WhiskeyDebates Saves American Healthcare (You're Welcome)
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28-07-2017, 08:15 AM (This post was last modified: 28-07-2017 08:30 AM by WhiskeyDebates.)
WhiskeyDebates Saves American Healthcare (You're Welcome)
Now I know what you're thinking "Whiskey doesn't make threads he's got like...1 thread and it was about musicals" and you would be right. But that changes today! I'm gonna be the OP and I'm going old school! I'm the OG OP and ...DTF I guess... (young people scare me). Next, you probably thinking "guys..it's fuckin' Whiskey, his plan is probably to set up a nationwide loudspeaker and call everyone pussies until they pretend they're better just to end the verbal abuse" and you would be wrong. That sounds like amazing fun but YOU WOULD BE WRONG! I have an actual plan! A good plan, one that is more efficient, more responsible, and more ethical. Now at this point, you're probably thinking " Jesus Whiskey we are this far into your thread and you haven't gotten to the bloody point!" and you would be right. I also recognize that me pointing that out is not helpful and if i'm being honest frankly kind of counter-productive so .... ya.

Now most of you know me as WhiskeyDebates, resident swear word assassin and shitfitter, but it's a little-known fact that in 2014 I graduated from Calgary's prestigious University of Smartering with a PhD, MD, and a BLT in Advanced Thinkology at the top of my class! ...I was also technically the bottom of my class. It was a small class. Our class picture was a selfie is what i'm saying. Anyway just keep that in mind plebs while I fix your country for you.

Now let's get medical up in this bizatch (nervous white guy laughter Haaaaaa...), slap on the rubber glove, and diagnose that mothafuka that is.......American healthcare!

Step 1) Diagnosis! or Why Can't You Silly Chimps Figure Out How Not To Die: Seriously It's Not That Hard, Adrian Paul Did It For like Six Fuckin' Seasons And He Had People Attacking Him With Swords Every Week! Get Your Life Toget-

OK, so when it comes to the question of why medical care is such a mess in America we have to ask three basic, but vital, questions if we are going to figure it out.

1.) Why has the cost of medical care increased so astronomically in the US?
2.) Whiskey you wonderful bastard, and 2020 winner of Times Man of the Year (probably.), what can we do to fix it!?
3.) Is Gal Gadot the most attractive human to exist ever or just of the last 4000 years? (Now you might think this is not relevant to a conversation on health care but you would be wrong. Those cheek bones are relevant to every conversation.)
4.) Whats your phone number Whiskey?

1.) So why have costs gone up so much? Wel it's really complex, and I don't wanna bore you all with economic jargon (seriously if ya'll need a Canadian to keep you alive, I'm not trusting you with math) so I'll just give a basic barebones explanation.
So the problem is that doctors, and the medical community as a whole, aren't beholden to the customers (sick people) but rather to insurance companies and the government and this brings with it a lot of problems.
Now it should come as no surprise to most that the US government and the insurance companies have sliiiiiiightly more million dollar bills than the average American. Now when the person footing the bill has basically unlimited money...you gonna charge more. And we see that all the time, with doctors ordering tests you don't need, procedures you don't need, and routinely prescribing drugs you don't need. They know the person footing the bill can afford it.
Because we don't pay the doctors directly we don't have as increased incentive to find the cheapest cost with the best quality, and because doctors don't get paid by their customers they don't have any incentive to cut costs or increase quality. They get paid no matter what and the same amount either way to the point that a lot of doctors can't tell you how much something costs because they don't even know themselves.

The reality of this becomes painfully clear when you just take insurance out of it. Just cutting out insurance, both private and governmental, can reduce costs by 50% or higher.

2.) So how do we fix it? Well as a professional Thinkologist it's my opinion that we have to start treating the cause not the symptoms and high prices for insurance are a symptom and not the cause. The cause is that no one in that chain has a really strong vested reason to lower costs or increase quality. You're not spending "your money", the government can spend as much as it wants, and the medical community is actively rewarded for ordering as many expensive and unnecessary tests it can get away with and intentionally overcharging. We need a new system that puts a desire for cheaper and better at the fore front, and sadly ..your mom only fits the bill for one of those things. Shit.

And we need a catchy slogan! Like.... "make healthcare great again!" or maybe " Plz can has less dying meow". Whatever figure that out later.

3.) Yes. To both.

4.) Ha! Nice try Aliza/Bucky/DLJ/Myself I'm not stupid enough to put my cell number out there on the internet for everyone to see. Ya gotta PM me for that.


Step 2) Treatment! or How a Single Maple Syrup Swigging Zamboni Pilot Saved America!

Fuck.

Ok now that I have dropped the F Bomb you know this is real talk so let's break some numbers down to give a general idea of what I'm about to talk about. According to NHE data from 2015 America spent 3.2 trillion dollars on health care in 2015. Now not all of that comes from government spending on Medicaid and Medicare. A lot of it is private companies, out of pocket spending and so on. But let's use that as a rough baseline for the program. If we need to we can shift some spending from the Defense budget... or maybe like I dunno tax the pot dragons or like..have a national tax on gold platted orphan-bone monocles or something LOOK the point lets just say we got two trillion-ish to spend. That's our budget, don't ask questions I let you ask questions earlier in this OP and the only one that was on topic was about Gal Gadot. Seriously it's no wonder you need me to save your bloo-
  • Phase out Medicare and Medicaid by taking that money and putting it towards what I call pre-surance (It's a fine name, fuck you fight me IRL).
  • Any person with a personal income under a certain threshold (let's say $200,000?) qualifies for the new program.
  • Basically every person in America over the age of 16 who qualifies receives $6000ish annually.
  • This money goes into a bank account in their name, right along side their savings or chequing, and can ONLY be spent on medical treatment. You can't pull money out of it to buy a jet ski, don't be an ass. You know who you are. Chad.
  • The payments are adjusted for inflation and can collect interest, and so on blah blah blah, BORING!

Some other things to take into account before we move on:

  1. This money is not taxable and not counted towards personal income, it's a flat cash total.
  2. Government puts in but is legally barred from taking out, that way the next time a Congressman feels the need to spend $200 000 to build a giant goddamn useless do nothing duck with the eyes of a serial rapist he can't raid your medical to pay for it.
  3. It's non-transferable except with express written permission and spouses can have joint accounts if they want.
  4. Surgery, sex reassignment, abortion, viagra, antidepressants, therapy, you name it if it's medical you can use it and no one gets a single fucking say other than you.
  5. Any time after the age of 60 you can opt to take a single one-time payout from the medical fund up to 80% while still receving your annual payment till the day you die.
  6. Charitable people who don't use as much or who are closer to the $200,000 cut off can easily donate, voluntarily, to individuals and families with higher medical costs.



Part 3) Cured! or How...Uh.....Goddamnit......

Ok so that's the basics of the plan so.... why do I think this will help. Heres a bunch of the more obvious stuff that I think is good about it.

  1. First off and most importantly you return the purchasing power back to the people and that's huge. They can demand lower prices and better quality and with them guarding the purse strings again they actually have the power to do that. When peopel spend their own money on themselves they put a high value on quality and price which leads to...
  2. The medical community has to go back to competing, they can't just over charge and give shitty service. They have to work to bring costs down, bring quality up, and as we saw with the example earlier ...by a fairly large amount to. You will see increased R&D (that's right minions, not just R...but the D as well awgoddamnitIfuckedthatup), new innovations, all kinds of stuff. I don't wanna be irresponsible and say we 100% will see a rise in sexy nurses (of both sexes) to draw in customers buuuuut..we will absolutely see more sexy nurses and really.....if you look in your heart...isn't that what America is all about? Sexy nurses treating bullet wounds.
  3. Hey, you know those giant private insurance companies? Their product just went from "if you don't buy it ..you will die!" to more of a supplemental product only for extreme cases where your Individual Medical Fund ain't enough. They have to go back to competing like mad because they don't have a strangle hold on the purse strings, which means more drops in prices and better customer service! Maybe like some more..uh.....sexy insurance salesmen?? hahaha NOPE!
  4. You know who else this is great for? Small businesses and workers, because now businesses can decide if they want to offer supplamental insurence to workers or maybe pay them a higher wage, or invest in more jobs, or RnD research, or hell maybe even bigger and better pension plans, a 35 hour work week, or drastically increased paid vacation time. And they have to spend less just on paperwork and governmental bullshit. More savings! BAM! BAM! BAM! What's that sound America? Just the sound of me increasing economic investment, private innovation, and organically raising wages across the fuckin' board, and also lowering the work week.
    Hell at worst, at absolute worst, we will see a marked rise in evil moustache twirling and comically large bags of money with dollar signs on them. Win fucking win brother!
  5. The plan disproportionately benefits families because the younger you get married the soon you can get a joint account and now you have a larger chunk of money to pull from if one of you gets sick or injured! And also ...regular sex! (Jesus that should really be enough on it's own don'tcha think?) And that's great news for the poor too! The Brookings Institue found that if you finish high school, get a full-time job, and wait until 21 to get married and then have kids your chance of rising above poverty levels is 98% and 75% will join the middle class. BAM! BAM! That's the sound of me drop kicking poverty and the rising rate of single parenthood right in the balls which disproportionately helps African Americans! Fuck Ya!
  6. Then you hit 60 and get to "cash out" 80% and depending on how much you spent through the years could be north of $400,000 for a single person or double that for a retiring couple. That's in addition to any savings, pensions, or other assets they have. AND you still get to collect your $6000 a year. BAM! That's the sound of near universal retirement at 60. For everyone. Even if you were homeless that whole damn time. AND I eased the burden on social security if not outright getting rid of the very need for it.
  7. The plan would be more than enough to fix the shocking damage done to my liver while writing this. Huzzah!


Here is some less obvious, but still fucking awesome, stuff for ya'll and I got good shit for everyone.

[Libertarians & Conservitives] This is a huuuuge shot in the arm for personal responsibility. By putting purchasing power back in the hands of individual and making them responsible for their own healthcare again they have a vested interested in lower prices and better quality, and healthy living. You smoke? You'll pay for it. Do you drink in excess? You'll pay for it. You have a bunch of stupid unprotected sex? You'll pay for it. You think ice cream is a pizza topping? pay for that to! We are chasing you down obesity and your not gonna get away this time cause well.....obviously. What's the top speed on one of those scooters anyway?
AND the doctors aren't beholden to government and corporations anymore for revenue so THEY have a vested interest in those things too. AND the near monopolistic control that insurance companies had over health care is shattered so now THEY have to compete with lower prices, better quality, and personalized health plans. AND AND AND the government is now 100% out of the insurance industry! AND I did all that by spending 2/3rds of what we already spend, I didn't raise taxes on the middle class or small businesses or even the top 1% at all! AND because costs will be dropping across the board in the market as much as half really quickly the cost of funding the program will actually DROP the longer it's in effect. That's the smell of responsable long term savings! Smells like.....cupons and grandmum.

[Liberals] The system doesn't give a fuck about your race, gender, sex, sexual orientation, religion or anything else its' 100% across the board equal. You can be a 56 year transexual who self-identifies as a fucking velociraptor and you will get the exact same amount of money as a cisgendered white male or whatever the fuck Dick Cheney is. Lucifer I assume. You don't have to go to anyone but your doctor for approval and the government doesn't enter your bedroom or your body one damn bit. The government gets no bill, you can get birth control or an abortion if that's what you need and no one has any place in that except you and your doctor. Private insurance companies lost 90% of their bargaining power and I gave it to individuals.

[Veterans] Veterans! You guys are giving everything you have to go to some of the shittiest shitholes in this planet to protect people you don't even know. You get $7000 a year for every year you are in active service. Also, you can "cash out" at 55. Oh, and cause I fucking love you guys if the worst should happen and you end up KIA your spouse gets all your Individual Healthcare Fund cash until she retires or remarries. Do you want more? 'cause I got more son! This shit ain't tied to your Military insurance or the VA so you can get treatment at any hospital you want and just swipey-swiping your IHF card and you don't have to deal with the VA at all if you don't want to. And if you leave the military you literally have to fill out zero paper work for any kinda change you can just go to a hospital the next day and get treatment as you please. But you get this fund on top of your insurance so you got double the coverage.
Hey, you got an old war buddy from Iraq whose living on the street, got no job, suffering from PTSD or has addiction problems? Well, this shit ain't tied to the military or employers so he still has the ability to get the treatment he needs. You and your lads can even use some of yours to help him if he needs more and you wanna. And if he gets better when he hits 55 he's probably got a tiny nest egg for retirement on top of any military pension or savings he might have.

[Everyone With a Goddamn Heart] Ya you read all that right this shit ain't tied to the employer or any company. Which means we just made basic access to medical care a human right that even the homeless have, and they can probably still retire at 60. As a homeless person. And we did it for less than we already spend today, 1/3rd less in fact.

[Environmentalists] The plan doesn't require me to kill any baby seals! I mean.. I might anyway casue I don't fucking trust the little greyish (seals are grey right? OMG how do I not know this? Oh GOD I ONLY SEE THEM WHEN THEIR REEEEEEEED *sobs*) bastards and I think they are up to something. The south pole is sending canada seals and they are criminals, they are rapists. Some, I assume, are good seals though. But we need to deal with the baby seal threat immediatly!
I KNOW! WE SHOULD BUILD A FUCKIN WA-


Part 4) Epilogue! or TLDR Which Lets Be Honest is Like 90% You.


So basically it's this if I had to boil it down to the talking points.....I decided to fix your health care America and I accidentally fixed the rest of your country while I was doing it. I did it for less money than it costs now, and I did it by giving Democrats what they want and giving Republicans what they want and I did it all while DRUNK. GET YOUR SHIT TOGETHER AMERICA! FOR FUCK SAKE HOW GODDAMN HARD IS IT TO JUST NOT DIE ALL THE DAMN TI-
[Image: source.jpg]

So aaaaaaaaaanyway I guess all that's left after this masterpiece that is in no way long winded or ranty is to ask two final questions.
When is my coronation as your new God-Emperor of Ameriakind?
and
Is this the best idea you ever heard oooooooor are you just a racist xenophobe who believes that a Thinkology degree is bullshit just cause I got it in Canada.

And it's my damn thread so those are the only two options!

(this was a work of semi-serious thought, late night whiskey consumption, insomnia, and COMEDY!!!! It's serious fucking businesses you guys......until it's not Tongue )

When valour preys on reason, it eats the sword it fights with.
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28-07-2017, 08:35 AM
RE: WhiskeyDebates Saves American Healthcare (You're Welcome)
(28-07-2017 08:15 AM)WhiskeyDebates Wrote:  4.) Ha! Nice try Aliza/Bucky/DLJ/Myself I'm not stupid enough to put my cell number out there on the internet for everyone to see. Ya gotta PM me for that.

Wait, what? Why am I being named here? Have I published my cell phone number on the internet?! Shocking

Paranoid!
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28-07-2017, 08:38 AM
RE: WhiskeyDebates Saves American Healthcare (You're Welcome)
(28-07-2017 08:35 AM)Aliza Wrote:  
(28-07-2017 08:15 AM)WhiskeyDebates Wrote:  4.) Ha! Nice try Aliza/Bucky/DLJ/Myself I'm not stupid enough to put my cell number out there on the internet for everyone to see. Ya gotta PM me for that.

Wait, what? Why am I being named here? Have I published my cell phone number on the internet?! Shocking

Paranoid!
Haha, I guess that joke was a bit too much of an over reach Big Grin

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28-07-2017, 02:22 PM (This post was last modified: 28-07-2017 03:03 PM by epronovost.)
RE: WhiskeyDebates Saves American Healthcare (You're Welcome)
@Whiskey Debate

Actually, it's a very bad plan (that has been attempted in the past on a lower scale with extremely poor results). Giving the same set amount of money to all people is very wastefull. Some people won't touch that money at all for extended period of time if even at all. Some will only use a part of it. Thus, it's sending money were there is no need. On the other side of the spectrum, some people will have issues and won't have enough money and won't be able to afford payment, others will have no issue at the moment but will have used a significant portion of their health insurrence money for a member of their family who was ill and thus have less resources when they will start to have health issues. In no way does it stimulate doctors not to over prescribe or over diagnose. Doctors need to be trusted for the medical system to work. If they tell you should take those drugs and those tests over 75% of the population will want to take them with no question asked, because that's how authority work. Thus, they will do what they judge is right in terms of how much or what to prescribe. If you want a good plan that works on a large scale, NEVER, EVER COUNT ON PEOPLE TO HAVE FORESIGHT, TEMPERANCE AND INTELLIGENCE. The best of us struggle to master those skills in a systematic fashion and 30% of humanity is basically made of assholes and/or idiots. Unfortunately, those assholes and those idiots are a fundamental part of society and all of us depend on their, health, education, skills and happiness.

PS: It was really fun to read BTW.

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28-07-2017, 04:04 PM
RE: WhiskeyDebates Saves American Healthcare (You're Welcome)
(28-07-2017 02:22 PM)epronovost Wrote:  Actually, it's a very bad plan (that has been attempted in the past on a lower scale with extremely poor results).
I don't have on hand any examples of a government funded health care plan that works anything like what I have proposed. It's almost invariably government over reaching into the market and trying to act like a business without any of the market checks that keep a more private industry in line.

(28-07-2017 02:22 PM)epronovost Wrote:  Giving the same set amount of money to all people is very wastefull.
Well, I'm more "libertarian" on my economic views so I'd argue that any government program is inherently waste full but I'll put that aside for now. The question I'm asking is which is more likely to be more wasteful? A system where we spend 3.2 trillion annually with rising prices and massively incomplete coverage where no one has a vested interest in lowering prices and improving efficiency or one where we spend as much as a 1/3 less, lower prices in the program and the market, with universal coverage that's not tied to a corporation or a job, where everyone involved has a vested financial interest in lowering costs and increasing efficiency?

That's not even taking into account the amount of money small business saves, how much we save by reducing costs at the VA, the nearly trillion dollars we can save annually by organically reducing Social Security costs, how much less of their income they have to spend on basic health care and the benefits as I see them go on and on.

(28-07-2017 02:22 PM)epronovost Wrote:  Some people won't touch that money at all for extended period of time if even at all. Some will only use a part of it. Thus, it's sending money were there is no need.
Right but if they don't touch it they can use it at retirement, help other people, do all kinds of good shit that all results in us spending less than we do now to cover more people with better quality care.
I think the people can make better use of their own tax money than sending it to massively "too big to fail" insurance companies that are government subsidised.

(28-07-2017 02:22 PM)epronovost Wrote:  On the other side of the spectrum, some people will have issues and won't have enough money and won't be able to afford payment, others will have no issue at the moment but will have used a significant portion of their health insurrence money for a member of their family who.
Do you think that is more or less likely to happen in a system where you can still get private insurance, only it costs as much as 2/3rds cheaper than it did before, and it's supplemental in nature?

(28-07-2017 02:22 PM)epronovost Wrote:  In no way does it stimulate doctors not to over prescribe or over diagnose.
...yes it does, that's basic economic theory. If the person footing the bill doesn't care how much it costs you are always going to charge that person more than someone who does. That's why prices in the tech market keep falling, cause the people don't have an unlimited amount of money to spend on the new iPhone.

(28-07-2017 02:22 PM)epronovost Wrote:  Doctors need to be trusted for the medical system to work. If they tell you should take those drugs and those tests over 75% of the population will want to take them with no question asked, because that's how authority work. Thus, they will do what they judge is right in terms of how much or what to prescribe.
If you continuously overcharge your customers for services they don't need you will lose customers. And we already see this in medicine, the link I included in my OP showed that by simply pulling government and private insurance out of the equation you reduce medical costs by as much at 50% or higher. And that's in an industry in which the government subsidises and forces people to buy the competition's product.

(28-07-2017 02:22 PM)epronovost Wrote:  If you want a good plan that works on a large scale, NEVER, EVER COUNT ON PEOPLE TO HAVE FORESIGHT, TEMPERANCE AND INTELLIGENCE. The best of us struggle to master those skills in a systematic fashion and 30% of humanity is basically made of assholes and/or idiots. Unfortunately, those assholes and those idiots are a fundamental part of society and all of us depend on their, health, education, skills and happiness.
Even if I agree to that....that current system has those same people (government has the highest concentration of asshole there is) taking other peoples money and giving it to other people (corporations which have the second highest concentration of asshole) and hoping they spend it wisely despite no one making an attempt to do so because they don't have too.

The current system counts on people to have foresight, temperance, and intelligence only it's relying on the very people that don't have to exercise those virtues at all (government/corporations/doctors) because they don't have any reason to do so. Some of them have active reasons not to.

(28-07-2017 02:22 PM)epronovost Wrote:  PS: It was really fun to read BTW.
Oh thank goodness haha, I was so buzzed and sleepy when I wrote that I was worried it would be the Amy Schumer of comedy. Just criminally not funny. I just enjoy having conversations about ideas, especially when the current ones don't work and what everyone else is rallying for is just more of the same.

Hell I'm Canadian this shit wouldn't help me a bit even if it worked so it's not like I got a vested interest in it haha

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28-07-2017, 04:43 PM
RE: WhiskeyDebates Saves American Healthcare (You're Welcome)
(28-07-2017 04:04 PM)WhiskeyDebates Wrote:  ...yes it does, that's basic economic theory. If the person footing the bill doesn't care how much it costs you are always going to charge that person more than someone who does. That's why prices in the tech market keep falling, cause the people don't have an unlimited amount of money to spend on the new iPhone.

I won't reply to all your comment, but here is a nut of common sense for you. When Steve Job told you, you need to pay me $800 to have this brand new phone, It's very easy to say ''fuck that shit, I'll keep the old cheap one''. That's called ''price flexibility'' some product have a large price flexibility because people can afford to wait and shop around that specific produt. Thus, competition brings the price down for them. Essential products like basic food, gas or healthcare are ''products'' that, no matter the price, you will have to buy and quickly. Competition has very little impact on those because you don't have time to shop for them and those who are offering it can overcharge a lot if they want you will still buy it anyway (that's why governemental regulation on those product is almost systematic). If one offers a to small prices he might be incapable of responding to the demand and develop different problem. In resumé, heathcare isn't a product, it's a vital need.

PS: I am Canadian too and I personnaly think the German Healthcare system has proven to be the most efficient in terms of coverage and cost.

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28-07-2017, 06:16 PM
RE: WhiskeyDebates Saves American Healthcare (You're Welcome)
(28-07-2017 04:43 PM)epronovost Wrote:  I won't reply to all your comment, but here is a nut of common sense for you.
Thanks, but.. I've already provided an example where with no substantive change other than just getting rid of government and private insurance and having people pay out of pocket can cut costs in half or more and again that's in a market where the competition is subsidized by the government and people are "forced" to buy their product

I get where you are coming from but your assertions are just not backed up by the available evidence as far as I can tell. Every medical practitioner who has adopted this policy of not bothering with insurance companies have seen a drop in prices from what the insurance companies charge, and their ability to care for patients go up. I can't find any examples of prices going up at all let alone drastically or even staying the same, and it's the same in other countries where doctors have done the same. It's why some projections have as much as 25% of doctors going over to this system by 2020. It's demonstrably better for care givers and patients.

It's a difference of a cholesterol test being $3 instead of $90, an MRI costing $400, instead of $2,000+ and so on.

(28-07-2017 04:43 PM)epronovost Wrote:  In resumé, heathcare isn't a product, it's a vital need.
That is nonsensical. Medical care provided by a relevant medical professional falls under "goods and services". There's no point where the demand for something, how vital the need is, magically makes a good or service, not a good or service. Just cause there is a vital need for something does not make that something not what it is.

(28-07-2017 04:43 PM)epronovost Wrote:  PS: I am Canadian too and I personnaly think the German Healthcare system has proven to be the most efficient in terms of coverage and cost.
Keeping Germany healthy is chronically expensive: this country has the fourth highest health expenses in the world and the compulsory individual fees, be they state or private, carry on rising faster than inflation.

The average state health insurance contribution is €500 a month, which is split between employee and employer – while the self-employed pay everything themselves, unless they’re lucky enough to be in the Künstlersozialkasse for freelancers in creative professions But both state and private health insurance companies have increased their premiums in recent months as rising unemployment has put more pressure on the welfare state.

Yet however much the contributions grow, they never seem to be enough for Germany’s ravenous healthcare system. It demands vast sacrifices, and in the past few years, the government has been forced to inject more and more tax money into the system: from 2008 to 2009, its contribution to the newly devised Gesundheitsfond (“health fund”) – a centralized pot into which everyone’s healthcare contributions are paid – doubled from €1.5 billion a year to €3 billion. The idea that healthcare should be at least partially funded by tax money is a central plank of more left-minded policy – the notion that everyone contributes and everyone gets basic healthcare, and that competitive capitalist model isn’t necessarily the most effective way to keep people alive.


As far as costs, it's the 4th most expensive in the world, and they doubled over the course of a single year.That kind of cost inflation will destroy them in the long run. In America, a knee replacement can cost as much as $60,000+, in Germany it can cost as much as $30,000 for JUST the surgery. That clinic I mentioned in my OP? $19,000 and that's for the surgery, medication, physical therapy, and even the airfare out to the clinic, with any complications being covered free of charge by the clinic. Hell, the guy in the article had a physical therapist and nurse show up to his hotel room for extended treatment and they didn't tack a dime onto his bill.

It's night and day.

I'm really enjoying our conversation epronovost, thanks for takign to time to read all my nonsense ahahThumbsup

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28-07-2017, 07:21 PM (This post was last modified: 28-07-2017 08:03 PM by epronovost.)
RE: WhiskeyDebates Saves American Healthcare (You're Welcome)
(28-07-2017 06:16 PM)WhiskeyDebates Wrote:  That is nonsensical. Medical care provided by a relevant medical professional falls under "goods and services". There's no point where the demand for something, how vital the need is, magically makes a good or service, not a good or service. Just cause there is a vital need for something does not make that something not what it is.

All ''Goods and Services'' aren't equal. Education is a service. It's a service in the sense that its somthing you obtain from other people. It's the same thing for healthcare. The only problem with those two and cable TV, is that if you don't have the two first, you are as good as dead. If you don't have the third one, you are mildly bored. No matter what happen, people will be sick, old or injured and will need treatment. Urgency and inhability to decline a service reduce the efficency of competition to reduce cost.

As population age, life expectansy rises, treatment become more complex, cost of healthcare rise inevitably. Your $6000 dollar might need to be transformed in $12000 a few decades as some treatment change, new tools are develpped or as people live older. That's the bane of all healthcare system. Bad living condition like eating cheap food, lack of physical exercise, high stress, long working hours, poluted environment, etc. also have a negative impact on health and they are very common. If life expectancy rise to 90 years old, you can expect cost to climb radically as the older you are the more healthcare you need to maintain a good living condition if not life itself.

In the end, to finance your system, one would need to spend at least 1.8 trillion dollars in the US and that's just for the $6000 per person per year (notice that this amount is extremely small if you have serious health problem). That's twice less than what is spend so far in the US in terms of healthcare, but its ignoring a lot of important details. It doesn't cover the cost of the infrastructures, the equipment, the pay of the personnel, the research and development in the domain of the treatment of disease and drug production. In the end, you end in a very similar situation than any country with a single payer healthcare system except with a few new weakness like relying on charity (a very bad system) to redistribute money.

There is no perfect system in healthcare, but to be considered good, this system should be available to all no matter their personnal fortune or health condition and provide them with the services they need. How to manage the cost seems to be the biggest issue and the only solution I can see to provide what we need is to pool the financial resources of the entire population to provide for the cost (AKA a form of taxation handled by a governement). How to keep the cost low? Provide a good environment for the population to live in, invest in prevention and education about healthcare, count on ethical behavior amongst the healthcare personel, make healthcare an essential spending, not a business in which you can and should make heavy profit.

PS: It is also possible that more Gal Gadot is good for your health, but I am not entirely sure about it.

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28-07-2017, 09:34 PM
RE: WhiskeyDebates Saves American Healthcare (You're Welcome)
Since I was named, I probably ought to reply.

btw, we already gained access to all your personal information when you signed up. But don't worry about that.

(28-07-2017 04:04 PM)WhiskeyDebates Wrote:  ...
I don't have on hand any examples of a government funded health care plan that works anything like what I have proposed. It's almost invariably government over reaching into the market and trying to act like a business without any of the market checks that keep a more private industry in line.
...

As I don't drink Whiskey (or whisky) I can't enter the Debates but the Singapore system has similarities to your proposal; in particular the savings part, which is called CPF - although there is more government involvement than your plan.

Singapore and Hong Kong have been vying for top spot on Bloomberg's rankings (based on efficiency metrics) since the ranking system started.

Here's the SG system and here's the HK system for comparison.

Both have a combination of public and private. I know less about HK's system but I did have emergency dental treatment there and can tell you that the dentist was as cute as GG (but shorter) which makes the experience almost worth it.

Despite having lived in SG for 7 years I never used the healthcare system so I have no first-hand anecdotes but it comes up in training courses a lot as an example of best practice service management. So I can say that as far as second-hand anecdotes go, I've never heard anything but praise.

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28-07-2017, 11:48 PM
RE: WhiskeyDebates Saves American Healthcare (You're Welcome)
(28-07-2017 07:21 PM)epronovost Wrote:  All ''Goods and Services'' aren't equal.
I didn't say that they were and neither did you. You argued that health care is not a product because there is a large and urgent demand for it and as I said before that's nonsensical.

(28-07-2017 07:21 PM)epronovost Wrote:  Education is a service. It's a service in the sense that its somthing you obtain from other people. It's the same thing for healthcare.
Yes, I go to an educational establishment and I give them money and in exchange, they provide me with a commiserate education. I don't mean to sound snarky here so forgive me if it comes off that way but ...ya education is a service in the senses that that is literally what it is and what service means. Just because they have a really really high demand doesn't mean economic theory and the market stops treating them like a service.


(28-07-2017 07:21 PM)epronovost Wrote:  The only problem with those two and cable TV, is that if you don't have the two first, you are as good as dead. If you don't have the third one, you are mildly bored. No matter what happen, people will be sick, old or injured and will need treatment. Urgency and inhability to decline a service reduce the efficency of competition to reduce cost.
Ok let's say I grant you that that's true for the sake of argument is that force which is acting to keep prices from going down enough to counter act all the other forces working to push down prices. The answer is no, demonstrably no, and I've provided a half dozen examples to support that position.

I don't mean to keep coming back to my original example but that clinic in my OP that story was from 2015 and there were 13 other out of pocket medical facilities in just that one city. The number of cash only doctors have more than doubled since 2015 and is expected to be a full 25% of all doctors by 2020 so the idea that I can't take a bus ride across town to a different doctor if one is over charging me is just kinda silly.

We seem to be confusing the forest for the trees. People need health care or they could die but they don't NEED health care from that specific doctor. If all treatment being equal (it's not) and a bus ride away is a guy who will do it for half of my current physician I can absolutely refuse or decline service for anything other the most sudden and severe of injuries.

(28-07-2017 07:21 PM)epronovost Wrote:  Your $6000 dollar might need to be transformed in $12000 a few decades as some treatment change, new tools are developed or as people live older.
I specifically mentioned in my OP how that's not the case and that we would probably be able to lower the payment if we wanted to. My program has multiple systems working against those factors that you list, some obvious and some not so much.
Taking the purchasing power away from insurance and giving it back to the people has been demonstrably shown to me to lower costs by as much as 2/3rds in some cases. The flexibility with business owners to give supplemental health care (instead of full coverage) or increased wages. You can still get supplemental health care from a private insurer if you need it but it's supplemental so it has to cover less and is thus cheaper. There are more I listed in my OP and they all compound on each other but the single biggest one is the fact that it's a "savings account" instead of reactionary spending and interest plays a huge role.

Keeping the math simple: $6000 a year every year, 3% the whole time and no expenditure of your fund. By the time you are 40 the government will have given you $144,000. However, because of the interest, you actually have $225,000. That's on top of lower prices for medical care, the access to cheaper and better quality private healthcare, and a lot of other stuff.

(28-07-2017 07:21 PM)epronovost Wrote:  That's the bane of all healthcare system.
Sure but again it's about competing factors and I don't see it winning out over the multiple overlapping forces pushing down costs. Modern healthcare systems have this bane cause the way they are designed either suppresses or out right undermines/eliminates these countervailing forces.

(28-07-2017 07:21 PM)epronovost Wrote:  Bad living condition like eating cheap food, lack of physical exercise, high stress, long working hours, poluted environment, etc. also have a negative impact on health and they are very common.
That's covered in the Op so I won't go into detail again.

(28-07-2017 07:21 PM)epronovost Wrote:  If life expectancy rise to 90 years old, you can expect cost to climb radically as the older you are the more healthcare you need to maintain a good living condition if not life itself.
Right, but which system is more likely to climb more? The system that has NO actually incentives or mechanics in place to push down costs or the one that has multiple forces working against that rise in costs.

(28-07-2017 07:21 PM)epronovost Wrote:  In the end, to finance your system, one would need to spend at least 1.8 trillion dollars in the US and that's just for the $6000 per person per year (notice that this amount is extremely small if you have serious health problem).
It's extremely small compared to the artificially inflated prices we have now which are in some cases 2-4 times what they are in comparable industrialized countries, but ONLY in those areas, the government is involved. In areas that they are not the price is below the global average, significantly lower. The program actively fights those high prices on multiple fronts. Which is why we wouldn't have to keep spending that much per year if we don't want to.

(28-07-2017 07:21 PM)epronovost Wrote:  It doesn't cover the cost of the infrastructures, the equipment, the pay of the personnel, the research and development in the domain of the treatment of disease and drug production.
It does actually indirectly for the most part, though in the OP directly a few times in places as well. A large amount of expenditure in Medicare and Medicaid is administrative and bureaucracy, all of which is gone in this program as just one example. The program is dramatically less expanse the the system we haev now and creates a dramaticaly less expensive industry even in the private sector, which again I've demonstated a few times now.


(28-07-2017 07:21 PM)epronovost Wrote:  In the end, you end in a very similar situation than any country with a single payer healthcare system
I haven't seen a single demonstration of this assertion at all and I've shown multiple examples of the exact opposite in markets where insurance just disappears.

(28-07-2017 07:21 PM)epronovost Wrote:  except with a few new weakness like relying on charity (a very bad system) to redistribute money.
It does not rely on charity for anything least of all the redistribution of wealth. The "redistribution of wealth" by government happens with the payments are made, if other people want to give if they have more to those that need it they can do so of their own volition and with no need to use force. Voluntary charity is a vastly more ethical way to do that than the alternative, but it's not something the program relies on to function.

(28-07-2017 07:21 PM)epronovost Wrote:  There is no perfect system in healthcare, but to be considered good, this system should be available to all no matter their personnal fortune or health condition and provide them with the services they need.
This program does that better than what we have now by a country mile, and that's demonstrable. It has universal coverage for everyone below a specific income, is not tied to employers or a government run insurance company.

(28-07-2017 07:21 PM)epronovost Wrote:  How to manage the cost seems to be the biggest issue and the only solution I can see to provide what we need is to pool the financial resources of the entire population to provide for the cost (AKA a form of taxation handled by a governement).
I'm really confused now cause that is literally how the program works hahaTongue, only individuals manage their health care spending and not 92 billion layers of governmental bureaucracy and miss management.

I might not have explained it well in my OP. I'm not arguing that we destroy Medicaid and Medicare and just hope the market fixes the problem on its own. We are still doing exactly what you said, using tax revenue to provide for the costs we are just changing when the money is given out so we create a system that fosters better care and lower costs instead of what we have now where we wait till you get deathly ill and THEN we give the money to the corporations/medical community creating a system where now one works to improve quality or cost.

It's really just a shift of priorities and who has control over your health.

(28-07-2017 07:21 PM)epronovost Wrote:  How to keep the cost low? Provide a good environment for the population to live in, invest in prevention and education about healthcare, count on ethical behavior amongst the healthcare personel...

uhhhh...

Quote:"If you want a good plan that works on a large scale, NEVER, EVER COUNT ON PEOPLE TO HAVE FORESIGHT, TEMPERANCE AND INTELLIGENCE. The best of us struggle to master those skills in a systematic fashion and 30% of humanity is basically made of assholes and/or idiots."

TongueTongueBig Grin


(28-07-2017 07:21 PM)epronovost Wrote:  make healthcare an essential spending, not a business in which you can and should make heavy profit.
I want the health care to have profits, if it's not making a profit it's got no money to innovate and improve. If you can't make a profit in an industry no one goes into that industry. It's one of the reasons our country had such a large brain drain of medical personnel in the late '90s.

(28-07-2017 07:21 PM)epronovost Wrote:  PS: It is also possible that more Gal Gadot is good for your health, but I am not entirely sure about it.
HOW CAN YOU NOT BE SURE?!
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