What is the point in private healthcare?

[ThatRobGuy]

Single-payer would not eliminate private insurance or private providers.

And cancer rates may improve if people are able to get regular checkups and screenings to catch it in earlier stages.

That could be true for certain types of cancers, but based on the data we currently have available for different countries, that hasn't played out that way for many forms of cancer.

In terms of cancer rates themselves

We're slightly higher than the nordic nations (who have much more generous healthcare programs), but not a night and day difference.

List of countries by quality of healthcare - Wikipedia

And in terms of health outcomes for many cancers and heart disease, we're pretty close to the top of the heap.


So that's the point I was making... new technological advancements (even if created in the name of profits and greed), still have provided some benefits with regards to certain new forms of treatment.

To circle back around to the original premise, my original question/answer is still applicable with regards to "which system is the best?"...which is "it depends on what you want out of it and which aspects are most important to you"

In terms of access (regardless of how much money you have), then there's no doubt single-payer is hands down the winner.

However, if you want quicker access to imaging (like an MRI), the latest and greatest in surgical advanced or imaging, or a higher density of specialists vs. regular practitioners, then the private healthcare system has produced more of those outcomes.

 

[RDKirk]

That could be true for certain types of cancers, but based on the data we currently have available for different countries, that hasn't played out that way for many forms of cancer.

In terms of cancer rates themselves
View attachment 304043

We're slightly higher than the nordic nations (who have much more generous healthcare programs), but not a night and day difference.

List of countries by quality of healthcare - Wikipedia

And in terms of health outcomes for many cancers and heart disease, we're pretty close to the top of the heap.


So that's the point I was making... new technological advancements (even if created in the name of profits and greed), still have provided some benefits with regards to certain new forms of treatment.

To circle back around to the original premise, my original question/answer is still applicable with regards to "which system is the best?"...which is "it depends on what you want out of it and which aspects are most important to you"

In terms of access (regardless of how much money you have), then there's no doubt single-payer is hands down the winner.

However, if you want quicker access to imaging (like an MRI), the latest and greatest in surgical advanced or imaging, or a higher density of specialists vs. regular practitioners, then the private healthcare system has produced more of those outcomes.

Cancer rate is a matter of environment and practices and probably some genetics.

What kind of cancer are we talking about? Melanoma in Australia? Lung cancer in France? Environment and practices.

A relevant statistic to health care would indicate how successfully cancers are caught in early stages, not how many cancers occur.

 

[ThatRobGuy]

Cancer rate is a matter of environment and practices and probably some genetics.

What kind of cancer are we talking about? Melanoma in Australia? Lung cancer in France? Environment and practices.

A relevant statistic to health care would indicate how successfully cancers are caught in early stages, not how many cancers occur.

Catching cancer in early stages is actually something the US does rather well... We're still number one in terms of detecting & treating breast cancer...and many of the top cancer specialists in the world reside within the US healthcare system.

...but as noted, that's part of the trade-off.

When a system is for-profit, it's going to mean higher salaries for specialists, which is why we have so many specialists and top researchers.

If you look at the pay disparities between a GP & Specialist in the US/UK respectively...it's easy to see why a higher percentage of doctors in the US choose to pursue a specialized field. You can basically double/triple your salary in the US becoming a specialist vs. a GP.

The flip side of that, is with fewer GPs, that means less time spent on "routine" care so to speak...and that has certain drawbacks (like your family doctor not spending as much time with you and not as much focus on some preventative aspects)

So like I said, it's still a matter of priorities and which aspects of healthcare people rank higher than others.

Overall, I still feel that single payer has the biggest pro/con ratio (and several countries have proven that you can have a healthy population with it).

My main point in this thread to was to rebut the notions mentioned in the OP, which were

Private healthcare has accomplished some good things (even if some of them where done in the name of profit incentives), that doesn't inherently mean that the products/services produced by the system are meritless just because the company making them wanted to get rich.

 

[RDKirk]

Catching cancer in early stages is actually something the US does rather well... We're still number one in terms of detecting & treating breast cancer...and many of the top cancer specialists in the world reside within the US healthcare system.

Only in the women getting breast examinations. They don't detect early breast cancer in women who don't get regular breast examinations. They don't detect early prostate cancer in men who don't get regular psa tests.

That regularity for more people will happen in a healthcare system that keeps regular examinations low-cost.

 

[MorkandMindy]

The reason cancer rates are so low in the US could be because people are dying sooner from other causes.

 

[MorkandMindy]

To me the total life expectancy is the way to get a whole picture of how the healthcare system and related parts function overall.

If people die from depression after healthcare costs have bankrupted them, that is caused by our weird healthcare system.

Life expectancy is usually a good overall indication of quality or quantity, of life.

 

[renniks]

1 It provides junk mail, lots of it.

2 It wastes 10% of the entire nation's GDP, on administration and huge profits for pointless billionaires.

Beyond that I'm not sure what it does for anyone.

It's a little thing called " choice". Some of us like choices, some seem to like someone else choosing for them.

 

[RDKirk]

It's a little thing called " choice". Some of us like choices, some seem to like someone else choosing for them.

Unless you have the price of an organ transplant in your checking account, there is already someone else choosing for you.

 

[ThatRobGuy]

The reason cancer rates are so low in the US could be because people are dying sooner from other causes.

Actually, our cancer rates aren't low when compared to other nations, they're right on par with other developed countries.

It's just that our 5-year survival rate for many of them exceed that of other countries.

With regards to some of our more common forms of cancer like breast cancer and melanoma...

The median age of onset of those cancers come before a person's other bad habits or chronic issues would have caught up with them (at least caught up with them to a degree where it causes mortality)

For instance, nearly half of women who get that diagnosis get it before age 60, and Melanoma can hit at virtually any age, and a lot of people under 50 have to deal with that.

 

[MorkandMindy]

It's a little thing called " choice". Some of us like choices, some seem to like someone else choosing for them.

That was why people liked meeting highway men: 'your money or your life' was choice. If they didn't get robbed they didn't get that wonderful choice.

 

[renniks]

That was why people liked meeting highway men: 'your money or your life' was choice. If they didn't get robbed they didn't get that wonderful choice.

Well with government healthcare we know we are getting robbed.

 

[rjs330]

The private insurance money goes in and what does it do?

A substantial amount goes to the owners of the healthcare companies, the profits are huge.

Some goes on advertising and administrating the ever more complex portfolio of different policies company offers and changes, terminates, or introduces.

The amount that goes to whatever services they pay for evidently achieves nothing.

How can that be? Well the private insurance companies need for itemized billing and the cost of adding that to the entire system is about equal to the amount they end up actually contributing.

Public sector dollars do no better. Instead of private companies it goes to the government. Government demands the same thing as private demands. And generally government has restrictions the private sector doesn't. It creates waiting lists, less access to diagnostic machines etc.

Not saying all government systems are the same. But they sure do not provide better service. Many will give better access to some, and less access to others. Frankly I don't think either system is acceptable.

 

[rjs330]

With regards to the topic of healthcare, there's always the conversation of "which kind of system is best?".

I've always felt this is too broad of a question.

When people have asked me this question, I always answer with "That depends, what are you looking to get out of it, and which particular metrics are important to you?"

It's sort of like with vehicles. If someone asks me "what's the best vehicle?", it depends on what they want out of it.

If they said
"I want something that will go from 0-60 really fast"
or
"I want something that can pull my boat trailer"
or
"I want something that gets crazy good gas mileage"

My answer would different for each of those.


Same is true of healthcare.

If someone said
"I want a system that produces the latest and greatest new technological advances" or they said "I want the one that produces the highest 5-year cancer survival rates and best 10-year heart disease survival rates" then my answer would be a private system.

If they said
"I'm willing to forego the latest and greatest technology, and willing to make modest sacrifices in cancer survival rates in favor of having a system where everyone can get pretty good care regardless of income, and guarantee that for everyone simply for being a citizen" then my answer would be a single payer system.



Market competition breeds innovation, which is why the US has some of the highest 5-year cancer survival rates and heart disease survival rates in the world (despite having more people per capita engaging in behaviors that increase the likelihoods of those occurring than other countries).

The downside of that, is that it can bankrupt someone in order to get that treatment.

Healthcare is a unique beast in that it's a market where several circumstances have inelastic demand. (for instance, if I get bit by a poisonous snake, it's "get me to the nearest hospital pronto", it's not like other market scenarios where I can come back home, get on my computer, and start looking up who can give me the best price like I could if I were looking to buy a new TV)


Overall, I lean more toward a single payer system because I feel the pros outweigh the cons after tallying everything up. But I still won't deny that private healthcare markets have created some pretty great stuff with regards to certain types of ailments.

Not to mention that so many of the medical advancements in the world have come from this for profit medical system. Yes I know there are issues with it. However, this system has created so many treatments and medicines that wouldn't have happened without it. The entire world has benefited from it.

That's not to say it can't be improved upon. There are single payer systems that work around the world. Canada is not one of them. I know of too many people who suffered needlessly because if it and if it were so great we wouldn't have Canadians coming here for medical care.

The actual care we get in America is top notch. The access to it for some is not. We do have single payer, it's called Medicare. If you are poor you can get it. However, if you are in that in between done of not being wealthy, and not being poor then you can struggle to get the care you need without employer supplied insurance. I know, my kids struggle with that. He makes pretty good money, but it's still not enough to get decent health insurance for his family.

So there has got to be a better way.

 

[rjs330]

It's a little thing called " choice". Some of us like choices, some seem to like someone else choosing for them.

That's true of either system. Until the patient can afford to pay whatever medical bills on his own, someone else does. And whether that's a private company or a government they are making health decisions for you. The insurance companies drive everything here. And in other countries with single payer, the government decides whether you get care it not and what you get.

It's not ideal until I get to decide. And that is long gone.

 

[renniks]

That's true of either system. Until the patient can afford to pay whatever medical bills on his own, someone else does. And whether that's a private company or a government they are making health decisions for you. The insurance companies drive everything here. And in other countries with single payer, the government decides whether you get care it not and what you get.

It's not ideal until I get to decide. And that is long gone.

I mean you can choose what insurance plan you want to get. Of course the choices have limits.

 

[FireDragon76]

That could be true for certain types of cancers, but based on the data we currently have available for different countries, that hasn't played out that way for many forms of cancer.

I've got a little yellow book I read years ago at my parents home (where I lived years ago) that blows apart the idea that early, frequent, copious testing leads to better health outcomes for cancer. Yet it's a myth that companies like Theranos used to exploit gullible investors. In some cases, early testing can actually lead to unnecessary medical interventions that harm peoples health (it did in my case, I got an unnecessary spinal tap due to an ectopic pituitary that a neurologist mistook for a tumor. This lead to weeks of dizziness and headaches, and permanent problems with my lower back).

Perhaps it was this book?

https://www.amazon.com/dp/B004C04SS4/ref=dp-kindle-redirect?_encoding=UTF8&btkr=1

That's why a country like Canada can get away with only a handful of MRI machines in the entire country, but in the US they are ubiquitous. In the US, they practice defensive medicine to keep lawyers away, not for the best health outcomes for patients.

 

[loveofourlord]

I've got a little yellow book I read years ago at my parents home (where I lived years ago) that blows apart the idea that early, frequent, copious testing leads to better health outcomes for cancer. Yet it's a myth that companies like Theranos used to exploit gullible investors. In some cases, early testing can actually lead to unnecessary medical interventions that harm peoples health (it did in my case, I got an unnecessary spinal tap due to an ectopic pituitary that a neurologist mistook for a tumor. This lead to weeks of dizziness and headaches, and permanent problems with my lower back).

Perhaps it was this book?

https://www.amazon.com/dp/B004C04SS4/ref=dp-kindle-redirect?_encoding=UTF8&btkr=1

That's why a country like Canada can get away with only a handful of MRI machines in the entire country, but in the US they are ubiquitous. In the US, they practice defensive medicine to keep lawyers away, not for the best health outcomes for patients.

it's also why hospital bills are high in the US.

they don't have room to keep everyone in the hospital for weeks to do tests to find out whats wrong with you, so they have to run everything that's potentially wrong with you, even the less likely because if they think it's one thing and it's a rarer one you might sue them.

 

[ThatRobGuy]

I've got a little yellow book I read years ago at my parents home (where I lived years ago) that blows apart the idea that early testing leads to better health outcomes for cancer. Yet it's a myth that companies like Theranos used to exploit gullible investors. In some cases, early testing can actually lead to unnecessary medical interventions that harm peoples health (it did in my case, I got an unnecessary spinal tap due to an ectopic pituitary that a neurologist mistook for a tumor. This lead to weeks of dizziness and headaches, and permanent problems with my lower back).

Correct... cancer is a nasty business, and unfortunately, for many of the more lethal forms of cancer, by the time a person is symptomatic, it's already "past the point of optimal intervention"

But, on the flip side, it'd be medically irresponsible to give a person routine CT/PET scans every six months if they don't have symptoms, as the level of radiation in those isn't good to be constantly exposed to.

There's some obvious ones that you can check for in non-invasive ways...like skin cancer, there's no risk in going to the dermatologist for a "look over" every couple months if it makes one feel better. And it doesn't hurt for older guys to get a prostate exam every year (well, maybe it hurts a little, just try to get a doc with smaller fingers).

But the ones like pancreatic cancer, lung cancer, etc... those can only be detected by imaging, and the kind of imaging they have to do isn't without its risks if done too often.

With regards to cancer prevention, the best bet is making good lifestyle choices. But people in most developed countries don't tend to do that.

For instance, the research is there for anyone to look at, and several studies have all concluded the same thing. The more meat you eat, the higher your risk for cancer and heart disease, and there's a causal relationship established by a linear trend among eating habits.

How plant-based food helps fight cancer

Vegans have the lowest cancer rates
Vegetarians (who still consume dairy and eggs, but no meat) have the 2nd lowest rates
Pescatarians (who consume fish but no other meat) have the 3rd lowest rates

For the rest of the "high meat diet" population, 40% will be diagnosed with some form of cancer in their lifetime.

It would seem like in terms of cancer prevention, rather than excessive medical screening, it'd be a better public health endeavor to dispel the pervasive narrative that "plant based eating is for sissies, real men eat steak and bacon covered in cheese!"


I'm sort of in the in-between zone. I'm not a vegan, but I've made a conscience effort over the past 4-5 years to reduce my animal product intake by ~80% for both health and environmental reasons. (in fact, I haven't consumed beef or dairy milk in a few years)

Although, my weekly "cheat day" where I have a chicken bowl from chipotle for lunch, and pizza for dinner isn't going away anytime soon lol.

 

[ArmenianJohn]

How does the US government "fund" healthcare.

When their solution for every problem has been to force businesses and employers to cover the cost of health insurance for employees.

Where do they "force businesses and employers to cover the cost of health insurance for employees"??? Where did you get that completely wrong idea?

 

[1rreducibly Complex]

Where do they "force businesses and employers to cover the cost of health insurance for employees"??? Where did you get that completely wrong idea?

...

Prior to 2014, there was no requirement that employers offer health insurance to their employees. The vast majority of large employers did offer coverage, but that was their choice. The ACA's employer shared responsibility provision (employer mandate) requires employers with 50 or more full-time equivalent employees to offer affordable health insurance to their employees who work at least 30 hours a week.3 If they don't, they face a penalty.

Everyone who knows the basics of US healthcare is aware of this.