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About that "World's Best Healthcare System" the U.S. is supposed to have...

So to recap: patient satisfaction numbers are unreliable, we can't accurately account for genetic differences across countries, we can't accurately account for nutrition variation across countries, the government health care programs we already have are ripe with fraud and utilization issues, and nobody wants anybody making less than $100k/year to pay more for anything because we need to just stick it all on The Man, but we are supposed to accept that (a) despite being unable to account for these extremely important variables we are supposed to just accept that some websites indicating single-payer systems "work" better than ours (whatever that means) performed by admittedly biased groups hold any grain of truth or applicability; and (b) it is possible for us to implement an even remotely well-functioning single-payor system akin to a Euro model given our last attempt at healthcare reform has been nothing less than a complete shitshow despite anyone with an ounce of common sense knowing well in advance that it was going to be a complete shitshow. Sounds great to me!

Look, nobody says that our current system is well-functioning. It is a disaster. But at the same time, as Ch points out, single-payer is simply not going to work here for a variety of cultural, political, and economic reasons that simply do not exist in other countries. The best way for us to start to control healthcare costs is to shift our national focus to nutrition and exercise to reduce our need for health care in the first place so that it is focusing on the truly unpreventable and the end-of-life process, and to link the cost of treatment with the cause of the problems. As I've mentioned before, there are ways to work within our current system to do just that, which are significantly easier and more likely to succeed than trying an overhaul to a single payer system.

This would be opening Pandora's Box and is a terrible idea.
 
What makes no sense is why we pay so much more for the same the drugs than people in Canada. Mexico, England and other countries do. Please do give me the "we can afford it" or "we pay for the investment in new drugs". The places that use the most should pay the least.

What we have is the ability to implement what many countries are moving towards -a hybrid system. Everyone is covered and you can buy additional insurance to get more personal service.

One of the biggest problems we have is the sense of entitlement many doctors have. There's no problem with doctors making a great living, but making $500,000, $1,000,000 and more inflates the cost of service.

Another reason our costs are so high is unlike other countries we have middlemen who add nothing to our care or outcomes. I'm sure many people or many of your friends have gone to your/their doctor and been told they need a certain procedure or even drug. Then they are told have to wait for a bean counter to approve what the doctor said is necessary. This adds to costs and doesn't help in results.
 
A friend of mine recently had a serious medical problem that was initially treated with two inexpensive antibiotics. His initial problem got better, but he developed intractable nausea and vomiting. His doctor then switched him to one very expensive medication which worked well and did not cause nausea at all. A couple of weeks ago while we were together in a country with a single-payer system he developed a recurrence and we visited a local doctor who prescribed the two inexpensive medicines. That doctor did not know of and could not obtain for us the more expensive medicine with tolerable side effects. My friend, retired military, suffered awful nausea and vomiting for several days until we could find a US DOD facility where he secured the better medicine.

What struck me most about this incident is that were my friend a citizen of that country he probably would not even know that there was an alternative to constant nausea. He would think that he was getting high quality, efficient medical care. What you want when you are sick is many, many options. A free country is the best place to get the most options. Although our health care has been wrecked by Medicare and Medicaid, it is still better than the "single payer" BS.

This story would have come off much less made up if you had at least named the country.
 
Why won't you tell us the country?

Was it Never Never Land?
 
Canada's health system was exactly the same as ours until about 1980. The issue is political will and special interest capture of US policymakers, not cultural and economic differences.

No system is perfect and every system has to make sense in its own cultural context. But the system we have now is manifestly broken. Obamacare doubles down on a broken system. Going the other direction, to a more "free market" system, doesn't make sense for two macro reasons: (1) the opposite approach works better in every comparable nation, and (2) there is no reason to believe that anything remotely close to a well-functioning market can work in the healthcare context. The goods are all credence goods, there is an unbridgeable information chasm between seller and buyer, and the goods themselves are often unaffordable by even the wealthiest consumers.

The rest of your post is your opinion. I have asked, and I renew the invitation, for you to post some links to good material backing up your opinion. I am genuinely interested in learning more about Medicare and healthcare policy overall. We're 10 pages in, and almost no one has posted a link to back up anything they've opined on. In any case, I would not advocate for expanding Medicare as currently structured to all Americans. I would advocate for taking the best ideas from the rest of the OECD, who have operated very successful laboratories for us the last 50 years, and structuring a new system that makes sense.

Theres a lot of opinions on this thread and I applaud you becoming more informed on the system. Ive enjoyed reading some of what you've posted.

I've dedicated 20+ years of my professional and academic life to making the system better. I've worked with CCIO and CMS on cost control demonstration efforts. I've worked with HHS and implementing various aspects of reform from Clinton through Obama. I've worked on the front lines enrolling Medicaid dual eligibles. I've worked with the state of NC and CCNC on developing an improved and efficient Medicaid system. I have the opportunity to work and negotiate with provider systems, ACOs and PBMs. I've worked on creating tools to identify cost/quality metrics to help manage network costs. I work with large employers trying to control their medical spend. I wish I could simply "link" to these experiences and how things really work but I can't. I don't spend a few hours reading about the system on a blog. I work in it 60 hrs a week trying to make it better. You can accept that or ignore it but don't act as if Im uninformed or simply pushing a personal agenda. I'm not.

And I don't disagree its broken. Special interests on all sides (from pharma to AARP) have sway in the process. The whole system is broken, from medicaid to medicare to the unacceptable # of uninsured we have. And based on my experiences, its incredibly naieve to think this country could easily adopt single payer as the panacea. Politics, culture and economics are highly intertwined in this. To suggest otherwise is misguided IMHO.
 
I don't think anybody said it would be easy. Just better.
 
No frustration, the several of us who have asked realize you are FOS.
 
You are frustrated and you want to cornhole a sheep. I will not provide my travel itinerary to satisfy your sexual desire.
 
I have no interest in your wife or daughter.
 
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