I believe a single payer is the only way forward on this. I think it's crystal clear that the free market, or capitalism, works for luxury goods but not for necessities.
It is assumed that a yes answer is conditional.
The question really is; do you think a universal/single payer system is the best way forward to better health care in terms of coverage and costs.
The details, while important, are way beyond the scope of this thread.
I believe a single payer is the only way forward on this. I think it's crystal clear that the free market, or capitalism, works for luxury goods but not for necessities.
Good to see you didn't leave the site.
The government has actually done a fairly good job with medicare and medicaid. Yes, there are definitely problems with both. They aren't perfect. But nothing is. Just like the prices of utilities (electricity specifically) the government has to manage this because the free market system cannot. And will not. The opportunistic profit-taking we've seen recently by tycoons who buy up critical single-suppliers of medications like epipens and jack the prices up by 800 to 1000% is a perfect example. The giant health conglomerates and the clear price fixing going on between medical companies and insurance companies is another example. $120,000 to have a child. I can't buy replacement pieces for my cpap with my OWN MONEY because the medical companies have insisted you must have prescription.
I would normally say I'm a republican. But their conduct over the last 10 years - the obstructionism, the ignoring of women's medical rights, the disregard of the wage gap, the tax cuts on the wealthy, have pretty much turned me off entirely. Their total failure to present something even slightly feasible to replace the ACA after 8 years of saying they were going to is unforgiveable. I think they were just as surprised trump won as hillary was, and they have no plan at all.
The rest of the industrialized world also agrees.
Free market and capitalism are antithetical to the point of health care. That's why, in my OP, I specified that price controls would have to be limplemented at all levels of health care. Personally, I think a cap of 10-15% profit is more than generous enough for all those involved.
But what would that look like? Profits are used to pay staff, and there is a nursing crisis. How would that be dealt with?
Devil in the details and all.
The free market works perfectly, if the aim is to extract the highest profit from said necessity.I believe a single payer is the only way forward on this. I think it's crystal clear that the free market, or capitalism, works for luxury goods but not for necessities.
No, profits are what's left after paying for the staff. Your point though, is a valid one. How do we handle companies that abuse the system through legal means? Its a tough one for sure, especially if you are trying to keep capitalism in the mix. Personally I think it's easier to hold the government accountable to waste, abuse, and fraud, than it is in the private sector.
It is possible that we may have to spend more than we do during the phasing in of a different system. I am prepared to pay more while the infrastructure is established and then selectively make changes. I'd be ok with that.
Good to see you didn't leave the site.
The government has actually done a fairly good job with medicare and medicaid. Yes, there are definitely problems with both. They aren't perfect. But nothing is. Just like the prices of utilities (electricity specifically) the government has to manage this because the free market system cannot. And will not. The opportunistic profit-taking we've seen recently by tycoons who buy up critical single-suppliers of medications like epipens and jack the prices up by 800 to 1000% is a perfect example. The giant health conglomerates and the clear price fixing going on between medical companies and insurance companies is another example. $120,000 to have a child. I can't buy replacement pieces for my cpap with my OWN MONEY because the medical companies have insisted you must have prescription.
Government-enforced monopolies and regulation on trade are not capitalism. EpiPen prices are a product of FDA regulation, not capitalism. In anything resembling a real capitalist system they would cost literal pocket change.
True. Good luck getting Republicans and free market guys to get rid of IP.
But shit! You might have stumbled on something here with your post! What if the government simply removed companies ability to create any health care related patents?
I don't support getting rid of IP entirely, and the issue isn't as simple as patent duration (the patent on the EpiPen has already expired, for example). The FDA can arbitrarily set increasingly strict standards which just so happen to invalidate products with expired patents, forcing a new EpiPen with a newly patented syringe which boasts 5% improvements in dose delivery consistency.
If you support getting rid of the FDA entirely and making medication entirely a matter of consumer choice, along with a restructuring of the patent system so that duration and/or profit caps are installed according to inventor demand, I can go along with that. Otherwise, kinda hard to profit off of new inventions in medicine (which are the true drivers of improvement in healthcare quality) when any Joe Patel can crank out generics in India for pennies, and therefore kind of pointless to try innovating.
I don't support getting rid of IP entirely, and the issue isn't as simple as patent duration (the patent on the EpiPen has already expired, for example). The FDA can arbitrarily set increasingly strict standards which just so happen to invalidate products with expired patents, forcing a new EpiPen with a newly patented syringe which boasts 5% improvements in dose delivery consistency.
If you support getting rid of the FDA entirely and making medication entirely a matter of consumer choice, along with a restructuring of the patent system so that duration and/or profit caps are installed according to inventor demand, I can go along with that. Otherwise, kinda hard to profit off of new inventions in medicine (which are the true drivers of improvement in healthcare quality) when any Joe Patel can crank out generics in India for pennies, and therefore kind of pointless to try innovating.
Nope. Isn't the FDA that caused the epipen disaster. The original epipen was patented. That patent expired. But exactly like has happened in a lot of the other drug cases that we are currently hearing about, the price was low enough on the epipen that no one wanted to make a generic version because they couldn't make money.
At that point, the company made a couple changes and repatented the 'new' epipen, and jacked the price up. With no generic company ready to make the mechanism or a similar one for a year or two, the original manufacturer was able to rape everyone. The free market got involved, of course, with companies stepping up afterwards, but now the prices are slowly coming back down, which makes it much less interesting for any company who wants to make a profit.
The same thing can happen with ANY drug or critical mechanism that only has one supplier and has a reasonable price, because it takes time to tool up, create the generic version, get it approved, and start selling it. And in that time, the original drug maker can make their money and drop the price again.
People say 'ohhhh FDA's fault', but they'd complain even more if drugs weren't tested before being released into the market. The FDA is underfunded, understaffed, but does the best they can (mostly).
Getting rid of drug safety testing would be a disaster.
It's a simple question. Do (we) Americans want healthcare?
The short answer is yes we do.
So we move onto how to soak the costs. Individuals are instantly bankrupted.
One night in the ER with some blood-work and fairly minor scans can be more than half a year's wages.
So we moved to insurance companies to soak costs. They cannot cover everyone and go bankrupt if they try.
It is ONLY through the national budget / US currency that we find a cushion of financing large enough to soak these costs.
ACA was a poor attempt to place it there, Medicare for all would achieve a much smoother and realistic result to meet needs.
Yes, costs also need to be addressed, but single payer is the only thing large enough to provide healthcare.
Hamburgerboy: you can't have it both ways. Either the FDA has a standardized system of approving medications and mechanisms, or we have no FDA. So you can't complain that "it's the FDA's fault". They are doing exactly what we want them to do - trying to keep us safe. They are not the root cause of this problem. They are just a convenient scapegoat.
It's a simple question. Do (we) Americans want healthcare?
The short answer is yes we do.
So we move onto how to soak the costs. Individuals are instantly bankrupted.
One night in the ER with some blood-work and fairly minor scans can be more than half a year's wages.
So we moved to insurance companies to soak costs. They cannot cover everyone and go bankrupt if they try.
It is ONLY through the national budget / US currency that we find a cushion of financing large enough to soak these costs.
ACA was a poor attempt to place it there, Medicare for all would achieve a much smoother and realistic result to meet needs.
Yes, costs also need to be addressed, but single payer is the only thing large enough to provide healthcare.
At some point we will have to say "sorry" and I accept that. Perhaps I can explain my objection to the automatic acceptance of UHC.
I've explained in that past that I object to Congress doing the formulation of a changeover, and that a select group of individuals take charge instead. This is not some blue ribbon panel advising, but doing the actual work free of Trump or whomever is in office. In fact members who are qualified could craft law and regulation in order to limit adverse unintended consequences. Congress funds an autonomous group to take time and do things right. I've suggested one thing, a nationwide system with access to medical history for all americans everywhere. The value of this cannot be overstated. But, we're looking for one thing above all, not spending money and I find that troubling.
Care is about the patient. There may be limitations on what we can do, but systems where punishment is the "solution" is a terrible idea. Note how improvements in care really didn't come about in outcomes as a whole because the entire premise was that people were irresponsible and negligent. Yes that happens, but you and I have spent enough time in hospital to see how nurses may spend 16 hours on a shift under constant pressure because care is expensive and it's financially simpler to burn them out. Unfortunately that means care is affected and removing support isn't going to make things better. Instead ask the nurses what they need, what they see, and solicit their input, not to some committee who will shuffle them to the back of ten thousand pieces of paper so they can move on to fracking.
Government is not a solution because it cannot be divorced from partisanship and the people in Congress have neither the time nor knowledge to do this right. EDIT- It can be a facilitator so others can do a proper job. Government isn't an evil entity but it is not all wise.
Naturally Congress has the final say and it should, but this is not really something new. Legislation has been written by other parties and approved, often with less than honorable intent. We don't want that. We want an open and expertly implemented system that takes into account the person in need. Is it fact that the better the treatment, the better the outcome, the lower the total cost will be. That approach makes sense to me as a professional and a person interested in care. If we need to make cuts? Then do so with understanding.
Is it really to much to ask for us and those we love?
I would actually go the opposite way, where everyone has universal catastrophic coverage to cover things like cancer and then everything else is paid for by HSAs or whatever. The primary cost driver in US health care is not the routine stuff, it's the end of life care, the cancer care, etc. This is where single payer can really shine if we let it.
Single payer aint going to solve anything until you get rid of the 1000 levels of beauracracy between a patient and the healthcare they receive, and stop letting big pharma ass rape everyone.
this guy works in the industry and wants to make as much money as possible.