Obamacare 5 years later. Crow, anyone?

[RandFan]

Its evidence

No it's not.

It's fallacy because A.) It is anecdotal and B.) It's just an assertion. It's less than worthless. It's fallacy.

 

[Meadmaker]

Canada and the UK have horrible health care systems.

I have relatives in the UK, and friends in Canada. They are so deluded that they think they have good health care systems.


It's so hard to get good, accurate, information. They keep telling me that everything is good. What's wrong with them? Some of them have had operations, and my aunt(UK) has had four years of cancer treatment even though she was told it would be terminal after at most two years. They have no complaints. I just don't understand their stupidity.

 

[Elf Grinder 3000]

I have relatives in the UK, and friends in Canada. They are so deluded that they think they have good health care systems.


It's so hard to get good, accurate, information. They keep telling me that everything is good. What's wrong with them? Some of them have had operations, and my aunt(UK) has had four years of cancer treatment even though she was told it would be terminal after at most two years. They have no complaints. I just don't understand their stupidity.

Well let them keep their health care! In fact let everyone keep whatever care they want!

Tell them that since everyone gets the right to choose they are only going to be subsidized by others that participate in the program.

Let me know how that works out

 

[Emily's Cat]

Well, remember first of all that ERs have to have spare capacity to meet peak demand which can easily be an order of magnitude higher than average demand and can happen randomly. That means there must be a great deal of unused capacity in the ER, on average: rooms, beds, equipment. Maybe not so much doctors because you can have doctors on call at home.

Have you ever seen an empty ER?

I don't think they actually resource for peak demand - I think they resource for reasonable capacity. It's not uncommon for a full ER to direct ambulances to a different hospital for overflow. Based on my (limited) experience in ERs, as well as what little I know of our contracting and network design, I don't think there's a huge amount of unused capacity in ERs.

There's a reason why insurers use price elasticity to direct traffic to urgent care centers and regular doctor's offices... and ERs, urgent cares, and doctors all profit. Right-sizing resources is a pretty big deal... and that means keeping the non-emergent cases out of the ER.

So that mitigates greatly the problem of the guy with the sore throat taking up too much space. On those rare days when there is a multi-car pileup on the highway, the guy with the sore throat is SOL. He's also probably SOL on Saturday night when all of the victims of barfights, alcohol poisoning, and shootings get brought in.

As for the number of providers one sees, I'm not sure that seeing two people is better than seeing four people for half the time each. I've been to the ER twice in the last four years for moderately serious issues: broken arm and sprained ankle. Both times I felt like I was on an assembly line, and things moved really quickly. For my arm, I was half way out the door with a wrap, a sling, some Vicodin, and a referral to see an orthopedist before I even found out the ulna was broken. I mean I thought it might be broken, but I wasn't sure. And the PA was like, oh, yeah, sorry I guess I forgot to tell you. It's right there on that computer printout I just handed you.

I'm still pretty sure you're wrong in this one. Maybe it's naive belief on my part - always possible. I just end up thinking that if ERs are the model of efficient use... then single payer systems would have more ERs and fewer doctors offices than the US does. Except they don't - it's completely backwards. They have far more generalists and primary care doctors offices, and far fewer specialists and hospitals - including ERs.

So I strongly suspect that we're both missing something simply because we don't have the right knowledge for this. But hey - maybe that's just argumentum ad populum on my part

 

[twinstead]

Let me know how that works out

Much to your consternation, everything seems to be working out quite fine in those godless "socialist" cesspools

 

[Shalamar]

Canada and the UK have horrible health care systems.

My insurance is better than the two countries and we don't have a 100% government run system.

Prove it.

In Canada, you are fully covered, for pretty much everything, without having to pay at point of service.

You don't get billed. No co pays. Less expensive prescriptions.

I suspect, like everything else you comment on, you have no clue on Canada's or the UK health care systems. And I know the Canadian system. My family lives in Canada. They use the health care system. And no one I know whats anything to do with the *************** that is the US system, either before, or after the ACA.

So I will say this.

You are either ignorant, or lying.

Back up your claims with facts, or give up, and apologize for your baseless opinions.

 

[Meadmaker]

Well let them keep their health care! In fact let everyone keep whatever care they want!

Tell them that since everyone gets the right to choose they are only going to be subsidized by others that participate in the program.

Let me know how that works out

It wouldn't work out well, and my aunt would be dead.

 

[Shalamar]

It wouldn't work out well, and my aunt would be dead.

That's what he wants.

 

[RandFan]

It wouldn't work out well, and my aunt would be dead.

That's what he wants.

People why should he care? So long as he can have the benefits of living in a society without ensuring the welfare of others why should he be bothered?

 

[Elf Grinder 3000]

Much to your consternation, everything seems to be working out quite fine in those godless "socialist" cesspools

You call Greece and the EU a success?

Europe is dying and the welfare state is partly to blame

They have a lot of potential but not much innovation comes out of Europe and the massive government with its massive taxes is partly to blame.

 

[Elf Grinder 3000]

That's what he wants.

I want the freedom to buy my own health care, I don't want the government mandating what I buy. That's what I want

You want government healthcare which is inefficient and has skyrocketing costs. and long waiting lines in the UK and Canada

People have died waiting for coverage in these utopias, in the UK the death rate is 4x higher
http://www.dailymail.co.uk/health/article-195277/NHS-death-rates-times-higher-US.html

Your aunt would not have died in the US. Everyone gets coverage, prior to Obamcare, if you have a life threatening illness the government still pays.

 

[RandFan]

You call Greece...

You already know that the problems of Greece have to do with tax evasion so this is just willful dishonesty. Why?

and the EU a success?

Of course, I've provided the proof over and over and over and over and over and.... well, you can't force someone to look at facts.

Europe is dying and the welfare state is partly to blame

I'd ask you for evidence but you know it doesn't exist. Now, here is the part where I post evidence and you ignore it or hand wave it away.

Index of Economic Freedom.

Social Progress Index.

Human Development Index.

 

[Nihilianth]

I don't think you need to be a boss in order to increase your wealth. You do, however, need a way to increase your bargaining power- which means either decreasing the supply of people who are fungible with you or increasing the demand for your specific skill set. It means making your skills somewhat less of a commodity item, and somewhat more unique.

The other way, is for the workforce to stand together on a united front and demand better wages. When it comes to supply and demand, there is, afterall, a single market of employees available for work. If people do what they did a hundred years ago and withdraw their labor, employers would be forced to give in.

 

[Nihilianth]

2. I don't have to pay as much as people in CA and UK for other people's health insurance. My taxes are lower, this is also better.

Maybe your taxes are lower, maybe not. As RF has continually pointed out, this is argument by assertion.

But for argument's sake, let's say your taxes ARE, in fact, lower here in the US than in CA or UK.

Taxes may be lower, but the costs of your healthcare, and your health insurance, is a HEEEEELLLLLL of a lot higher than in either CA or UK!

Give your money to the government where they put it to good use (infrastructure building, a bloated military that "protects your freedoms!" education, you name it.) Or give EVEN MORE MONEY to a money-hungry greedy bastard who will just pocket it, and buy him or herself a yacht that you'll never see.

There's your "choices."

 

[Border Reiver]

Its evidence



1. I have the freedom to purchase the insurance I want in the US, this is better than being forced to purchase a government plan.

In Canada you may purchase supplemental insurance if you desire. You also have access to the entire spectrum of health care.

2. I don't have to pay as much as people in CA and UK for other people's health insurance. My taxes are lower, this is also better.

About $2500 of the taxes my wife and I pay go to maintaining the provincial healthcare system. How much is your annual insurance premium?

3. I don't have to wait for 6 months to get an operation like I would in CA or UK. THerefore its better in the US.



Based on the evidence.



You don't have either evidence or proof

what operation are you referring to? Wait times vary by province and operation as there are a limited number surgeons, etc. that being said, neither my wife or sons have had to wait wait more than three months for any surgery (I've never had anything other than my wisdom teeth out), and surgery for life threatening conditions will get moved ahead of non critical surgery.

 

[3point14]

About $2500 of the taxes my wife and I pay go to maintaining the provincial healthcare system. How much is your annual insurance premium?

I suspect it's not about absolute results. It's about how much btter one's healthcare plan is than one's neighbours or the bloke down the road or those lazy people at the bottom of the pile working three jobs.

 

[twinstead]

You call Greece and the EU a success?

Europe is dying and the welfare state is partly to blame

They have a lot of potential but not much innovation comes out of Europe and the massive government with its massive taxes is partly to blame.

This is when you provide evidence that Europe is 'dying', correct?

 

[anduin]

Canada and the UK have horrible health care systems.

I live in the UK, and while the Tories have been attacking the NHS in the last 5 years, it's still an excellent model. I look at the US and I can't understand how people put up with a more expensive system that doesn't cover all of the population.

Our politicians scare people with the American model.

 

[anduin]

1. I have the freedom to purchase the insurance I want in the US, this is better than being forced to purchase a government plan.

I also have freedom to buy into any private system, but I don't need to, the NHS works quite well.

2. I don't have to pay as much as people in CA and UK for other people's health insurance. My taxes are lower, this is also better.

I don't mind paying taxes to get a system that cover everyone in the country. As to paying as much as people in CA and the UK, I'd be curious to read your figures, would you like to compare?

I'm also not sure about the claim about lower taxes. You have to compare your tax AND your healthcare insurance costs for it to be comparable to the UK.

3. I don't have to wait for 6 months to get an operation like I would in CA or UK. THerefore its better in the US.

I've never had to wait 6 months for anything. I broke my rib last year in a home accident and I had an ambulance in the middle of the night, then next day I had tests, x-rays and ECG without paying a single penny at the point of care. I didn't have to show my insurance papers, I didn't need to worry about cards, payments, or anything.

I love the system that we have, your model is insane.

You didn't provide any evidence, you just stated uneducated, unsupported and uninformed assertions.

 

[sunmaster14]

Have you ever seen an empty ER?

Absolutely. All the time. When I've gone to the ER (not just for myself, so I've been there plenty of times over the years), it's a total crapshoot. Sometimes I get to see a doctor within 15 minutes; sometimes it takes 4 hours. I thought everybody has had that experience.

I don't think they actually resource for peak demand - I think they resource for reasonable capacity. It's not uncommon for a full ER to direct ambulances to a different hospital for overflow. Based on my (limited) experience in ERs, as well as what little I know of our contracting and network design, I don't think there's a huge amount of unused capacity in ERs.

I don't see how there can't be. Pooling the resources of multiple hospitals in the area reduces fluctuations in total demand, but there are still going to be massive fluctuations. The difference between a Saturday night at the ER and a Monday night is probably enormous right there, and that's not even a random fluctuation, so pooling resources doesn't help. Sure, you can staff more doctors at the ER on a Saturday night, but you're not going to be able to expand and contract significant infrastructure over the timescale of days. The existing infrastructure has to handle peak demand. And demand over that amount is buffered by waiting times, with the non-urgent patients waiting the longest.

There's a reason why insurers use price elasticity to direct traffic to urgent care centers and regular doctor's offices... and ERs, urgent cares, and doctors all profit. Right-sizing resources is a pretty big deal... and that means keeping the non-emergent cases out of the ER.

Well, the insurers have to respond to the prices provided by the hospitals. I don't dispute that the prices are higher for ER care than for clinical care. I'm just saying that those prices are artificial. They are however real to the people paying those prices, which includes the insurers.

I'm still pretty sure you're wrong in this one. Maybe it's naive belief on my part - always possible. I just end up thinking that if ERs are the model of efficient use... then single payer systems would have more ERs and fewer doctors offices than the US does. Except they don't - it's completely backwards. They have far more generalists and primary care doctors offices, and far fewer specialists and hospitals - including ERs.

Well, our health care system is all screwed up. Ridiculous incentives have caused major inefficiencies to arise. I wouldn't take the way the system is currently set up as evidence for that being the most efficient solution. It's probably evidence for the opposite actually.

So I strongly suspect that we're both missing something simply because we don't have the right knowledge for this. But hey - maybe that's just argumentum ad populum on my part

Well, that's why I put my ideas out here for review. I want to see if somebody can explain to me if and why I'm wrong. I'd be happy to be proven wrong, if I learn something from it.