> not getting healthcare as a 20-something is popular, but incredibly shortsighted.
My idea is that it is not something that you should have to think about. I mean I understand it is a difficult topic because you have these outliers that can totally destroy your life if you have a baby with a malfunctioning heart or whatever but it comes back to the question of what we think is fair. I sincerely believe that healthcare is too expensive. The problem is that nobody who is in a position to cut costs has the incentive to do so.
I mean I hear all these complaints about medicare from providers like oh there are restrictions on what you can bill and what you can't and I am just thinking "good" because otherwise the doctor will put every single patient who comes in with a stomach ache through an MRI without using any of her judgment. I mean it looks badly on her if one out of a thousand patients turns out to have something she didn't catch but it doesn't hurt her at all for all those 999 useless MRI and the cost of those. The hospital is happy because they already have the machine and the technician who is there so is drawing salary so they have an incentive to maximize the use of the machine and the technician.
I am hopeful for medicare for all but we should remember that this is not the end of the problem. There are no silver bullets. As a society, we have to constantly make difficult choices and I for one support "death panels" which to me means that certain cases where the cost is too great AND the outcome is not good enough can and should get denied.
> where the cost is too great AND the outcome is not good enough can and should get denied.
I'm not completely clear on the point you're trying to make, but this is how things work in socialised healthcare. Not everything is paid for - instead the money that is available is spent on those that return the best value-for-money balanced against not being unfair on an individual level. The question of whether to MRI everyone with tummy pain is translatable into a clinical question and can be tested in clinical studies.
In the UK we work on using a QALY - or quality-adjusted life-year to help with these sorts of decisions. They are used on boards in NICE (for general health-provisioning guidance) and the cancer drugs fund [1] which aims to give quick guidance on the fast-developing and expensive field of anti-cancer therapies.
Sure there are no silver bullets, but issues you bring up are being tackled to a relatively sophisticated degree in other countries.
My idea is that it is not something that you should have to think about. I mean I understand it is a difficult topic because you have these outliers that can totally destroy your life if you have a baby with a malfunctioning heart or whatever but it comes back to the question of what we think is fair. I sincerely believe that healthcare is too expensive. The problem is that nobody who is in a position to cut costs has the incentive to do so.
I mean I hear all these complaints about medicare from providers like oh there are restrictions on what you can bill and what you can't and I am just thinking "good" because otherwise the doctor will put every single patient who comes in with a stomach ache through an MRI without using any of her judgment. I mean it looks badly on her if one out of a thousand patients turns out to have something she didn't catch but it doesn't hurt her at all for all those 999 useless MRI and the cost of those. The hospital is happy because they already have the machine and the technician who is there so is drawing salary so they have an incentive to maximize the use of the machine and the technician.
I am hopeful for medicare for all but we should remember that this is not the end of the problem. There are no silver bullets. As a society, we have to constantly make difficult choices and I for one support "death panels" which to me means that certain cases where the cost is too great AND the outcome is not good enough can and should get denied.