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Posted
36 minutes ago, dream big said:

...and no one who advocates for universal healthcare addresses the heavy costs transferred to the tax payer. 

Literally every single serious healthcare reform plan includes measures to reduce or control costs, including those that would achieve universal coverage, because as you said above, we can all agree that medical costs are high.

Posted
12 hours ago, Breckey said:

If universal health care saves more people through access to medical services in those 10 - 25 years then would have died from cancer is it worth it then? If universal health care decreases health costs because people aren't waiting until they're really sick to seek health care and instead focus on preventative medical services would it be worth it?

Medical costs in this country are out of control. If people stop using the ED as a easy button for having a cough or other non-urgent health care need because they have access to other services it would decrease the burden on the currently insured. I agree that there needs to be a period where the pharmaceutical companies but at some point, just like other patents, it needs to go into the public domain. This is especially true for companies that use Federal grant dollars to fund their research.

It's not an "if." We have plenty of countries with what you seek. The US has better medicine, better research, and better outcomes. 

 

It's not like you're suggesting something new with a "what if it works better" as incentive. The left is pushing for what much of the world has already tried, and we know the trade-off. 

 

So, as I said, is it worth a 50 year delay to curing cancer? For the whole planet?...

Posted (edited)
11 minutes ago, Lord Ratner said:

It's not an "if." We have plenty of countries with what you seek. The US has better medicine, better research, and better outcomes. 

 

It's not like you're suggesting something new with a "what if it works better" as incentive. The left is pushing for what much of the world has already tried, and we know the trade-off. 

 

So, as I said, is it worth a 50 year delay to curing cancer? For the whole planet?...

What you're proposing as a certainty (universal healthcare in the US = delay in curing cancer) is such a bizarre, unprovable hypothetical / red herring argument that I don't even know how to comment properly.

Re: what the rest of the (developed) world has...I mean better average outcomes and much, much lower costs no matter which model they use? That's what they have.

Some countries are almost entirely private-market, job-based systems, some are fully public for both payers and providers, and there's nearly everything in between. Some have rationed care and some have almost on-demand services. Some countries with good average outcomes spend a lot (well, not compared to us but still, a lot more than average), and some with equally good average outcomes spend very little comparatively. What they all, literally all, have is better average outcomes and lower costs than we enjoy in the U.S.

If having "better research" and being the world leader in healthcare innovation is somehow inextricably tied to failing to deliver good outcomes to all of our people, and I'd argue it's not, it's a bad trade off.

Great books to read: The Healing of America and Which Country Has The World's Best Health Care?

Also bravo to us all for making any and all political threads eventually circle back to the same issues we've been debating since approximately 1945. 🍺

Edited by nsplayr
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Posted
15 hours ago, Lord Ratner said:

...

If providing universal health coverage guarantees that the cure for cancer is delayed 50 years, is it worth it? 25 years? 10? It is indisputable that there will be a delay, yet most won't even grant that.

If all the animals on the equator were capable of flattery, then Thanksgiving and Halloween would fall on the same date.  Is that worth it?

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Posted

The US has one of the lowest life expectancies out of 1st world countries. We have one of the highest expenditures on healthcare per capita. Logical DFP - our country/economic model is horribly inefficient compared to most other similar nations and could easily be improved.

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Posted (edited)

So back to the point of we provide nearly all the medical innovation. It’s a bit like NATO. We do all the spending to provide the blanket of defense, incur the wear and tear on equipment, and spend lots on people. The other member countries spend a lot less and probably look like their military models are way better because it doesn’t take as much money, but they get the same level of relative security. 
 

If you go to a system that disincentivizes medical innovation, what then?

 

Edit: our life expectancies are also lower because a lot of Americans choose to make unhealthy life decisions like being overweight. Medical systems can only work so many miracles. 

Edited by SurelySerious
Posted
40 minutes ago, SurelySerious said:

So back to the point of we provide nearly all the medical innovation. It’s a bit like NATO. We do all the spending to provide the blanket of defense, incur the wear and tear on equipment, and spend lots on people. The other member countries spend a lot less and probably look like their military models are way better because it doesn’t take as much money, but they get the same level of relative security. 
 

If you go to a system that disincentivizes medical innovation, what then?

 

Edit: our life expectancies are also lower because a lot of Americans choose to make unhealthy life decisions like being overweight. Medical systems can only work so many miracles. 

I don't think that's a great comparison. The European Union has IVO 100 million more citizens than the US, and their total healthcare expenditures are much smaller than ours. And their average outcomes are better. So they're doing more "work" in providing healthcare to more people, but also spending less and the healthcare on average is better.

There is some cost for innovation, but I'm not convinced at all that A) it's the primary driver of US healthcare spending, or B) that US citizens need to shoulder all of it. Throw on top of it that many of the biggest pharma companies are based abroad (think Roche, Sanofi, Novartis, and GSK, all top-10 in revenue and all based in Europe), the argument kinda doesn't works as well.

Posted
11 hours ago, SurelySerious said:

So back to the point of we provide nearly all the medical innovation. It’s a bit like NATO. We do all the spending to provide the blanket of defense, incur the wear and tear on equipment, and spend lots on people. The other member countries spend a lot less and probably look like their military models are way better because it doesn’t take as much money, but they get the same level of relative security. 
 

If you go to a system that disincentivizes medical innovation, what then?

 

Edit: our life expectancies are also lower because a lot of Americans choose to make unhealthy life decisions like being overweight. Medical systems can only work so many miracles. 

The cherry on top is when the SJWs in these countries criticize our military spending.  Like, really?

Posted
44 minutes ago, dream big said:

The cherry on top is when the SJWs in these countries criticize our military spending.  Like, really?

It's coming...maybe...

Defund the Police. And the Military, Too.

IDK if the left would actually severely cut the American Military or more accurately the globalist puppetmasters who fund and direct the Left in Western Countries would actually allow them as they require an actual force to confront and deter their other enemies in the world, secure the global commons, etc...  No offense to Europe but I don't see a massive increase in military expenditures in European nations along with the will to use that military capability on expeditionary missions to perform the roles that a now diminished US military no longer can do

Like Defund the Police, the real meaning is not said.  Destroy local police departments so our brownshirts can scare the hell out of regular people and control them but keep the FBI and National Enforcement that are centrally directed so we can control them and use them as we want vice independent police departments.  Defund the Military means something else, not sure they know exactly what they mean by that except take that money and use it to build further addicts to the welfare state.

Posted (edited)

Are you familiar at all with the author of the article you linked to? Or the MLK speech Bacevich references throughout?

What are your thoughts on the argument he’s making? Not the headline, which got you and the rest of us to click (mission accomplished), but his actual argument.

Edited by nsplayr
Posted
5 hours ago, nsplayr said:

Are you familiar at all with the author of the article you linked to? Or the MLK speech Bacevich references throughout?

What are your thoughts on the argument he’s making? Not the headline, which got you and the rest of us to click (mission accomplished), but his actual argument.

Reducing military spending relegates the United States to a second-tier world power.  Is that what we want?

No, I don't think we've spent wisely in wars of the past two decades. I wish we weren't involved in Iraq, Afghanistan, or Syria.  But Obama didn't do anything to reduce our involvement there.  As soon as Trump started movements to withdraw from the region Democrats fell back in love with war.

If modern monetary policy advocates are correct, we can just print as much money as we need to find our social programs.  Maybe we should try that and see what happens?

Posted
On 7/15/2020 at 8:20 AM, brawnie said:

The US has one of the lowest life expectancies out of 1st world countries. We have one of the highest expenditures on healthcare per capita. Logical DFP - our country/economic model is horribly inefficient compared to most other similar nations and could easily be improved.

That's not due to healthcare costs, its due to personal choice. I'll be for universal healthcare when everyone has to take a fitness test and do a body comp test. 

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Posted
18 hours ago, nsplayr said:

Are you familiar at all with the author of the article you linked to? Or the MLK speech Bacevich references throughout?

What are your thoughts on the argument he’s making? Not the headline, which got you and the rest of us to click (mission accomplished), but his actual argument.

Read Bacevich before but do not actively follow and have read several MLK speeches/letters, not claiming in anyway to be an authority on either men or their work but don't see the problem (perhaps I'm assuming you think I was being passive/aggressive/asshole-ish) in posting it as an example of the next great frontier likely to come from the radicalized left.  Not saying Bacevich is the vanguard of that but he is adding his voice to a chorus I don't think he fully appreciates what they are really singing... 

His wiki is worth a read and I know who he is, not a career academic who never did anything other than pontificate about the theoretical, never sacrificed anything and petulantly judgmental of others who have fought, lost and sacrificed for others.  I respect him but disagree with him.

Thoughts on the argument(s) laid out in the piece?  In reference to MLK's original point on the trifecta of racism, extreme materialism, and militarism being sins the USA is uniquely guilty of and to be expunged if we are to fulfill our destiny?  That these are interconnected cultural pathological tendencies that are we suffer unduly more than others from?  Quite simply no,. 

He is confusing national policies with the millions of choices of individuals on what they wish to do with their wealth, doesn't like the fact that most people are not interested in spending an inordinate amount of money on others and chooses to chide them for it in a sly manner by impugning their nation/culture/country is uniquely worse than others, despite about a metric shit of ton of reality to the contrary.  Lecturing others on why they should spend their money on others and deny themselves the fruits of their labor, beyond a reasonable point, is ridiculous.  It is not his or King's place to berate Americans that they have a responsibility beyond what their personal conscience dictates.  If Bacevich were lecturing all other citizens of the developed and rich world, he might have a leg to stand on in this point, but he doesn't so until I see him publish a world wide call to global charity outreach for all, I and other free Americans will do what we think is right and what is legally required with our money.

He confuses historical cultural problems that others now long dead created as the sin of the living now and berates them because they live their lives in recognition of the consequences now of those damn mistakes.  Certain communities of people have higher rates of anti-social behavior not because they are biologically predisposed to it but because people long dead now made choices that set them up in a worse starting position when we all start the game of life.  I believe we can deliver additional resources to those communities in ways that are not punitive to others and generate the least amount of resentment.  Decrying Americans as especially racist because they see with eyes the problems our society has and sometimes make reasonable choices based on that, sometimes they could make better choices than they do and rarely they make wrong choices based on that is unfairly high bar.  Again, if he applies this judgement to the other developed and wealthy countries, we can have a discussion but singling us out as uniquely bad is wrong, unacceptable and misses on many levels.

Militarism, NOT an American sin and if you like the Liberal International Order, he had better come to peace with the fact that the world is not exactly a safe place.  Lots of bad people have military power and are willing to use it in ways we and other nations that ascribe to a liberal enlightenment set of values would not.  Say what you will, but we are likely the most benign global hegemonic power to date.  It's not that we're so bad, it's that the world is so violent.  Thankfully it is getting less so compared to previous decades and we can certainly improve the way we and the other usual suspects deter aggression, secure the global commons, promote trade and communication, etc... but it is necessary if we want to be the ones who set up the game, enforce basic rules and try to keep it fair.  From what I've seen of the other contenders for our position, the world better grow a brain and help us keep it together, I doubt very seriously they would like it if the other guy takes the helm. 

That's it, that's all I got.  Bracevich and King have a point, just not an argument to judge ourselves so harshly as they opine.

America is good, Western Civilization is awesome, the alternatives to free markets and individual freedom/choice are awful.

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Posted
17 minutes ago, Clark Griswold said:

America is good, Western Civilization is awesome, the alternatives to free markets and individual freedom/choice are awful.

Concur. Now can we get back to when that Japanese kid down the street is going to pay me my owed reparations for Pearl Harbor? I’ve suffered long enough...

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Posted
On 7/14/2020 at 8:24 PM, nsplayr said:

What you're proposing as a certainty (universal healthcare in the US = delay in curing cancer) is such a bizarre, unprovable hypothetical / red herring argument that I don't even know how to comment properly.

Re: what the rest of the (developed) world has...I mean better average outcomes and much, much lower costs no matter which model they use? That's what they have.

Some countries are almost entirely private-market, job-based systems, some are fully public for both payers and providers, and there's nearly everything in between. Some have rationed care and some have almost on-demand services. Some countries with good average outcomes spend a lot (well, not compared to us but still, a lot more than average), and some with equally good average outcomes spend very little comparatively. What they all, literally all, have is better average outcomes and lower costs than we enjoy in the U.S.

If having "better research" and being the world leader in healthcare innovation is somehow inextricably tied to failing to deliver good outcomes to all of our people, and I'd argue it's not, it's a bad trade off.

Great books to read: The Healing of America and Which Country Has The World's Best Health Care?

Also bravo to us all for making any and all political threads eventually circle back to the same issues we've been debating since approximately 1945. 🍺

It's not absurd at all. The only evidence that exists is that our system overwhelmingly produces results, and the other systems don't. Claiming that we will somehow socialize medicine *and* remain the development powerhouse that we are is nothing more than a proclamation of faith.

Besides, the "better outcomes" argument is a tired, shallow analysis of the medical landscape in the US.

https://www.forbes.com/sites/physiciansfoundation/2018/04/09/u-s-health-outcomes-compared-to-other-countries-are-misleading/#349bc17d1232

 

It's not a complicated concept, and the experiment has been run dozens of times. Our system produces a level of wealth that creates billionaires on one hand, while flooding the rest of the planet, and especially the poor and destitute, with quality of life they otherwise wouldn't have on the other.

 

The European countries that are pointed to as examples to follow became so precisely because they moved in our direction, *especially* the Nordic countries. The rest, such as the UK, have a system that most Americans would recoil from, especially the middle class, as soon as they found out how difficult it is to get "elective" surgeries done. And unsurprisingly, the well-off in the UK pay extra for insurance that gets them better care. So less innovation and development, but the rich still pull ahead.

 

We have the same goals. Provide better care for everyone. But your way leverages the future to pay for the present, and that is the definition of a bad trade off.

Posted
52 minutes ago, Lord Ratner said:

It's not absurd at all. The only evidence that exists is that our system overwhelmingly produces results, and the other systems don't. Claiming that we will somehow socialize medicine *and* remain the development powerhouse that we are is nothing more than a proclamation of faith.

Besides, the "better outcomes" argument is a tired, shallow analysis of the medical landscape in the US.

https://www.forbes.com/sites/physiciansfoundation/2018/04/09/u-s-health-outcomes-compared-to-other-countries-are-misleading/#349bc17d1232

 

It's not a complicated concept, and the experiment has been run dozens of times. Our system produces a level of wealth that creates billionaires on one hand, while flooding the rest of the planet, and especially the poor and destitute, with quality of life they otherwise wouldn't have on the other.

 

The European countries that are pointed to as examples to follow became so precisely because they moved in our direction, *especially* the Nordic countries. The rest, such as the UK, have a system that most Americans would recoil from, especially the middle class, as soon as they found out how difficult it is to get "elective" surgeries done. And unsurprisingly, the well-off in the UK pay extra for insurance that gets them better care. So less innovation and development, but the rich still pull ahead.

 

We have the same goals. Provide better care for everyone. But your way leverages the future to pay for the present, and that is the definition of a bad trade off.

There is absolutely no way to prove or disprove the idea that achieving universal healthcare coverage in the United States would mean a certain delay in a cure for cancer. It's not even worth debating about because it's an unprovable hypothetical.

My prefered healthcare systems for the US if I could waive a magic wand are maybe the Netherlands or Canada, which have different approaches but both work very well overall. I'm not a proponent of a UK-style system of public payer, public provider, although that's exactly the kind of healthcare that I had while on active duty and overall it worked great for me and my family.

And discounting the long-term findings comparing healthcare systems published in a peer-reviewed journal (JAMA) with a Forbes article written by two guys is...insufficient. They even seem to hand-waive things that drag down American healthcare outcomes like obesity, suicides, teen pregnancies, etc. that are absolutely issues that can be addressed with more effective healthcare systems.

The big problem with American healthcare is average outcome, not, "Do we provide great care for the wealthy?" because on that measure then yea, we're great. If I have the money or the right coverage I'm flying my ass to the Mayo or Cleveland clinics no matter where I live in the world.

Unfortunately we don't have one system where everyone has that option, we have a mishmash of several systems and on average we spend more and get worse outcomes than most other developed nations. We could choose literally any other system to model off of and likely would be able to spend less, have better average outcomes, or both.

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Posted

No thanks. I don’t care to wait for access to medical care. Both countries have people coming to the US (as does every other country) to get health care because the US sets the medical health care standard. It’s that good. And it’s available. It may not be cheap but I’m okay with that. I work hard so that I’ll have access. I’m not in favor of others using the product of my labor for their own shortcomings and desires instead of maintaining their own health. No where are we told we are going to have a fair life. In fact you being where you are in life increases in equality of outcome not decreases it. And that’s a good thing.

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Posted (edited)
17 hours ago, nsplayr said:

 I'm not a proponent of a UK-style system of public payer, public provider, although that's exactly the kind of healthcare that I had while on active duty and overall it worked great for me and my family.

Do you think there’s a reason it worked for your family and many other mostly young, healthy families? If you think back with a critical eye, did it really work good for you? I honestly don’t have too many complaints myself, but I think there is some truth to the old joke:

”What do you call the Med school student who graduated first in his class?”

”Doctor”

”What do you call the Med school student who graduated last in his class?”

”Captain”

Maybe I’m just mean though

Edited by herkbier
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Posted

Agreed. My time under Tricare prime is 180 out (in a total abortion kind of way) from standard/remote. Seeing civ docs with freedom of choice (assuming they take Tricare) is so much better. Tricare prime is “great” for cost, but you get a dog shit product...good luck if you’re anything but strong and healthy. 

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Posted (edited)
7 hours ago, nsplayr said:

 

My prefered healthcare systems for the US if I could waive a magic wand are maybe the Netherlands or Canada, which have different approaches but both work very well overall. I'm not a proponent of a UK-style system of public payer, public provider, although that's exactly the kind of healthcare that I had while on active duty and overall it worked great for me and my family.

You've clearly had different experiences with military medicine than I have.  If your bar for success is 30 day waits to see a PCM followed by denying specialist care, treating everything with Motrin, and pushing most of the intake care to people without medical/nursing degrees, then sure, it'll be cheaper for everyone involved.

Edited by pawnman
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Posted (edited)
1 hour ago, herkbier said:

Do you think there’s a reason it worked for your family and many other mostly young, healthy families? If you think back with a critical eye, did it really work good for you? I honestly don’t have too many complaints myself, but I think there is some truth to the old joke:

”What do you call the Med school student who graduated first in his class?”

”Doctor”

”What do cal l the Med school student who graduated last in his class?”

”Captain”

Maybe I’m just mean though

I mostly agree man, don’t get me wrong. I have a huge scar on my back that required a second surgery under anesthesia all stemming from a very straightforward dermatological procedure that the mil doc fucked up by the numbers.

Then again I got LASIK for absolutely free (game-changer) and when we had a baby, it cost us exactly $6...they charged us for the meal that I ended up eating while my wife was in labor.

So maybe I’m just an optimist haha but yea point taken, and all of my top 10 picks if I could magically have the US under a single new healthcare system have private care.

But also like y’all are saying, I think Tricare Standard or Reserve Select are excellent models. Either no or manageable premiums, wide availability of docs that take it, very little paperwork, etc...I am unabashedly a fan of Tricare Standard and have found it to be vastly better than any of the options I’ve ever been offered from even sledge Fortune 500 civilian companies.

Edited by nsplayr
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Posted
3 hours ago, nsplayr said:

 

Then again I got LASIK for absolutely free (game-changer) and when we had a baby, it cost us exactly $6...they charged us for the meal that I ended up eating while my wife was in labor.

 

Props to you man. "Hold on babe I have to finish the brownie in this meal before you give birth"

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Posted
On 7/14/2020 at 4:36 AM, Breckey said:

If people stop using the ED as a easy button for having a cough or other non-urgent health care need because they have access to other services it would decrease the burden on the currently insured

There already is an option that isn't the ED, and it's called urgent care clinics, which are all over the place. 

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Posted

Since this is an anonymous forum where people share anonymous thoughts, I'd like to hear why you all are planning on voting red this year? Specifically, what policies are actually making you interested in the republican platform? Because I can't find many convincing ones? I voted for Bush in 2000 and 2004 and McCain in 2008, but since ~2009, I feel republican views have shifted out of line with my own.

Important issues for me where I think dems have a better plan than reps:

1) Infrastructure development/maintenance - a large pointed investment in the Army Corps of Engineers plus an actual plan for future technologies (battery tech at the DoE, renewable energy) seems like a better plan than just saying "We'll put $1T towards infrastructure" and not having a detailed vision

2) Finding a way to deal with the inevitable dystopia as machines displace workers who can't easily retrain (truck drivers, factory workers, manual laborers, single parents with kids, etc) - you have to have strong job retraining programs and a social safety net like never before seen or else society will not handle this transition. This is a legitimately insane thing happening right now with no plan to fix it - even to your jobs (commercial pilots likely won't exist in 50-100 years), and the republican plan is to let the unbridled free market sort this out.

3) A plan to deal with the increasing economic bullshit that we have now seen twice where losses are socialized and gains are privatized. CEOs and stockholders say they take all the risk, but have you ever seen a billionaire go bankrupt when their company didn't save any money and then were hit with a period of economic stability? Oh, all of the airlines and many other companies that just did stock buybacks over the last decade as opposed to having any reserves? Oh, okay. If we keep the system we currently have, we are keeping a system, which has proven to be catastrophic to the average person now twice in the last 12 years. Increase marginal tax rates of the upper echelons, a wealth tax on money over a huge amount of dollars is not that insane, increase worker protections, and let businesses fail.

4) Global warming action - the current Admin's plan to just let free with coal and fossil fuels is a short-sighted terrible one. But I guess that's what happens when you don't believe 99% of scientists and can just say "fake news" to everything that you don't like. It's real, sorry homies.

5) BLM/police brutality/social issues/gay rights/etc - Republican strat is just to not care, democrat strat is to at least talk about the issues. Whether you like it or not, a large part of bringing stability back to the nation is mediating between groups that feel marginalized. It's not effective to just say "suck it up, buttercup"

Others: universal healthcare, budget deficit (both sides have no plan here, long gone are the days where republicans were the "deficit hawks"), military action (we don't need to be in Iraq/Syria/Afghanistan/Israel/Saudi, we need to come home and focus on developing future weapons to maintain parity with China), and a bunch more.

So go ahead, convince me as to your issues and why the republican party will deliver better results.

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