Why do YOU think Healthcare is a Right and not a Privilege?

[Bigbamboozal]

I believe it's a right because: I'm Canadian, it IS a right here bro.
And you know, that's worked out really, really well for me.

[Spectral]

italy, where legally you can go in a cafe and ask for a glass of water freely.
and there are still fountains

You can ask just about anywhere you like, but I don't know of anywhere that people are legally obligated to give you water simply because you've asked.

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- It has nothing to do with misuse, people rarely get cancer because of abuse, babies being born with defects, genetic mutations, babies suffering from defects because of things their parents did, companies destroing your environment and making you sick... Your views are narrowminded and well... retarded (also a pre existing condition

Are you claiming that there isn't any healthcare spending that stems from misuse and/or overconsumption?

[petej0]

Are you claiming that there isn't any healthcare spending that stems from misuse and/or overconsumption?

Thats not the point!

[Spectral]

For profit hospitals in the US are some of the worst run hospitals in the western world.

Hey look I can be hyperbolic without citation too.

At least non-profits aren't as likely to commit fraud.

Part II of this blog post has a quick summary that's worth reading (links to citations are in the post):

Hospitals are about evenly split between for-profit and not-for-profit institutions. Measuring “hospital quality” is even harder than measuring school quality, but researchers have tried to do this on various metrics. The results are hard to sum up, and I was only able to find a few studies and not anyone’s magisterial summation of the field, but it looks like there are minimal differences between for-profit and non-profit private hospitals, with government hospitals doing worst of all:

— A team from Harvard finds that for-profits and non-profits have about equal quality, and government-owned hospitals are worse than either. A follow-up study by the same team finds non-profit hospitals becoming for-profit is not associated with a drop in care.

— Truven Health Analytics finds some advantages for church-owned nonprofit hospitals, with secular nonprofit hospitals and for-profit hospitals in the middle, and government-owned hospitals worst of all. Note that this is my interpretation of a lot of different data and you might want to look at the particular metrics they use to draw your own conclusions.

— A textbook on the hospital industry finds that “on average, the performance of non-profit hositals in treating elderly patients with heart disease appears to be slightly better than that of for-profit hospitals, even after accounting for systematic differences…however, this small average difference masks an enormous amount of variation in hospital quality within the for-profit and not-for-profit hospital groups.”

— A study in a cardiology journal found “no evidence that for-profit hospitals selectively treat less sick patients, provide less evidence-based care, limit in-hospital stays, or have patients with worse acute outcomes than nonprofit centers”.

On the whole, I do not see any good reason to believe that nonprofit hospital in the United States are any better at managing costs or providing treatment than for profit hospitals. The problems with the American healthcare system's spending are not likely to be a result of for profit hospitals.

[RuneDK]

Personally I think Healthcare is a privilege and not a right.

If you misuse your body you should have to deal with the consequences unless you have purchased protection in the form of insurance.

Also, in ANY civilized country, no hospital is going to turn you away if you have something life threatening that HAS to be taken care of even if you don't have insurance.

Forcing doctors to see patients under universal health care greatly diminishes a doctors will to continue practicing. It also reduces the will of any people who would be willing to undergo 10+ years of education to become a doctor because the limited ability to make good money in the profession.

So someone born with something is not taking care of their body? Someone who gets cancer isn't taking care of themselves? You can do everything right and still get sick. This is the dumbest post I've ever seen about how healthcare should be a privilege.

[Spectral]

Thats not the point!

I tend to be irritated by blatantly false claims regardless of whether they're the central point or not; bit of a personal tic.

[Deleted]

Forcing doctors to see patients under universal health care greatly diminishes a doctors will to continue practicing. It also reduces the will of any people who would be willing to undergo 10+ years of education to become a doctor because the limited ability to make good money in the profession.

If you want an honest discussion, don't open with bullshit.

Living in a country with universal healthcare this is simply not true. No doctors are quitting their jobs here and we actually have to limit the number of people that are allowed to start med school each year to prevent overcrowding the colleges with med students.

I'll be sure to ask the doctors in my family if they feel worse knowing people won' t go bankrupt using their services. /s

Everyone should have the right to access to healthcare (which they currently have in the US). If they cannot pay for it, well, that's on them. They do not have the right to force others to pay for it, just like any other service. You want the service, pay for the service.

That said, the problem with healthcare in the US is much bigger and deeper than who pays for the insurance. The majority of the argument (on both sides) is completely missing the target. The healthcare problem facing Americans was not solved with Obamacare and will not be solved with Trumpcare. Please, stop focusing on the insurance aspect of healthcare.

This is very much accurate. The problem with healthcare in the US is that it's treated as a supply and demand market, where free market mechanics will work. This is simply not true. If a TV for example is too expensive, you do without. Smart people will not bankrupt themselves for a TV. If you are sick and not getting better without healthcare you will pay whatever it takes even if it bankrupts you. The total failure of US politics to realize this is what enables greedy pharmacy to ask ridiculous prices for their product.

[Alexeht]

Also, in ANY civilized country, no hospital is going to turn you away if you have something life threatening that HAS to be taken care of even if you don't have insurance..

You will still get nice big bill on the end.

If you misuse your body you should have to deal with the consequences unless you have purchased protection in the form of insurance.

Most peoples health issues are caused by work, so resolution would be to make all employers pay fully for healthcare.

[Spectral]

If you want an honest discussion, don't open with bullshit.

Living in a country with universal healthcare this is simply not true. No doctors are quitting their jobs here and we actually have to limit the number of people that are allowed to start med school each year to prevent overcrowding the colleges with med students.

I'll be sure to ask the doctors in my family if they feel worse knowing people won' t go bankrupt using their services. /s

I don't know how much of a problem it is, but in the UK, there seems to be a real shortage of doctors at present. Obviously this varies greatly by country, so it's hard to know whether healthcare would generally be improved by a larger supply of doctors. To be frank, I doubt it, but it's hard to really know.

One set of advantages that many countries with universal healthcare have over the ridiculous American system is that becoming a doctor isn't as onerous of a process. The American system requires that doctors spend a ridiculous amount of money on medical school and they have to already have a (likely expensive) bachelor's degree to even get started. There's an unholy alliance of universities that rather enjoy having this be a very expensive process and current doctor's associations that prefer keeping pay artificially high through the use of licensing requirements that are more onerous than anything that's actually necessary for good care.

It's another example of just how fucked the American system is. What's striking is that people outside of the United States generally see pretty easily that the American system is a mess, but from a distance, the causes look much simpler than when you start to peer closer. We could solve the uninsured problem with some good policy, but I have no idea how to even start addressing the university cartel problem.

[petej0]

I tend to be irritated by blatantly false claims regardless of whether they're the central point or not; bit of a personal tic.

You make a good point, people do misuse their bodies, but people are victims of unfortunate health conditions. Why dont we get past this issue and focus on the real issue. Cost and how to provide care for everyone.

On the whole, I do not see any good reason to believe that nonprofit hospital in the United States are any better at managing costs or providing treatment than for profit hospitals. The problems with the American healthcare system's spending are not likely to be a result of for profit hospitals.

I have posted this before in this thread, I will post it again. I would suggest everyone read it.

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I don't know how much of a problem it is, but in the UK, there seems to be a real shortage of doctors at present. Obviously this varies greatly by country, so it's hard to know whether healthcare would generally be improved by a larger supply of doctors. To be frank, I doubt it, but it's hard to really know.

A problem created by Government and the AMA. So it can easily be solved.

https://www.forbes.com/2009/08/25/am...ha-dalmia.html

[Spectral]

You make a good point, people do misuse their bodies, but people are victims of unfortunate health conditions. Why dont we get past this issue and focus on the real issue. Cost and how to provide care for everyone.

I think use and consumption patterns matter a lot when trying to control costs. I think it's sufficiently tied to policy decisions that we can't reasonably ignore overuse of medical care. Particularly in the United States, there's a weird combination of insane costs combined with an unending appetite for consumption of treatments of questionable value.

I'm not here to blame people for getting cancer or deny people care; I simply don't think we can ignore why consumption of care is as high as it is. People tend to not think of healthcare as a good in the economic sense and I think it leads to a lot of faulty thinking when we ignore that it really is a consumed good.

A problem created by Government and the AMA. So it can easily be solved.

https://www.forbes.com/2009/08/25/am...ha-dalmia.html

I'd say almost the opposite - this is a problem created by the government and the AMA (and university interests), so it's nearly impossible to solve. The asymmetric benefit to a small group types of political problems while taking from everyone in a way that's harder to notice are exactly the kind of political problems that never seem to get resolved. A great example is sugar subsidies - these are obviously stupid, destructive, and costly, but because they benefit a small, very interested group that will dump tons of money into lobbying and cost everyone else only a little bit (and the cost is hard to notice), they're not going anywhere for the foreseeable future.

I'd love if you were correct and knocking down the cartel nature of licensing and social signaling from degrees was viable, but I see no indication that the problems will do anything but get worse in the coming decades.

[zezel81]

I believe it is a privilege.
Why? No doctor or person should work for free and no one should have to pay you for your illness.
With that said.
Do I believe the poor should get it free? yes, if they are trying as a job certain extent life threatening only the rest they have to get insurance and all free for thier children for everything.
Do I believe middle class pay? Optional only for adults but children a must. As above anything that cankill you is free to a certain extent. In which you may have to pay something. If you cannot afford it proof must be shown.

If you want free medical join the military.
If you want free education. Join the military.
Or be poor and do paperwork for 10years.

[Deleted]

Your health is not something anyone should profit from. You should be helped. It's not a hard concept to grasp.

Have you heard of socialism?

[Dragoncurry]

Just because healthcare in the USA is a fucking nightmare that nobody in developed countries can understand. Most countries can do universal healthcare just fine. Why can't the usa do it? There's no reason to keep this situation like it is now.

Never mind. You're oversimplifying and as GoblinP mentioned, there are issues with not for profit hospitals being unable to manage costs or population health either. Prime example: Johns Hopkins.

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Read the entire 11 pages!! Hospitals make a killing charging patients for items and procedures with a price that has no basis.




The Government would not pay these rates, because they dont pay these rates vie Medicare now. So I would have to respectfully disagree with you.

Holy shit, there were 10 more pages? Brb.

[Spectral]

Your health is not something anyone should profit from. You should be helped. It's not a hard concept to grasp.

The bolded is a terrible idea. If no one can profit from improving treatments, do you figure that maybe some people that currently work hard to improve treatments might be inclined to go do something else they can profit from? It's pretty hard to draw venture capital if you're forbidden from profiting at all.

For that matter, when you say that not anyone should "profit", surely you're not claiming that medical professionals, researchers, and entrepreneurs shouldn't be paid, right?

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I have posted this before in this thread, I will post it again. I would suggest everyone read it.

Sorry, missed this earlier - I agree, everyone should read this. Pricing is downright insane. I work in a field where I wind up being much more familiar with what pricing structures and insurance contracts with hospitals look like and when I first started learning how all this worked, it absolutely blew me away. I think the average person knows that medical billing is a mess, but I don't think the average person understands the shape of that mess and what the insane headline stickers look like.

The bizarre sticker prices also come with a variety of other oddities about how hospital AR departments actually handle these bills. There are organizations that simply write off any bill under $10K if the payor doesn't begin paying fairly quickly on the assumption that it's bad debt and they'll never get the money. There are others that go after people for money that they simply don't have. Which bucket you wind up in (completely scot free or life destroyed) is almost entirely a matter of luck regarding which organization you're in proximity to.

This is an insane system.

[petej0]

I think use and consumption patterns matter a lot when trying to control costs. I think it's sufficiently tied to policy decisions that we can't reasonably ignore overuse of medical care. Particularly in the United States, there's a weird combination of insane costs combined with an unending appetite for consumption of treatments of questionable value.

I'm not here to blame people for getting cancer or deny people care; I simply don't think we can ignore why consumption of care is as high as it is. People tend to not think of healthcare as a good in the economic sense and I think it leads to a lot of faulty thinking when we ignore that it really is a consumed good.

How much of that overconsumption is Doctors running their own tests for CYA meassures? Is there any metric that shows patients are or would willing overuse medical care?

I'd say almost the opposite - this is a problem created by the government and the AMA (and university interests), so it's nearly impossible to solve. The asymmetric benefit to a small group types of political problems while taking from everyone in a way that's harder to notice are exactly the kind of political problems that never seem to get resolved. A great example is sugar subsidies - these are obviously stupid, destructive, and costly, but because they benefit a small, very interested group that will dump tons of money into lobbying and cost everyone else only a little bit (and the cost is hard to notice), they're not going anywhere for the foreseeable future.

I'd love if you were correct and knocking down the cartel nature of licensing and social signaling from degrees was viable, but I see no indication that the problems will do anything but get worse in the coming decades.

If you are saying that the problems caused by government cant be solved then we are doomed. I dont see it that way, the health insurance industry is reaching a tipping point in which it will either have to push premiums to rates that companies and people could no longer afford, or health insurance will collapse. It cant continue paying these high costs imposed by the health care providers.

[Spectral]

How much of that overconsumption is Doctors running their own tests for CYA meassures? Is there any metric that shows patients are or would willing overuse medical care?

These things are really hard to measure, right? I want to be careful about laying blame on personal choice - I don't think people are walking around saying, "oh boy, I can't wait to get a biopsy that I don't really need". Obviously this isn't the case. Likewise, I don't see surgeons as mustache-twirling villains that do work that they don't think is at all helpful for the sake of profit. It's more that the way the incentives line up and the way culture lines up trends towards a lot of tests being ordered that aren't needed, a lot of caution being taken (you're right about CYA) and so on.

If you are saying that the problems caused by government cant be solved then we are doomed. I dont see it that way, the health insurance industry is reaching a tipping point in which it will either have to push premiums to rates that companies and people could no longer afford, or health insurance will collapse. It cant continue paying these high costs imposed by the health care providers.

I would love if I believed that the US government was sufficiently competent to address these problems. As it stands, I see a set of misalignments of incentives and lack of good coordination to do any good reform. The easiest part of this to see is that no one in Congress is inclined to suggest that that end-of-life spending is far to high and that it's time for a better approach to palliative care instead of trying to squeeze out every last second of life; even mentioning that this is a good idea is met with shrieks about "death panels", even from some people that surely know better.

I am not optimistic that this situation will improve greatly in the near future.

[petej0]

These things are really hard to measure, right? I want to be careful about laying blame on personal choice - I don't think people are walking around saying, "oh boy, I can't wait to get a biopsy that I don't really need". Obviously this isn't the case. Likewise, I don't see surgeons as mustache-twirling villains that do work that they don't think is at all helpful for the sake of profit. It's more that the way the incentives line up and the way culture lines up trends towards a lot of tests being ordered that aren't needed, a lot of caution being taken (you're right about CYA) and so on.

There is truth to this, but there are others who avoid much needed treatment because they cant afford it, so they put it off until it becomes a huge issue and it is more costly to deal with. People should not put off going to the doctor for that pain in their lower back because they cant afford the $50 copay. Especially when it turns out that the pain was caused by a tumor that could have easily been taken care of but was put off and now threatens the ability of the person to be able to walk the rest of their life placing them in need of long term medical devices the rest of their lives.

I would love if I believed that the US government was sufficiently competent to address these problems. As it stands, I see a set of misalignments of incentives and lack of good coordination to do any good reform. The easiest part of this to see is that no one in Congress is inclined to suggest that that end-of-life spending is far to high and that it's time for a better approach to palliative care instead of trying to squeeze out every last second of life; even mentioning that this is a good idea is met with shrieks about "death panels", even from some people that surely know better.

I am not optimistic that this situation will improve greatly in the near future.

I too, am not optimistic in the Governments ability to correct the problems it created this is why we need a better informed public who can push these issues into debates. Instead we get Abortion, gay marriage and toilet assignments headlining our Presidential debates.

End of life care is the most expensive, we want to hold onto our loved ones as long as possible. Obama touched on the issue during the ACA debate, it is a moral dilemma, how do you decide that someone is too old for society to benefit from expensive procedure done for them?

[Mormolyce]

A right is something that enough people agree that they want.

Personally I think Healthcare is a privilege and not a right.

...

Also, in ANY civilized country, no hospital is going to turn you away if you have something life threatening that HAS to be taken care of even if you don't have insurance.

My head hurts.

[Spectral]

There is truth to this, but there are others who avoid much needed treatment because they cant afford it, so they put it off until it becomes a huge issue and it is more costly to deal with. People should not put off going to the doctor for that pain in their lower back because they cant afford the $50 copay. Especially when it turns out that the pain was caused by a tumor that could have easily been taken care of but was put off and now threatens the ability of the person to be able to walk the rest of their life placing them in need of long term medical devices the rest of their lives.

Yeah, this is correct as well. I agree.

I too, am not optimistic in the Governments ability to correct the problems it created this is why we need a better informed public who can push these issues into debates. Instead we get Abortion, gay marriage and toilet assignments headlining our Presidential debates.

End of life care is the most expensive, we want to hold onto our loved ones as long as possible. Obama touched on the issue during the ACA debate, it is a moral dilemma, how do you decide that someone is too old for society to benefit from expensive procedure done for them?

From a government spending perspective, I actually don't think this issue should be that hard. Agencies, including the HHS have estimates on what a year of quality life is worth, they just choose to not bother applying it when it comes to Medicare spending. It's really quite ridiculous, but the issue is incredibly charged and much more visible than choosing not to spend money on something that causes stochastic loss of life, but is harder to see.

For a humane discussion of these issues (which can see really cold-blooded), I'd recommend people read Being Mortal by Atul Gawande.

I couldn't agree more about what a stupid distraction the typical political arguments are. We're spending trillions of dollars per year on a mediocre medical system, even marginal improvements would save staggering amounts of money, but we're going to put that as an issue of roughly equal importance to gay wedding cakes. Culture war idiocy subsumes all.