I recently quit my job to start my own indie game studio. I came dangerously close to being unable to file the paperwork to prove that I was experiencing a "qualifying life event" that would allow me to sign up for ACA insurance outside of the normal once-per-year window. It's not that I was lazy -- I started looking at options over a week before I left my job, and between the various websites being down every night, and insurance representatives not knowing what they're talking about, and having to figure out coverage for my partner also, the whole process was way trickier than it should have been.
A former coworker of mine recently went through the same process when he quit, and ended up without insurance for a short period.
A lapse in insurance coverage means exposure to basically unlimited costs. That's not a position anyone should have to take, whether due to financial hardship or missing a paperwork deadline. And until we get single-payer, there are going to people who fall through the cracks who have to face the possibility of losing their life savings if they get hit by a bus.
So the US spends a ridiculous percentage of it's GDP (15-20%) on health care. Many treatments for serious diseases are far too expensive for a family living on a median income to afford, so health insurance is a requirement in order to avoid bankruptcy in the face of a serious health problem.
My question is, are we getting something for this money? Does healthcare research and innovation in the United States justify what it's costing us, or does the whole system need a reboot?
It's the latter. Privatization of sectors that are responsible for meeting human rights such as right to life (enforced by the police - as of now a public entity), liberty (right to vote - in some cases needs to be afforded by paying for IDs), education (we had a strong public education system until late 1980s), health care (private insurance companies are run as profit-making corporations, treating patients as cash-cows that are disposed of when valueless), and others is not sound policy for a democratic nation. We fell victim to the siren songs of lobbyists and paid media analysts, and have supported massive privatization and agglomeration efforts by corporates over the past 30+ years. This is hurting us.
I was more asking whether or not the quality and advancement of the healthcare in the United States justifies what it costs. Are we getting what we pay for?
Another way to phrase it: if we trade market forces for universal access, will the rate of healthcare innovation slow down?
no, because policies governing access to health care should not share a lot of commonalities with R&D efforts in medical science and technology. The former should be public, while the latter should be commercially driven as much as possible. In our country, the former is predominantly privatized, while the latter is public funded. As a result, we have shown relatively slow progress in R&D while doling out sub-standard health care.
p.s. I really like this statement - "You start to understand how an economy works when you realize Karl Marx and Adam Smith were hitting on the same idea". It is accurate in that both men seeked a more efficient economic system - a far cry from what we have today. What we should have is a combination of both ideas - merging public guarantee of basic rights with the concept of private property.
The former should be public, while the latter should be commercially driven as much as possible.
I think there's a recipe for consensus building here. Granted that you'll never be able to pay for universal health care by eliminating public research grants, but there's got to be some lobby money coming from medical R&D for policies like this.
As for Marx and Smith, the statement is not just about efficiency, but also oppression. Forceful intervention into an economy is oppressive and inefficient. Impoverished workers operating in unsafe conditions are both oppressed and unproductive. These are obviously blanket statements that require nuance for specific situations, but that's basically what I was getting at.
I'd personally like to see an environment where initial risk is taken on by the capitalist, and as a venture matures, ownership gradually passes to labor. When you think about it, it's not too far off from what we have now with the Seed -> VC -> IPO cycle.
Hmm that is also an interesting and truthful way of looking at that statement. I echo your sentiment for businesses to be more employee centered. We have to buck the trend for making profit margin the absolute bottom line.
This is a terrible article. It takes something HRC said decades ago, contrasts it to something she said recently (out of context of course) and presents it as a concrete cause and effect scenario. The ACA took a monumental amount of effort and wasn't even particularly groundbreaking in terms of legislation in its final form. Single-payer really is a pipe dream right now.
Just discovered that my wife and I can't get insurance until the next open enrollment period (November?), because we missed the previous one.
Supposedly this policy was enacted to prevent people from getting insurance only when they get sick. Who comes up with this stuff?
If there was ever a bloated carcass of an industry awaiting disruption... unfortunately its so institutionalized that any new system would require rogue doctors / hospitals.
To be fair, single payer healthcare systems are a mess... A relic of 1940s Era economic thought. No one serious about designing national health systems even considers them anymore. The waiting lists, under and over staffing, wage setting and budget impossibilities make it impossible. Canada has been convening one health council after another for 20 years to try and fix their system, and every one says they have to go mixed. But politics of identity make that hard. I guess it must be the same for Bernie... Hard to reject your roots.
The most successful universal coverage systems are mixed models, like France and Germany. Make the private system compete with a public system (and vice versa). The details of how that works depend on what part of the outcome you want to target: best costs, best patient outcomes, etc...
Half of America still thinks the word 'socialism' is a curse word. There are enough ignorants, malcontents, and profiteers to hold back meaningful progress far beyond any of our lifespans.
Not to be a wet blanket or anything, but people expecting big, commonsense improvements to the US social system are doomed to be disappointed.
Additionally, the sheer size of the health insurance industry is a speed limit on how quickly such a transition could happen, both because of their ability to retard or corrupt political progress, as well as the scale of economic disruption such a change would entail.
A former coworker of mine recently went through the same process when he quit, and ended up without insurance for a short period.
A lapse in insurance coverage means exposure to basically unlimited costs. That's not a position anyone should have to take, whether due to financial hardship or missing a paperwork deadline. And until we get single-payer, there are going to people who fall through the cracks who have to face the possibility of losing their life savings if they get hit by a bus.