Unfortunately none of that deals with the cost of the actual drugs, which is a huge driver in increased costs. One easy, quick solution to that: state that we will pay no more than the average cost of a drug across a basket of similar countries: let's say Canada, the UK and Germany. If you want to charge more for the drug than the average cost across those countries, you can do so but you lose your patent exclusivity. We currently subsidize the rest of the world by paying outrageously high prices compared to similar economies to the point that states are now looking at importing drugs from Canada that were manufactured in the US in the first place.
There's a lot of other waste in the pharmacy/PBM/drug space that could be fixed, but the above is the lowest hanging of fruit.
I was going to mention this but you beat me to the punch.
I am going to skirt dangerously to Tug talk here, but the fact that the US is not only footing the in pharma but in things like biomedical devices is definitely problematic. We might not have the best standard of care, but we’re still the best in scientific/medical research. That research ain’t cheap and the cost has to be passed on to somebody.
That’s why when people start comparing the US healthcare system to other countries, I get a little upset. There are some very unique problems that the US has to deal with that other countries do not. It’s fine to look to these places for ideas, but trying to replicate Canada or anyone else probably won’t work.
Truth is, there is no such thing as completely private R&D in medicine or biotech. NSF is almost always somewhere in the funding tree. And, yes, that includes Harvard and its $31 billion endowment. You'd think they wouldn't need the Fed's money. But that's in part why they have $31 billion. They know the power of spending other people's money.
I think it's difficult to discuss this because so many people refuse to even entertain the idea that the U.S. healthcare system isn't the gold standard in the world. All they hear is how we get the best care in the world, so changing the system would result in a lower standard of care. I don't understand how anybody could look at the data and come to that conclusion, though:
/>
I think it's best to separate the quality of care vs how we pay for it. I don't think anyone would argue that most hospitals deliver quality outcomes. I don't think it's a secret that when a wealthy person from another country on one of those charts needs emergency heart surgery that they come to the USA for it. There's obviously a problem when someone goes bankrupt due to medical bills though.
I'm watching the Crown on Netflix. I get most of my information from Netlfix and pendantically pass it off as my own knowledge.
Anyway, Churchill's Foreign Sec'y, Anthony Eden, is in the US meeting with someone, and he's having severe pancreas issues and needs surgery. Wants to do it in Boston because it's the best place in the word for that surgery. But not because of capitalism. He says to Churchill, he says, "because of the high fat diet in the US"; so we're good at fixing things caused by being like @CFetters_Nacho_Lover and @CfettersNachoLover . According to the pasty Brits.
So, I wonder, but don't necessarily know or believe, if we're good at some things and other countries are good at other things. Are we good at some medical technology because of the nature of our demographics and not because of the system? IDK. Maybe it doesn't matter.
Anyway, thought I'd throw some causation analysis in for fun.
Interesting point. I chortled at a brit mocking any other country for their diet. In the UK, I also think mr. pancreatitis would have had to wait his turn for his procedure. Or maybe if he was a bigwig he could have jumped the line.
I don't know about the fat content, which I'd guess is just as bad; but the fucking taste and the things they eat ... JFC those people can't cook.
The royal family apparently eschews garlic. Literally forbidden in the Buckingham palace kitchen. Hey Britty, try it sometime. It might make your disgusting food taste a bit better.
Anyway, I digress.
We’re all having big belly (YSWIDT) laffs in the press room about the fatty shit Americans eat, but this another example of what I’m talking about with challenges that the US faces and other nations don’t (well, until recently as we?ve gotten very good at exporting fast food), is obesity and diet.
I know it’s fashionable on this bored to make fun of overweight people, but it is a very real problem for many that leads to other serious conditions and ultimately drives up the cost of healthcare.
Again, I have no clue how to solve it. But that’s another layer of complexity to the issue.
I think it's difficult to discuss this because so many people refuse to even entertain the idea that the U.S. healthcare system isn't the gold standard in the world. All they hear is how we get the best care in the world, so changing the system would result in a lower standard of care. I don't understand how anybody could look at the data and come to that conclusion, though:
/>
I think it's best to separate the quality of care vs how we pay for it. I don't think anyone would argue that most hospitals deliver quality outcomes. I don't think it's a secret that when a wealthy person from another country on one of those charts needs emergency heart surgery that they come to the USA for it. There's obviously a problem when someone goes bankrupt due to medical bills though.
I'm watching the Crown on Netflix. I get most of my information from Netlfix and pendantically pass it off as my own knowledge.
Anyway, Churchill's Foreign Sec'y, Anthony Eden, is in the US meeting with someone, and he's having severe pancreas issues and needs surgery. Wants to do it in Boston because it's the best place in the word for that surgery. But not because of capitalism. He says to Churchill, he says, "because of the high fat diet in the US"; so we're good at fixing things caused by being like @CFetters_Nacho_Lover and @CfettersNachoLover . According to the pasty Brits.
So, I wonder, but don't necessarily know or believe, if we're good at some things and other countries are good at other things. Are we good at some medical technology because of the nature of our demographics and not because of the system? IDK. Maybe it doesn't matter.
Anyway, thought I'd throw some causation analysis in for fun.
Interesting point. I chortled at a brit mocking any other country for their diet. In the UK, I also think mr. pancreatitis would have had to wait his turn for his procedure. Or maybe if he was a bigwig he could have jumped the line.
I don't know about the fat content, which I'd guess is just as bad; but the fucking taste and the things they eat ... JFC those people can't cook.
The royal family apparently eschews garlic. Literally forbidden in the Buckingham palace kitchen. Hey Britty, try it sometime. It might make your disgusting food taste a bit better.
Anyway, I digress.
We’re all having big belly (YSWIDT) laffs in the press room about diet, but this another example of what I’m talking about with challenges that the US faces that, until recently (because we?ve exported American fast food), is obesity and diet.
I know it’s fashionable on this bored to make fun of fat people, but it is a very real problem for many that leads to other serious conditions and ultimately drives up the cost of healthcare.
Again, I have no clue how to solve it. But that’s another layer of complexity to the issue.
Good point about obesity. No easy solutions, and I want to enjoy my food and my god given right to mock fatties, but there are some better approaches:
...only about 3.5% of the population is classified as obese, compared to rates as high as 30% or greater in countries like the U.S. And it's not just a generally healthier diet and lifestyle that's kept the Japanese trim.
Citizens must adhere to government-mandated waistline limits or face consequences. The government has established waistline limits for adults ages 40 to 74. Men must maintain a waistline at or below 33.5 inches; for women, the limit is 35.4 inches. The "metabo law" went into effect in 2008, with the goal of reducing the country's overweight population by 25% by 2015. The government's anti-obesity campaign aims to keep "metabolic syndrome" — a number of factors that heighten the risk of developing diabetes and vascular diseases, such as obesity and high blood pressure, glucose and cholesterol levels — in check, thus minimizing the ballooning health care costs of Japan's massive aging population.
My plan is all people who have medical conditions due to being obese or smoking, etc get no help from taxpayers. Costs of everything go down for people who try to lead a decent lifestyle. Leave the fat people to the churches.
My two cents: The cost of the progression of technology and the embedded return on investment for facilities has created the higher cost of care in the US.
When I was younger we had a charming show on early TV ~ Marcus Welby MD with two actors that would focus on one malady after another in the various episodes. The humorous part was that there was no technology in the day so really the doctors were largely flying blind.. the testing was elemental and rudimentary and as a result the solutions were often country doctor approaches which amounted to try this because it has been helpful to similar cases that I have seen over time. Many surgeries were exploratory in nature which amounted to lets take a look and go from there.
Fast forward to today and the picture is vastly different ~ visualization through MRI, Sonar, CaTSCAN ETC provides unheard of levels of advanced diagnosis, drugs platforms have widened as research has created sceismic breakthroughs, sophisticated levels of testing is geometrically better, hospital facilities are geometrically better and the level of sophistication has gone skyward as we approach levels of bionic healthcare solutions.
the issue is that all of this has been accomplished within the construct of Profit Based modeling which has caused pricing to go skyward as well. As an example, during the 80]s and 90's the growth rate of earnings revenue and cash flow for drug companies, hospital companies, medical supplies, surgical technology and the beginnings of biotech all grew 3x faster than the underlying economy.
The growth rate advanced just like clockwork. Since 2000, the growth rate of these groups has slowed as a result of the increased size and scale of the remaining companies, and the increased cost basis of operation has occurred as a result of the accumulated levels of increased pricing *** occurring over the last 30 years.
*** [During the 80's - 90's the accelerated growth rate also meant accelerated buyouts that reduced the number of competing companies in geometric fashion as furiously companies bought each other. Each buyout typically came at a premium to the publicly listed price through stock swaps and debt employed to close the deal. The importance is that the geometric buyout pattern reduced competition and increased the cost basis of the cost of care without providing additional benefit. ]
Summary: our health care provider network has the greatest access to technology available, and also the highest profit generating basis of operation on the planet ~ no wonder it doesn't profile like any other health care system ~ the entire basis of operation is fundamentally different.
My plan is all people who have medical conditions due to being obese or smoking, etc get no help from taxpayers. Costs of everything go down for people who try to lead a decent lifestyle. Leave the fat people to the churches.
the issue is that all of this has been accomplished within the construct of Profit Based modeling which has caused pricing to go skyward as well. As an example, during the 80]s and 90's the growth rate of earnings revenue and cash flow for drug companies, hospital companies, medical supplies, surgical technology and the beginnings of biotech all grew 3x faster than the underlying economy.
Waiting for @Swaye to come in with tall tales about VA medical care.
My plan is all people who have medical conditions due to being obese or smoking, etc get no help from taxpayers. Costs of everything go down for people who try to lead a decent lifestyle. Leave the fat people to the churches.
We must not forget about people who use pot, have unprotected sex, drink alcohol, do extreme sports, don’t floss, etc.
I get where you’re coming from, we do have to have some accountability in all of our own individual healthcare. But until there’s better access to preventative care and address some of things in America that contribute to a sedentary lifestyle (for example) I don’t think punishing people will work.
My plan is all people who have medical conditions due to being obese or smoking, etc get no help from taxpayers. Costs of everything go down for people who try to lead a decent lifestyle. Leave the fat people to the churches.
We must not forget about people who use pot, have unprotected sex, drink alcohol, do extreme sports, don’t floss, etc.
I get where you’re coming from, we do have to have some accountability in all of our own individual healthcare. But until there’s better access to preventative care and address some of things in America that contribute to a sedentary lifestyle (for example) I don’t think punishing people will work.
This is a great point. What do I owe anybody who plays, or let's their kids play, football and 28 concussions later need life-tim care.
And, yeah, you nailed it: drugs and alcohol ... and smoking. We? are picking on fatty here ( @CFetters_Nacho_Lover and @CfettersNachoLover , still waiting for you to weigh (lolz) in), but the troof is we? put A LOT of bad shit into our bodies.
I think it's difficult to discuss this because so many people refuse to even entertain the idea that the U.S. healthcare system isn't the gold standard in the world. All they hear is how we get the best care in the world, so changing the system would result in a lower standard of care. I don't understand how anybody could look at the data and come to that conclusion, though:
/>
I think it's best to separate the quality of care vs how we pay for it. I don't think anyone would argue that most hospitals deliver quality outcomes. I don't think it's a secret that when a wealthy person from another country on one of those charts needs emergency heart surgery that they come to the USA for it. There's obviously a problem when someone goes bankrupt due to medical bills though.
I'm watching the Crown on Netflix. I get most of my information from Netlfix and pendantically pass it off as my own knowledge.
Anyway, Churchill's Foreign Sec'y, Anthony Eden, is in the US meeting with someone, and he's having severe pancreas issues and needs surgery. Wants to do it in Boston because it's the best place in the word for that surgery. But not because of capitalism. He says to Churchill, he says, "because of the high fat diet in the US"; so we're good at fixing things caused by being like @CFetters_Nacho_Lover and @CfettersNachoLover . According to the pasty Brits.
So, I wonder, but don't necessarily know or believe, if we're good at some things and other countries are good at other things. Are we good at some medical technology because of the nature of our demographics and not because of the system? IDK. Maybe it doesn't matter.
Anyway, thought I'd throw some causation analysis in for fun.
Interesting point. I chortled at a brit mocking any other country for their diet. In the UK, I also think mr. pancreatitis would have had to wait his turn for his procedure. Or maybe if he was a bigwig he could have jumped the line.
I don't know about the fat content, which I'd guess is just as bad; but the fucking taste and the things they eat ... JFC those people can't cook.
The royal family apparently eschews garlic. Literally forbidden in the Buckingham palace kitchen. Hey Britty, try it sometime. It might make your disgusting food taste a bit better.
I think it's difficult to discuss this because so many people refuse to even entertain the idea that the U.S. healthcare system isn't the gold standard in the world. All they hear is how we get the best care in the world, so changing the system would result in a lower standard of care. I don't understand how anybody could look at the data and come to that conclusion, though:
/>
I think it's best to separate the quality of care vs how we pay for it. I don't think anyone would argue that most hospitals deliver quality outcomes. I don't think it's a secret that when a wealthy person from another country on one of those charts needs emergency heart surgery that they come to the USA for it. There's obviously a problem when someone goes bankrupt due to medical bills though.
I'm watching the Crown on Netflix. I get most of my information from Netlfix and pendantically pass it off as my own knowledge.
Anyway, Churchill's Foreign Sec'y, Anthony Eden, is in the US meeting with someone, and he's having severe pancreas issues and needs surgery. Wants to do it in Boston because it's the best place in the word for that surgery. But not because of capitalism. He says to Churchill, he says, "because of the high fat diet in the US"; so we're good at fixing things caused by being like @CFetters_Nacho_Lover and @CfettersNachoLover . According to the pasty Brits.
So, I wonder, but don't necessarily know or believe, if we're good at some things and other countries are good at other things. Are we good at some medical technology because of the nature of our demographics and not because of the system? IDK. Maybe it doesn't matter.
Anyway, thought I'd throw some causation analysis in for fun.
Interesting point. I chortled at a brit mocking any other country for their diet. In the UK, I also think mr. pancreatitis would have had to wait his turn for his procedure. Or maybe if he was a bigwig he could have jumped the line.
I don't know about the fat content, which I'd guess is just as bad; but the fucking taste and the things they eat ... JFC those people can't cook.
The royal family apparently eschews garlic. Literally forbidden in the Buckingham palace kitchen. Hey Britty, try it sometime. It might make your disgusting food taste a bit better.
Anyway, I digress.
We’re all having big belly (YSWIDT) laffs in the press room about diet, but this another example of what I’m talking about with challenges that the US faces that, until recently (because we?ve exported American fast food), is obesity and diet.
I know it’s fashionable on this bored to make fun of fat people, but it is a very real problem for many that leads to other serious conditions and ultimately drives up the cost of healthcare.
Again, I have no clue how to solve it. But that’s another layer of complexity to the issue.
Good point about obesity. No easy solutions, and I want to enjoy my food and my god given right to mock fatties, but there are some better approaches:
...only about 3.5% of the population is classified as obese, compared to rates as high as 30% or greater in countries like the U.S. And it's not just a generally healthier diet and lifestyle that's kept the Japanese trim.
Citizens must adhere to government-mandated waistline limits or face consequences. The government has established waistline limits for adults ages 40 to 74. Men must maintain a waistline at or below 33.5 inches; for women, the limit is 35.4 inches. The "metabo law" went into effect in 2008, with the goal of reducing the country's overweight population by 25% by 2015. The government's anti-obesity campaign aims to keep "metabolic syndrome" — a number of factors that heighten the risk of developing diabetes and vascular diseases, such as obesity and high blood pressure, glucose and cholesterol levels — in check, thus minimizing the ballooning health care costs of Japan's massive aging population.
That approach might work in Japan, that is more homogeneous in make up and culturally puts a high emphasis on not straying to far from the norm. Plus they’re less reliant on cars (walk more) and have mostly higher quality, more nutritious food.
I didn’t mean to derail this topic into how to fight obesity, by the way. Again, I just think whatever is done with healthcare needs to work (at least in the short term), within an *American* framework.
My plan is all people who have medical conditions due to being obese or smoking, etc get no help from taxpayers. Costs of everything go down for people who try to lead a decent lifestyle. Leave the fat people to the churches.
We must not forget about people who use pot, have unprotected sex, drink alcohol, do extreme sports, don’t floss, etc.
I get where you’re coming from, we do have to have some accountability in all of our own individual healthcare. But until there’s better access to preventative care and address some of things in America that contribute to a sedentary lifestyle (for example) I don’t think punishing people will work.
This is a great point. What do I owe anybody who plays, or let's their kids play, football and 28 concussions later need life-tim care.
And, yeah, you nailed it: drugs and alcohol ... and smoking. We? are picking on fatty here ( @CFetters_Nacho_Lover and @CfettersNachoLover , still waiting for you to weigh (lolz) in), but the troof is we? put A LOT of bad shit into our bodies.
I wouldn’t even go to that extreme...I know so many bicyclists that have needed MULTIPLE knee surgeries because they train too hard or are reckless on mountain trails.
And now we have people with carpal tunnel or other issues from sitting at a desk using a computer for too long.
And the TV watching. YOU’LL RUIN YOUR EYES!!!!!!1 😅
I think it's difficult to discuss this because so many people refuse to even entertain the idea that the U.S. healthcare system isn't the gold standard in the world. All they hear is how we get the best care in the world, so changing the system would result in a lower standard of care. I don't understand how anybody could look at the data and come to that conclusion, though:
/>
I think it's best to separate the quality of care vs how we pay for it. I don't think anyone would argue that most hospitals deliver quality outcomes. I don't think it's a secret that when a wealthy person from another country on one of those charts needs emergency heart surgery that they come to the USA for it. There's obviously a problem when someone goes bankrupt due to medical bills though.
I'm watching the Crown on Netflix. I get most of my information from Netlfix and pendantically pass it off as my own knowledge.
Anyway, Churchill's Foreign Sec'y, Anthony Eden, is in the US meeting with someone, and he's having severe pancreas issues and needs surgery. Wants to do it in Boston because it's the best place in the word for that surgery. But not because of capitalism. He says to Churchill, he says, "because of the high fat diet in the US"; so we're good at fixing things caused by being like @CFetters_Nacho_Lover and @CfettersNachoLover . According to the pasty Brits.
So, I wonder, but don't necessarily know or believe, if we're good at some things and other countries are good at other things. Are we good at some medical technology because of the nature of our demographics and not because of the system? IDK. Maybe it doesn't matter.
Anyway, thought I'd throw some causation analysis in for fun.
Interesting point. I chortled at a brit mocking any other country for their diet. In the UK, I also think mr. pancreatitis would have had to wait his turn for his procedure. Or maybe if he was a bigwig he could have jumped the line.
I don't know about the fat content, which I'd guess is just as bad; but the fucking taste and the things they eat ... JFC those people can't cook.
The royal family apparently eschews garlic. Literally forbidden in the Buckingham palace kitchen. Hey Britty, try it sometime. It might make your disgusting food taste a bit better.
Anyway, I digress.
We’re all having big belly (YSWIDT) laffs in the press room about diet, but this another example of what I’m talking about with challenges that the US faces that, until recently (because we?ve exported American fast food), is obesity and diet.
I know it’s fashionable on this bored to make fun of fat people, but it is a very real problem for many that leads to other serious conditions and ultimately drives up the cost of healthcare.
Again, I have no clue how to solve it. But that’s another layer of complexity to the issue.
Good point about obesity. No easy solutions, and I want to enjoy my food and my god given right to mock fatties, but there are some better approaches:
...only about 3.5% of the population is classified as obese, compared to rates as high as 30% or greater in countries like the U.S. And it's not just a generally healthier diet and lifestyle that's kept the Japanese trim.
Citizens must adhere to government-mandated waistline limits or face consequences. The government has established waistline limits for adults ages 40 to 74. Men must maintain a waistline at or below 33.5 inches; for women, the limit is 35.4 inches. The "metabo law" went into effect in 2008, with the goal of reducing the country's overweight population by 25% by 2015. The government's anti-obesity campaign aims to keep "metabolic syndrome" — a number of factors that heighten the risk of developing diabetes and vascular diseases, such as obesity and high blood pressure, glucose and cholesterol levels — in check, thus minimizing the ballooning health care costs of Japan's massive aging population.
That approach might work in Japan, that is more homogeneous in make up and culturally puts a high emphasis on not straying to far from the norm. Plus they’re less reliant on cars (walk more) and have mostly higher quality, more nutritious food.
I didn’t mean to derail this topic into how to fight obesity, by the way. Again, I just think whatever is done with healthcare needs to work (at least in the short term), within an *American* framework.
It's an important point because obesity is a leading factor for heart disease, diabetes, and cancer. And in the US this approach is not helping:
My plan is all people who have medical conditions due to being obese or smoking, etc get no help from taxpayers. Costs of everything go down for people who try to lead a decent lifestyle. Leave the fat people to the churches.
We must not forget about people who use pot, have unprotected sex, drink alcohol, do extreme sports, don’t floss, etc.
I get where you’re coming from, we do have to have some accountability in all of our own individual healthcare. But until there’s better access to preventative care and address some of things in America that contribute to a sedentary lifestyle (for example) I don’t think punishing people will work.
This is a great point. What do I owe anybody who plays, or let's their kids play, football and 28 concussions later need life-tim care.
And, yeah, you nailed it: drugs and alcohol ... and smoking. We? are picking on fatty here ( @CFetters_Nacho_Lover and @CfettersNachoLover , still waiting for you to weigh (lolz) in), but the troof is we? put A LOT of bad shit into our bodies.
Yes and as I channel the Angelic Presence from the 11th dimension, they are consistent with their message that raising your vibration through the love chakra and banashing negative thoughts at inception is the key to transcendental physical, emotional and spiritual health ~ so all of this worrying about the financial markets and being miserable about the black hole recruiting dumpster fire is counter productive to your health. Zen babay.
I think it's best to separate the quality of care vs how we pay for it. I don't think anyone would argue that most hospitals deliver quality outcomes. I don't think it's a secret that when a wealthy person from another country on one of those charts needs emergency heart surgery that they come to the USA for it. There's obviously a problem when someone goes bankrupt due to medical bills though.
I think the quality of care in the USA vs. other countries is often overstated. Take your example of emergency heart surgery: For starters, it's probably not that big of an emergency if there's time to travel abroad to get on the operating table... But also, there are plenty of countries with cardiac clinics that rival the best in the USA. I went looking for top rated cardiac clinics in the world, and it turns out that it's hard to find real data. The USA tends to dominate the tippy top of the list, but only on lists that are based off of things like positive reviews. What I wanted to see was hard data on outcomes, but I didn't have time to keep looking. There are cardiac centers in Germany, the UK, Japan, Isreal, etc. that are world class. If rich people are coming to the USA for treatment, it's probably because the USA is good at letting rich people pay $100K cash for a surgery and skip to the front of the line. Agree on your last sentence, though. Last I heard, medical bankruptcy is a thing that exists only in our country.
I am going to skirt dangerously to Tug talk here, but the fact that the US is not only footing the in pharma but in things like biomedical devices is definitely problematic. We might not have the best standard of care, but we’re still the best in scientific/medical research. That research ain’t cheap and the cost has to be passed on to somebody.
That’s why when people start comparing the US healthcare system to other countries, I get a little upset. There are some very unique problems that the US has to deal with that other countries do not. It’s fine to look to these places for ideas, but trying to replicate Canada or anyone else probably won’t work.
Summary: our health care provider network has the greatest access to technology available, and also the highest profit generating basis of operation on the planet ~ no wonder it doesn't profile like any other health care system ~ the entire basis of operation is fundamentally different.
To these last two, I also think the notion that the USA is king shit of turd mountain when it comes to R&D and technology is also very overstated here. Unfortunately, I don't have time to find data that breaks down R&D spending in specific fields like medical research, but the OECD, World Bank, etc. track gross R&D spending for all nations as a total (USA #1!), percentage of GDP (USA #10 behind countries with public medical systems like Isreal, South Korea, Sweden, Japan, Switzerland, Austria, Germany, Denmark), and per capita (#2 behind South Korea). Per capita is interesting, too, as it's fair to ask the question: In the USA, we pay so much more per capita for our medical care, so how far down the list would we be once you subtract the premium we pay over even the next most costly medical system? Well, we wouldn't even be on the list, as our premium over Switzerland is larger per capita than the highest per-capita cost of R&D on the whole list.
Let's just look at this practically, too. Whiz bang medical research and technology is worthless if only the rich can afford to use it. When I separated my shoulder and wanted surgery, I asked for an MRI so I could be referred to a surgeon. I was told I had to do six weeks of physical therapy first on a broken wing before that was an option. In Japan, your family doctor would have an MRI machine in his office. You'd walk down the hall and climb in. There is one such machine in my entire county.
We’re all having big belly (YSWIDT) laffs in the press room about the fatty shit Americans eat, but this another example of what I’m talking about with challenges that the US faces and other nations don’t (well, until recently as we?ve gotten very good at exporting fast food), is obesity and diet.
I didn’t mean to derail this topic into how to fight obesity, by the way. Again, I just think whatever is done with healthcare needs to work (at least in the short term), within an *American* framework.
But that's the thing. America faces challenges other nations don't because we're too stubborn to fix things. Deregulation and muh freedoms are the greatest virtue here, and people are perfectly happy to suffer just to stick it to the man. In the USA, we don't prevent disease and the underlying conditions, we treat these conditions in the emergency room once they've become 100 times costlier. Fixing healthcare "within an American framework" is an oxymoron.
@1to392831weretaken states "To these last two, I also think the notion that the USA is king shit of turd mountain when it comes to R&D and technology is also very overstated here. Unfortunately, I don't have time to find data that breaks down R&D spending in specific fields like medical research, but the OECD, World Bank, etc. track gross R&D spending for all nations as a total (USA #1!), percentage of GDP (USA #10 behind countries with public medical systems like Isreal, South Korea, Sweden, Japan, Switzerland, Austria, Germany, Denmark), and per capita (#2 behind South Korea). Per capita is interesting, too, as it's fair to ask the question: In the USA, we pay so much more per capita for our medical care, so how far down the list would we be once you subtract the premium we pay over even the next most costly medical system? Well, we wouldn't even be on the list, as our premium over Switzerland is larger per capita than the highest per-capita cost of R&D on the whole list.
Let's just look at this practically, too. Whiz bang medical research and technology is worthless if only the rich can afford to use it. When I separated my shoulder and wanted surgery, I asked for an MRI so I could be referred to a surgeon. I was told I had to do six weeks of physical therapy first on a broken wing before that was an option. In Japan, your family doctor would have an MRI machine in his office. You'd walk down the hall and climb in. There is one such machine in my entire county."
I don't disagree, I was making the subtle point that the super high inflation of healthcare marketplace capitalization in the US has in large part driven the technological advances globally and after the costs have come down because of size and scale of production, everyday use of previously exclusive limited availability technology has become the norm globally, with much more reach than would otherwise have happened ~ that wouldn't have happened on this kind of size and scale and timeline [and maybe not at all] without the profit induced mega cash flow bubble in the US previously having funded it.
Doesn't speak to the outcome for how to fix our cost benefit equations, just states the perhaps unseen net effect of our previously overstated tech cash flow and artificially high profit margins bubble in all things medical care.
My plan is all people who have medical conditions due to being obese or smoking, etc get no help from taxpayers. Costs of everything go down for people who try to lead a decent lifestyle. Leave the fat people to the churches.
We must not forget about people who use pot, have unprotected sex, drink alcohol, do extreme sports, don’t floss, etc.
I get where you’re coming from, we do have to have some accountability in all of our own individual healthcare. But until there’s better access to preventative care and address some of things in America that contribute to a sedentary lifestyle (for example) I don’t think punishing people will work.
Many of those things are examples of things you can use in moderation and not have issues. Being obese leads to a cascading effect of conditions. If you're going to subsidize obese people they should be on a policy of "hit these weight loss targets or lose your care."
Unprotected sex would probably be a net positive right now given the birth rate is at a historic low and we're having to import more labor than ever.
I think it's difficult to discuss this because so many people refuse to even entertain the idea that the U.S. healthcare system isn't the gold standard in the world. All they hear is how we get the best care in the world, so changing the system would result in a lower standard of care. I don't understand how anybody could look at the data and come to that conclusion, though:
I've really liked this graph since I saw it in 2011, as it really puts things in perspective, comparing per-capita spending, results (in the form of life expectancy at birth), and number of doctor visits per year. So cost, quantity, quality all on one graph:
Not exactly crushing it in infant mortality, either:
Now add the graph where it shows government spending as a percentage of the market over those years and outcomes...what's the R value on that?
Unfortunately none of that deals with the cost of the actual drugs, which is a huge driver in increased costs. One easy, quick solution to that: state that we will pay no more than the average cost of a drug across a basket of similar countries: let's say Canada, the UK and Germany. If you want to charge more for the drug than the average cost across those countries, you can do so but you lose your patent exclusivity. We currently subsidize the rest of the world by paying outrageously high prices compared to similar economies to the point that states are now looking at importing drugs from Canada that were manufactured in the US in the first place.
There's a lot of other waste in the pharmacy/PBM/drug space that could be fixed, but the above is the lowest hanging of fruit.
[We should also stop letting the rest of the world bully our pharma industries as we are essentially subsidizing all medical pharma research for all the "socialized" medical programs of the world.]
Or we could stop letting those countries get free rides on our tax dollar subsidized research. I'm sure we would be accused of imperialism or whatever but research costs are extremely high and have to be recouped somehow. You either get lower costs with less breakthroughs or the inverse. Fuck it, stop giving away generics to the CCP because they have "developing nation" status and charge them a premium for being an adversary.
p.s. there's a reason the most money to be made is in boner pills and it isn't just the demand factor.
My plan is all people who have medical conditions due to being obese or smoking, etc get no help from taxpayers. Costs of everything go down for people who try to lead a decent lifestyle. Leave the fat people to the churches.
Or just don't socialize the costs and let people pay for their own medical needs and expenses as they see fit or can afford to. *gasp
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I know it’s fashionable on this bored to make fun of overweight people, but it is a very real problem for many that leads to other serious conditions and ultimately drives up the cost of healthcare.
Again, I have no clue how to solve it. But that’s another layer of complexity to the issue.
...only about 3.5% of the population is classified as obese, compared to rates as high as 30% or greater in countries like the U.S. And it's not just a generally healthier diet and lifestyle that's kept the Japanese trim.
Citizens must adhere to government-mandated waistline limits or face consequences. The government has established waistline limits for adults ages 40 to 74. Men must maintain a waistline at or below 33.5 inches; for women, the limit is 35.4 inches. The "metabo law" went into effect in 2008, with the goal of reducing the country's overweight population by 25% by 2015. The government's anti-obesity campaign aims to keep "metabolic syndrome" — a number of factors that heighten the risk of developing diabetes and vascular diseases, such as obesity and high blood pressure, glucose and cholesterol levels — in check, thus minimizing the ballooning health care costs of Japan's massive aging population.
https://www.mic.com/articles/84521/japan-has-cut-obesity-to-3-5-in-a-controversial-way-that-wouldn-t-fly-in-america
When I was younger we had a charming show on early TV ~ Marcus Welby MD with two actors that would focus on one malady after another in the various episodes. The humorous part was that there was no technology in the day so really the doctors were largely flying blind.. the testing was elemental and rudimentary and as a result the solutions were often country doctor approaches which amounted to try this because it has been helpful to similar cases that I have seen over time. Many surgeries were exploratory in nature which amounted to lets take a look and go from there.
Fast forward to today and the picture is vastly different ~ visualization through MRI, Sonar, CaTSCAN ETC provides unheard of levels of advanced diagnosis, drugs platforms have widened as research has created sceismic breakthroughs, sophisticated levels of testing is geometrically better, hospital facilities are geometrically better and the level of sophistication has gone skyward as we approach levels of bionic healthcare solutions.
the issue is that all of this has been accomplished within the construct of Profit Based modeling which has caused pricing to go skyward as well. As an example, during the 80]s and 90's the growth rate of earnings revenue and cash flow for drug companies, hospital companies, medical supplies, surgical technology and the beginnings of biotech all grew 3x faster than the underlying economy.
The growth rate advanced just like clockwork. Since 2000, the growth rate of these groups has slowed as a result of the increased size and scale of the remaining companies, and the increased cost basis of operation has occurred as a result of the accumulated levels of increased pricing *** occurring over the last 30 years.
*** [During the 80's - 90's the accelerated growth rate also meant accelerated buyouts that reduced the number of competing companies in geometric fashion as furiously companies bought each other. Each buyout typically came at a premium to the publicly listed price through stock swaps and debt employed to close the deal. The importance is that the geometric buyout pattern reduced competition and increased the cost basis of the cost of care without providing additional benefit. ]
Summary: our health care provider network has the greatest access to technology available, and also the highest profit generating basis of operation on the planet ~ no wonder it doesn't profile like any other health care system ~ the entire basis of operation is fundamentally different.
the issue is that all of this has been accomplished within the construct of Profit Based modeling which has caused pricing to go skyward as well. As an example, during the 80]s and 90's the growth rate of earnings revenue and cash flow for drug companies, hospital companies, medical supplies, surgical technology and the beginnings of biotech all grew 3x faster than the underlying economy.
Waiting for @Swaye to come in with tall tales about VA medical care.
I get where you’re coming from, we do have to have some accountability in all of our own individual healthcare. But until there’s better access to preventative care and address some of things in America that contribute to a sedentary lifestyle (for example) I don’t think punishing people will work.
And, yeah, you nailed it: drugs and alcohol ... and smoking. We? are picking on fatty here ( @CFetters_Nacho_Lover and @CfettersNachoLover , still waiting for you to weigh (lolz) in), but the troof is we? put A LOT of bad shit into our bodies.
I didn’t mean to derail this topic into how to fight obesity, by the way. Again, I just think whatever is done with healthcare needs to work (at least in the short term), within an *American* framework.
And now we have people with carpal tunnel or other issues from sitting at a desk using a computer for too long.
And the TV watching. YOU’LL RUIN YOUR EYES!!!!!!1 😅
Let's just look at this practically, too. Whiz bang medical research and technology is worthless if only the rich can afford to use it. When I separated my shoulder and wanted surgery, I asked for an MRI so I could be referred to a surgeon. I was told I had to do six weeks of physical therapy first on a broken wing before that was an option. In Japan, your family doctor would have an MRI machine in his office. You'd walk down the hall and climb in. There is one such machine in my entire county. But that's the thing. America faces challenges other nations don't because we're too stubborn to fix things. Deregulation and muh freedoms are the greatest virtue here, and people are perfectly happy to suffer just to stick it to the man. In the USA, we don't prevent disease and the underlying conditions, we treat these conditions in the emergency room once they've become 100 times costlier. Fixing healthcare "within an American framework" is an oxymoron.
Let's just look at this practically, too. Whiz bang medical research and technology is worthless if only the rich can afford to use it. When I separated my shoulder and wanted surgery, I asked for an MRI so I could be referred to a surgeon. I was told I had to do six weeks of physical therapy first on a broken wing before that was an option. In Japan, your family doctor would have an MRI machine in his office. You'd walk down the hall and climb in. There is one such machine in my entire county."
I don't disagree, I was making the subtle point that the super high inflation of healthcare marketplace capitalization in the US has in large part driven the technological advances globally and after the costs have come down because of size and scale of production, everyday use of previously exclusive limited availability technology has become the norm globally, with much more reach than would otherwise have happened ~ that wouldn't have happened on this kind of size and scale and timeline [and maybe not at all] without the profit induced mega cash flow bubble in the US previously having funded it.
Doesn't speak to the outcome for how to fix our cost benefit equations, just states the perhaps unseen net effect of our previously overstated tech cash flow and artificially high profit margins bubble in all things medical care.
Unprotected sex would probably be a net positive right now given the birth rate is at a historic low and we're having to import more labor than ever.
Or we could stop letting those countries get free rides on our tax dollar subsidized research. I'm sure we would be accused of imperialism or whatever but research costs are extremely high and have to be recouped somehow. You either get lower costs with less breakthroughs or the inverse. Fuck it, stop giving away generics to the CCP because they have "developing nation" status and charge them a premium for being an adversary.
p.s. there's a reason the most money to be made is in boner pills and it isn't just the demand factor.