- Joined
- Dec 6, 2015
- Messages
- 10,322
- Reaction score
- 6,025
- Gender
- Undisclosed
- Political Leaning
- Undisclosed
1. Not at all; again it is meant to highlight the fact that Republicans often oppose expansion of subsidy of the poor, and aggressively pursue reductions of such subsidy, and therefore are unlikely to support an expansion of subsidy of the kind seen in the Singapore health system.
2. I think that Republicans like Democrats are primarily bought by their donors, and thus will not in good faith pass legislation that will benefit the American people at their expense, which is primarily why the US would never pass a system like Singapore's (I can't even begin to imagine the outcry).
HSAs? Sure. Anything remotely resembling Singapore's system? Not at all.
3. According to what/who?
If you honestly believe that extensive price setting in Singapore negotiated with providers using the governments clout and economy of scale (which is a big part of the reason SP/UHC systems have substantially reduced costs) doesn't have an overwhelming impact on prices and cost efficiency without proof for such a fantastic claim, I don't know what to call that save partisan nonsense.
Price setting in the States is deficient due both to political cronyism/regulatory capture and fragmentation; it's part of why it pays the most of any industrialized country in the world for drugs as an example; because providers effectively write the legislation through their politician cronies on both sides of the aisle.
And the US government still pays more vis a vis other governments, nevermind pharma (because it lacks the same negotiating power of other first world governments due both to political corruption/porkbarreling and the lack of universal coverage seen in Singapore and SP countries). Further, administration costs and redundancies account for a huge portion of waste, which is precisely due to the nature of the fragmented market.
They're not primarily the ones who set the prices; again, it's the providers who have all the political power that get to effectively demand ransom. Joe Blow pays the ransom precisely because he doesn't have much of a choice.
Again, and other countries get comparable, or even better results with more population coverage while paying much, much less.
Apparently my point has been missed; I simply stated that the sourcing for their data/ranking is indicated at the top.
Again, I'm not talking about the red herring of simple life expectancy, I'm talking about tangible metrics like survival rates and cost per capita, ability to get care, as well as aggregate measures of health. The US system is unquestionably good in terms of direct outcomes, but utterly deficient with respect to both cost efficiency, and the accessibility of those outcomes. Sure, your survival rate is great in the States if you can get and afford adequate treatment, but that's a rather substantial 'if'. Above all, for the money paid for care in the States, you'd damn well better get the very best in the world, but that's not always the case, and even if you do, it is not nearly commensurate with the premium you are paying.
While I agree there are elements of the nation master index which are at best questionable, it's worth noting that their findings actually aren't too dissimilar vis a vis rankings by accredited institutions on the matter like the Commonwealth Fund and WHO.
Pointing to microcosms and anecdotes, particularly chronically underfunded institutions such as the NHS (if you don't believe me, go look into the matter a little) and VA (egregiously so) doesn't really make your argument.
Elective surgery gets put off because that's how triage works; procedures and treatments are prioritized according to patient need, not wallet; you don't get to line skip because you have more money than the next guy; thus non-electives and essential care gets priority when it comes to resources. Heart surgery and chemo before hip replacements.
Last edited:
