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Message: <blockquote data-quote="Ovinomancer" data-source="post: 7828476" data-attributes="member: 16814">1.  The outcome differential between the US healthcare system and other OECD countries is actually very small.  It's played up for politics.  So, calling it broken or malignant is hyperbole born of ignorance.2.  I'll actually agree the US system is badly flawed, though, despite 1) above (I don't agree the stats show the flaws well).  However, the solution isn't single payer or remaining flawed -- this is a narrow policy preference that is only grounded in personal beliefs.2a.  I say this because the current US system is so badly flawed because of government intrusion into the system.  Not that there should be none, because that's silly, but the specific intrusions made into the system are actively damaging to cost control or quality of outcomes.  This is what happens when the laws governing your health are made by politicians without knowledge instead of being between patient and doctor.  Add to it that the US politician is well captured by the large medical organizations that are built to take advantage of the current system and also by the insurance market which does the same.  Neither wants the system to become more transparent.2b.  The idea that the solution to this problem in the US is to rely on those same captured politicians to create a sweeping change in system that will have good outcomes.  The very suggestion that they're capable is ridiculous.  The only form of socialized medicine that might work would be to have the Federal government step out of regulation altogether and let the states work out their own systems, creating at least a 50 member think tank with real outcomes to find a reasonable solution.  Any federal system will be worse that what we currently have.3.  The biggest problem I have with socialized medicine programs is that your medical choices are constrained by non-doctor politicians.  There's a persistent canard that doctors direct care, but it's bogus -- they direct care within the bureaucrats' guidelines of what's to be available.  Faceless bureaucrats determine if this disease is worth spending on or if you'll just get palliative care if unlucky.  Supply is determined by the bureaucrat, not the patients or doctors.  There are problems with market based health care systems, sure, but the blind faith that papa government will do the right thing has been shown to be endlessly misplaced throughout history.4.  To create a market based health care system in the US, we need to get off the insurance pays for routine care model.  Having insurance pay for a office visit obscures the costs entirely, allowing the system to create byzantine ways of hiding costs which leads to both doctors advising unnecessary procedures to cover malpractice suits (tort reform is also necessary) and the patient failing to understand the full cost ramifications of accepting the procedures.  Just trying to get cost information before agreeing to a procedure is often met with 'but you have insurance, don't worry about it.'  It's decidedly flawed because at the point of service, costs are completely hidden (I've noticed most doctors don't know actual costs at all).   Transparent pricing at point of service will act to reduce overall costs greatly, as people will be able to make informed choices about procedures and require doctors to justify the procedures as medically necessary to the customer rather than the bureaucrats at the insurance office (and, to be fair, he hires someone to do this).Socialized health care is not the only model possible.  Pretending it is just betrays political leanings.  If the goal is actually good care, the method achieved should not matter.  Sadly, the health care fight is more about displaying political bona fides in supporting specific policy outcomes than discussing ways to find better care.  Some things about me:  I've been hospitalized twice without insurance in the US.  Both were life-threatening and required weeklong stays in the hospital.  The first was acute appendicitis and the second was a runaway staph infection in my left arm (that almost had to be amputated).  I am not wealthy, nor are my parents.  I was unemployed the second time (just went back to school).  I did not have to declare bankruptcy, and, while I carried medical bills for a few years, did not have to skimp terribly to make it through.  Both times I was able to work with the hospitals and doctors to get cash pricing instead of insurance pricing, which drastically reduced my bills to workable amounts.  I've been there, and done the hard work of finding out what costs and prices actually are to negotiate better cost/benefit for me.  It took a lot of time in billing offices, and would have been well served by having the system be less obscure to everyone involved.</blockquote>

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