It is just insane to me that you have a medical issue and you're calling around for quotes. I know we have had this conversation to death for decades now but it just makes me so angry.
-I went to urgent care for some swelling on my neck that escalated quickly. 45 minutes later I was getting a MRI. This was on a Friday. They called and said it was cancer.
-Monday I was seen by a ear nose throat doctor. Yes, cancer indeed.
-Tuesday I saw a oncologist.
-At this point I decided to move to Portland since my sister lives up here. So the oncologist referred me to another ENT doctor in Portland.
-About a week later I saw a dentist and radiologist on the same day. Everyone agreed that due to the bad shape my teeth are/were in and the location of the cancer my teeth need to come out.
-A few days later another oncologist
-All my teeth removed (this has been rough)
-Tomorrow a "simulation" and PET scan to see if the cancer has spread
-Tuesday is something called a swallowing test
-Wednesday is a check up with the oral surgeon
-Friday is some intake thing for the feeding tube and a meeting with the nutritionist.
-Next Monday feeding tube installed.
-Next Tuesday another check-up with the G.I doctor.
-Next Wednesday radiation and chemo start.
So yeah.. I have no clue how much this shit is costing and I don't really care since I have Medicare. I just wish everyone had the same luxury.
For example, I got a quote this summer for an outpatient MRI that was 20% the cost of a hospital MRI, faster, and would accomplish the same thing. Now I tell everyone I know about this. If enough people do this, the hospital will not be as free to increase the cost and might even lower it (or at least start providing quotes!)
This price-shopping process is slowed by all the shenanigans that keep prices and services provided confusing, and demand to improve this is hampered by insistence that patients are never in a state of mind to shop for the best healthcare provider. It’s simply untrue—and there are workarounds in the worst cases like healthcare POAs and family members donating time.
Calling around and shopping is what people do on practically every other service or good they buy now.
In terms of how they would be set, Medicare already spends a ton of time created a system of DRG codes for every condition along with a set payment (adjusted by COL and other things).
Of course Medicare rates are sometimes less than the cost to provide the care. But I see us just getting to the point that the govt will just say “tough shit”.
You dont call around for quotes of $100+ services?
Why?
Free services mean a few people will overuse and abuse.
It is perfectly sustainable if you have a population that isn't ideologically opposed to taxes. You can fix that with education.
> and bad capitalism.
Good capitalism or bad capitalism, who cares? This sounds like a pointless ideological concern, again.
> Free services mean a few people will overuse and abuse.
It seems spiteful to me to deny universal healthcare to the majority because a minority might abuse it.
The most efficient provider should get his or her business. That way we can treat more people for strep and increase human welfare.
No one thinks that no end user cost (what people usually mean when they say free) <> no money spent.
My point: Let's stop comparing healthcare to road construction/maintenance. It's human lives. It works differently.
Also, speed limits can be comparable to turnpike's, the interstates are rarely "blocked" unless you mean congested, which is a different issue and one that more road at that location would actually make worse. Construction costs are comparable to turnpike construction and maintenance costs and are slow because, unlike a turnpike it's most visible and most delaying in areas like cities where you can't move cars to a shoulder, something that isn't an issue for turnpikes..
By whom? Traffic is just an argument for mass transit
>roads not really good
That’s an argument for more government not less. They’re fine where I live.
>speed limit low
It’s reasonable in cities and towns
>construction expensive and slow
Also high quality
You already have a beurocracy in “your” health care system. It’s just a private one and not a public one. The difference is cost involved in administrative overhead deciding who gets care and for what.
A nation needs a good health care system and a good road system to afford productive workers.
Both systems when implemented poorly cause human death and disability.
Huh? I don't see any argument at all. The fact is that it is, right now, blocked.
> That’s an argument for more government not less. They’re fine where I live.
Yeah, sure - I live in the Czech Republic, a place where we have more government and the worst roads you will ever see in a first world country.
It's definitely not an argument for "more government" - actually it's not an argument for either because you've provided zero arguments. Why it'd be better than it is now?
> Also high quality
The highways are definitely not high quality, it's just good enough. Visit Germany sometimes. Construction time has almost no relevance to quality, btw (if we don't talk about extremes).
> It’s reasonable in cities and towns
We are talking about interstates.
> You already have a beurocracy in “your” health care system. It’s just a private one and not a public one.
Yeah, I know. Again, what's your point? You stated facts that are well known by everyone interested in this topic. There are very clear advantages to a free market and there are very clear disadvantages of a public solution (and of course the contrary).
Have you ever thought about the fact that only people in the USA actually want a public system? Maybe a private system could work well if implemented correctly (see Switzerland, a country with one of the best healthcare in the world - that is private) - government is not a universal and definitely not always the best solution.
> The difference is cost involved in administrative overhead deciding who gets care and for what.
Is that the only difference, really? How much experience exactly do you have with public systems? Are you sure you have a complete picture? I have lived in several ones over my whole life. I prefer the US system.
BTW is there really a difference? You know the same thing needs to happen in a public system as not everyone is eligible for everything? How does it compare to waiting for 4 months until a doctor is available (in non-urgent cases)? How does it compare to generally substantially lower quality of care (not medical, but care - as in quality of food in hospitals, whether they treat you respectfully, whether you need to sleep on a hallway because all rooms are packed with 5+ people...)?
Do you know that only the most basic (we call it "medically necessary") treatments are paid and everything else needs to be paid out of pocket in full as there is no possibility to insure yourself for upper level of care (actually it's illegal)?
> Both systems when implemented poorly cause human death and disability.
Exactly. So let's stop with "hurr durr we need full government intervention" and let's focus on what's wrong, why it happened and how to fix it ASAP - and you're not going to fix anything ASAP if your way is to rebuild the whole thing and nationalize/bankrupt (or both, as is common with governments doing business) huge companies.
The USA system needs change, however I'm pretty sure that such dramatic change would leave the country in ruins (or more likely in a lot of dead bodies) simply because it's extremely hard to run such system even if you've been doing it and continuously improving it and gaining experience for the last 70 years and your country is 20x smaller - and there is no country in the world where a public system would have substantially better results than the US one.
There's obviously some variation here, and for that an hourly rate makes sense.
Health care should be more like car repair: go in for a quote, then pay when you decide on a provider. Obviously emergencies are different, but things like strep or broken bones are pretty common, so they should have a set price.
That's an assertion, not an argument supported by observations. In the European countries the government sets prices for procedures, and it works well, life expectancy there isn't lower than it is in the US.
Americans pay out the nose for drug prescriptions, which fund the vast majority of research and development budgets, which then benefit all people, worldwide.
And all of those countries make more revenue selling to the US than they do any other country by a long shot.
What you haven't answered is whether the research can be supported without the American market subsidizing of that research.
It is in fact, expensive to develop new drugs and something has to pay for that development.
Citation needed.
If the world wants and needs better drugs, there are other ways to fund research. If we give a damn, we can find such solutions.
Given that the US has this system and US healthcare is multiples more expensive with worse or similar outcomes in essentially every field, I suggest we can put that theory to rest now.
(definitely not defending the US system)
The US does not have this system.