The elephant in the room (re: the pandemic response) is the privatized health care system. With costs so high, people will avoid treatment, and with few security nets, people will go to work sick. How exactly do you prevent a rapid spread in that situation?
They seem to only partly be private (like the US).
> Long term care for the elderly, the dying, the long term mentally ill etc. is covered by social insurance funded from earmarked taxation under the provisions of the Algemene Wet Bijzondere Ziektekosten, which came into effect in 1968.
According to the German Wikipedia article every Dutch person is required by law to have a "legally defined" healthcare contract. Sounds quite different to the US system.
At face value, this is almost exactly what Obama did. It killed most of the cheap options for people who just want emergency coverage and was essentially a tax in disguise which many Americans objected to.
This is false. "Catastrophic coverage" was ended because of the sheer wealth of data that these insurance policies did not in fact provide their customers with what the customers were expecting. That is: a person with such a policy who unfortunately suffered a major accident or severe illness would find the insurance company wriggling out of any financial responsibility.
The rules were tightened up, and without any explict legal language banning them, insurance companies dropped such policies because they knew they could not satisfy the new rules requiring actual coverage.
I'm not contesting that there were people who didn't understand their plans, there are people who don't understand their plans now. That doesn't change that they were low cost insurance products that could be combined with an untaxed HSA to produce a comparatively strong safety net at a low price for the consumer. It also doesn't change the all around price inflation that happened following the market consolidation that came in wake of the changes you mention.
private health insurance in the US is (even under Obamacare) expensive, and the deductibles are high if you're on those cheap plans.
Under an Obamacare cheapest possible insurance option you're not going to be bankrupted by (for example) a heart attack, but you'll still be paying the bill for a long time. That ignores hospitals like SF general that charge you directly (and are out of network) so you can still be trivially bankrupted.
The British NHS is private at the primary care level. Every GP is a private business contracted by the government to provide local health services.
It’s the elimination of the uninsured risk (aka will I get paid for treating this individual) that is the difference. Not whether the healthcare provider is employed directly by the state.
I've lived in two different countries which have competently managed and effective health care systems. They're different from each other and it's noticeable, but so are various traits they share. They both try to learn from what other countries are doing better, they both keep costs down, they both are competently managed and essentially socialist (that is, they work for the entire population).
Here's a trio of predictions: At least one of the competent European health systems will mishandle the Corona crisis and a lot more people will die than in the neighbouring countries. The American fanbois will use that as a solid proof that anything and everything that country's health system is wrong, including the things its neighbours also do. Noone in the American health system will try to learn from the more successful handling in some European countries, and definitely not from any country like South Korea or Taiwan, outside the Indoeuropean language zone.
In Switzerland, health insurance may be private, but is mandatory and there is a large catalog that even the cheapest insurance must cover.
On the other hand, the state (each canton) pours large amounts of money into hospitals and research. There are laws and regulations at various levels (edit: eg how many doctors may open a new cabinet), and in these days we are reminded that doctors can be mandated to work when a crisis requires it.
Calling this a "completely private healthcare system" is a bit misleading.
> Calling this a "completely private healthcare system" is a bit misleading
The assets are privately owned. That’s completely private.
It’s not laissez faire. But those are different things. Subsidies and buying mandates are compatible with total privatisation, something often lost in this debate.
The SARS-CoV-2 test is or was $2000 without insurance. And now the private test clinics have it and get to charge whatever they want. In the past, such tests would be provided to the public for free. Instead, the poor and working-poor do without, have to go to work sick because they don't have sick days, and infect more people because they don't have a choice unless they want to lose their jobs, their housing, and become homeless.
I have worked a lot of jobs before I got into sent where that was the expectation. Being sick was a matter of “pushing through” and “not being a burden”
Will find out end of March start of April how well or badly it was handled reading the stories on Reddit of people being sick doctors not allowed to do tests. So far the us response seems to be about protecting the stock markets and corporations not the people.
The "low" numbers are only low because the reported numbers are explicitly for confirmed cases, but the CDC and government has made it clear that testing is to be restricted as much as possible. Even if the US was capable of testing at the rates of other countries, which it isn't because the CDC has refused to use the WHO tests instead favouring US developed private tests.
Even in places like Washington that have ballooning case numbers they're not permitted to just do widespread free testing.
>> Better than who for example? Better than Iran? I'd certainly hope so. Other than Iran, I'd say it's too early to tell.
> China? At no point we're we arresting people for spreading the word about it?
I'm no fan of the Chinese government, but
1) their authoritarianism both kick-started this epidemic and bungled the initial response
2) AND seems to have contained the epidemic once its severity was understood.
The US and many other developed countries seem to be on track to bungling their initial response, as well. That's pretty inexcusable since they've had the benefit of months to prepare.
The US government should have paid to build up a test kit stockpile in February, but I guess now we get to see how badly free market principles handle an epidemic.
Does anyone want to have a retrospective view and consider how we elected a stupid celebrity as President?
We elected someone who filled up all important positions with incompetent fools and weakened the government everywhere it matters. Why is everyone so surprised?
At this point no one should be surprised that the rest of the world is looking to China for solutions, strategy to deal with outbreaks, possible vaccines and even bringing back economic growth. The US cannot show leadership in anything.
not sure why people are hating on this - the approach of the current WH has been to destroy what little remaining respect for the US that the rest of the world had.
Likely because having the respect of the rest of the world or electing Hillary Clinton in 2016 would have made very little difference in the face of (a) a pandemic virus, and (b) the major structural problems in the US economy that the article points to.
You're right that the president elected in 2016 wouldn't by themselves have been able to stop a pandemic or address major structural economic problems.
But sometimes, just basic competence can go a long way, and although I didn't expect to agree with many of her policies, Clinton would almost certainly have brought that to the White House and the rest of the administrative branch.
So you think Clinton would have called the coronavirus a hoax and actively worked to delay and reduce testing while it spread uncontrolled? Fascinating. I think things can always get worse, but at this point, the federal government's response to this led by vice president dumb and president dumber is pretty close to rock bottom. Hard to get worse than actively encouraging the spreading of the virus while holding back almost all testing and preparedness. Even a week can make a huge difference and the federal government has done little in almost two months. I have a hard time believing a different president wouldn't be more effective in the face of this pandemic. Hell, a fucking dog as a president would be better than a president that actively works to worsen outcomes like the current one. That is criminal, but of course, nothing new for him.
They ran a corrupt, unlikable technocrat against him, one who called Americans deplorable; Romney lost for a similar reason, when he called Americans lazy.
The large majority are economic left and socially conservative. Amusingly, that's how Trump RAN during his campaign, but has since fallen in line with the Republican establishment. The democrats give slight relief via left-ish economics, but never go too far, and the right talks a lot about social conservative values, but ultimately concedes to the left, while gutting us economically. It's a great system if you're socially and economically libertarian, since it overrides the majority without looking like its going against the will of the people. Trump ran on policies that seemed closest to the actual will of the people, and won. Surprise.
But according to Western media, free, rich, and democratic America, with our great President Trump, should be able to handle this crisis, much better than poor, enslaved, and totalitarian China.
This is what the Western media has been pushing down our throats for the past 2 months. Did something just change in the past week?
45 comments
[ 3.0 ms ] story [ 110 ms ] thread> Long term care for the elderly, the dying, the long term mentally ill etc. is covered by social insurance funded from earmarked taxation under the provisions of the Algemene Wet Bijzondere Ziektekosten, which came into effect in 1968.
The rules were tightened up, and without any explict legal language banning them, insurance companies dropped such policies because they knew they could not satisfy the new rules requiring actual coverage.
Under an Obamacare cheapest possible insurance option you're not going to be bankrupted by (for example) a heart attack, but you'll still be paying the bill for a long time. That ignores hospitals like SF general that charge you directly (and are out of network) so you can still be trivially bankrupted.
It’s the elimination of the uninsured risk (aka will I get paid for treating this individual) that is the difference. Not whether the healthcare provider is employed directly by the state.
I've lived in two different countries which have competently managed and effective health care systems. They're different from each other and it's noticeable, but so are various traits they share. They both try to learn from what other countries are doing better, they both keep costs down, they both are competently managed and essentially socialist (that is, they work for the entire population).
Here's a trio of predictions: At least one of the competent European health systems will mishandle the Corona crisis and a lot more people will die than in the neighbouring countries. The American fanbois will use that as a solid proof that anything and everything that country's health system is wrong, including the things its neighbours also do. Noone in the American health system will try to learn from the more successful handling in some European countries, and definitely not from any country like South Korea or Taiwan, outside the Indoeuropean language zone.
In fact the only completely private parts have reasonable prices.
Switzerland [1]. And the Netherlands has a mostly-private system [2].
[1] https://en.m.wikipedia.org/wiki/Healthcare_in_Switzerland
[2] https://en.m.wikipedia.org/wiki/Healthcare_in_the_Netherland...
On the other hand, the state (each canton) pours large amounts of money into hospitals and research. There are laws and regulations at various levels (edit: eg how many doctors may open a new cabinet), and in these days we are reminded that doctors can be mandated to work when a crisis requires it.
Calling this a "completely private healthcare system" is a bit misleading.
The assets are privately owned. That’s completely private.
It’s not laissez faire. But those are different things. Subsidies and buying mandates are compatible with total privatisation, something often lost in this debate.
> The insured person pays the insurance premium for the basic plan up to 8% of their personal income.
So some huge portion is state-subsidized for lower incomes.
Medicare advantage in the US has similar privitisation aspects as well.
Personally, I think sick people who don't have paid sick leave should be paid to cough on people who oppose requirements for paid sick leave.
The "low" numbers are only low because the reported numbers are explicitly for confirmed cases, but the CDC and government has made it clear that testing is to be restricted as much as possible. Even if the US was capable of testing at the rates of other countries, which it isn't because the CDC has refused to use the WHO tests instead favouring US developed private tests.
Even in places like Washington that have ballooning case numbers they're not permitted to just do widespread free testing.
> China? At no point we're we arresting people for spreading the word about it?
I'm no fan of the Chinese government, but
1) their authoritarianism both kick-started this epidemic and bungled the initial response
2) AND seems to have contained the epidemic once its severity was understood.
The US and many other developed countries seem to be on track to bungling their initial response, as well. That's pretty inexcusable since they've had the benefit of months to prepare.
The US government should have paid to build up a test kit stockpile in February, but I guess now we get to see how badly free market principles handle an epidemic.
We elected someone who filled up all important positions with incompetent fools and weakened the government everywhere it matters. Why is everyone so surprised?
At this point no one should be surprised that the rest of the world is looking to China for solutions, strategy to deal with outbreaks, possible vaccines and even bringing back economic growth. The US cannot show leadership in anything.
But sometimes, just basic competence can go a long way, and although I didn't expect to agree with many of her policies, Clinton would almost certainly have brought that to the White House and the rest of the administrative branch.
The large majority are economic left and socially conservative. Amusingly, that's how Trump RAN during his campaign, but has since fallen in line with the Republican establishment. The democrats give slight relief via left-ish economics, but never go too far, and the right talks a lot about social conservative values, but ultimately concedes to the left, while gutting us economically. It's a great system if you're socially and economically libertarian, since it overrides the majority without looking like its going against the will of the people. Trump ran on policies that seemed closest to the actual will of the people, and won. Surprise.
The "frog" has been "boiling" slowly for a long time and is almost cooked.
See also:
- America: The Farewell Tour by Chris Hedges
- Chalmers Johnson's Decline of Empires: Signs of Decay https://youtu.be/Q2CCs-x9q9U
- The History of the Decline and Fall of the Roman Empire by Gibbon
- The Rise and Fall of the Great Empires by Taylor
This is what the Western media has been pushing down our throats for the past 2 months. Did something just change in the past week?
https://www.theatlantic.com/ideas/archive/2020/02/why-democr...