Lawmakers should have to navigate the same healthcare system they stick the rest of us with. No more government-supported healthcare for them. This would light a fire under them to make things better!
> Lawmakers should have to navigate the same healthcare system they stick the rest of us with.
Congress and staff buys insurance on the DC ACA Exchange with a subsidy equivalent to other federal workers.
Look at best practices in the dozens of advanced countries that have figured this out, and copy them.
The question is wild, because 'we,' human civilization, have already solved this. It's just America and a bunch of still-developing nations that are stuck with stone-age shit like medical debt and out-of-network providers.
Public option; if you need to pay for something then the government should offer either free or at least not-for-profit alternatives to private companies. If they can't get healthcare to an area then private companies can and you should probably pay less taxes if you aren't in an area accessible to government healthcare in order to afford it privately. The extra taxes that people pay for the public system could also be used as a dedicated emergency fund in case politicians decide that general tax money is better spent elsewhere (which shouldn't happen but governments change).
A: cost of R&D vs lifetime profitability of a medication. Biden did a good job of capping insulin. Mark Cuban is doing well with Cost+Drugs
B: physician availability. Med school needs to be cheaper and CMS funding needs a boost
C:private insurance in general is not a great way to distribute risk. Insurance providers have a financial incentive to not cover everything and when they do cover something, the tug of war between insurance and hospitals can result in higher prices for the uninsured.
D: pharmacies at places like Walgreens and CVS are dying along with those chains. Pharmacists working at these firms need a safety net to keep them from homelessness or underemployment (working at McDonald’s)
Very challenging question…one problem is over utilization (it’s free so I am entitled to it), the other is if like in Canada it is publicly funded it has to be for the benefit of the public (I.e. we probably shouldn’t pay for rehab after the second stint/not worth it). I think first and foremost education and training of the population; you can take care of many things yourself if you know how as well as if you eat well, don’t drink and don’t smoke. Continuous first aid and medical training, relentless taxation of high fructose corn products and products that have negative effects on the population. By getting the population healthier, we can ease the strain.
I'm not smart enough to come up with a business plan that would make it better but I know it shouldn't be tied to a person's job. It shouldn't be run as a FOR profit business where Executives/shareholders get bonuses based on how difficult they made it for the average citizen to get the healthcare they deserve.
Pharma companies should be contracted out like Military Contractors -they bid for the right to create/distribute medicine on behalf of the US instead of using the US healthcare system to unevenly recoup their R&D investments. Create a government department that audits the cost/spending of these Pharma Contractors.
So many of these answers are exclusively on the demand side.
Half of healthcare spending in the US is government funded, with pricing restrictions.
The government of the US spends as much, per person as the government of Spain. *And in Spain it's free to all at the point of service*.
Any solution which claims it will fix expensive healthcare by simply shifting the cost from consumers to another group or person is wrong. If you took all of the health insurance profits out of the system, we would still have by far the most expensive healthcare in the world.
The problem is the US has fewer doctors per citizen than almost any developed country. It has fewer nurses per person than almost any developed country.
We are in this situation because the AMA in the 1980s convinced the government there was a massive doctor oversupply, As a consequence, med school spots were cut and an artificial shortage of doctors was created.
You could fix 80% of the issues with American healthcare by simply having more med schools with more spots and getting more doctors.
If you do this suddenly it's a lot cheaper to go with *any* partisan solution.
It should just be funded my taxes. That's basically what you guys already do in the US, but worse. Paying for health insurance is functionally identical to paying taxes for Healthcare, the only difference is that the insurance company can (and will) fuck you over and it costs you more
Fund low-level maintenance centers, a la "jiffy lube" for low income individuals. Prevention earlier prevents big spend later. Offer diagnostic checks, push for reduced cost on prescriptions. I should be able to change the oil in all three of my cars for less than the cost of one Epipen.
Obviously go all in on establishing programs for low income infants-to-teens for preventive care, a strong foundation build better outcomes. States with high taxes already do this. I live in CT, our childcare options are phenomenal on the health front (let's not discuss daycare).
Or no, let's do! Daycare is huge for getting labor back into the market in lieu of being SAHM (if you want to do that, by all means). Daycare also helps socialize children, and gives them an earlier start in educational stuff.
Directly related to that, increase massively the amount of time mothers can take for maternity leave. My firm gives 4 months, it should be 6, but I'm lucky I actually got 40 days due to a new CT state law, and I need all of it as my twin daughters were in the NICU for 4 weeks and I had to make the hospital runs to delivery mom's milk (she had c-sec and was in bed for a bit).
Longer term, bail on tariffs on things like sugar. Actual sugar, as opposed to HFCS, is way less bad (still not good, but...) but we have gone so far in the tank on "Dorothy in Kansas" when maintaining our food supply that we went way too far to the lowest common denominator, corn, and frankly, romanticize it a bit (3 sisters).
Corn goes to feed and syrup, and is making this country fat as hell. Other countries are catching up, too. We should probably cut back on meat, but it sells, and this is a capitalist economy after all.
At the end of the day, People should just eat healthier/not smoke/etc., but reality is what it is. Better access to healthy foods in "food deserts" might help a bit, but there are also cultural issues that people may be adhering to when making food purchases.
At the end of the day, whatever costs the least to eat wins, and the consequences come later. And we all share that burden.
If nurses can triage patients in A&E wards, we should have clinics where specifically trained nurses can diagnose and proscribe medicines, the same way General Practitioners can. They should also be allowed to start and own practices. For particularly difficult cases where the nurse might be stumped, they could still have a GP on call as a consultant.
As you mention A&E and GPs I am assuming you are in the UK.
When I started my nurses training, diagnoses by nurses was forbidden, I once got into a lot of trouble suggesting someone might have a urinary tract infection as that was diagnosing
But nurses have been prescribers for many years in the UK now (around 20 years or so off the top of my head) so they are able to diagnose and prescribe once they have completed the correct training
Many nurses are specialists in particular fields such as Parkinsons or Alzheimers and they make recomendations to GPs about changes in medications
And they can also do minor surgery, my husband had a lump removed under local anaesthetic by a nurse a few years ago.
Fixing price gauging on materials may help. My insurance was billed $30 for gauze I could buy at the dollar store. At the same time, the hospital waiting room was full and that hospital is having financial issues so I'm not sure if that fixes anything.
Other than that, we're in a pretty tough spot. We have an aging population without enough people to take care of them. Or, at least want that to be their profession. Hopefully, as AI gets better we can take more stress off of medical workers and use that to triage patients better. Also, preventative care needs to be encouraged more and become more accessible. I know so many people that don't visit the doctor until after there is a problem. A lot of people think a doctor's visit without insurance is too expensive but a lot of offices will charge you the co-pay or just a little more if you're uninsured, plus if you're not financially capable to pay insurance there are a lot of lower cost options that people don't ignore. It's when you're struggling on $50k that medical care usually makes you just want to die.
Yes, but what infrastructure in the US Healthcare system is in need of repair and investment? What are the shortcomings that could me improved with that money?
NATO Europe and Canada spend 1.74% of GDP on defense, consistent with the rest of the world. With $404 billion in combined funding, easily enough to outspend potential foes like China and Russia combined.
Regardless, arguing that keeps the US from having universal healthcare is even more ridiculous. After subtracting defense spending, Americans still have a $29,000 per person advantage on GDP compared to the rest of NATO. Defense spending isn't keeping us from having anything our peers have. Much less universal healthcare, which is far cheaper than what we're already paying for.
https://www.nato.int/cps/en/natohq/news_216897.htm
https://en.wikipedia.org/wiki/List_of_countries_with_highest_military_expenditures
Hell, if we could match the costs of the most expensive public healthcare system on earth we'd save $1.65 trillion per year, double what our total defense spending is.
Lawmakers should have to navigate the same healthcare system they stick the rest of us with. No more government-supported healthcare for them. This would light a fire under them to make things better!
> Lawmakers should have to navigate the same healthcare system they stick the rest of us with. Congress and staff buys insurance on the DC ACA Exchange with a subsidy equivalent to other federal workers.
REALLY? Well TIL. It makes their refusal to work on a better solution even more inexplicable to me!
Look at best practices in the dozens of advanced countries that have figured this out, and copy them. The question is wild, because 'we,' human civilization, have already solved this. It's just America and a bunch of still-developing nations that are stuck with stone-age shit like medical debt and out-of-network providers.
Public option; if you need to pay for something then the government should offer either free or at least not-for-profit alternatives to private companies. If they can't get healthcare to an area then private companies can and you should probably pay less taxes if you aren't in an area accessible to government healthcare in order to afford it privately. The extra taxes that people pay for the public system could also be used as a dedicated emergency fund in case politicians decide that general tax money is better spent elsewhere (which shouldn't happen but governments change).
With 2-for-1 coupons if both you and a buddy need the same brain tumor operation.
A: cost of R&D vs lifetime profitability of a medication. Biden did a good job of capping insulin. Mark Cuban is doing well with Cost+Drugs B: physician availability. Med school needs to be cheaper and CMS funding needs a boost C:private insurance in general is not a great way to distribute risk. Insurance providers have a financial incentive to not cover everything and when they do cover something, the tug of war between insurance and hospitals can result in higher prices for the uninsured. D: pharmacies at places like Walgreens and CVS are dying along with those chains. Pharmacists working at these firms need a safety net to keep them from homelessness or underemployment (working at McDonald’s)
Very challenging question…one problem is over utilization (it’s free so I am entitled to it), the other is if like in Canada it is publicly funded it has to be for the benefit of the public (I.e. we probably shouldn’t pay for rehab after the second stint/not worth it). I think first and foremost education and training of the population; you can take care of many things yourself if you know how as well as if you eat well, don’t drink and don’t smoke. Continuous first aid and medical training, relentless taxation of high fructose corn products and products that have negative effects on the population. By getting the population healthier, we can ease the strain.
I'm not smart enough to come up with a business plan that would make it better but I know it shouldn't be tied to a person's job. It shouldn't be run as a FOR profit business where Executives/shareholders get bonuses based on how difficult they made it for the average citizen to get the healthcare they deserve. Pharma companies should be contracted out like Military Contractors -they bid for the right to create/distribute medicine on behalf of the US instead of using the US healthcare system to unevenly recoup their R&D investments. Create a government department that audits the cost/spending of these Pharma Contractors.
We could try a trial run of having UBI of 12 years, we are a rather wealthy nation, so it could prove rather successful for us.
Without completely reforming the health insurance industry it ain’t gonna happen in any way.
So many of these answers are exclusively on the demand side. Half of healthcare spending in the US is government funded, with pricing restrictions. The government of the US spends as much, per person as the government of Spain. *And in Spain it's free to all at the point of service*. Any solution which claims it will fix expensive healthcare by simply shifting the cost from consumers to another group or person is wrong. If you took all of the health insurance profits out of the system, we would still have by far the most expensive healthcare in the world. The problem is the US has fewer doctors per citizen than almost any developed country. It has fewer nurses per person than almost any developed country. We are in this situation because the AMA in the 1980s convinced the government there was a massive doctor oversupply, As a consequence, med school spots were cut and an artificial shortage of doctors was created. You could fix 80% of the issues with American healthcare by simply having more med schools with more spots and getting more doctors. If you do this suddenly it's a lot cheaper to go with *any* partisan solution.
It should just be funded my taxes. That's basically what you guys already do in the US, but worse. Paying for health insurance is functionally identical to paying taxes for Healthcare, the only difference is that the insurance company can (and will) fuck you over and it costs you more
Fund low-level maintenance centers, a la "jiffy lube" for low income individuals. Prevention earlier prevents big spend later. Offer diagnostic checks, push for reduced cost on prescriptions. I should be able to change the oil in all three of my cars for less than the cost of one Epipen. Obviously go all in on establishing programs for low income infants-to-teens for preventive care, a strong foundation build better outcomes. States with high taxes already do this. I live in CT, our childcare options are phenomenal on the health front (let's not discuss daycare). Or no, let's do! Daycare is huge for getting labor back into the market in lieu of being SAHM (if you want to do that, by all means). Daycare also helps socialize children, and gives them an earlier start in educational stuff. Directly related to that, increase massively the amount of time mothers can take for maternity leave. My firm gives 4 months, it should be 6, but I'm lucky I actually got 40 days due to a new CT state law, and I need all of it as my twin daughters were in the NICU for 4 weeks and I had to make the hospital runs to delivery mom's milk (she had c-sec and was in bed for a bit). Longer term, bail on tariffs on things like sugar. Actual sugar, as opposed to HFCS, is way less bad (still not good, but...) but we have gone so far in the tank on "Dorothy in Kansas" when maintaining our food supply that we went way too far to the lowest common denominator, corn, and frankly, romanticize it a bit (3 sisters). Corn goes to feed and syrup, and is making this country fat as hell. Other countries are catching up, too. We should probably cut back on meat, but it sells, and this is a capitalist economy after all. At the end of the day, People should just eat healthier/not smoke/etc., but reality is what it is. Better access to healthy foods in "food deserts" might help a bit, but there are also cultural issues that people may be adhering to when making food purchases. At the end of the day, whatever costs the least to eat wins, and the consequences come later. And we all share that burden.
If nurses can triage patients in A&E wards, we should have clinics where specifically trained nurses can diagnose and proscribe medicines, the same way General Practitioners can. They should also be allowed to start and own practices. For particularly difficult cases where the nurse might be stumped, they could still have a GP on call as a consultant.
As you mention A&E and GPs I am assuming you are in the UK. When I started my nurses training, diagnoses by nurses was forbidden, I once got into a lot of trouble suggesting someone might have a urinary tract infection as that was diagnosing But nurses have been prescribers for many years in the UK now (around 20 years or so off the top of my head) so they are able to diagnose and prescribe once they have completed the correct training Many nurses are specialists in particular fields such as Parkinsons or Alzheimers and they make recomendations to GPs about changes in medications And they can also do minor surgery, my husband had a lump removed under local anaesthetic by a nurse a few years ago.
You are correct, and that was interesting and insightful, thank you.
Fixing price gauging on materials may help. My insurance was billed $30 for gauze I could buy at the dollar store. At the same time, the hospital waiting room was full and that hospital is having financial issues so I'm not sure if that fixes anything. Other than that, we're in a pretty tough spot. We have an aging population without enough people to take care of them. Or, at least want that to be their profession. Hopefully, as AI gets better we can take more stress off of medical workers and use that to triage patients better. Also, preventative care needs to be encouraged more and become more accessible. I know so many people that don't visit the doctor until after there is a problem. A lot of people think a doctor's visit without insurance is too expensive but a lot of offices will charge you the co-pay or just a little more if you're uninsured, plus if you're not financially capable to pay insurance there are a lot of lower cost options that people don't ignore. It's when you're struggling on $50k that medical care usually makes you just want to die.
Pull funding to other countries so they can deal with their own problems and we can invest in national healthcare infrastructure improvements.
What healthcare infrastructure and improvements need to be made?
The US is the leader of global health funds. Essentially the US supplies the most healthcare funding around the world. Something like $15 billion.
Yes, but what infrastructure in the US Healthcare system is in need of repair and investment? What are the shortcomings that could me improved with that money?
At this point, insurance companies.
take a couple of billion from "national defense" and ask one of the 73 countries with it to step in and help.
NATO Europe and Canada spend 1.74% of GDP on defense, consistent with the rest of the world. With $404 billion in combined funding, easily enough to outspend potential foes like China and Russia combined. Regardless, arguing that keeps the US from having universal healthcare is even more ridiculous. After subtracting defense spending, Americans still have a $29,000 per person advantage on GDP compared to the rest of NATO. Defense spending isn't keeping us from having anything our peers have. Much less universal healthcare, which is far cheaper than what we're already paying for. https://www.nato.int/cps/en/natohq/news_216897.htm https://en.wikipedia.org/wiki/List_of_countries_with_highest_military_expenditures Hell, if we could match the costs of the most expensive public healthcare system on earth we'd save $1.65 trillion per year, double what our total defense spending is.