★UNITED STATES PRESIDENTIAL ELECTION 2016★

i can only tell you my experiences and my friends experiences with healthcare in canada, which has been for the most part good and invalueable.

the us has 300 million people, why wouldnt there be alot of articles about how every other system is bad? if china spoke english, im sure they'd be a buttload of people arguing a single-party state is a good thing, with many opinion articles to prove so.

ive only heard the irs mentioned twice in recent memory, once during a roseanne episode where they talk about how the forms are confusing, and then when i heard they were going after fifa.

whatever the targetting scandal is, its not supposed to disobey mandates from above, so its not their fault. just like you cant blame the nsa. blame the people in power
the irs not wasting money, and its good at getting people who try to avoid paying taxes. seems like a well-run agency to me

 

Well, it's completely reversed for Taiwan.

Taiwanese in USA would fly all the way back here to use our single payer system, if he requires some serious but not emergency medical attention.
Because hey, it's cheaper.

If people from other countries would go to US for treatment, I think that's more of a issue of medical resources. I can proudly say our medical service in Taiwan is definitely tier 1 on Earth, not in any way worse than US, probably even better in some fields.

For me? I have to pay for the insurance monthly and I probably only use that shit to clean my teeth twice a year. Is it unfair? I have to say, not really.
I don't know much about obamacare, but if you do have to pay for other people's healthcare...well, that means someone has to pay for your healthcare.

For example, 5 months ago my dad's legs were severely injured, because other workers accidentally dumped some heavy rocks right onto his legs.
Comminuted fracture for both legs annnd nope, no permanent damage were done, he can even walk slowly without a crutch now and guess what, we didn't really have to pay for the whole thing.
We got free bed in the ward, operation also didn't cost us a lot. In fact, we probably spent more money on his food and other stuff.

There are two bitches, cancer and hemodialysis. Both of them alone can consume like 20% of the annual income of our insurance system.
We do have quite a few douchebags, especially old man, exploiting the advantage of the system and literally going to hospital on a daliy basis. But that's just rare cases and they might be punished in near future.

 

I think a health insurance system can also cause places to go over the top for the sake of having things to charge for the insurance. My dad had a pretty bad fall in Dubai and smashed his nose up. In the UK they'd probably just set it straight and send him on his way, but in Dubai (with health insurance) they sent him for an MRI scan, X-rayed it and a few other bits and pieces. I mean, sure that's great, especially when insurance is paying, but I don't know how necessary that was. It's things like that which makes the health insurance system so expensive in the first place. Everyone is just out to make money and it's either your health or your wallet that takes the penalty for that.

 

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Note: This is a high brow political joke that only in the know can understand.

 

the main point was to name agencies and dept in the USA govt run well and out of all the 100's only one was named which has just been involved in scandals and lies.

That's my entire point about the govt running our healthcare. I do not trust them to have my health in their best interest. The medical field is big business as it is and with all the corruption and red tape and power hungry people in Washington, and under the table deals etc etc I cant see them doing right by me in this area and to me nothing is more important than my health and the health of my loved ones.

Maybe a single payer system for those who cant afford private healthcare and also a private option for those who could afford it, (with the stipulation it be high quality and fair rates)

 

Easier to sue.

 

I was making fun and not being completely serious, even if i would happen to be at least partially correct.

 

As an Englishman, whenever Americans talk about politics I get scared and I'm pretty clueless but I'm goig to dip my oar in anyway.

Healthcare & Education in the States is out of control from an outsiders point of view.

With education I don't know mch other than from speaking with people who study/studied there. But it sounds like the institutions openly screw over the working middle class and put the current generation through the wringer. I don't get why education needs to be that expensive.

With healthcare/insurance - the arguement that it is the best in the world and that the USA does all the innovating really doesn't hold water. I have family in the States and I can never understand why they often defend their broken system and resist all ideas as a matter of course - I swear ts almost as if they get comfort from how much money they spend on their health insurance.

It isn't even an issue of higher taxes. Way before Oblamacare people in the US paid more tax for healthcare (per capita) than UK, Australia or Canada - yet got as far as I understand it, nothing or very little in return.

As I understand it everything is just so damn expensive because your hospitals cannot or do not negoitate properly with opportunistic suppliers & there is a top heavy supply chain. There are other contributing factors such as higher paid staff, lawsuits, higher cost of nicer facilities, newer (more expensive) drugs.

Suppose you are a small, exclusive, specialist private hospital and you need Nx1 number of pills. You will employ a person to procure these. The hospital will get a crap deal on the pills because you do not have purchasing power (the supplier's salesman has 10 of these orders a day in his inbox). Sure there is some competition but apparently not enough for the hospital to pay comparable costs to say the National Health Service. In addition you had to pay someone for procurement to make sure the product was correct, order the right amount according to inventory/shelf life, etc - all of those costs along with the inflated price of the pill is passed down to the end user, plus an additional percentage, because - well you are running a business & there is cashflow to worry about.

Now say you are the United Kingdom's NHS. You have a contract for the national supply of Nx100'000 pills. All the suppliers now fight hard for that business because that contract will add a significant value to their company. All the secondary costs that go along with the logistics & producement of these pills can also be marginalised now. As the only fish in the pond the NHS can negotiate not only on price but also on contract terms.
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The idea that only private enterprise is or can be efficient is simply not true, nor that the competition of savvy consumers will drive the industry to work hard in their favor and deliver ever decreasing costs for high value services. God bless capitalism and all that but it just isn't the case.

Ultimately those sky high prices are not a result of excellent services or world beating recovery/survival rates, people are just as ill as everywhere else - it is just that people in the supply chain take advantage of citizens for big profits. Ohh Marketing - Yeah Marketing, it is weird for most people when they listen to american radio or tv and see ads for medicine, it feels like stepping back in time whwere some snake-oil salesman would be punting their "youthful elixir" on the street corner from a wagon. It's insane "ask your doctor about xxxx" - seriously that should ring alarm bells! I expect my doctor to prescribe me the best solution, unbiased, based purely on science and the motivation for me to get better. I tell the quack what is wrong, he tells me how to fix it - that is how that interaction should work, I don't wanna walk in to his office and tell him I saw this great advert on tele and do you reckon I should give it a go because the person on the tele-box looked really happy. But besides all the speculation about doctors & their motivations to prescribe drugs, there is what feels like an unhealthy level of marketing - and air time isn't that cheap, so you pay for all that too.

So what is the solution?
Well it is, infact Medicare (Part D). Yes Medicare, kind of, I know - but put the pitchforks/flaming torches down for one second. Because it already works, Medicare gets better deals than private institutions on the treatments it is buying. though Medicare covers a finite (tiny) number of applications for a finite (tiny) number of cases.

If the government created a similar body with a wider scope then it would be able to act to regulate the market, harness that purchasing power that the rest of the world enjoys and take money out of Pharma companies pocket.

Now there are of course about a million different drugs/treatments available privately and national health services are much more conservative (have to be to keep the costs down) - and all that good stuff could still be purchased through channel/distributors. But a regulated body that could wield the purchasing power for approved/established drugs and treatments would do 2 things:

1- it would greatly & immediately reduce the price of routine care.
2 - it would trickle down & reduce the price of competing treatments (not available through the scheme)

So you are saving a ton of money for everyone (assuming that those savings get passed on to consumers).
Finally, you make a deal with the hospitals - they can buy 80% of the same products for lets just say 40% of the price through the scheme but maybe they have to give a little back, or perhaps you whack a percentage on the sales and put the money back into an expanded Medicare package for the poor - or whatever maybe you don't fuck the poor, you just decreased the cost of healthcare now so they can afford it and you can finally afford a quadbike!

Now the USA is a very big place, with lots of economically diverse states & whether you think the government could handle something like that on a federal scale I don't know. But for sure the current system does not work in the favor of the patients, hospitals or doctors.


So whats wrong with this, why wouldn't you want the goverment to step in? How else can you solve the problem that a pill developed in the United States can be bought in the United Kingdom for 25% (I'm talking before the goverment then subsidise it further to the patient). It can't just be that voters hate the idea of the government doing anything? I mean even if it failed private hospitals could still buy at a greater cost from private suppliers if there were any left.

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TL;DR

USA, before Obama / Obamacare was already spending the same or more tax dollars per capita on healthcare than countries with national health services.

Healthcare costs are cruelly high in USA because market power falls on the side of supply rather than demand.

Solution: Government should try to regulate supply whilst still operating in a free market.

 

That is quite possibly because of concerns about malpractise lawsuits.
MRI scans, X rays, etc are often there to CYA incase something gets missed. Even if he showed no signs of concussion, internal bleeding, etc some places go over the top to prove they took more than every necessary precaution and made every possible effort to diagnose anything out of the ordinary.

Its great practise anyway but it is one reason why this kind of thing is better but also more expensive.

 

I have always found it difficult to explain to someone who lives in a different country and is used to their countries ways how and why things are good or bad in the USA.
It's like for years people from other countries ask me, aren't you scared to walk out of your house and get shot since you live in NYC?

I'm like wtf??? are you kidding me???

NYC is or at least was before all this recent crap started the safest largest city in the USA, but people who don't live here have such a distorted view of what goes on here (not their fault) from the selective and slanted news they read written by journalists outside the USA.

I don't mean to sound rude, and I hope it is not taken the wrong way, but just like I could have no idea how things really are in another country, the small details, the ins and outs of things, neither can people who don't live here know either.

 

I think you're mixing NYC with Detroit. That's the common view most of the world has about Detroit. It's probably right as well.

 

Yeah im not so sure that liberal use of Cranial Xray is such an amazing thing, AZK.

 

I can't say I don't know places that I could get to in about 30 minutes where you are more likely to get shot (though it actually never happens, suprisingly). But that's in the middle of nowhere, in county territory - in other words not part of a city/town.

Sometimes I find it hard to say one way or the other when it comes to my stance on certain issues. It's like, when I sit at the stop light and it's not changing, I get mad because there aren't cars going the other way. But at the same time, I know that the stop light is timed in such a way as to avoid congestion at other intersections.

I dunno if that analogy will make sense to anybody. I'm not even sure it makes sense to me, now that I read it again.

I can say that I would rather like to see more people like Bernie Sanders in congress (I dunno if the senate needs it desperately right now but it probably wouldn't hurt), maybe not necessarily in the president's chair. Approval ratings for congress keep dropping, and it's become more and more evident that they are the most unproductive and downright sinister branch of our government. And if there's anything that Bernie Sanders has shown he can do in the past, it's actually come to a compromise in order to achieve something.

 

I saw some photos of detroid. Kinda reminded me of photos of Nazis destorying ghettos.

What youre trying to say (what the fuck kind of a statement is that, lol) is that even though its an annoyance you acknowledge it as a necessary evil that leads to some form of greater good in the end.

 

nope I know where I live LOL and so do the people who have asked me that question and it was several different people at different times, some dude from Austrailia just asked me that a few days ago.

 

hehe I know I was illustrating a point I made using that as an example.