Comment by no-name-here
1 day ago
The US is dead last in terms of health outcomes among every developed country (despite spending far more), but you believe expectations will cause every other developed country's system to fail here? I guess your argument is that the propaganda machine pushing the idea that America's healthcare is not the worst in terms of outcomes (while also being about the most expensive), would prevent Americans from accepting no longer having the worst results and the highest costs?
> Many providers don’t accept Medicare. Very few providers accept Medicaid.
1. About the same percent accept Medicare as private insurance (85-90%, while ~70% accept Medicaid - is that "very few"?).
2. "Medicare for all" is one of the primary proposals being discussed.
3. Previous smaller expansions of government healthcare resulted in expanded provider capacity to handle them, not less, but your argument is that we'd see the opposite results from further expansion?
4. And in this new world where everyone had Medicare or similar, your argument is that providers would choose to ignore most patients, where they don't under the existing system where government-sponsored healthcare makes up a significantly smaller portion of the customer base?
5. And your argument is that if the government finds that healthcare providers contract to the point that outcomes remain the worst among every developed country, as they are today, that the government would be unwilling to make any changes (such as reimbursement rates) to address this?
I’m saying the US won’t implement anything like what other countries implement. I honestly think Philip Greenspun’s proposal ( https://philip.greenspun.com/politics/health-care-reform ) makes sense but has no chance of being implemented. Americans asking for some kind of single payer system are expecting something better than basic health care.
I remember when President Obama suggested “maybe you’re better off not getting the surgery but taking the painkiller” ( https://youtu.be/rin4h4cRs6Y ). That seemed to surprise many of the people who wanted a single payer option. He stopped suggesting that kind of cost-cutting that very quickly.
I also remember when a few people received anthrax in the mail. Every news story said that people who had any contact with the letter had received Cipro to avoid developing an infection. After a couple of weeks, the government actually announced that other (cheaper) antibiotics were effective against anthrax, but it was obvious that no company was going to hand their employees something other than Cipro.
Incidentally, my autistic adult son has Medicaid. I don’t think I’ve yet found a doctor who will accept it. Luckily he’s also on my health insurance.
> The US is dead last in terms of health outcomes among every developed country (despite spending far more), but you believe expectations will cause every other developed country's system to fail here? I guess your argument is that the propaganda machine pushing the idea that America's healthcare is not the worst in terms of outcomes (while also being about the most expensive), would prevent Americans from accepting no longer having the worst results and the highest costs?
The argument is that the US system has a much lower floor, which leads to the bad health outcomes, but also generates a lot of people who expect and demand more than most universal healthcare systems would give them. An Uber driver with the cheapest marketplace plan he could find would benefit greatly from any universal healthcare system; a guy with really bad ulcerative colitis (https://www.propublica.org/article/unitedhealth-healthcare-i...) would likely not be able to get a prescription for a cocktail of drugs at non-FDA-approved doses costing $2M/year.