Quote from: smscotten on August 08, 2013, 04:27:41 AM

Quote from: hlynur on August 08, 2013, 03:35:27 AM

thanks for stuffing another hole of my dangerous half-knowledge. Tongue

didn't follow that in the news too deeply.

Well, don't worry, I only stuffed it full of more dangerous half-knowledge. ACA has a lot of other provisions in it; there is a lot more to it than I described or could describe. And you're 100% right that the debate in the US is pretty insane. Republicans didn't want ACA because it is socialism (even though it isn't) and Democrats wanted it because if it failed it would mean the Republicans won the fight. So it really didn't matter how good or bad the bill was. The talking points are the same no matter what. Republicans calling Democrats socialists and Democrats calling Republicans meanies.

Quote from: hlynur on August 08, 2013, 03:35:27 AM

The more i think about it the more i doubt that a similar insurance system would function in the USA. I often underestimate the sheer scale of it as a country with its socioeconomic differences in many regions.

One of the biggest problems we have is that health insurance isn't insurance. Health insurance is a subscription. People here expect that if they have a full time job, they will never pay for any medicine or doctor's bills, aside from a nominal co-payment.

I pay my doctor out of pocket, and I have conversations with him about what the most cost-effective treatment is. Very often an older medicine is just as effective as a newer medicine but with a higher risk of side effects. If I go with the cheaper version I save hundreds of dollars every month and get just as good care. With health plans, doctors write out prescriptions for the newest, most expensive drugs because they aren't paying for it and the patient isn't paying for it, so you may as well get the absolute best option.

In the US, if you start talking about cost-effective medicine people freak out like it means cutting corners and getting shoddy care. But because I pay out of pocket, I get to make reasoned choices about the health care options in front of me and I'd like to think that I'm not making the whole health care charliefoxtrot here in the US worse than it already is.

Because very few people have to be concerned about prices and healthcare costs don't hit their paychecks in a visible way, costs skyrocket with medical waste. The doctors prescribe the most expensive stuff because it's the best, the patients don't complain because it costs them the same $10/month either way, the pharmaceutical companies love it because they're selling the primo expensive stuff and taking it to the bank. The insurance companies don't care because they just pass the higher costs on to higher monthly premiums, and the employer doesn't care (the employer probably cares, but it doesn't hit home) about the higher insurance rates because they have to pay the increase or be seen as "cutting back the health benefits" and besides, the employer can just give everyone a smaller raise next year so it doesn't hit their bottom line. The patient, well, the patient just keeps getting more and more of their paycheck going to health coverage, but it comes out of their check before they receive the check so it's hard to miss what you never had.

Unless people start paying for their own health care, this cycle will never end and eventually the country will be basically a "company town" where we all work for the health care industry. ACA guarantees us this future. If ACA required people to carry only minimal, high-deductable insurance (something that is actually insurance) it wouldn't be nearly as bad. But the minimum requirements mean that we'll never have the opportunity to directly pay for our regular doctor visits or medicine again.

And that's something people here in the US don't understand: paying someone to pay your regularly occurring bills is a bad idea, whether that someone is your employer, a commercial entity, or the government. I have insurance on my motorcycle. If I crash it, I'll be paid some money so that I can buy another one. I hope I never crash my motorcycle, but I have a plan in place to protect me financially in case it happens. I do NOT have an "insurance" policy where I pay a monthly fee for my gasoline. Why not? Because I know I'm going to buy gasoline. In order to offer me such a policy, the issuer would have to charge me more than I would pay at the pump, or else go out of business. There is no way that that could be a good deal for me. But people just don't seem to get that when it comes to, say, their annual checkups.

TL;dr: there is a lot more wrong with the US's health care system than attempts at socialism.

Behold, read above an impractical, this-size-fits-me, health-meme of an opinion.

So little time for so many logical holes. Not a single paragraph, impressive self-serving cluelessness.

Well, let's start here: you seem to have left out the humiliating suffering of almost 2 Million citizens...sorry, 1.7 Million US households that declare bankruptcy EVERY YEAR at the inability to cover their healthcare expenses. Many of them carrying the high-deductible traps or self-pay you feel so giddy about. 15 million others will deplete their savings to cover medical bills. Another 10 million will be unable to pay for necessities such as rent, food and utilities because of medical bills.

Do you intend to sell the notion that this "issue" will be solved when larger proportions of citizens go WITHOUT insurance? At least I'm glad you jumped first.

For everyone else that might've found the above post interesting, but still be coachable about it, the difference between vehicle insurance and health insurance should be easy to comprehend: while your scooter has a known value at any point in time, a limited value both you and your insurance company can agree it's better to declare a total loss, no such cap actually exists for humans, especially for loved ones. By law, no one can decide you're a total loss until the most emotionally involved human being decides to kill you. Are there any parallels in the commercial insurance world to this? No, human healthcare is in a category of its own.

Irrespective of whatever downward cost pressure may be obtained with your localized self-pay-want-to-haggle strategy, or your willingness to do research and become a pseudo-doctor that can fake "informed decisions" about which medications you take, or take trips to Thailand for the kidney transplant, when it comes to pulling the plug on your wife or your daughter, most people are inclined to do quite the opposite of haggling.

Healthcare and education....two aspects of life you really, really are best advised not to skim on.