Maggie's Farm

De je veux on Healthcare: My observation is the more Healthcare you have, the more you need.
I am reposting a thread from awhile back.

Trauma excepted. Medicine that makes an actual consistent difference in the treatment of disease has only been around for 30 to 65 years. When I was a kid there were a few vaccines, a few modestly effective antibiotics, topical antibiotics, digitalis and nitro, a primitive insulin, asprin, opiates, Epsom salt and baking soda.... There wasn't that much that could be done regardless of status or income, you recovered on your own, or you didn't. At that point, the REAL advances in health were as much a consequence of childhood VACCINES, potable water, public health and sanitation, adequate nutrition, and occupational safety.
That aside, consider the possibility that modern medicine is outstripping the ability of regular people to pay for it. Extreme preemies may have life long expensive complications; an aging population consuming drugs, not for a few years, but for decades; people who survive terrible accidents may need life long medical support, along with those who suffer brain injuries(strokes) or cancer. Yes, it is ironic that modern medicine begets the need for more medicine. That's the paradox. I don't necessarily have a solution and I don't think much of the ACA or Medicare for all. I'm just pointing out that sometimes these outcomes have to be considered and addressed; it is not just a consequence of magical thinking. Maybe the federal government will need to be the insurer of last resort, especially for orphan diseases and extreme cases. Just a reminder, health insurers pulled some pretty dirty tricks in the past. I, for one, am intrigued by the Australian system.
Example: a little girl in our area wound up a quadruple amputee due to a strep infection. Yes, it is a miracle that her life was saved, but the life long costs are mind boggling, even with the support of the community. See bellatucker.org.
#2 Exasperated on 2017-01-19 08:17 (Reply)

That aside, consider the possibility that modern medicine is outstripping the ability of regular people to pay for it..

As a counter example look at what has happened to the price of largely privately purchased (insurance rarely covers it, and government doesn't fund it) lasik surgery in the last couple of decades. The cost has dropped dramatically, it has become far more widely available, and the procedure has improved significantly in safety and comfort.

There is a consistent pattern. Government artificially restricts access to a resource. In health care this includes such policies as Certificates of Need, the IPAB, FDA approvals, required coverage in insurance, and others. Limited access drives up the per unit cost, to which, surprise!, the answer is almost always additional government subsidy and regulation. One would almost suspect that was the goal in the first place.

#2.1 Christopher B on 2017-01-19 12:15 (Reply)
The root cause is this: the price people are willing to pay for anything is the difference in perceived value between having the thing and not having it. So long as people continue to place an insanely high value on being alive rather than dead (intentionally being absurd), there will be continuous upward pressure on healthcare spending.

It's not that people in the past were less willing to spend on healthcare, they were simply unable to. Either what they needed did not exist (see Rockefeller's daughter dying of diphtheria), or else they simply did not have the resources. Stating that healthcare is an absolute right that a government has an absolute duty to provide places a claim of population times that value of being alive on the public fisk, effectively backed by the full faith and credit of the nation.
#2.2 Another guy named Dan on 2017-01-19 13:18 (Reply)

The most extreme forms of medicine may in fact be outstripping the ability of "regular people" to pay for it. But we're not going to get far with the idea that no one of us can afford the most expensive medicine, but all of us together can afford the most expensive medicine for everyone at once.

For decades, the cutting-edge medicine has been available only to people with lots of money at their disposal--their own or some kind of donated money that lands in the laps of a lucky few. The medicine typically gets streamlined and cheaper with scale, experience, and competition. Gradually, regular people get access to it at a price that's within range of a regular budget. Does that mean there is inequality at each moment? Yes, it does. It also means that each generation gets better medicine that it can afford, a form of inequality we should be embracing.
#2.3 Texan99 on 2017-01-19 13:38 (Reply)

Really good comments who reveal awareness of the paradox.
"It's not that people in the past were less willing to spend on healthcare, they were simply unable to."

Exactly! I had an argument with a lefty once who insisted that the system killed his mother and that life saving treatments were denied her because she was poor. Except, she got cancer at a time when it really was a death sentence. Wealth and status might have bought someone a few days, weeks, or possibly months but basically there was NO effective treatment, regardless of your status.
#2.4 Exasperated on 2017-01-19 16:59 (Reply)

My mother and aunt trained for and became Registered Nurses (RNs) in the 1930s. They witnessed the arrival of sulfa drugs and penicillin - to them, truly miracle drugs. Today, the research points to drugs tailored to a patient's DNA - another miracle. Whether said drugs can become truly affordable - as sulfa and penicillin were - is another issue.
#2.5 Frances on 2017-01-19 23:23 (Reply)

I'm 4th generation Chicago. What, jumps out at me, is the mind boggling opportunity for fraud; graft; extortion; fake,makework jobs; featherbedding; regulatory mazes; fat,bloat,waste; all the fake diversity and equality monitors; staggering bureaucratic ineptitude and unaccountablility. Great if you were born to write forms and compose check lists; the DMV on steroids.
Think of the opportunities for the SWAMP, in finding cushy, high paying sinecures in which to place their children. Think Hunter Biden; he could be the poster child, but he is just the tip of the tip of the tip...….. of the iceberg. (I hope DJT continues to hammer away on this. The beautiful people consider employment for their offspring a perk, an entitlement.) It is just another aspect of the cost shifting scams that have come to dominate, the media/academia/political/public sector complex. They make the military industrial complex look like minnows.