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0 pointswing-_-nuts3y ago0 comments

So raise the reimbursement rates to the point where hospitals can survive, or cut the fat. See? Simple.

Every time someone makes an argument like this, it's always to say that somehow, medical treatment in the USA is special compared to other countries. We couldn't possibly have universal healthcare work here. Please.

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bumby3y ago

Possibly misattributed, but usually given to HL Mencken:

"For every problem, there is a solution that is simple, neat, and wrong."

Don't kid yourself into thinking a complex system that makes up 20% of GDP is going to have a simple solution. Just a couple examples you'd have to contend with:

1) Insurance companies get a say too, according to the Constitution. That means they get to lobby in their own interests. That political problem itself is a boondoggle.

2) The US funds a disproportionate amount of medical R&D. Some of that fat is going to be cut from research. You need to have a plan on how that will effect long term quality of care and innovation.

3) Physician licensures are limited by the AMA. If you expand coverage, you will need to expand supply because any time something becomes "free", people will consume more of it. That's not a necessarily bad thing in healthcare, but needs to be addressed. The AMA also gets to defend their political interests.

There's lots and lots of other issues. I'm not claiming the US healthcare system is great. But pretending it has a simple fix is naïve.

wing-_-nutsOP3y ago

Again, I point to the fact that nearly every other industrialized nation does it better than us, with a fraction of the resources. I find it highly suspect when people say the problem is so complex we can't possibly fix it. Every other major western (and some asian) economy has addressed this. We are not exceptional. We can fix this too.

bumby3y ago

Yes, but that is, in part, because the US effectively subsidizes other countries medical R&D. Similar when other countries cap their drug costs while the profits are made up within the US. That means we subsidize other countries healthcare costs at the expense of our own. A country-to-country comparison is incomplete without understanding those systemic issues.

It's like when people point out how much the US spends on the military compared to other Western industrialized nations. Part of that discrepancy is due to the fact that the US disproportionately funds organizations like NATO. Other countries reap the benefit without footing the bill. There was a lot of outrage in Europe when the US tried to enforce the NATO GDP spend that other countries already agreed to.

The US can do better, but I would argue we can't unless we fully understand the complexities of the system. That means not getting enamored by the idea that there are simple fixes. The first step IMO is getting the political will to do so (and to understand the tradeoffs within a complex system), because many of the potentially solutions are stymied at Congress.

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bumby3y ago

Possibly misattributed, but usually given to HL Mencken:

"For every problem, there is a solution that is simple, neat, and wrong."

Don't kid yourself into thinking a complex system that makes up 20% of GDP is going to have a simple solution. Just a couple examples you'd have to contend with:

1) Insurance companies get a say too, according to the Constitution. That means they get to lobby in their own interests. That political problem itself is a boondoggle.

2) The US funds a disproportionate amount of medical R&D. Some of that fat is going to be cut from research. You need to have a plan on how that will effect long term quality of care and innovation.

There's lots and lots of other issues. I'm not claiming the US healthcare system is great. But pretending it has a simple fix is naïve.

wing-_-nutsOP3y ago

bumby3y ago

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