Socializing health care doesn’t turn us into Stalin-era Soviets.

[mac_in_tosh]

Medicare, which actually relies on private insurance companies, is limited in what it can do compared to other nations' national health care services, such as negotiate drug prices. So it's not totally fair to use any of its shortcomings as an indication of what a true single payer health care system would be like. As for the current U.S. system of health care, it forces people to stay in jobs they hate and has people living in fear of getting sick and being bankrupted. Every other western democracy has national health care and while those systems might not be perfect I think most citizens of those countries value what they have and have a hard time understanding how the U.S. puts up with its for-profit health care.

But John Oliver can put it better than I can: Medicare for All: Last Week Tonight with John Oliver

 

[User.45]

Medicare, which actually relies on private insurance companies, is limited in what it can do compared to other nations' national health care services, such as negotiate drug prices. So it's not totally fair to use any of its shortcomings as an indication of what a true single payer health care system would be like. As for the current U.S. system of health care, it forces people to stay in jobs they hate and has people living in fear of getting sick and being bankrupted. Every other western democracy has national health care and while those systems might not be perfect I think most citizens of those countries value what they have and have a hard time understanding how the U.S. puts up with its for-profit health care.

But John Oliver can put it better than I can: Medicare for All: Last Week Tonight with John Oliver

I'll add that capitalists have yet to explain to me how insulin cartels (literal meaning) are in line with capitalism.

 

[mac_in_tosh]

I'll add that capitalists have yet to explain to me how insulin cartels (literal meaning) are in line with capitalism.

My guess is that, like everything else, it's related to lawmakers doing favors for political contributions.

 

[User.45]

My guess is that, like everything else, it's related to lawmakers doing favors for political contributions.

There's a word for this, it starts with a C and ends with orruption.

 

[SuperMatt]

I'll add that capitalists have yet to explain to me how insulin cartels (literal meaning) are in line with capitalism.

Funny how the government is talking tough about anti-competitive behavior in teach, but they are completely ignoring the collusion with the pharmaceutical companies intentionally pushing up the (formerly very low) price of things like insulin. The day this happened, the government should have been immediately busting heads.

 

[thekev]

I'll add that capitalists have yet to explain to me how insulin cartels (literal meaning) are in line with capitalism.

I would suspect that if we relied on a drug manufacturer based somewhere like China, and they started rapidly ratcheting up the price of certain drugs based entirely on market conditions, this would arise as a topic of national security. For whatever reason, we ignore it with domestic and UK based companies. I'm using the term manufacturer somewhat loosely here.

 

[Alli]

I would suspect that if we relied on a drug manufacturer based somewhere like China, and they started rapidly ratcheting up the price of certain drugs based entirely on market conditions, this would arise as a topic of national security. For whatever reason, we ignore it with domestic and UK based companies. I'm using the term manufacturer somewhat loosely here.

Same as we take domestic terrorism less seriously than the global variety.

 

[User.168]

.

 

[User.45]

And the private sector is not rife with that?


So private companies are, in fact, rife with fraud, overspending and general mismanagement? Clearly what is required is to not allow capitalism to run free because it will destroy everything in its path. Regulation is needed. Allowing perfect to be the enemy of good is a very rickety bridge to stand on.

US healthcare in its current state is far from perfect. It is, also, far from good.

Infant Mortality Rates are higher than most other first world countries.
Source: OECD

Infant mortality rates

Infant mortality rate is the number of deaths of children under one year of age.

data.oecd.org

View attachment 7137

Life expectancy is significantly lower than in comparable countries

View attachment 7143


Source for the next graphs: Peterson KFF analysis of OECD Data

How prepared is the US to respond to COVID-19 relative to other countries? - Peterson-KFF Health System Tracker

The ongoing novel coronavirus pandemic has already overwhelmed the health systems of several countries and is projected to overburden the health system in the United States. A surge in patients with the new coronavirus disease (COVID-19) would challenge the ability of the U.S. healthcare system...

www.healthsystemtracker.org

The U.S. is an outlier among comparable countries when it comes to the share of the population with insurance coverage
View attachment 7138

Adults in the U.S. have higher out-of-pocket expenses on average than adults in most comparable countries

View attachment 7139

American adults are more likely to delay or forego medical care due to cost

View attachment 7140


What could possibly be causing all of these high costs for healthcare in the US? Odd, considering that the US has fewer practising physicians per 1,000 people than almost all comparable countries

View attachment 7141

Hmmm.... interesting. Companies, the epitome of efficiency and American freedom, taking the piss maybe? Surely not.

View attachment 7142


So, despite all of the alleged corruption that is likely to be happening in the government run health care in other Western countries, as suggested by facebook experts, people pay less for more effective medical treatment with less admin overheads, resulting in lower infant mortality and higher lifespan. Interesting. Damn you, inefficient, evil and socialistic health care systems.

The US ought to be ashamed of itself.

the money (literally and figuratively) is in the last figure. That admin staff comes with many fold higher admin spending too. I’ll repeat this story. Patients with epilepsy can’t run out of medication. They end up in the er if its bad and can even die. So i see a patient of mine in the ER. They need to start a new med but i want them also out of the ER immediately, so i prescribe the drug, run a prior authorization on it. So I’m typing my consult note while talking to a guy on the phone who reads diagnoses off a list and he can’t pronounce any even the 5th try. So after like 5 nonsensical questions and Me giving him 4 ICD10 codes, each of which should fucking cover this basic drug on its own, he gives me an approval. So i spent 15-20 min on the phone wasted so i can make sure this person can afford the stuff I’m prescribing so he actually stays out of the ER. This is where a lot of time(=money) goes.

Funny how the government is talking tough about anti-competitive behavior in teach, but they are completely ignoring the collusion with the pharmaceutical companies intentionally pushing up the (formerly very low) price of things like insulin. The day this happened, the government should have been immediately busting heads.

i use insulin as an example because people can’t defend it in the name of innovation. When it comes to insulin, my 15-year-old pharmacology book would still be adequate. If I ventured into most anything else, this wouldn’t be the case.

 

[User.45]

And the private sector is not rife with that?


So private companies are, in fact, rife with fraud, overspending and general mismanagement? Clearly what is required is to not allow capitalism to run free because it will destroy everything in its path. Regulation is needed. Allowing perfect to be the enemy of good is a very rickety bridge to stand on.

US healthcare in its current state is far from perfect. It is, also, far from good.

Infant Mortality Rates are higher than most other first world countries.
Source: OECD

Infant mortality rates

Infant mortality rate is the number of deaths of children under one year of age.

data.oecd.org

View attachment 7137

Life expectancy is significantly lower than in comparable countries

View attachment 7143


Source for the next graphs: Peterson KFF analysis of OECD Data

How prepared is the US to respond to COVID-19 relative to other countries? - Peterson-KFF Health System Tracker

The ongoing novel coronavirus pandemic has already overwhelmed the health systems of several countries and is projected to overburden the health system in the United States. A surge in patients with the new coronavirus disease (COVID-19) would challenge the ability of the U.S. healthcare system...

www.healthsystemtracker.org

The U.S. is an outlier among comparable countries when it comes to the share of the population with insurance coverage
View attachment 7138

Adults in the U.S. have higher out-of-pocket expenses on average than adults in most comparable countries

View attachment 7139

American adults are more likely to delay or forego medical care due to cost

View attachment 7140


What could possibly be causing all of these high costs for healthcare in the US? Odd, considering that the US has fewer practising physicians per 1,000 people than almost all comparable countries

View attachment 7141

Hmmm.... interesting. Companies, the epitome of efficiency and American freedom, taking the piss maybe? Surely not.

View attachment 7142


So, despite all of the alleged corruption that is likely to be happening in the government run health care in other Western countries, as suggested by facebook experts, people pay less for more effective medical treatment with less admin overheads, resulting in lower infant mortality and higher lifespan. Interesting. Damn you, inefficient, evil and socialistic health care systems.

The US ought to be ashamed of itself.

The physician to population figure is misleading because the usa has nurse practitioners and physician assistants who can complement primary care. Quality of care is less consistent though, but a good NP can do physician level care. It’s just not necessarily that common.

 

[User.168]

.

 

[Herdfan]

The physician to population figure is misleading because the usa has nurse practitioners and physician assistants who can complement primary care. Quality of care is less consistent though, but a good NP can do physician level care. It’s just not necessarily that common.

Yes. My daughter's pediatric office had one or the other of these on staff simply to handle walk-ins and call-ins for routine colds, ear infections etc. Took a lot of simple stuff off the Dr.'s plate. If it was more serious, they could get the Dr, but otherwise they would be the only one she saw.

 

[User.168]

.

 

[Chew Toy McCoy]

If somebody were to start their own country today based on what is out there already absolutely nobody would use the US healthcare system model and that includes the people who can actually afford it.

 

[User.45]

Yes. My daughter's pediatric office had one or the other of these on staff simply to handle walk-ins and call-ins for routine colds, ear infections etc. Took a lot of simple stuff off the Dr.'s plate. If it was more serious, they could get the Dr, but otherwise they would be the only one she saw.

Those stuff are ran by the physician usually, but yeah, a good clinic nurse is golden.

of course.

some of the prices I’ve seen discussed elsewhere are mind boggling.

View attachment 7179

It's multifaceted:
1) Americans love tech, often out of proportion to the necessity of that very technology. Among other things, this involves, cars, guns and pharmaceuticals.
2) Some drug prices and patents are ridiculous. Like Clobazam, an anxiolytic invented in the 70s that made a great comeback as a "novel" antiseizure drug in the 2010s. Should cost cents; one of the more expensive drugs.
3) It's not in the medical culture to streamline drug lists. People just add and add drugs... The best way to earn my respect as a physician is to discuss reducing the number of drugs a patient takes. If I encounter a patient with weird symptoms who's seen 5 other physicians before and nobody could figure out what's going on is (besides 100% honesty) is to start withdrawing drugs that might be unnecessary/unhelpful/toxic/expensive.

I forgot to mention a term I learned as a clinical fellow:
Financial toxicity. I think it says it all, but essentially the cost of a drug/treatment can often have a higher impact on patients than actual direct drug side-effects. Even the worlds bestest drugs fail if the patient doesn't take it because they have choose between drug or food.

 

[User.168]

.

 

[SuperMatt]

One thing I am always shocked about when in the US is to see the direct to consumers pharma ads on the tv. That really needs to be stopped

The Congress could so something about it. Of course, so could the FDA which originally decided to start allowing such ads in 1997. But I have a feeling if the Sackler family can avoid jail for mass-murder, then it’s highly unlikely anybody can get TV drug ads pulled.

 

[Chew Toy McCoy]

One thing I am always shocked about when in the US is to see the direct to consumers pharma ads on the tv. That really needs to be stopped

I believe in every other country in the world except for the US and New Zealand that kind of advertising is illegal.

 

[Chew Toy McCoy]

The Congress could so something about it. Of course, so could the FDA which originally decided to start allowing such ads in 1997. But I have a feeling if the Sackler family can avoid jail for mass-murder, then it’s highly unlikely anybody can get TV drug ads pulled.

On top of that it also seems to be a major source of advertising revenue. I don’t know what could possibly fill that void if it was stopped.

 

[SuperMatt]

On top of that it also seems to be a major source of advertising revenue. I don’t know what could possibly fill that void if it was stopped.