WhiskeyDebates Saves American Healthcare (You're Welcome)
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29-07-2017, 12:04 AM
RE: WhiskeyDebates Saves American Healthcare (You're Welcome)
(28-07-2017 09:34 PM)DLJ Wrote:  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.

Thumbsup

Absolutely! I've studied the HK (lived there for a bit back in '05 or '06 I don't remember haha) and the Singapore model for years. It's really interesting stuff, and I think one of THE greatest success stories of the last 20 years for freer markets. I know correlation is not causation but when you look at healthcare costs around the globe the more hands off the government is with the market the faster the standard of living seems and other positive economic markers seem to rise.

The Scandinavian model is REALLY interesting too as despite what most people think it has one of the freest markets in the world. High social programs and taxation aye but the market is faaaaaaaaar less restrained than the US.

Some good reading here if you're interested.

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29-07-2017, 04:05 AM
RE: WhiskeyDebates Saves American Healthcare (You're Welcome)
Even if I agreed with nothing in the OP (and that's far from the truth), he'd still get a thumbs up for taking the damn time and effort to properly format shit for readability!

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29-07-2017, 04:14 AM
RE: WhiskeyDebates Saves American Healthcare (You're Welcome)
(28-07-2017 06:16 PM)WhiskeyDebates Wrote:  The average state health insurance contribution is €500 a month, which is split between employee and employer
For the record: If you are on compulsory healthcare (GKV Gesetzliche Krankenversicherung) you, your wife and kids are covered by those 500€, of which you, the employee pays 250€.
The maximum (2015) is: 750€, split in half, until you make 65.000€ a year (750 being 15% of 5000 per month and we get 13 salaries/year).
As a general rule/ rule of thumb: PKV (Private Krankenversicherung) has similar cost, but only covers the employee. You have to pay hefty extras to cover your family. Yet, the coverage is much, much better and wider than GKV.


(28-07-2017 06:16 PM)WhiskeyDebates Wrote:  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 article is somewhat old, written in 2010. Things have changed a bit since then.
The amount of taxes that have to be added increased from 3bio annually to >10bio actually (red and grey bars), yet with a downward trend recently.

(28-07-2017 06:16 PM)WhiskeyDebates Wrote:  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.
Merkel, a conservative is chancellor since 2005.

(28-07-2017 06:16 PM)WhiskeyDebates Wrote:  and the compulsory individual fees, be they state or private, carry on rising faster than inflation
I dont see this to be true. The fee of the compulsory insurance is a fixed % of your income (see graph). With your salary increasing to make up for inflation, they increased too. I cant see how they raise faster than inflation other than the % being increased. I am on private insurance (PKV, which works a bit different) and just went through my files: from 2010-2017 my salary/healthcare ratio is constant.

[Image: DWO-EGK-2-jpg.jpg]

Quote: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.
Since 2010 unemployment in Germany went down from 7% to 4%, lowering pressure accordingly (as you can see in the graph. Fewer tax € had to be injected).
In 2010 the fee for compulsory insurance was actually lower (14,9%) than in 2009, then raised again to 15,5% and remained constant.
My (private) insurance was raised 10% during 2010.


Gesundheitsfond:
The fonds in general is nothing special to Germany. Most countries with socialized healthcare have such a fond. The article also somewhat suggests the fond is new in Germany, but it was *only* overhauled in 2010.

The fond is supposed to have, by law, a liquidity reserve of 20% of its monthly income (18,3bio). This is to be able to cover short term fluctuations in expenses of the fond. Until 2017 it has accumulated 10bio which is in excess of 50% of its monthly income. This showed a loophole in the law, not setting up an upper threshold for reserves. Interestingly the governemnt is injecting billions of tax euros, while the fond has reserves of 10bio. I guess/hope this is going to be dealt with soon.

Fun fact:
In November 2016 a law was pased that 1,5bio should be taken from those reserves (10bio, 4bio required by law) to cover refugees/asylum seekers. I dont think this supports the notion of Germany being overly burdened with "tidal wave of muslims", at least not in terms of providing healthcare.

Quote: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.
I am not sure what the author of the original article is referring to, but here is my take on it:
Like all doomsday predictions this hasnt come true yet, 7 years after the article was written. The german healthcare system is in its death throes for over a lifetime now, according to some people. While it clearly has its flaws, and is becoming more expensive every year (what is not?), it, kind of, seems to work, so far, somehow.

Graph shows annual expenses as bars (part paid by tax in red again, like in previous graph). Frankly, i dont see a doubling in cost/expenses.
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29-07-2017, 09:41 AM (This post was last modified: 29-07-2017 09:55 AM by epronovost.)
RE: WhiskeyDebates Saves American Healthcare (You're Welcome)
(28-07-2017 11:48 PM)WhiskeyDebates Wrote:  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.

No, I argued that healthcare was a need and that has a product it had very little flexibility.

(28-07-2017 11:48 PM)WhiskeyDebates Wrote:  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.

On that we agree, I simply consider that the market in general is a form of extortion designed to protect the interest of a gentry when it comes to essential services.

(28-07-2017 11:48 PM)WhiskeyDebates Wrote:  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.

The problem with you ''cash only doctor'' is that they don't treat emergency. If I have a heart attack, someone will call the emergency and will drive me to the closest hospital to be treated, not the best, not the cheapest, not the one where I usually go. I have no chance to say no or to negotiate. I will be brought to one hospital and they will charge me whatever they want since I am in no position to refuse. ''Cash only doctors'' and standard model of competition are only useful in bringing the cost down for familly medecine, prevention and readaptation. Things that you can afford to wait and have time before you.

The big problem is that people who need the most healthcare have very little mobility and energy to cross town to receive care. There is also the problem of people living in small town or in very rural areas where competition will be next to null since there is not enough doctors and specialist to do the job. ''Cash only doctors'' are a nice experiment since they cut private insurrence thus circumvent the cost associated with dealing with their bureaucracy and their profit driven model, but they have severe limitations. Plus, I would argue that if you are reasonnably ill, you will not be in the best mood to move around town, searching for the cheapest treatment for your fever. If you need surgery for a chronic pain, vaccination or a family doctor, then competition become usefull since these form of treatment are those who are the most flexible.

(28-07-2017 11:48 PM)WhiskeyDebates Wrote:  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.

Keeping the math simple by the time I am 40, I would have enough money to afford payment for one year of treatment for cancer and a broken bone (if we adjust for lower prices). That's not that bad, much better than I thought in the first place. But, that's not that great. If I happpen to get AID, this money will never be enough. If get cancer young, I am fucked. If I happen to get it twice or even thrice (which isn't that rare), I am also fucked. The money you offer is good, but its not enough to cover the 10% who will be unlucky when it comes to health. There is probably ways to reduce those costs by reducing hospitalisation for example, but still we would be running a very tight show.

(28-07-2017 11:48 PM)WhiskeyDebates Wrote:  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.

Actually, yes, your program requires an extansive bureaucracy to collect the money for the $6000 per year and distribute it. Make regular census of said citizen to make sure everybody has that money and than, if you deposite it in a bank or something similar, that money won't stay iddle. It will gain interests by being invested like in any other funds which means there will be a bureaucracy to manage those trillion of dollars worth of money. You would probably also need an emergency fund in case the market tanks and people loose their savings like in 2007-2008. It's probably going to be much lighter than the Medicare and Medicaid probram since this is the worst system in a first world country, but still, it's not without cost and without bureaucracy.

(28-07-2017 11:48 PM)WhiskeyDebates Wrote:  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.

Well yeah, it relies on charitable donation to treat people who don't have a lot of money in the bank like very sick children, elderly people with important chronic illness, people with very bad health and living habits, etc. Voluntary charity might be more ethical, but it's not very efficient. Since its inssurance money that can also double as retirement money, people would be ill advised to depart from it. There is strong incentive not to give away money from those funds.

(28-07-2017 11:48 PM)WhiskeyDebates Wrote:  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.

I completly agree with the premise and the intention, I simply don't think the result will be as fantastic as what you claim they will be. Marginally better, probably, much better, I don't think so.

(28-07-2017 11:48 PM)WhiskeyDebates Wrote:  
(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

That betrays my vision of humanity and any system of governance. The best we can produce is flawed from the start. Thus miracle solutions don't exist. Which doesn't mean we shouldn't struggle for them anyway.

(28-07-2017 11:48 PM)WhiskeyDebates Wrote:  HOW CAN YOU NOT BE SURE?!
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I just needed a larger sample to make sure there is no bias in my highly scientific process to assess if she was gorgeous or not. Turns out she is! But now I must submit it to peer review, which I will conduct myself! That's how creationist do it, thus it must be good. I will report those results soon!

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04-08-2017, 01:26 AM
RE: WhiskeyDebates Saves American Healthcare (You're Welcome)
Shit, sorry epronovost got busy then got distracted.
[Image: 211dfa164e6e307761399522bbcbec0ced6f5816_hq.gif]

(29-07-2017 09:41 AM)epronovost Wrote:  No, I argued that healthcare was a need and that has a product it had very little flexibility.
Not to split hairs but...

"In resumé, heathcare isn't a product, it's a vital need."

...ya you did. Still, I take your meaning now having gone back and re-read, and can chock it up as a miss understnading on my part so no worries mate.

(29-07-2017 09:41 AM)epronovost Wrote:  On that we agree, I simply consider that the market in general is a form of extortion designed to protect the interest of a gentry when it comes to essential services.

I ......want to respond to this but i'm not sure how as it really doesn't make any sense to me, no offence. I'm afraid I must ask for you to expand upon this, as any attempt by me to respond atm would have me guessing and I'd rather avoid that if I can.

(29-07-2017 09:41 AM)epronovost Wrote:  The problem with you ''cash only doctor'' is that they don't treat emergency.
They can and they do, there are several urgent care centres in the US that don't take insurence. Not only that but I have to ask how do you think an emergency visit went before 1965 before the government got involved in medical insurance?

Just because it's a cash business doesn't mean the whole bill has to be paid up front and all at once.


(29-07-2017 09:41 AM)epronovost Wrote:  ''Cash only doctors'' and standard model of competition are only useful in bringing the cost down for familly medecine, prevention and readaptation.
This assertion does not match trends current, historical, or globally. Again if that was the case we should be able to see that in American Healthcare prior to the governments involvement and we don't, prices were rising at about the rate we would expect with the tech trends and inflation at the time, with costs and expenditures only really taking off after the government got involved.

America is spending 17.1% of its GDP on health care, radically more than most of the rest of the world, so much so that by some accounts it's as much as the next 10 countries combined and is ranked 50th out of 55 on the Bloomberg Health-Care Efficiency Index.

Singapore, the closest nation to my idea, spends 4.6% of its GDP, is ranked #1 in the world on the same index, and that 4.6% has been consistent since their Independence and that's super important. Important because they got independence in 1965, the same year Medicaid was introduced in the US. In the exact same span of time, 1965-2015 Singapore's stayed consistently at the same % and in America, it more than tripled (and still rising), with Singapore being the best system of healthcare in the world and America being nowhere near the top 30.

What you are claiming is not borne out in reality, it's just not. It's the same story in Hong Kong and every other country and community with a similar model.


(29-07-2017 09:41 AM)epronovost Wrote:  Keeping the math simple by the time I am 40, I would have enough money to afford payment for one year of treatment for cancer and a broken bone (if we adjust for lower prices). That's not that bad, much better than I thought in the first place. But, that's not that great. If I happpen to get AID, this money will never be enough. If get cancer young, I am fucked. If I happen to get it twice or even thrice (which isn't that rare), I am also fucked. The money you offer is good, but its not enough to cover the 10% who will be unlucky when it comes to health.
BASIC universal health care is what the system is, you're bringing up cases that are not meant to be handled by a basic system. A basic program is not ment to cover 100% of all costs anyone could possible have. If you are in that 10% you get private insurance to supplement that fund and cover extra costs, insurance that would be MUCH cheaper and spent on services that would be much cheaper under this system.

(29-07-2017 09:41 AM)epronovost Wrote:  There is probably ways to reduce those costs by reducing hospitalisation for example, but still we would be running a very tight show.
I hate to keep harping on about it but no that is not correct. The #1 healthcare system in the world spends less than 1/3rd of America per capita. $2752 to be exact, almost half of what I'm suggesting.

Depending on a lot of variables an MRI in Singapore can cost as much as 1/6th the cost in the US for example.

(29-07-2017 09:41 AM)epronovost Wrote:  Actually, yes, your program requires an extansive bureaucracy to collect the money for the $6000 per year and distribute it.
All of which is already in place, I'm talking about eliminating the bureaucracy that comes specifically from Medicare and Medicaid and its support structures. Compliance costs with these programs are a huge source of wasted money and inefficiency.

(29-07-2017 09:41 AM)epronovost Wrote:  It's probably going to be much lighter than the Medicare and Medicaid probram since this is the worst system in a first world country, but still, it's not without cost and without bureaucracy.
At no point did I say it was.

(29-07-2017 09:41 AM)epronovost Wrote:  Well yeah, it relies on charitable donation to treat people who don't have a lot of money in the bank like very sick children, elderly people with important chronic illness, people with very bad health and living habits, etc.
No, it does NOT "rely" on charity. Those things you list are the realm of private insurance. Pointing out that the system allows for charitable donations does NOT mean the system relies on it.

(29-07-2017 09:41 AM)epronovost Wrote:  Voluntary charity might be more ethical, but it's not very efficient.
Actually, it's far MORE effeicent than the alternative.



(29-07-2017 09:41 AM)epronovost Wrote:  I completly agree with the premise and the intention, I simply don't think the result will be as fantastic as what you claim they will be. Marginally better, probably, much better, I don't think so.
Ok well, the data I've presented says otherwise. The examples I have given say otherwise. Singapore and Hong Kong have health systems similar to mine and they do BETTER than my projections. A LOT better.

I'm 100% open to any actual data you might have that contradicts or counter acts mien because seriously I freaking love learning more about economics.

(29-07-2017 09:41 AM)epronovost Wrote:  That betrays my vision of humanity and any system of governance. The best we can produce is flawed from the start. Thus miracle solutions don't exist. Which doesn't mean we shouldn't struggle for them anyway.
The point I was making, rather tongue in cheekily, was that your alternative plan for reducing costs has as one of it's primary pillars the exact thing you told me never to do. It also ignores human nature and action but still, I just got a good lighthearted chuckle out of it, no harm no foul Smile

(29-07-2017 09:41 AM)epronovost Wrote:  I just needed a larger sample to make sure there is no bias in my highly scientific process to assess if she was gorgeous or not. Turns out she is! But now I must submit it to peer review, which I will conduct myself! That's how creationist do it, thus it must be good. I will report those results soon!
That's about masturbation, isn't it? I feel it's about masturbation. Understandable either way though haha

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04-08-2017, 12:31 PM (This post was last modified: 04-08-2017 01:29 PM by epronovost.)
RE: WhiskeyDebates Saves American Healthcare (You're Welcome)
I skipt some large portion of your post not because they weren't interesting, but mostly because, at that point they were either completly out of the perview of this ''debate'' like my opinion on the market and essential services and those I have to conceed like the fact that Medicair and Medicaid are a huge sink in money and that your system (or at least one similar has proven to work on several occasion).

I would just like to make a warning on them. The Singapore system is indeed lauded for its efficency, but Singapore itself is a microcosm. It's an enormous commercial city. There is no problem linked to disparities in services between rural and urban zones, there is no such thing as remote zones like in the US, regionalism isn't an issue either. They admnistrate a population of about 6 million people vs over 300 million spread over an enormous territory. Administration cost and bureaucracy is exponential. This makes the administration and the deployment of public services extremely easy and cheap compared to a vast country. It should be considered that any system taken from a small City-State will be difficult to adapt efficently to the geopraghic reality of an enormous country. Equipping and managing around 10 hospitals vs equipping and managing 3000 makes an enormous difference especially when you consider all the problems the US has that Singapore and Hong Kong can't have.

America, unlike Singapore, is also a nation with a very immigration rate. How does your system cover for recent immigrants and their family. They didn't have time to save a lot of money from your $6000 per person per year plan. They might arrive with medical needs and not have the money to cover for them. They can't really count on family members helping them out unlike natural born citizens. There is around a million new immigrants comming in the USA per year and it takes around 10 to 15 years to build a reasonnable amount of money via saving by using your plan. How does it work for them?

(04-08-2017 01:26 AM)WhiskeyDebates Wrote:  BASIC universal health care is what the system is, you're bringing up cases that are not meant to be handled by a basic system. A basic program is not ment to cover 100% of all costs anyone could possible have. If you are in that 10% you get private insurance to supplement that fund and cover extra costs, insurance that would be MUCH cheaper and spent on services that would be much cheaper under this system.

The only problem is that nobody knows if they are going to be unlucky anybody could be in that 10% and when you know it, its a bit too late to take insurrence. Many if not most amongst that 10% will be poor, thus will need financial support. I suggest that you create an emergency fund to take care of those cases instead of private insurrence which will have a high cost since they are now a luxury and cover only the most pricey and extansive problems which makes their risk augment significantly.

Relying on charity is inefficent simply because charity doesn't generate enough revenue to cover such kind of cost (yes, per dollar charitable organisation are extremely efficient, amongst other thing because they pay very few of their employees, but they have a too small budget to cover an important population). The only place where it could cover medical cost would be after natural disaster or terrorist attack where its easy to motivate the public.

PS: Yes, its all about masturbation (turns out its good for your health)

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04-08-2017, 03:05 PM (This post was last modified: 04-08-2017 03:46 PM by Deesse23.)
RE: WhiskeyDebates Saves American Healthcare (You're Welcome)
Not trying to interrupt your conversation or hijack it but trying to add valuable info:

Quote:I would just like to make a warning on them. The Singapore system is indeed lauded for its efficency, but Singapore itself is a microcosm. It's an enormous commercial city. There is no problem linked to disparities in services between rural and urban zones, there is no such thing as remote zones like in the US, regionalism isn't an issue either, they admnistrate a population of about 6 million people vs over 300 million spread over an enormous territory. This makes the administration and the deployment of public services extremely easy and cheap compared to a vast country. It should be considered that any system taken from a small City-State will be difficult to adapt efficently to the geopraghic reality of an enormous country.

Lets see about European nations then. Nations that have 60-80mio populations, are subdivided into heavily urbanized areas as well as rural ones, nations that arent city states, France and Germany. See below.

Quote:America, unlike Singapore, is also a nation with a very immigration rate. How does your system cover for recent immigrants and their family.
Well i cant speak for WD and his system, but my last post already gave info on how this was dealt with in Germany.
Quote:Fun fact:
In November 2016 a law was pased that 1,5bio should be taken from those reserves (10bio, 4bio required by law) to cover refugees/asylum seekers. I dont think this supports the notion of Germany being overly burdened with "tidal wave of muslims", at least not in terms of providing healthcare.
Germany has an average cost of 4000€/person. So 1mio immigrants would cost 4bio€ and add 1/80 (1,25%) to the total cost (considering Germanys has 80mio people). If we consider what societies like ours are spending on military equipment for example, i consider 4bio€/1mio persons who cant provide for themselves each year a sum to be overly worried about.

Ok, lets compare Europe instead of Singapore to the US:
Quote:America is spending 17.1% of its GDP on health care....Singapore, the closest nation to my idea, spends 4.6% of its GDP
European expenditures. Right hand column "% des BIP" means "% of GDP"
Most of them are below 10%, the highest ones at ca. 11%, which makes the US spend (almost) twice the money on its peoples´ healthcare than europe on average.

Quote:The #1 healthcare system in the world spends less than 1/3rd of America per capita. $2752 to be exact
The biggest economies in Europe, concerning total population, France and Germany, are spending 3600€ and 4000€ respectively ("euro je Einwohner")

[Image: Current_healthcare_expenditure%2C_2014_YB17-de.png]


Since european countries have many different flavours of public healthcare (i like to point out that WDs point about basic helathcare is imho very important in this discussion) here is an overview.
Yellow: state funded (=tax)
Orange/red: obligatory insurance / accounts
blue: other
[Image: Healthcare_expenditure_by_financing_sche...B17-de.png]

Bloody pic wont load, so here is the link


Detailed breakdown of the per-capita-cost.
Red: state funded
Yellow: private funded
Blue: Obligatory insurance / accounts
[Image: Current_healthcare_expenditure%2C_2014_F1_YB17-de.png]

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12-08-2017, 01:58 AM
RE: WhiskeyDebates Saves American Healthcare (You're Welcome)
Sorry for the delay again. I have to do a frankly idiotic amount of research for each post I make and my time has just been so damn limited lately.

(04-08-2017 12:31 PM)epronovost Wrote:  I skipt some large portion of your post not because they weren't interesting, but mostly because, at that point they were either completly out of the perview of this ''debate'' like my opinion on the market and essential services and those
I think your opinion on the market is relavant and could explain some of the differences we have. Though I won't force you to elaborate, the implication I took from what you did say was that you view the market (which in an actual free market state is just a system of voluntary exchange) as a form of extortion, but the idea of the government seizing and redistributing other peoples money to pay for a service as not extortion.
I'll just say that I don't agree with that at all, but again I'm just going on what I think you are saying so feel free to pay me no mind on this hahah.


(04-08-2017 12:31 PM)epronovost Wrote:  I have to conceed like the fact that Medicair and Medicaid are a huge sink in money....
It's not so much that they are huge money sinks that bother me. Hell almost all government programs are, and there are even huge inefficient money sinks in the market as well. It's that fact that BEFORE the ACA (ObamaCare) the US was already spending more than double on those programs than it was bringing in for those programs.
That's not sustainable nor is it good for a country. Debt financing is, in a very basic explanation, just taking money from the future and spending it today. There is an old phrase in economics "if you live beyond your means you will be destined to live beneath your means". I'll save us both from a long rambling tangent but it blows my freaking mind that people today don't seem to understand that the bill always comes due and you can only kick that can down the road so long. History is rife with examples of nations who debt financed themselves out of existence, each one of them convinced it couldn't happen to them.

(04-08-2017 12:31 PM)epronovost Wrote:  that your system (or at least one similar has proven to work on several occasion).
It's actually every occasion I can find, I've just been trying to stick to examples as close to modernity as I can.

(04-08-2017 12:31 PM)epronovost Wrote:  I would just like to make a warning on them. The Singapore system is indeed lauded for its efficency, but Singapore itself is a microcosm.
I agree absolutely 110%. It's why I didn't use a carbon copy of the Singapour model, or the HK model because you have to take into account these factors as best you can. That's why I have been supporting my system with contemporary examples, examples from inside America today, from America historically, and across a half a dozen or so (..I think Tongue ) indicators and factors that support such a system conceptually, economically, and historically.

I'm definitely not for just trying to do a quick copy+paste of the Singapore system, it's just the most contemporary example at my disposal.

(04-08-2017 12:31 PM)epronovost Wrote:  How does your system cover for recent immigrants and their family.
They get the same amount annually as everybody else, which is the only consistently fair position to both members of the host nation and those immigrating to the nation.

(04-08-2017 12:31 PM)epronovost Wrote:  They didn't have time to save a lot of money from your $6000 per person per year plan.
They also didn't have the same time to pay into it through taxation.

(04-08-2017 12:31 PM)epronovost Wrote:  They might arrive with medical needs and not have the money to cover for them.
Ok so.... even leaving aside the fact that moving to an entirely new nation is extremely time consuming and expensive and that if you're willingly engaged in such an expense with the knowledge that you won't be able to afford basic medical care when you arrive then that strikes me as being wildly irresponsible and I'll just repeat what I said before. If the basic medical payment is not enough to cover your basic medical needs than get insurance. Insurence that will, again, be significantly less expensive than now. That's literally what it's designed for.

(04-08-2017 12:31 PM)epronovost Wrote:  They can't really count on family members helping them out unlike natural born citizens.
True but they do have much easier access to insurance, and also not to split hairs but immigrant communities having been setting up community groups that help with this exact thing for decades and in some cases over a century.

(04-08-2017 12:31 PM)epronovost Wrote:  There is around a million new immigrants comming in the USA per year and it takes around 10 to 15 years to build a reasonnable amount of money via saving by using your plan.
Reasonable amount? 15 years at the $6000 rate is more than the Singapore government would spend a person over their entire life. Twice. And for better and more efficient service. The government of Singapore didn't start spending more than $1000 per person (GDP PPP) until 2011.
$6000 was an arbitrary number that I selected 'cause it was comparable to current government spending which again is radically overinflated compared to the rest of the industrialized world. It's nearly 6 TIMES more than the most efficient needs to spend. ALL medical care spending in that country isn't even half of my rate.

(04-08-2017 12:31 PM)epronovost Wrote:  How does it work for them?
The same as every other citizen, as it should.

(04-08-2017 12:31 PM)epronovost Wrote:  The only problem is that nobody knows if they are going to be unlucky anybody could be in that 10% and when you know it, it's a bit too late to take insurance.
Well......ya that's how insurance works. You are supposed to get it before you need it. You don't try to get fire insurance on your house after it's burnt down. It will also be cheaper and more accessible.

You don't try to get life insurance after you're dead lol

(04-08-2017 12:31 PM)epronovost Wrote:  Many if not most amongst that 10% will be poor, thus will need financial support.
I've mentioned lots of ways to go about doing so and how this system makes doing so easier.

(04-08-2017 12:31 PM)epronovost Wrote:  I suggest that you create an emergency fund to take care of those cases...
I can see how that would be reasonable, but my follow up question would be as follows.

Given that the US government is already spending more than double what we should be how do we pay for a such a fund?

(04-08-2017 12:31 PM)epronovost Wrote:  instead of private insurrence which will have a high cost since they are now a luxury and cover only the most pricey and extansive problems which makes their risk augment significantly.
.........that is literally the opposite of reality and I've shown it several times now.

(04-08-2017 12:31 PM)epronovost Wrote:  Relying on charity...
My word haha. Nothing in the system relies on charity, and I've clarified that four times now. I have no idea where you are getting this idea from.


I also want to point out that where the market is left to work, for the most part, prices come down over time and where it's not they rise. Nowhere is this more obvious and inarguable than in what we call "time cost". Time cost is the cost in hours worked, at the average wage, for a worker to be able to afford a good or service.
A good example of this is the time cost of a washer-dryer combo fell by 83% from 1959 to 2012 with the average worker in 1959 having to work 181.8 hours to afford it while a 2012 worker only has to work 31 hours.

This trend is consistent across comparable foreign markets, and reflective in American history as well prior to those dates, and for most products and services. This trend was even present in healthcare as well prior to Medicare and Medicaid, however, after their introduction...not so much.

Time cost in 1958 to cover per capita health care expenditures were 118 hours and in 2012 it is 467 hours (and still climbing) nearly a 400% increase. This trend is consistent across nearly all government subsidized industries including higher education and student loans to name a few.

You can read more about it here if so inclined.

@ Deesse I'm reading your stuff, I swear, and it's very enjoyable you have my thanks!

When valour preys on reason, it eats the sword it fights with.
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