chris_gerrib: (Default)
[personal profile] chris_gerrib
Posted elsewhere, in response to a question on how America can "fix healthcare."

This really isn't rocket science. Most of the rest of the world has figured it out years ago. The solution, in broad strokes, is:

1) Get everybody to pay into the healthcare system, whether via taxes or private insurance. Actually, taxes are cheaper because private insurance has marketing and profit overheads. But everybody is important, in that you don't want some freeloader rolling into an emergency room, especially for something that could have been managed cheaply had they been able to see a doctor sooner.

1a) Everybody in is also important in that, just like auto insurance or homeowner insurance, those that don't file a claim subsidize those that do.

2) Allow the large payers (in our case Medicare / Medicaid) to negotiate pricing. In every other country, they do so, and get meds and equipment at a fraction of the cost. For example, in Belgium, if you need an artificial hip joint, you get the same one you do in the US (both made in a factory in Indiana) but the Belgium one cost $800 and the US one costs $20,000.

3) Pay doctors on performance, not activity. Right now, my doc has every financial incentive to order every test I'll take. Penalize hospitals for things like hospital-based infections. Again, the financial incentive of a hospital is to keep you in. These changes will force the health-care system to get more efficient.

Most of the rest of the world accomplishes this by having a government paid-for (Canada) or government-ran (UK) system that relies on private insurance for supplementary things, like private rooms or other upgrades. In fact, in Canada, they call it Medicare and it works like US medicare except you buy in at birth. I'll say it because somebody will comment on it, but even when Canada has to ship somebody to the US (which they do, at government cost, because it's cheaper than having Canadian specialists) they deliver quality health care at a fraction of the cost.

Date: 2017-06-30 03:10 am (UTC)
nodrog: Robot B-9 from LoS (Danger)
From: [personal profile] nodrog

But what about eugenics?  If government takes care of your health, that is best done by controlling your behavior, viz banning smoking.  You know the worth of an ounce of prevention!

        We have seen more than once that the public welfare may call upon the best
        citizens for their lives. It would be strange if it could not call upon
        those who already sap the strength of the State for these lesser
        sacrifices, often not felt to be such by those concerned, to prevent our
        being swamped with incompetence. It is better for all the world, if instead
        of waiting to execute degenerate offspring for crime, or to let them starve
        for their imbecility, society can prevent those who are manifestly unfit
        from continuing their kind. The principle that sustains compulsory
        vaccination is broad enough to cover cutting the Fallopian tubes.

        - Oliver Wendell Holmes, Jr., Buck v. Bell, (1927)

Wikipedia says, “The Supreme Court has never expressly overturned Buck v. Bell.”  Let's get to it!  It's for the Greater Good!

[Or as Comrade-Queen Hillary used to say, “It's for the children.”  She knew a meaningless liberal-knee-jerk buzz phrase when she said one!]

p.s. Yes, my tongue is in my cheek.  Problem is, there are no natural barriers between what you're saying, and what I'm saying.

Date: 2017-06-30 03:27 pm (UTC)
nodrog: the Comedian (Comedian)
From: [personal profile] nodrog

We are the government and the government is us

Really?  Try running for Senate.

Or better, read, as just one example, the background of John Kerry and tell me what ʹusʹ you think he comes from.

Long gone are the days when a Danʹl Webster could have and maintain a working farm.  “We are the government and the government is us” stops being true at the Statehouse level.  Beyond that lies a world to whom “the flyover states” are paid lip service - and which is always shocked when that lumpenproletariat, that “racist, sexist, homophobic, xenophobic, Islamophobic basket of deplorables” hit back.

Date: 2017-06-30 03:41 pm (UTC)
nodrog: T Dalton as Philip in Lion in Winter, saying “What If is a Game for Scholars” (Alternate History)
From: [personal profile] nodrog

Really?  Okay; you're in Illinois; how did your State Representative(s) vote on the 28th Amendment?  You know, the duly ratified Amendment to the US Constitution that gives same-sex couples the constitutional right to marry?

… Oops…

Date: 2017-06-30 04:43 pm (UTC)
nodrog: the Comedian (Comedian)
From: [personal profile] nodrog

My state legalized gay marriage in 2014 and civil unions in 2011

Yes, a good many of them did - including here in South Carolina.  So obviously due process could have been followed.  Instead, one of the most heinous examples of “legislating from the bench” to ever mar US and Western law was perpetrated - committed, like a crime.

I would have voted for such an Amendment, for several reasons.  The decision was taken from us, from all of us - the “us” you say govern us.

But hey, we can decide what our State flower should be!  Yay democracy!

[SC is also one of five (5) States to still recognize ʹcommon-lawʹ marriages, what I call a ʹSpartacus marriageʹ:  “This is my wife, and I am her husband.  Any questions?”  I favor this also.]

p.s. Yes, that Daniel Webster.  No, he was no Cincinnatus, but he did retain ownership of that parcel of land!

“Strangers in Their Own Land”

Date: 2017-07-05 04:31 pm (UTC)
nodrog: the Comedian (Comedian)
From: [personal profile] nodrog

A New York Times Op Ed I agree with.

…  Awright, wise guy, get up.


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