not something that gets reported very much...

Re:If wages are to rise, workers need more bargaining power by nunya213 on Wednesday June 06, 2018 @12:57PM (#17248810)
"Infant mortality rates for full-term babies vary across the U.S., but all states are worse than many European countries, a new study suggests."

From your own source, literally doesn't help your case at all.

Re:If wages are to rise, workers need more bargaining power by bzbarsky on Wednesday June 06, 2018 @01:15PM (#17248996)
I am aware of what the article says.

The bit you quoted does not negate my two points about the data in that article.

But just to be very clear, Connecticut is cited as having an infant mortality rate that is slightly above the comparison country rates. Note that those countries were picked for a comparison because they have the 6 lowest mortality rates in Europe. [1]

Anyway, Connecticut is maybe somewhat similar to the comparison countries in terms of ethnic group demographics (mostly negating my point (2)) and has a more expansive definition of "infant mortality" than those countries last I checked, which is part of my point (1).

Mississippi, at the other end of the spectrum, has a vastly different ethnic makeup, has much worse abortion availability (increasing the number of babies with birth defects carried to term). And still has the more expansive definition of "infant mortality".

Now I'm not saying that it's a good thing that Mississippi has higher rates of SUID/SIDS. And I'm not saying limited abortion availability for cases when the child wouldn't survive is good. But I am saying that drawing conclusions about US healthcare here, as opposed to other societal factors, requires apples-to-apples comparison. And drawing conclusions about outcomes for a specific case (specific family) requires understanding whether those societal factors apply to it.

Or to put it another way, families that are willing to do an abortion when told their child, if carried to term, would not live more than a few months will have a lower infant mortality rate than families that are not willing to do said abortion.

One other thing which _is_ mentioned in the study itself but not in the article: "survival rates among preterm infants in the US were found to be very similar to those of the same European countries". Please model that with the "the US just sucks" model.

[1] The numbers in the actual study: Connecticut has an estimated FTIMR of 1.29 with a 95% confidence interval of 1.08 - 1.53; note that they don't have an actual hard number for reasons I haven't figured out yet. The six European countries involved are Austria, Denmark, Finland, Norway, Sweden, and Switzerland. Their numbers range from 0.97 to 1.24 according to the study.