There will never be a better healthcare because the true cost of fixing a body more often than not far exceeds the value that body produces.

People run to dismiss this with "well we need a different system then", but the problem is a fundamental one on par with "eating your cake and having it too".

The only way to get as close as possible to "good" healthcare is to have enough money to pay for everything out of pocket.

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elmer2 12 hours ago | parent | next [-]

"The only way to get as close as possible to "good" healthcare is to have enough money to pay for everything out of pocket."

This isn't possible. Healthcare is a finite resource and having universal, government care not only puts your life into the hands of the government (see the UK for an example where parents are not allowed to take their children out of the hospital) but offers worse outcomes.

When you are young and healthy, it's great. As you age, life-or-death surgeries have long wait times. This can be seen in any country with universal care. My aging relatives in Canada are going through this right now and have been forced to come to the US to get surgery in months rather than waiting years.

MAID has been great for healthcare costs in Canada. Many people that would otherwise have been costing the system money, are now a benefit. The sad realization is that government-run programs need MAID to cut down on costs.

I know lots of expats living in Asia that are now getting older. They have to go elsewhere to get any surgeries done, because of this exact reason.

To make it better, we should only have insurance for surgeries that can't benefit from the free market and are relatively rare. Common surgeries and procedures should have no insurance. The prices would eventually fall to levels that were affordable.

The masses don't want plans like this. They like easy solutions that sound good when you say them and don't take a whole lot of thought besides an elementary school level of thinking.

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malfist 13 hours ago | parent | prev | next [-]

There are already better systems of healthcare. The US one is only good if you're wealthy

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tumdum_ 12 hours ago | parent [-]

It’s actually better to be average Western European than white and top 1-5% American: https://jamanetwork.com/journals/jamainternalmedicine/fullar...

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eigenspace 12 hours ago | parent | next [-]

It turns out that when you make a massive profit motive to sell expensive fancy interventions, health outcomes suffer.

You see this to an even more extreme degree amongst the ultra rich and powerful, who are often using cutting edge, experimental treatments, and often reaping the downsides of being on that edge (though of course also the upsides).

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WarmWash 11 hours ago | parent | prev [-]

To be fair, the structure of that study is pretty bizarre. Why only look at 6 specific illnesses rather than something like life expectancy?

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tumdum_ 11 hours ago | parent [-]

They are looking at the outcomes of specific procedures because they are interested in the health care system quality. Looking at things like life expectancy would make it impossible to disentangle them from other factors like lifestyle or environment.

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WarmWash 10 hours ago | parent [-]

Sure, but it's only six (6) specific illnesses. There are tens of thousands of illnesses. I'm almost 100% confident you could cherry pick any six illenses to get any outcome you want.

Edit: Seems the lead author is also a vocal supporter of universal healthcare, being a senior fellow of the Center for American Progress. So yeah, probably why it's such a strange setup, and what compelled me to check since this kind of thing is super common for "activist research".

I guess the takeaway is to always take a study for what it is, rather than what it paints itself to be.

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tumdum_ 10 hours ago | parent [-]

So you are saying that they cherrypicked some obscure illnesses to make Europe look good? They used data for:

- infant mortality

- maternal mortality

- colon and breast cancer survival

- heart attack mortality

- childhood acute lymphocytic leukemia (most common childhood cancer)

Those are one of the most common health issues.

Also, here is another recent paper showing how it’s better (health care wise) to be average in EU than wealthy in US: https://www.nejm.org/doi/full/10.1056/NEJMsa2408259

	▲	WarmWash 9 hours ago \| parent [-]
		No, I didn't make the argument they were obscure, in fact they all are from a set of common illnesses that....also contains thousands of illnesses. Again, this is the kind of stuff you see with "activist research". Why would they only do 6 instead of hundreds or thousands? I'm sure you see my point. There are also other oddities like using median county wealth rather than household wealth. In many wealthy counties there are still poor areas, I know more than a few. In fact if you look at the appendix, most of the households in the study are, well, average or poor. They also don't include absolute numbers or definitions for the illnesses. All in all, it's a bad study, and clearly made to color in an agenda. The second study looks more grounded, thanks.

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glaslong 12 hours ago | parent | prev | next [-]

I don't really need to live forever, I just don't want to have to think about whether bleeding out in a cab is a better deal than an ambulance.

Or if that random doctor who just walked in is out of network and going to charge $30,000 for my stitches when $3,000 was already egregious.

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preg_match 11 hours ago | parent | prev | next [-]

There will never be a perfect healthcare system, sure, but the US healthcare system is just bad, and can be improved. We pay more for worse outcomes on average compared to most developed countries. Obviously it's just not working, I think it's indisputable at this point.

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order-matters 13 hours ago | parent | prev | next [-]

> the true cost of fixing a body more often than not far exceeds the value that body produces

i softly agree but also think that a body does not need to generate value to pay for the costs in order for the whole process to sustain itself. Monitoring the stars for asteroids heading towards earth provides no market value, for example, but we can still afford to do it. so it's a matter of cost and available expenditure. the market is not net 0, so its possible to generate enough value to have enough to afford healthcare as an expense as a society

what are the costs of fixing a body? The residency pipeline is a bottleneck on labor, but assuming that gets sorted out and AI is capable of guiding any reasonable person through the process, why cant the cost of labor for a doctor drop dramatically?

i would guess limited resources are the biggest blockage, but i dont know how to break down a $20k hospital bill for giving birth into its actual costs. its hard to believe that really needs to be $20k.

I actually think its the opposite. there is so much friction with healthcare and the process of healing is slow enough that costs are inflated because the overall operating cost for the entire facility including rent, ER, having people on standby, who knows what else, all need to be recovered through whatever volume they process and they arent processing as quickly as the resources are able.

healthcare needs do not subscribe to a neat work schedule, and so we have to pay a lot of market prices to have the right availability at all times. but thats not a true cost, it is a result of accounting and underutilization

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thuuuomas 13 hours ago | parent | prev [-]

Redundancy is robustness is expensive.