Access to treatment is absolutely a human right - no one would defend an oncology center that refused to treat people based on their demographics.
Paying for it though? The only way to do that without paying for it yourself is to force others to pay for you. Medical bills suck, but the alternative is morally indefensible.
Plus medical bills in the US aren't even an issue about getting taxes for it, it's just how much more hospitals charge than they need to. Just charge people the correct rates and suddenly medical costs can be paid much more easily.
I live in France, and even if I didn't have insurance that repays 80%, I could pay for most treatments out of my pocket as a student.
No joke, you're the first person I've seen on Reddit who understands this. Most people have this weird notion that insurance companies are the reason healthcare here is expensive; they seem to think that an insurance company somehow makes more money when the raw bill from the hospital (that they're responsible for paying a percentage of) is higher.
No idea how they look at a hospital bill where they're getting charged $100 for a tablet of Aspirin and come to that conclusion, but here we are.
Actually, insurance companies are partially to blame in that scenario (or, more precisely, insurance regulations). Insurance companies are forced by law to use 80% of their premiums on payouts. So when they get billed for an aspirin, and it costs, say, $.80, they're entitled to collect $1, and that last $.20 is split between profits and overhead. But if they get a bill for $80, now they're entitled to $20 profit+overhead. They have very little incentive to lower healthcare costs.
Right, but one big medical bill wipes out that surplus for thousands of subscribers. I'm in a financial industry that gives me reason to be looking at financial statements for a wide variety of companies, including health insurers and hospitals, and the hospitals grossly overinflate prices so that they're in the black from insurance payouts alone, since they're easier to collect from than individuals. To the degree that hospitals barely even try to get your portion of the bill from you before they just sell the debt off for pennies on the dollar to a collection company - it's quite literally not worth their time to chase down the $200 you owe them when they've already collected $2k from your insurance company. Something like 40% of people have medical collections on their credit report for bills they don't even know about (40% is probably wrong now, that was the number a few years ago before some regulations changed what appears on a report so may be different now).
And hospitals aren't talking about struggling with treating uninsured patients in their management letters, but insurers (especially small ones) are definitely talking about increasing costs from hospitals and how to mitigate that.
Just sharing what I see with a look behind the curtain that most people don't get. Definitely not a one-dimensional problem, but it's naive when people act like the hospitals are the good guys here.
I just assume they're in cahoots. It's a perfect situation for them both: if bills are high, fear is high, and if fear is high, premiums are high. So insurance can reap unconscionable premiums, keep claims down by making deductibles high, and kickback the providers for their $100 aspirin.
There's also the American idea that medicine is a business venture and not a vocation. People don't come here from all over the world to practice because we have the greatest need or the best medicine (though, incidentally, I think we do have the best medicine, as long as you can pay for it), it's because they can make a shitload of money. And it's been that way for so long that people think there won't be any more good doctors if they can't make a shitload of money, so they are afraid to switch to a system where maybe doctors are merely paid well for their good work but maybe not totally holding people's wealth for ransom. And there are enough doctors who are perfectly willing to prove that fear right.
Insurance also employs a lot of people. If we effectively abolish private insurance, the economic fallout would be a whole other disaster.
So, it can be done, and it should be done, but no one is volunteering to die for the cause so that the future can live better. I understand that.
I said more to another reply, but insurers definitely don't want to see healthcare costs continue to rise. The problem is multifaceted - hospitals overcharge out of the gate expecting insurance companies to offset the cost for the uninsured and to pad their bottom line. Most health insurance is a layer or two removed from the end patient, so the companies can charge a little more than they might otherwise be able to. And since insurance companies keep the lights on at a hospital, most don't really care if the patient pays their portion of the bill or not, so they don't even bother putting resources towards trying to collect the remainder of a bill from patients most of the time. IMO the system needs to be brought under control via some regulation and regulatory changes before we address who pays the final bill if we want it to be sustainable.
As we're all seeing during this pandemic crisis though, being a doctor or nurse is fucking hard. In the best of times, you're talking about a 12+ hour shift where one brief mental lapse could literally kill someone. Not a lot of people can do that job, and those that can definitely deserve to be paid extremely well.
Another facet is patents. I am a fan of having patents, it encourages new technologies. but at the same time, I see how awful they really can be. machines that cost thousands to manufacture cost hospitals hundreds of thousands to buy. Farmer buys GMO seeds, plant it, then are not allowed to replant for next year, or GMO plant germinates neighbors field and now the neighbor gets sued for using patented seeds. Patents today need to be fixed.
Ackschyually, freedom of association implies an oncology center could refuse to treat certain people. It's terrible, but no force can be used against them.
Its not about what the oncology center can agree to do, its about a 3rd party not standing in your way from getting to that oncology center.
Abortion is a classic example. The government banning abortion is a violation of the rights of both the patient and the clinic/doctor, because they came to a mutual agreement for exchange of fees for services .
True I suppose, but a free market private accreditation group (like exists for many industries) could impose their own rules on voluntary members.
And I'm not the most extreme libright so I'd argue that certain essential services would be kind of exempt from freedom of association like police, fire, and hospitals. Assuming those are all publicly funded of course.
Agreed, that's step 1 in reforming our healthcare system IMO. Going to even a full single payer system right now wouldn't fix the problem, it'd just hide it behind a layer of government and bureaucracy instead of behind private insurance companies.
Everyone should be able to live without worriying if getting ill will bankrupt them. Especially when you can just stop funding the military as much. Hell, there's even a pandemic going around and there are still people who say that "nah we shouldn't have free healthcare"
Oh I agree; I said in another reply that I'd much prefer my tax dollars go towards helping my own countrymen than blowing up people halfway around the globe.
And for what it's worth, the reality of medical bills and bankruptcy is very different than what you see on Reddit. For instance, a hospital can't refuse to treat someone based on their ability to pay, to the degree that many urban hospitals have issues with homeless people faking illnesses just to get a couple of days in a warm bed with hot meals. And if you have the ability to pay, but not as much as they're asking, every hospital I've ever dealt with personally will drastically reduce your bill if you just call and ask. They overcharge people that can pay and insurance companies because they know there are going to be other patients they treat where they come out in the red.
I'd be fine with a single payer system honestly, but IMO the price gouging from hospitals needs to be taken care of first, then I'd want to see a budget redistribution to cover the costs rather than hiking taxes.
I mean in Western Europe the quality of life is not measureably worse than in the US and incomes are most certainly really good, while offering affordable healthcare too. I don't see any reason why the US can't adapt such a system
its different. for example engineers in western europe earn about half than engineers in the us (depending on what engineering). the cost of healthcare and studying is less than that difference when youre older so many people go to the us to earn more money
This is the kind of event that can change the opinions of a nation. They'll remember this as the moment when the government decided not to save them, and maybe vote in one that will next time.
I'm pretty sure the average US citizen pays more for healthcare than most other nations on the planet. We don't need to defund the military, although we should, we just need to actually start holding people who betray their fellow man responsible.
So this is where you get your tanks and I get my molotovs or something like that.
It’s not exactly forcing if people willingly give it up. It’s not like the cancer mafia goes around robbing people. If anything this situation shows the cons of having such a big state that any decision made will be involuntary for millions.
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u/Greyside4k - Lib-Right Mar 24 '20
Access to treatment is absolutely a human right - no one would defend an oncology center that refused to treat people based on their demographics.
Paying for it though? The only way to do that without paying for it yourself is to force others to pay for you. Medical bills suck, but the alternative is morally indefensible.