If "better health outcomes per dollar" is not "what you want" -- how come?
[1] https://www.pgpf.org/blog/2022/07/how-does-the-us-healthcare... [2] https://www.piie.com/blogs/realtime-economic-issues-watch/wh...
IMO, if the US decided to actually help its citizens every country the average progressive considers "great at healthcare" would likely implode under the sudden increase in cost. The cost of medication alone would likely nearly bankrupt several governments. Imagine if the price of insulin, almost completely funded by US citizens paying absurd prices, went up to its US price.
Much like with defense, the US taxpayer is the hero of the rest of the world's healthcare. Without US tax cattle the rest of the world would not be as nice as it is. It's just like when prices go up at your favorite store due to theft. The US is punished by insurance companies because other countries refuse to pay more.
If we're paying more for nurse salaries, hospital administration, insurance company bureaucracy, and ineffective procedures near end-of-life with low probability of success, it's unlikely the cost diff is mainly due to "subsidizing innovation."
By removing the for-profit system, you would actually be removing rampant rent-seeking on something that should be a human right.
> Imagine if the price of insulin, almost completely funded by US citizens paying absurd prices, went up to its US price.
A very strange example to select, considering it was first discovered by Canadians and the patent was later sold for $1. US citizens are certainly not "subsidizing" insulin elsewhere.
[0] https://www.pbs.org/newshour/economy/do-other-countries-pigg...
[1] https://www.washingtonpost.com/opinions/2022/11/29/us-health...
Of course, anyone can do a google search and find some opinion pieces confirming their world view, that doesn't make it true.
The post article in particular just looks at the total revenue and essentially says "look how big it is compared to other countries, we must be subsidizing them". But this just justifies the extreme profit-seeking already in the sector, it's not an argument that it's necessary for innovation.
Even your own source [1] contradicts the idea that high costs are inevitably caused by this subsidization:
> Why doesn’t competition bring U.S. health-care prices down? The answer: America’s stagnant third-party payment system allows hospitals and doctors to avoid competing on price.
Because I don't confuse "individual" with "group".
The fallacy here is to tally up every dollar spent on medical treatment in a given year, then saying "here we spent X on medical treatment, but it could only be 0.7X if the government were in charge".
But you never asked me how much I spent on medical treatment. What if I spent 0?
Well then, your plan has me spending more than I used to, to get me something I didn't want/need. It's not a good deal for me. And if it's a good deal for someone else, it's only because you shackled me up and made me work the fields for their benefit. No thanks.
Even if I was the sort to engage in that non-sense, the problem itself is insurance. And that holds true whether some private company (or many) is in charge of the insurance, or the government is in charge of it. You think BCBS rejects claims, but that the feds don't reject them? Wow, do I have a bridge to sell you.
When someone wants a good or a service, and they pay for it themselves, they are price-conscious. When they don't pay for it themselves (because the insurance company does, or the government), they aren't price conscious. But this encourages the goods-provider to raise their prices... even discourages them from keeping them low. Low prices signal low quality. This encourages the payers to reject claims, then once more the goods-providers to raise prices again to cover for all the rejected claims (bonus if they can go after the goods-buyers for the price too!).
And it all spirals out of control. There is nothing in this mechanism that makes it less ridiculous if the federal government owns the insurance company, and it is the only insurance company permitted by law.
I take that back, there is one thing different. Now you can introduce price caps, woohoo! That will certainly fix the problem. Some committee 2000 miles away and months-distance from the facts can magically determine a fair price for all physicians and surgeons nationwide for some procedure's medical code (not the procedure itself, these are always unique... but the little alphanumeric codes, nice and uniform so they fit in the database).
That definitely won't cause further meltdowns. Will it be blamed on nefarious capitalists hiding in the woodpile? Will it just be chalked up to disappointing reality "there can be no other way"? Probably will depend on just where we're at in the election cycle.
If you want to see prices drop (plummet really), outlaw all insurance. Make people pay cash, out of pocket, for everything. You starve if you can't sell your stuff to people who want it, and if those people only have 1/100th of what you used to ask, then you either learn to live with the 1/100th, or you starve. No one gives out bank loans for heart transplants.
But... they don't. Peer countries with gvt subsidized/socialized care spend less than the US (per procedure and in aggregate).
> Starving the people you want to provide your medical treatment isn't the brightest strategy
Gosh, it's almost like I pre-empted the latter complaint with the note that you've responded to above...
Expanding the number of doctors, and lowering doctor pay and workload, and lowering the cost of becoming a doctor will produce better health outcomes for everyone. Yes, some people will stand to lose from this, just like the current bloat of worthless administrators and billing clerks and other paper-pushers will stand to lose from a cleanup of the system.
I don't care about their well-being.
> I love when someone says "seems to work". In the strict sense, that only ever means "does something". Not necessarily "does what someone wants"... and never "does what I want".
> When it works for those other countries, does it "do what you want"? Because it doesn't "do what I want" at all.
This exact criticism can be levied on the current US system.
So go do it. No one's cockblocking you. Well, except the AMA. Or are you saying that you'll only do this if you get your socialized medicare-for-all quackery?
Wouldn't be shocked if it was held hostage like that, but no thanks.
> This exact criticism can be levied on the current US system.
I never said it worked. Wouldn't catch me saying that ever.
I love when someone says "seems to work". In the strict sense, that only ever means "does something". Not necessarily "does what someone wants"... and never "does what I want".
When it works for those other countries, does it "do what you want"? Because it doesn't "do what I want" at all.
> With the monetary savings of #2, it could even give every medical student a fully free ride.
Won't someone think of the millionaire heart surgeons in the 1%? They obviously needed free rides back when they started, it's why they're only single digit millionaires!
> Funding directly by setting a price cap,
Starving the people you want to provide your medical treatment isn't the brightest strategy. Increases to price caps are always reactive, after they've been complaining for years. The bureaucracy demands that it take years more to raise the price caps. And by the time that happens, they've been bleeding money the whole time. It's a strong incentive for them to do all sorts of things that you don't want... and if you do it for any length of time at all, it trains them to do these bad things so even if you realize the error of your ways and withdrawn the bad policy, they keep on doing the bad things.
Quite clearly, the problem with health insurance is that we need a gigantic insurance company larger than any other in history, and that it needs to be managed by the paragons of competency, the federal government. Of course, they'll need to staff up... and with all the layoffs in the private insurance industry, we'll hire all those empathetic, kind-hearted subject matter experts.
Should be the best thing ever. I can't possibly see anything that might go wrong.