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Comment by danharaj | Hacker News Reader

Propose an alternative.

People can die in the ER waiting room, without ever being treated?

I don't think this happens often, at least not due to the patient not getting attention in a reasonable amount of time. ERs triage patients based on severity of condition and if you are in more critical condition you get bumped up the line.

But there is an issue in certain areas of people using ERs like a GP because the ER can't legally turn people away due to EMTALA

The ER is only required to assess patients and if you come in uninsured, unable to pay and with a GP-level complaint (flu, whatever) you'll receive no further treatment other than the assessment.

A lot of people seem to think ERs are simply required to treat everyone, which is not even close to true.

Medicaid (free healthcare for the poor) and Obamacare (require insurance with subsidized rates for the poor) are examples of how to address this issue.

Medicaid is socialized healthcare so I think you and i spoke past each other.

Get rid of health insurance and watch prices come down.

There is no way to predict what would happen in a world with health insurance suddenly removed. This seems like a nonsequitor.

It would never happen. But if it did prices would stop going up at least.

There is no way to predict that. It's all guessing.

Maybe. But couldn't we at least ask the question and have the same studies done on eliminating health insurance that we did for the Affordable Care Act (ACA). Implementing the ACA did not exactly go as planned either.

1. Deregulation - reduce compliance and legal burdens. That would bring cash prices down, so instead of 1% perhaps 50% can afford them. That's a start.

2. Charities. You can start your own: give 5% of your income to underinsured. For example:

http://www.philanthropyroundtable.org/almanac/hall_of_fame/j...

At the urging of Frederick T. Gates, perhaps his most trusted philanthropic adviser, Rockefeller became increasingly devoted to medical research. In 1901, he funded the Rockefeller Medical Research Institute in New York City. Modeled on the Institut Pasteur in France and the Robert Koch Institute in Germany, it was the country’s first biomedical institute, soon on a par with its European models. The results were dramatic. Within a decade, it created a vaccine for cerebrospinal meningitis and had supported the work of America’s first winner of a Nobel Prize in medicine. Today, known as the Rockefeller University, it is one of the leading biomedical research centers in the world. Twenty-four Nobel Prize winners have served on its faculty.

But don't force charity on others who may be struggling.

What if even with the amazing price reductions achieved by deregulation, charities still can't cover for all uninsured patients?

Why should this matter? There will always be more things desired than money to pay for them.

The continued health and well-being of our fellow human beings take precedence over most other 'things'. If it's a choice between letting someone buy an extra boat and giving someone potentially life-saving preventative care, the choice is clear.

Rockefeller University is an impressive research outfit, but not a) a pharmaceutical company or b) a treatment center. It deals more with moonshot basic research that most people won't benefit from for a few decades (e.g., Oswald Avery's early work on genetics) and doesn't directly affect the plight of the poor and underinsured.

Having worked in non-profits extensively, it's also disingenuous to claim that non-profits answer to anyone other than their primary donors, whose priorities are frequently not aligned with regular people.

1. Regulation is not the cause of high healthcare costs in America. One could argue that the lack of regulation in certain areas could be responsible for price hikes[1] in healthcare.

2. Charity has had thousands of years to solve societal problems, yet it didn't. What you're describing is a pipe dream.

Within the span of a less than a century, countries around the world have addressed healthcare effectively such that care is available to most, if not all.

[1] https://en.wikipedia.org/wiki/Martin_Shkreli#Daraprim_price_...

Deregulation might work if all market participants behaved like angels. But few people do, and so over time deregulation tends to result in cutthroat behavior, consolidation, and price increases.

Airline tickets are cheapest ever, and that's despite the fact that relative to biotech which is the fastest evolving field currently, airplane technology has been practically stagnant since the deregulation

It is much easier to compare airline tickets than hospitals/medical procedures. The worst case scenario for choosing wrong in the first case is a flight you're uncomfortable on and overpaid for.

Airlines are still heavily regulated on safety-related issues. (That might be the sweet spot.)

It's a shame this is being downvoted. It's a valid point of view that has merit and should be part of the discussion.

> 2. Charities. You can start your own: give 5% of your income to underinsured. For example:

That's a shockingly high amount, especially if you don't get healthcare out of that.

16% of my taxes go to pay for my health care system, which covers the whole country. For someone on a median income that's 3% of their income. For someone on a top 10% income that's 4.15% of their income.

To spend 5% of your Gross Income on the NHS in the UK, you have to pay 31% in total taxes, that's an income of £75k, that's circa top 5% income.

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