This is Why Healthcare for Profit is Wrong

[goldberry]

This sounds horrendous, but this guy is correct, and we are not going to solve our healthcare problems if we don't acknowledge that this is a huge part of it.  If you are in a business for profit, the goal is to make as much profit as possible.  If you have shareholders, it's to maximize shareholder profits.   There is ZERO POSSIBLE CHANCE that this will not conflict with what is morally right for people's lives, people who are suffering from sickness and disease.  I have no qualms about saying I find it disgusting.

https://www.cnn.com/2018/09/11/health/drug-price-hike-moral-requirement-bn/index.html

A pharmaceutical company executive defended his company's recent 400% drug price increase, telling the Financial Times that his company had a "moral requirement to sell the product at the highest price."

"I think it is a moral requirement to make money when you can," Mulye told the Financial Times, "to sell the product for the highest price."

The Financial Times said Mulye compared his decision to increase the price to that of an art dealer who sells "a painting for half a billion dollars" and said he was in "this business to make money."

[happi duck]

*speechless*

[lexi]

Oh I have an opinion about this. But I can’t even get started on it or I’ll be too upset. 

Looking at you Mylan...

[Mbelle]

This is so depressing.  

[PerfectFifth]

19 minutes ago, Thatboyofmine said:

It’s totally disgusting and it’s the reason I’m voting for progressives.    My son is a type one diabetic and there are young adults dying because they’re rationing insulin.  Insulin, for Pete’s sake!   And that medicine the guy is talking about in the cnn article above... I’m on that medicine daily and have been for months and will continue to be.   It’s gross and it’s amoral to care more about profit than someone’s life. 

Here’s an article about insulin prices from the NYtimes.   https://www.nytimes.com/2018/06/22/well/diabetes-patients-at-risk-from-rising-insulin-prices.html

Thatboy...my son is also a type 1 diabetic, newly diagnosed this year. The learning curve of both the condition  and the reality of how screwed up our health care system truly is has taken a toll on my husband and I mentally and physically. I knew health care was a joke but had not experienced it. And yet, my capitalist loving R family still doesn't see that the government needs to help. They still believe let the market work it out. Deregulation will solve everything. The whole thing just makes me want to cry. My son is doing beautifully. It's been haaaaard! And he has struggled with depression and bitterness but he's getting there. But I worry about his future. 

ETA: In my extended family we try to stay away from political conflict. We want to love each other. It's truly hard when i have to just swallow it if they make a comment, but I finally just dropped the bomb that I'm for single payer. I'm not saying it won't have its problems but I'm tired of hearing conservatives saying its bad and will ruin everything but not acknowledging the problems of the system or acknowledging it but refusing to change it. I give up. Progressives all the way for me!!!

Edited September 12, 2018 by PerfectFifth
additional info

[Crimson Wife]

There IS a happy medium between totally free markets and socialized medicine. Profits aren't the problem with healthcare. Price-gouging for life-saving treatments is.

Congress could pass a law stating that for FDA approval of a medication, the manufacturer can only charge costs + a maximum profit of 5% (or whatever we deem to be fair).

[Crimson Wife]

Here is another capitalist-friendly option that could help bring down the costs of pharmaceuticals: Prizes not Patents

[PerfectFifth]

While I agree with you in theory Crimson, congress will NEVER do it. They've done nothing so far. They have no plans of doing it in the future. And all this waiting around is getting us nowhere. In the meantime my son has to deal with a future that includes ridiculous costs, fighting for every single thing that will make him healthier and make living with his condition easier and it doesn't ever get easier. They will approve something one time and reject it the next. I've had them fight me on needles for gosh sakes. What?! Should he just snort the insulin. I'm done waiting. I stand with Single Payer and a politician that will fight for it.

[Crimson Wife]

11 minutes ago, PerfectFifth said:

While I agree with you in theory Crimson, congress will NEVER do it. They've done nothing so far. They have no plans of doing it in the future. And all this waiting around is getting us nowhere. In the meantime my son has to deal with a future that includes ridiculous costs, fighting for every single thing that will make him healthier and make living with his condition easier and it doesn't ever get easier. They will approve something one time and reject it the next. I've had them fight me on needles for gosh sakes. What?! Should he just snort the insulin. I'm done waiting. I stand with Single Payer and a politician that will fight for it.

Single payer would be a DISASTER for those of us with medically complex children. You think you're fighting now? It would be a MILLION times worse under socialized medicine. Socialized medicine keeps costs down by rationing, pure and simple. I've seen the criteria for cochlear implantation in countries with socialized medicine and my daughter would be excluded because they're overly stringent. We had to change from a HMO plan to a more expensive PPO plan to get the surgery approved but at least we could get it done. If we lived in England, Canada, etc. she'd be S.O.L.

[TechWife]

36 minutes ago, Crimson Wife said:

Single payer would be a DISASTER for those of us with medically complex children. You think you're fighting now? It would be a MILLION times worse under socialized medicine. Socialized medicine keeps costs down by rationing, pure and simple. I've seen the criteria for cochlear implantation in countries with socialized medicine and my daughter would be excluded because they're overly stringent. We had to change from a HMO plan to a more expensive PPO plan to get the surgery approved but at least we could get it done. If we lived in England, Canada, etc. she'd be S.O.L.

Health care is rationed now by the insurance companies. The difference is that now things are rationed to maximize profits for the shareholders. 

[Paige]

20 minutes ago, Crimson Wife said:

Single payer would be a DISASTER for those of us with medically complex children. You think you're fighting now? It would be a MILLION times worse under socialized medicine. Socialized medicine keeps costs down by rationing, pure and simple. I've seen the criteria for cochlear implantation in countries with socialized medicine and my daughter would be excluded because they're overly stringent. We had to change from a HMO plan to a more expensive PPO plan to get the surgery approved but at least we could get it done. If we lived in England, Canada, etc. she'd be S.O.L.

To be fair, our system is already a disaster for many medically complex kids in our country and for some kids who aren't even that medically fragile or complex. It's not like our system is working for all the kids; just those who can afford the insurance that covers what they need.

Whether you are American, English, or Canadian, if you have money or can raise funds you can have outstanding care. The Canadians and people from the UK I know who have the same issue as my DD and can't have the surgery she had in their countries raise money and still can come here. Those overseas know that they'll get their wheelchairs, medication, and other typical treatments with their country's healthcare. Americans who are denied or who don't have insurance have to pay for everything- not just the complex things. 

[Paige]

5 minutes ago, Arctic Mama said:

 

 

Failures in single payer don’t abdicate the US of failures in our own system, before the ACA or afterward.  But it isn’t a panacea either.  There are benefits to be considered and improvements that could be adopted, as well as cautions we should take into account in what hasn’t been working for patients or the economies. Anyone who thinks it’s absolutely cut and dried is ignorant, partisan, or both.  

I agree- no system is perfect! I think our country is in a great position if it had the will to change. We have so many examples to study and see what works and what causes problems; what some unintended consequences have been, and with all that information I don't know why we can't come up with something that's pretty decent. 

 

[PerfectFifth]

2 minutes ago, Paige said:

I agree- no system is perfect! I think our country is in a great position if it had the will to change. We have so many examples to study and see what works and what causes problems; what some unintended consequences have been, and with all that information I don't know why we can't come up with something that's pretty decent. 

 

I also agree. I am pretty partisan I will admit and sometimes even ignorant, but I can't help but feel that many don't really care to fix it. There are some who speak out but it never really goes anywhere. And what would be the motivation. I am all for the idea of making it non-profit from top to bottom, but I doubt there would be any support for it and I know movement in that direction works against research etc. Profit is a motivator. There is no doubt. So I'm frustrated and have met a lot of wonderful caring people who can't afford to upgrade to a PPO. They don't have jobs that provide even an HMO. We have an HMO. With a lot of fighting, many many hours of calls, I have been able to get the things my son needs to keep him healthy, out of the hospital and stable, which in the long run will save the health insurance company money. But I have time to sit on hold forever, understanding bosses and the education to know how to handle bureaucracy. To many don't have some or many of these things. Hope I'm making sense. This is just a situation that makes me see red. It's hard to read about a CEO making gazillions of dollars and know that my kid has to figure out how to get a decent job, with decent pay, the right health insurance that covers his stuff.....and then don't change jobs in case the next situation is worse......It's frustrating.  I do know, better health care is just a talking-point that quickly gets ignored after the election..No real solutions being implemented that I'm aware of. Again I admit I'm not all-knowing.

[SKL]

I agree that is sad and bad.

That said, many useful drugs would not even exist if there were no profit motive.

The profits from successful drugs fund R&D for future treatments / cures.  Putting government in charge of this would not work.

I don't like a lot of what I see in big pharma.  Among other things, the majority of drugs taken in this country aren't even needed and actually make people sicker in one way or another.  But I am not sure what the fix is for that.  I think a lot of it is consumer driven.  Nobody wants to get old, to feel pain, to have to wait for things.  I still believe that voting with our pocketbooks is effective in the big picture.

[PerfectFifth]

1 minute ago, happysmileylady said:

So what happens to the insurance companies and the PBMs if the US moves to single payer?

Quick question  What is a PBM?

 

[Mbelle]

I am for single payer healthcare.  I would like options to buy private.  

Currently we are independent contractors and we are paying $1750 per month.  We still have co-pays and deductibles.  It is insane.  It is a driving factor in our decisions as a family and I'm feeling very upset about it. 

As we know there can be issues and I have heard about some of them in dh family about the australian system.   If you have upgraded private care then there are far less issues and really it's very nice. I would like that option.  I think some of the issues sound like good old government regs that need to be updated.  For example a person on public may have a procedure and they are still following old protocols.  They still work, but it is not cost efficient and takes more time.  The person on private care will have the same condition but will have the latest updated procedure.  However, everyone gets cared for.  Some of the other issues are the exact thing we run into here with our health insurance.  The dr knows what will fix the problem, but the insurance company requires that you try something else first.  This kind of thing really infuriates me.  It is seriously a waste of time and money and also I have seen people have to suffer for more time.

 

[TechWife]

11 minutes ago, happysmileylady said:

So what happens to the insurance companies and the PBMs if the US moves to single payer?

They could offer supplemental plans to cover copays and some uncovered services.  They could also process claims for the single payor. Mostly, they won’t make as much money off of sick people, which is one of the benefits of single payer. 

[HomeAgain]

12 minutes ago, happysmileylady said:

So what happens to the insurance companies and the PBMs if the US moves to single payer?

Probably the same thing that happens to insurance companies in other countries.  They move to offer supplemental insurance that goes above single payer healthcare.


I've had Tricare/military healthcare my whole life.  I really am glad that I've had it but it means that I view this fight sort of from the outside.  I've never had to deal with crazy monthly bills or worrying about whether we'd eat or buy meds.  If everyone could have the same I'd be overjoyed.  That's not saying that military healthcare doesn't have issues, but it's nothing like the civilian side of things.

[PerfectFifth]

http://www.pnhp.org/facts/single-payer-faq

I am only half way through this article, but it's interesting. I know there is no "Perfect" fix but much of this article seems well researched and facts backed up with research articles. It goes into quite a lot of detail in regards to coverage and what happens to existing employment within the HC System. 

ETA: It also seems to debunk a lot of the theories regarding decreased research, massive wait times ...but again I just started reading it, before someone jumps down my throat. ?

Edited September 12, 2018 by PerfectFifth

[Faith-manor]

55 minutes ago, TechWife said:

Health care is rationed now by the insurance companies. The difference is that now things are rationed to maximize profits for the shareholders. 

Thank you!

I am tired of the rationing scare. Seriously. Thousands of people die every year because their care is rationed by insurance companies and hospitals that can't afford to dole out high end care for free. Sorry. The argument is a total non starter. 

And yes, some single payer systems have had issues. But not all. France, Germany, Denmark, Sweden....world class and the citizens live MUCH longer than the US. They have high "happiness" or quality of life scores, low infant and maternal death rates, low child death rates across the spectrum. While life style issues do come into play in this, the biggest reason they don't die of treatable disease and injuries is because they can get treatment and it isn't dictated by the CEO and investors of Blue Cross Blue Shield.

My sister has a very expensive to treat, rather rare autoimmune disorder. She is an American citizen living in France, an EU permanent resident. She has ZERO problem getting treatment. She would die if she came back to the states. She would make too much money to get Medicaid which would cover treatment, but not enough to purchase a cadillac health plan, and even then, without the pre-existing condition law, she'd be hosed even if she could afford the damn policy.

No thanks. I've seen enough death and destruction here to no longer be scared of single payer systems like much of Western Europe and the Scandinavian countries have.

For what it's worth, if there ever should have been rationing, it should have been my father figure. Medicaid coughed up more than a quarter million dollars of cancer treatment because he wanted to gamble on the 1% chance (not a typo, you read that right) of getting "more time". He didn't get any extra time obviously. The tax payers could have used that money to pay for someone else's insulin or epilepsy meds, or cochlear implant, or kidney transplant, or......

I've seen the other side.

[HomeAgain]

43 minutes ago, happysmileylady said:

 

Although I am not confident that these companies would just remove a major part of their business model to increase supplimental care...

 

How does this actually eliminate this "for profit" issue?  Doesn't it just mean that pharmaceutical companies and hospital companies can still raise their prices in the same manner since those insurance policies that the richest people (in a country with a very wide range between the richest and the poorest) will still be willing to pay those prices and to heck with all those folks stuck on government care?  

No.  Supplemental covers things that regular healthcare does not.  Like the kids who have plagioenceph....argh.  Where they need a helmet to correct the head shape before a deformity can cause other problems.  Most insurance companies don't cover these because they are considered cosmetic corrections (though problems down the road would be covered).  A parent could purchase supplemental insurance that would cover things like this, or a special insulin pump/continual monitor.  Or even the difference between a private room at a hospital instead of a shared one.

We need a couple of things in our country:
1. transparency in cost/billing procedures.  Right now, you don't know what you pay until after you see the doctor and surprise items can still show up, like the couple who got a bill for having a nurse in the room while the dad held the newborn.  Nobody can shop around and find the best price if they need a non-life threatening procedure.
2. a law against advertising drugs.  Seriously.  Drugs are marketed to patients now and it shows in the mark up.  They should be banned from advertising prescription-based medicines.
3. single payer health care.  We really need to reexamine our thoughts on human rights in this country and whether someone has the right to live.  If a medical procedure steals their life while giving them a way to breathe, we haven't given them the right to live.  We've robbed them of the dignity of death and sentenced them to poverty.

[HomeAgain]

2 minutes ago, happysmileylady said:

 

Single payer, I am just really seriously not convinced that it would work here, the way it works elsewhere because of all the things that make the US so different from all those other countries.  

What makes the U.S. so unique?

[TechWife]

43 minutes ago, happysmileylady said:

The population of the US is about 4 times the size of the population of Germany, approx. 5 times the population of France and about 50 times the population of Denmark.

How exactly do we scale those systems up like that?  Do the advantages scale up?  

 

I am not "scared" of single payer type systems.  I am just very skeptical that anything like what happens in countries a quarter of the size of the US has the same results in our country it has in those countries.  

Multiplication. There is nothing that leads me to believe they won’t scale up. 

[HomeAgain]

1 minute ago, happysmileylady said:

Second largest country in the world.

Very strong states rights (along with populations behind that, the population of California is 6 times that of the entire country of Denmark.)

Currently the major world superpower

Shares a large land border with Mexico, one of the top 25 most dangerous countries in the world

Major cultural diversity not present in many (most) first world countries

And several others.  

 

Canada shares a large land border with us and we're pretty dangerous.  Our children can't even go to school without worrying about being shot and our maternal death rate is horrifying.  Canada has single payer health care.  They're also pretty diverse in culture.  We have more people, but we also have more states than they have provinces to help manage it in bites.

So, we're not unique.  We just think it's better to allow people to die in the hands of a healthcare system that benefits companies at the expense of people and pretend we really are a first world country.

[HomeAgain]

In the current list, Mexico is down at 30.  Sweden is 37. Last year Mexico was even further down the list at 45.  U.S. was 53. What list are you looking at that says it's in the top 25 most dangerous?

 

[liber]

And does anyone know how much it actually costs to get a drug(the ones that make it) to market, from concept through all trials and FDA regulation?

My dh had tested (he out sourced it) about 11 compounds that have already been approved in other countries.  He tested these compounds against known drugs used to treat various diseases.  A couple of compounds out performed the standard of care for a couple of the diseases he tested.  Price tag, $500,000.  That was just to get started.  The timeline to market is about 4-6 years spending 50-100 million to get it approved.  That is one drug.  If the compound was a new one, the timelines would be even longer and more expensive.  one in every ten drugs make it to market.  However, millions of dollars have been spent on all ten.  Investing in drug development is high risk which is why there is such a high return for shareholders.  You need deep pockets.  You need to be ok with losing money.  Those drugs that failed, investors lost their money.  They want to recoup their loss.  They do so, when that one drug makes it to market.  Not only do shareholders make back their money, but that profit on the drug needs to pay everyone from the CEO down to the janitors that clean the building.  all the infrastructure to support drug development needs to be funded somehow.

Someone above was upset about the cost of insulin.  I asked dh about that.  He said it is a large protein that is difficult to make and that is why it is expensive.

When these discussions come up, dh always says to me, Do people want safe and effective drugs or cheap drugs?  

The other thing, people need to be incentivized  to do things.  Very few people do things purely out of the goodness of their hearts.  People want to make money and it is probably the easiest way to incentivize people.  

Dh does not only because he wants to help people, but he likes the intellectual challenge of coming up with new drugs and new uses for drugs already out there, but  also because he wants to make money too.  If all things go well, when we sell the shares we will have enough to retire.  

[Sneezyone]

We used to invest heavily in basic research as a public good. Disinvest and you reap what you sow.

Edited September 13, 2018 by Sneezyone

[liber]

The US funds a lot of research.  More than Canada.  Dh has always been envious how much the US government funds.  That is why the company that dh used to work for move to the US.  Better funding opportunites.

[Sneezyone]

1 minute ago, liber said:

The US funds a lot of research.  More than Canada.  Dh has always been envious how much the US government funds.  That is why the company that dh used to work for move to the US.  Better funding opportunites.

 

We fund research but only a fraction of that is basic research, much less than what used to be spent. Too much is now outsourced to the private sector which only funds money makers. It’s cool today to poke fun at basic research.

http://www.sciencemag.org/news/2017/03/data-check-us-government-share-basic-research-funding-falls-below-50

[ktgrok]

2 hours ago, happysmileylady said:

  The more people there are the more billing there is, the more meds there are, the more buildings are needed, etc etc etc.  

But we are already doing the billing and the meds and the buildings. We just are doing it all haphazard with hundreds of different billing systems and insurance protocols, etc. Single payer would simplify all that. 

1 hour ago, liber said:

 

When these discussions come up, dh always says to me, Do people want safe and effective drugs or cheap drugs?  

 

If you can't afford to buy the drug it doesn't matter how safe and effective it is, does it?

[Paige]

2 hours ago, happysmileylady said:

 

these things are not independent of each other.  So lets presume Sweden is number 37.  Do any of the countries that border Sweden have the second largest populations in the world?  Are any of them a major world super power?

Come on, every situation and country is unique. We aren't unique in our uniqueness. 

You could just as easily argue that smaller countries with lower GDPs and a smaller tax base would have it harder. Or say that major world super powers should be able to do more for their citizens instead of less. And I don't know what Mexico being next to us has anything to do with it. Mexico itself has universal healthcare. 

There are other large countries, there are other powerful countries, and many, many diverse countries. I don't claim other systems are perfect, but we are really outliers compared to the rest of the world. We can have the most powerful country, put people on the Moon, have a little robot on Mars, create the entire secret Nuclear City complexes that lead to the invention of the Bomb in the 40s, yet still can't make sure that everyone has healthcare. That's ridiculous. Of course we can do it if we wanted to. 

[chiguirre]

Both China and India have public healthcare. It's not great and anyone who can pay out of pocket for private care does, but everyone can access basic care. Given how huge, how diverse and how poor both of those countries still are, that's a real accomplishment. If we put our minds to it, I am sure the US could do at least as well as Chile or Portugal (both have higher life expectancies even though they're both much poorer than us).

[Crimson Wife]

9 hours ago, TechWife said:

Health care is rationed now by the insurance companies. The difference is that now things are rationed to maximize profits for the shareholders. 

The only times we ever experienced denials from our insurer were when we were stuck with Kaiser HMO. With PPO's we can always go out of network at a higher cost share. 

The rationing that happens here is financial, because not everyone can afford insurance premiums, deductibles, and co-pays. We could do a better job at alleviating the financial burden without eliminating the good quality care than many people are happy with (even if they're not thrilled about the costs that they are paying for it). 

[Pawz4me]

8 hours ago, Ktgrok said:

But we are already doing the billing and the meds and the buildings. We just are doing it all haphazard with hundreds of different billing systems and insurance protocols, etc. Single payer would simplify all that. 

Yes. One of the most sound arguments for a Medicare-for-all-type system I've heard has been from doctors and medical billing people. They say private insurance is so difficult to deal with, often seeming to arbitrarily deny coverage for no reason (most of us have probably BTDT), and that just when they figure out what relatively routine things they can count on one plan/insurer covering or not -- they change. With Medicare they know what is and isn't covered, denials just to be denying are MUCH less of an issue, and apparently yearly changes aren't typically big deal things.

From personal experience--After my mom died Medicare got all their billing done quickly and did their reimbursements. It took the hospital over a year to get things sorted out with her supplement (Blue Cross). They had to resubmit denied claims SO many times, all of which, as far as I could tell, BC ultimately ended up covering. It really delayed our being able to finalize her estate settlement (and that's a very minor thing compared to someone being delayed getting life saving/pain relieving treatment).

We aren't unique. Well, I guess we are. All countries are unique in some way. The argument that we are somehow "more uniquer" simply doesn't hold water. It does make us look incredibly arrogant and ignorant to claim it.

[TechWife]

15 hours ago, happysmileylady said:

 

Although I am not confident that these companies would just remove a major part of their business model to increase supplimental care...

 

How does this actually eliminate this "for profit" issue?  Doesn't it just mean that pharmaceutical companies and hospital companies can still raise their prices in the same manner since those insurance policies that the richest people (in a country with a very wide range between the richest and the poorest) will still be willing to pay those prices and to heck with all those folks stuck on government care?  

They won't willingly do it, which is why health insurance reform has been so hard. The insurance industry actively lobbies congress. However, if it becomes law, they WILL do it. They would have no choice.

No, it means that the single payer would have negotiating power to lower those prices and to put in place uniform pricing. The single payer would hold the hospitals accountable in much the same way as Medicare does now - with outcomes driving how the hospital is paid for the services rendered. The vast majority of the population would have the single payer insurance. Those who have supplemental or top off plans would be far fewer, so they would not be able to control the prices in facilities that accept the single payer insurance. There would be some private providers who don't participate in the single payer system, but most would, I believe. That would really depend on how the system was set up, though. There are a lot of variables that would need to be nailed down, but other nations do this and it does work.

[TechWife]

16 hours ago, SKL said:

 

The profits from successful drugs fund R&D for future treatments / cures.  Putting government in charge of this would not work.

The federal government already funds R&D. When it is federally funded, the information must be shared. If it is privately funded, then the information is proprietary, which is what results in high cost, brand name drugs. Pharma funds R&D solely to make a profit, whereas the gov't funds R&D based upon what would most benefit the citizens (should, anyway, but sadly lobbyists get into the picture here, too). Sadly, the federal gov't is funding less research every year.

[Sneezyone]

2 minutes ago, TechWife said:

The federal government already funds R&D. When it is federally funded, the information must be shared. If it is privately funded, then the information is proprietary, which is what results in high cost, brand name drugs. Pharma funds R&D solely to make a profit, whereas the gov't funds R&D based upon what would most benefit the citizens (should, anyway, but sadly lobbyists get into the picture here, too). Sadly, the federal gov't is funding less research every year.

 

Yep, this.

[TechWife]

14 hours ago, happysmileylady said:

...

"our children can't even go to school without worrying about being shot"   THis is a super other topic that has nothing to do with health care.  But if you want to go there, our children are more likely to die in a car wreck on their way to school than they are to be shot at school.  Statistically speaking.   

...

Our maternal death rate IS horrifying.  I would LOVE to see studies that actually explain why.  

...

And, in general, these things are not separate from each other.

What other country is second in the world in population, borders a country in the top 25 most dangerous, is one of the largest world super powers AND has the diversity of the US.  Is there a country that fits ALL of those?  Because those things don't operate independently of each other in the dynamics and politics of all this. 

Gun violence and car accidents actually are public health concerns.

One of the biggest reasons for our high maternal death rate is lack of access to maternal health care. Access encompasses availability and affordability. Our rural hospitals are closing at an alarming rate, physicians can't afford to provide services in low population areas due to high malpractice insurance costs. Midwives aren't readily available, either. In some states their practice is highly restricted and in others prohibited altogether. Insurance is cost prohibitive for many people. There is a lack of a concerted effort to educate women on childbearing and childbirth, so many don't know how important it is to get prenatal care. People who don't receive prenatal care are at higher risk for complications during birth that lead to death for the mother and the infant. The reasons are legion and pretty well known.

The US has some unique aspects, but when it comes to health care, we aren't at all different. We are all human beings, with bodies that operate in the same manner. Externals that are different can be managed and I can't think of how any of them would be insurmountable to achieving a single payer system. While I love my country, we aren't that special.

[TechWife]

13 hours ago, happysmileylady said:

https://www.businessinsider.com/most-dangerous-countries-in-the-world-global-peace-index-2018-6

 

Mexico, number 24

Most are in the middle east or Africa.

But again...

 

these things are not independent of each other.  So lets presume Sweden is number 37.  Do any of the countries that border Sweden have the second largest populations in the world?  Are any of them a major world super power?

None of this has anything to do with whether or not single payer would work.

[Garga]

What does Mexico being along our border have to do with health care?  

[Lady Florida.]

16 hours ago, happysmileylady said:

 

Our maternal death rate IS horrifying.  I would LOVE to see studies that actually explain why.  

 

 

Here are just a few of the many, many articles that come up in a Google search

http://www.berkeleywellness.com/healthy-community/health-care-policy/article/why-maternal-mortality-so-high-us

http://www.slate.com/articles/health_and_science/medical_examiner/2017/05/medical_error_isn_t_to_blame_for_our_high_maternal_mortality_rate.html

https://www.npr.org/2017/12/07/568948782/black-mothers-keep-dying-after-giving-birth-shalon-irvings-story-explains-why

[goldberry]

19 hours ago, SKL said:

The profits from successful drugs fund R&D for future treatments / cures.  Putting government in charge of this would not work.

  I still believe that voting with our pocketbooks is effective in the big picture.

 

In addition to what has already been said about public vs private funding, research how much pharma companies spend on advertising and marketing in the U.S.  The claim they would have no money for R&D is false.  It's a choice about where to spend the money.

And regarding voting with our pocketbooks, I agree with that in many cases, but the idea of a sick person (or a parent with a sick child), who might even be bankrupt or unemployed or at least seriously low income at that point, "voting with the pocketbook" on issues that affect their quality of life or even life-or-death - no.  That crosses the line into inhumane and immoral.

[PrairieSong]

My dad was an MD and he complained constantly about how much he hated fighting with insurance companies. For example, a patient of his in the hospital who had Condition X was only allowed by the insurance company to stay Y number of days in the hospital. Because profits! If that patient needed to stay longer due to a complication or an underlying medical condition or whatever, too bad. Dad would try his darnedest to convince the insurance company. Sometimes he was successful, and sometimes he had to discharge patients too soon. So incredibly frustrating, to not be able to do the best thing for his patients.

That is only one way insurance companies ration health care. 

We could do so much better. 

 

[Janeway]

22 hours ago, Crimson Wife said:

There IS a happy medium between totally free markets and socialized medicine. Profits aren't the problem with healthcare. Price-gouging for life-saving treatments is.

Congress could pass a law stating that for FDA approval of a medication, the manufacturer can only charge costs + a maximum profit of 5% (or whatever we deem to be fair).

I agree with this. There is a difference between just being for profit and actual price-gouging. Price-gouging is illegal for things like gasoline during times of crisis. I am unsure why it is not illegal in healthcare, other than the fact that pharmaceuticals spend more in congress than the big tobaccos did in the 80's and before. Also something to keep in mind and not just blindly accept every drug offered to you for yourself or your children, elders, etc (vaccinations are drugs too) when at the doctor. Or criticize those who do not (not saying you do at all, or anyone on this board, just thinking about this).

Edited September 13, 2018 by Janeway

[Mbelle]

I feel very positive that we can do whatever  we want when we put our mind to it.  We are a positive can do nation and have been from the very beginning.  I believe our diversity is an asset.  Sometimes we don't like things about each other, but we do not let it get in the way of getting things done.  We need to get a grip on the guns, and we will.  Love always wins! If we can sustain a half a billion dollar military industry then I feel confident we can manage a single payer health care system.  

 

[PrairieSong]

9 minutes ago, Mbelle said:

I feel very positive that we can do whatever  we want when we put our mind to it.  We are a positive can do nation and have been from the very beginning.  I believe our diversity is an asset.  Sometimes we don't like things about each other, but we do not let it get in the way of getting things done.  We need to get a grip on the guns, and we will.  Love always wins! If we can sustain a half a billion dollar military industry then I feel confident we can manage a single payer health care system.  

 

I hope so, but I don't always feel very positive about it. There is so much opposition to it, as well as misinformation.

[SKL]

3 hours ago, goldberry said:

And regarding voting with our pocketbooks, I agree with that in many cases, but the idea of a sick person (or a parent with a sick child), who might even be bankrupt or unemployed or at least seriously low income at that point, "voting with the pocketbook" on issues that affect their quality of life or even life-or-death - no.  That crosses the line into inhumane and immoral.

What I meant was that the tens of millions of people who do have a choice can vote with their pocketbooks to put pressure on bad actors, just like they do in other industries.  Most of us have a choice of remedies and the sources of those remedies.  Those of us who could make a change with minor discomfort could stop buying from the bad actors until they agree to price the meds fairly for those who don't have a reasonable choice of remedy / source.  There are also other ways to put pressure on them, for example, boycotting other companies connected with the directors who allow this kind of abuse to occur.  It has worked in the past.

[Bootsie]

3 hours ago, Janeway said:

I agree with this. There is a difference between just being for profit and actual price-gouging. Price-gouging is illegal for things like gasoline during times of crisis. I am unsure why it is not illegal in healthcare, other than the fact that pharmaceuticals spend more in congress than the big tobaccos did in the 80's and before. 

One problem is that there is no precise, consistent definition of price-gouging.  Also, price-gouging regulations are generally state or local based, and not federal laws.

[Murphy101]

Someone needs to tell that jerk that gluttony is a vice not a virtue.

 

[historically accurate]

6 hours ago, Ordinary Shoes said:

I've always found it interesting how many "friends" American opponents of single mayors have in Canada and other countries with a single payor, i.e. the rest of the world. I'm not sure there are enough Canadians to go around so every American can be friends with a few of them. And not only are there all of these "friends" who live in single payor countries, they all seem to have needed healthcare services. Call me skeptical...

It's a bit odd that these "friends" have horror stories about being denied care when the vast majority of the citizens of countries with single payors like their healthcare system and have no desire to have anything even remotely like the American system. ISTM that if you add the "friends" who were denied care to the "friends" who had to come to the US to receive treatment (the other claim that is often made during these discussions), that would constitute a majority of Canada. Given that Canada is a democracy, surely all of these "friends" would have gotten rid of their single payor by now if it was really all that bad. 

 

 

I don't have any friends in Canada (nothing against Canadians, just no way to run into them smack dab in the USA, so I can't speak to that. But my mother lived in a camper and traveled the USA for 4 or 5 years before settling down in Florida for her retirement. She ran into and still runs into a lot of snowbirds from Canada. She has not found one who prefers the US medical system; they are all EXTREMELY careful to live 6 months and 1 day in Canada to retain their healthcare benefits.