We’re Getting Ripped Off

Is this a repost? Because that one doesn't look like this one.

Is there any serious research that shows this to be true?

In America, the Big Lie that all Americans tell about themselves and their country, is that the US is #1 in everything. And, if statistics happen to show that the US isn't #1, there's always a reason, an excuse, as to why in this instance the US isn't #1, but it totally could be, it just doesn't want to, or it has to deal with some exceptional circumstance that lesser countries just don't have to deal with.

To me, the idea that the US subsidizes global healthcare innovation feels just like such an excuse. It gives Americans an opportunity to martyr themselves. "We could have cheaper healthcare, but we bear this burden, for you."

Come on. It's a load of horseshit.

And even if it were true, why would you accept it? America hates altruism, deriding it as socialism, so much so that "socialized" healthcare is seen as a horrible thing. It's not ok for Americans to pay for each other's healthcare, but it's suddenly perfectly ok to pay for the development of healthcare for other countries?!? You're happily spending healthcare money for the benefit of other countries, but not your own population?

This makes no sense. This can't be true. It's a bad excuse to cover up failed exceptionalism, because the truth is simply that a lot of people with money to pay for lobbyists are benefiting from the current system.

Well it's an interesting question and the answer is not ambiguous as far as I can tell. The US share of global R&D spending on pharmaceuticals is approaching 60%: https://www.abpi.org.uk/facts-and-figures/science-and-innova...

To answer your question I think there's little doubt that dramatically cutting health (and pharmaceutical) costs per person in the US (i.e. with a single payer model) would dramatically impact global R&D spending on pharmaceuticals.

But are you saying that the average American citizen is ok paying ridiculous health care costs (with only a limited number of citizens having coverage) because their payments are subsidising global health R&D? I really, really doubt that. Also this idea is clearly socialist which is one of the main arguments against universal health coverage in the US.

I can't force myself to understand this Ferengi-like mindset.

Paying for the un/under-insured through for-profit intermediaries is what lead to high medical prices. If it's a social service, if should be funded through taxes.

And people putting off routine procedures and tests, which then compound into more expensive procedures and care, can be explained not just by apathy, but by the high cost of doing routine medical care.

My dad slightly burned his forearm opening the radiator cap of his car. He drove to the hospital, where they washed his arm, put gauze, tape and sent him home with a non-negotiable $600 USD bill. He's Mexican, but they can collect in Mexico too. As a side note, this would have cost him $0 in Mexico, because taxes.

I support Medicare for all but I’m also realistic that it will result in a two-tiered public/private system, similar to what the UK has with the NHS and separate cash pay services and private insurance. The key is to disconnect the private system from employment where the costs and purchase decisions are obfuscated from the end consumer. When a critical mass of consumers pay out of pocket for services, the market will drive down prices and increase transparency. At least that’s the best shot at it, based on what I’ve seen.

In a medicare for all situation, the biggest problem would be pumping up the system to handle a huge influx of new claims. I imagine roll out would be "in 1 or 2 years, everyone will be enrolled in medicare". Which would give the federal government time to hire enough claims processing agents.

Hospitals are already setup to bill medicare so that isn't an issue.

After that, it will just be businesses making the necessary arrangements to cancel current insurance plans.

What is going to be weird is "How do we handle HSAs" and "What does supplemental insurance look like?"

The industries I see negatively impacted by this are the healthcare industry (harder to charge huge prices for medical treatments in a single payer system), the insurance industry (I doubt many individuals or employers will opt for supplemental plans), and the pharmaceutical industry (government has more negotiating power over price when it isn't a single patient paying for it).

An optional medicare plan would be, IMO, a disaster. It is basically the worst of all worlds. Everyone pays more for medicare, not everyone can afford it, and we are still in a weird mishmash of payment that will depend entirely on who your employer is, if you opted in for medicare, etc. If it goes down like Obama care did, I can also see some red states deciding "We aren't going to allow medicare opt in!" which would, frankly, defeat the purpose of making the opt in happen. Further, it sets itself up for easy repeal later on.

Medicare for all, once given, will be near impossible to take away.

If we really want to get politicians on board we should bring up how much our current healthcare system hurts small businesses. There is not a politician in the US that doesn't kiss up to the small business owner, yet we have what is probably the worst possible system for someone trying to start a home business.

If you have a family it's borderline irresponsible to quit your job and leave behind that employer sponsored health plan. As an individual you're at the mercy of the insurance companies and they are merciless.

I can't even image who would argue against it. What was the point of tying health insurance to work in the first place? I'm finally in a situation where I'm managing my own insurance and being compensated for the "lack of benefits" directly. I got a plan way better than my last one, for $5 more than what my side of the cost was. And I no longer feel chained to my employer. Even if you like where you work, that's not a good situation to be in. Companies get the worst options, and it still cost both parties a horrible amount, and now the employee is stuck with that crappy plan when they could have shopped around for a much better deal directly.