Anyone here ever seriously consider moving or move out the the USA?

[jhkim]

But is that an important measure of health? The U.S. system does great at getting billable tests and procedures done, because providers make money based on how much of this they do. However, medical *outcomes* aren't overall better in the U.S. compared to other First World countries. We aren't terrible, and we do well in some areas - but by measures like life expectancy and others, we are only middle-of-the-road. Where we do stand out is in spending far more - both from government and from individuals - than other First World countries.

It's easy to save money on tests and procedures if you just try to wait out the patient till they get fed up or die.

Also, I'd love to see the metrics on life expectancy being used.

Life expectancy is a straightforward measure - it's how old people are when they die. The only tricky part is averaging correctly between different cohorts to get the total percentage correct, and that's straightforward statistics. As for tests and procedures, I've seen and heard a lot - both from the doctors I know and from other sources that the U.S. tends to be overdo things on tests, medication, and procedures. Some articles on the tendency:

https://www.scientificamerican.com/article/unnecessary-tests-and-treatment-explain-why-health-care-costs-so-much/

https://www.propublica.org/article/unnecessary-medical-care-is-more-common-than-you-think

In theory, healthcare is pretty affordable. The problem lies in what tier you're in. You can have $80 mo. coverage that only covers the bare minimum or you can go $200 mo. for what should be standard health coverage. I personally don't see the point in paying minimum if you still have to cash out $$$$ in the event of a surgery. In terms of decent and affordable health coverage we need to do a lot better. Limited health insurance shouldn't be a first world problem. Tbh I don't see the justification why a man received a 48 page, million dollar bill for covid treatment. What's up with the prices!? The average assistant makes $700 wk/ and let's be frank, the braking down of specialties is rather unnecessary unless you're treating rare deseases etc. An actual doctor should know how to treat 90% of health problems imo.

I know a lot of people who are doctors or work in health care, and everyone complains about the U.S. system. It seems to me that the prices reflect that it is heavily government subsidized and regulated rather than free market, but it's also being run for profit. They're charging as much as the market will bear. I think it's a classic case of perverse incentives.

I also know my friends who are expats to other countries like Taiwan, South Korea, and Germany are generally happy with the other country's medical care.

[Pat]

I agree that it isn't the fault of military spending. However, other First World governments with universal health care generally spend *less* than the U.S. governments does on health care. So it's not per se lack of money. However, a hurdle of restructuring will be difficult both in bureaucracy and politically, and that change may be expensive to get over the hurdle.

It's not a simple matter of restructuring and political will. A significant part of the cost is because the US subsidizes the rest of the world when it comes to things like research and drugs, a significant part of the rest is because of different priorities (the US has much shorter lines), and a hideous amount is due to the third party payer structure the government has set up, which basically weaponizes rent seeking.

[jhkim]

I agree that it isn't the fault of military spending. However, other First World governments with universal health care generally spend *less* than the U.S. governments does on health care. So it's not per se lack of money. However, a hurdle of restructuring will be difficult both in bureaucracy and politically, and that change may be expensive to get over the hurdle.

It's not a simple matter of restructuring and political will. A significant part of the cost is because the US subsidizes the rest of the world when it comes to things like research and drugs, a significant part of the rest is because of different priorities (the US has much shorter lines), and a hideous amount is due to the third party payer structure the government has set up, which basically weaponizes rent seeking.

Pat - wouldn't doing away with the horrible third party payer structure be a part of restructuring?

I'm not saying that it's simple. I don't know how we get from our current structure to a better system, but it seems like an important thing to get more research into and develop agreement on.

[Shasarak]

The child mortality rate is a dodge; not every country reports theirs the same way.

Nice dodge you got there, shame if anything was to happen to it.

[Pat]

I agree that it isn't the fault of military spending. However, other First World governments with universal health care generally spend *less* than the U.S. governments does on health care. So it's not per se lack of money. However, a hurdle of restructuring will be difficult both in bureaucracy and politically, and that change may be expensive to get over the hurdle.

It's not a simple matter of restructuring and political will. A significant part of the cost is because the US subsidizes the rest of the world when it comes to things like research and drugs, a significant part of the rest is because of different priorities (the US has much shorter lines), and a hideous amount is due to the third party payer structure the government has set up, which basically weaponizes rent seeking.

Pat - wouldn't doing away with the horrible third party payer structure be a part of restructuring?

I'm not saying that it's simple. I don't know how we get from our current structure to a better system, but it seems like an important thing to get more research into and develop agreement on.

Restructure generally means you shuffle a few things around. This is more a gutting.

And why bother to develop an agreement? We're in the era where everything gets passed on party-line votes. "Bipartisanship" is a word people use to attack the other side for not agreeing with them.

[jhkim]

Pat - wouldn't doing away with the horrible third party payer structure be a part of restructuring?

I'm not saying that it's simple. I don't know how we get from our current structure to a better system, but it seems like an important thing to get more research into and develop agreement on.

Restructure generally means you shuffle a few things around. This is more a gutting.

And why bother to develop an agreement? We're in the era where everything gets passed on party-line votes. "Bipartisanship" is a word people use to attack the other side for not agreeing with them.

Why bother to talk here at all? I'll admit I'm amused by a few zingers, but trading petty insults gets dull really quick, I find.

It's more interesting to hear what people's actual opinions are, and talk to them like human beings.

[oggsmash]

 Thus we come around to where I think it is better for me to just move.  Take care of my health (eat right stay in shape) eliminates a huge number of problems for me and the people around me doing the same does so for them.   If I move somewhere there I am living as if its 1985 all around me with tech and medical, I am fine with it.  I get to let my mind be free of the rest of the stuff the USA seems convinced it has to delete itself over.

[KingCheops]

Thus we come around to where I think it is better for me to just move.  Take care of my health (eat right stay in shape) eliminates a huge number of problems for me and the people around me doing the same does so for them.   If I move somewhere there I am living as if its 1985 all around me with tech and medical, I am fine with it.  I get to let my mind be free of the rest of the stuff the USA seems convinced it has to delete itself over.

Being healthy really is the biggest part of it all.  Our doctors up here are good about lecturing you on eating healthy and exercising when you show up looking like a human pear like I have done the last two times I visited a clinic.  I resented it at the time but then pre-Covid I got into good shape and holy shit it made a difference.

[oggsmash]

Thus we come around to where I think it is better for me to just move.  Take care of my health (eat right stay in shape) eliminates a huge number of problems for me and the people around me doing the same does so for them.   If I move somewhere there I am living as if its 1985 all around me with tech and medical, I am fine with it.  I get to let my mind be free of the rest of the stuff the USA seems convinced it has to delete itself over.

Being healthy really is the biggest part of it all.  Our doctors up here are good about lecturing you on eating healthy and exercising when you show up looking like a human pear like I have done the last two times I visited a clinic.  I resented it at the time but then pre-Covid I got into good shape and holy shit it made a difference.

   I agree obviously, and when a nation like the USA constantly goes on and on about universal health care, but can not be bothered to ensure schools have mandatory physical education for every grade, says a whole lot.   I think a PE teacher at every school in the USA is probably massively cheaper than perpetual treatment of chronic issues caused by being fat and inactive.  So, if this is being missed by the galaxy brains running the country, I have to think they are too stupid to see the obvious, or they simply prefer a population to be Fat, sick, and tired, because they are much easier to control.

[BoxCrayonTales]

Have you ever been bankrupted by medical bills?

[oggsmash]

Have you ever been bankrupted by medical bills?

  Have you?  I do know a fellow, back in the 90's who went to India for a heart procedure that here was going to cost him possibly up to 3/4 of a million dollars for total care and costs.  He got the same thing done in India for a grand total of 10k (including air fare and 1 month stay for follow up care). 

  I think that issue lies not so much with a universal health care, but with health care costs that have broken through a top end point that is not justifiable in the USA. 

  I would also say I can not see a situation where I could be bankrupted from health care costs for me.  I would check out before bankrupting family to keep a husk of me alive.

[HappyDaze]

I would also say I can not see a situation where I could be bankrupted from health care costs for me.  I would check out before bankrupting family to keep a husk of me alive.

Hopefully you have an advanced directive in place and every adult member of your immediate family are fully in agreement with it. If not, you may not get your wish. Check your local laws to be sure, and consider too the policies of whatever hospital system you're likely to land in. Also note that if something happens to you when traveling outside the locale where your directive was drafted, it may or may not hold up (lots of people come to Florida on vacation and have something bad happen to them...and their out of state/country documents don't necessarily hold up).

[oggsmash]

I would also say I can not see a situation where I could be bankrupted from health care costs for me.  I would check out before bankrupting family to keep a husk of me alive.

Hopefully you have an advanced directive in place and every adult member of your immediate family are fully in agreement with it. If not, you may not get your wish. Check your local laws to be sure, and consider too the policies of whatever hospital system you're likely to land in. Also note that if something happens to you when traveling outside the locale where your directive was drafted, it may or may not hold up (lots of people come to Florida on vacation and have something bad happen to them...and their out of state/country documents don't necessarily hold up).

  I do.  I have watched a few people die pretty horrible deaths hooked to machines the past few years.  Luckily for a couple of them their families took a proper course of action.  The other ones...it was not great.  I recently got a chance to yet again see it when My mother died a few months ago (she had some health issues, and honestly probably did not visit her doctor due to rampant Covid fears...which  though anectdotal, I know 14 people who have had covid, 2 had to go to the hospital, all recovered.  My mother who was feared away from going anywhere near medical facilities because of raging covid fears spread daily, died because she had sprung a leak so to speak and did not get it checked out) and the last month was pretty fucking horrible. 

    I do not get to choose how I came into the world, but I do get a small say in how I go out.  I have made my say.

[BoxCrayonTales]

I think that issue lies not so much with a universal health care, but with health care costs that have broken through a top end point that is not justifiable in the USA. 

You don't think that these two things are related?

[moonsweeper]

Have you ever been bankrupted by medical bills?

I actually did have to file bankruptcy due to medical bills in 2008-2009...and there is no way I would touch universal health care. 

Now if you want to talk about making the actual procedure and treatment costs 'public information' then we can discuss something that needs to be examined.