8 ms·

Why do Americans continue to accept this terribly flawed systems for their 'healthcare'.

jamesmp98 7y ago
Cold war Era propaganda that has many people still believing that "socialism is when the government does stuff" plus a pretty frightening lack of critical thinking skills among many Americans
minikites 7y ago
Because powerful moneyed interests have convinced many of them that we have the best healthcare system in the world and any change would make it worse.
- hn_throwaway_99 7y ago
  True, but though this may sound arrogant, this reinforces my belief that people are generally too stupid to think about cause and effect rationally. Nearly every time I or my family have to deal with the US healthcare system I end up lamenting it's insanity, from lack of transparent pricing, lack of care follow-through when my elderly relatives are treated, the super high expense for simple visits or procedures, etc. And I'm someone with good health insurance. To go through this system and think "well it couldn't possibly get any better than this" makes me think one's capacity for either self delusion or idiocy knows no bounds.
  - save_ferris 7y ago
    A big problem is that healthcare isn't often truly debated rationally. When the ACA was going through Congress, there were accusations of "death camps" flying around that the new healthcare system was going to round up and exterminate old people. These rumors were sometimes pushed by congressional candidates and high-level party officials. Fast-forward to today, and you see opponents of the ACA claiming that they're trying to protect preexisting conditions coverage too, when they're absolutely not. Our political system rewards lies and disinformation, and when a significant portion of the population believes these lies without any skepticism, then we're no longer debting rationally.
    - cr0sh 7y ago
      > Our political system rewards lies and disinformation, and when a significant portion of the population believes these lies without any skepticism, then we're no longer debting rationally. I know it's the topic under discussion, but today your statement applies to virtually everything under debate. We are in a very bad situation, that only seems to be spiralling downward, to what end is anyone's guess.
      - save_ferris 7y ago
        Not to devolve the conversation into a partisan debate, but when you have the former speaker of the house telling a reporter that how people feel is as logically true as hard data, we have a problem. And it's not going away any time soon. https://youtu.be/LrerNmwpzHY?t=59 https://youtu.be/LrerNmwpzHY?t=59
  - deleted 7y ago
    [deleted]
  - cr0sh 7y ago
    > one's capacity for either self delusion or idiocy knows no bounds. The fact that it's the 21st Century, and despite all the progress of science that religion still exists, should give you pause.
asveikau 7y ago
A lot of people are making a lot of money. Either through positions that shouldn't exist or taking advantage of inflated prices. Plus we have had decades of propaganda about public sector waste, that doesn't care about or ignores private sector waste.
- secabeen 7y ago
  > A lot of people are making a lot of money. Either through positions that shouldn't exist or taking advantage of inflated prices. Yep. Just look at health care and related salaries in other countries. There are many fewer people in pharmaceutical sales in the EU or in Asia. Likewise, while being a doctor is a comfortable career in EU countries, no doctor earns $400k+ per year, like some surgeons/specialists in the US do. The problems aren't unique to any specific role in the US system, they are ubiquitous. I am generally opposed to any major health care reform that the AMA, the AHA, PhRMA, or AHIP is in favor of.
  - osullivj 7y ago
    There are plenty of consultant surgeons and specialists practicing on Harley St in London who make way more than USD400K/annum.
    - secabeen 7y ago
      Interesting. And they are making that money via just NHS, or is there additional private insurance involved? (I'm in the US, so I'm learning here)
      - osullivj 7y ago
        They work in both systems, but make the big money in private practice, which is often paid by insurers, but sometimes as cash. For instance Google Cyrus Abbasian; he works in both systems and I recently paid cash for a consultation with my son.
deleted 7y ago
[deleted]
leggomylibro 7y ago
Apparently a growing number of us aren't.
ptah 7y ago
american exceptionalism
baselined 7y ago
This is a loaded question with many different factors. One factor is privatized insurance is only concerned about turning quarterly profits over providing care. Additionally they are not held accountable for unethical practices as they continue to break the law without any ramification.
foolrush 7y ago
See Lyotard and his notion of Grand Narratives. The uniquely American Self Made Man conveniently overlooks wealth accumulated by men vis a vis free labour. To constrict these men, to suggest their wealth wasn’t “earned”, is to deny the other men of lesser social position of the “opportunity” to do so themselves. That is, the myth perpetuates the energy that permits the men running these insurance companies to make billions. All reinforced by the whimsical meth-addled pipe dream that “I could be king too, one day” of the legion of white men of lesser caste.
- minikites 7y ago
  "John Steinbeck once said that socialism never took root in America because the poor see themselves not as an exploited proletariat but as temporarily embarrassed millionaires. This helps explain why American culture is so hostile to the idea of limits, why voters during the last energy shortage rejected the sweater-wearing Jimmy Carter and elected Ronald Reagan who told them it was still 'morning in America.' Nowhere does the myth of progress have more fervent believers." —Ronald Wright
  - foolrush 7y ago
    Precisely. Reinforced yearly, daily, and minutely by the constructs of media.
drieddust 7y ago
<sarcasm> Because they do not like it when Goverment Regulations work in their favour. They love their right to have freedom to choose guns, big corporate bailouts,poor healthcare. </sarcasm> On a seriously everything including regulations have a place in civil society.
mmanfrin 7y ago
None of the responses to your question seem to hit at what I believe the source: racism. Single payer has met resistance from the right because people have this misguided notion that they will have to pay for "other peoples mistakes", which is just dogwhistle.
- fromthestart 7y ago
  Way to paint with an absurdly broad stereotypical brush with absolutely no substantiation. How about small government? Maybe people are worried about turning healthcare in the U.S. into even more of a dysfunctional bureaucratic nightmare like the current VA? What about ideals like self sufficiency? Avoiding centralization of power? Wanting power over one's healthcare and the choice to go without? No, much easier to dismiss 50% of the population as "racists" without even attempting to understand that they may have perfectly reasonable values that are contrary to your own. Ironic that your own comment is a racist stereotype.
  - asveikau 7y ago
    > How about small government? A lot of the small government rhetoric in the present day United States is actually rooted in racism. Google Lee Atwater's n-word quote for a 1980s GOP strategist's perspective. To summarize: overt racism becomes unpopular with some of the electorate so they come up with coded language about small government and taxation to appeal to racists.
    - dsfyu404ed 7y ago
      Well since small government is apparently racist I'll just pack up my "the government has no business telling you what not to smoke" rhetoric and leave. I know this might be hard to believe but some people actually believe that all of society would benefit from less government involvement in all manner of things. Calling all that racist looks like you're just trying to find an excuse to dismiss it without having to make an argument for why it won't work.
      - 7y ago
Taylor_OD 7y ago
What alternative do I have as an American citizen?
- deleted 7y ago
  [deleted]
kevin_b_er 7y ago
US conservatives. Most attempts to fix this system are stonewalled, blockaded, or hit with waves of propaganda against fixes. Some people are making good money compared to something like single payer. And profit is always more important than people.
mikorym 7y ago
I don't think there is a obvious answer to the question of what the health care system of the future should look like. In South Africa, public hospitals are terrible and private hospitals are generally good and operated as far as I understand in a similar fashion to the US counterparts. This may suggest that our future should look like the US's present. But it is a complicated subject. To start off with, many of the doctors at public hospitals are good doctors, paid well and respected. However, by a combination of being a new nation, having diverse cultures, having a high Gini coefficient (or <insert here coefficient>), having terrible rural schools (and excellent middle and upper class schools), etcetera, our public health care is frankly terrible. The hospitals are not well stocked, you'll wait for hours, they'll amputate your leg unnecessarily. In our scenario we have both the European "socialist" model, which worked well during South Africa's past. However, once the hospitals had to cater (and rightly so) for the full population, including poor and formerly disadvantaged, the system could not cope. So now we also have the American "money driven" model, but of course it is expensive and you have to have a medical fund or you are out. I don't think it is a question of idealogy. It's a simple premise. There is the world of sick people (which you are lucky if you join only a few times a year). And there is the world of healthy people. The premise is that sick people need to be treated. However you get there is perhaps politics, but I see it simply as a resource and logistic problem that need to be approached with commitment and expertise. This simple premise: to heal the sick, is how I see the early doctors that came to Africa [1]. Of course OPs topic is more complex, mental health, but my point is that idealogy is often lost on people (including myself) that have more obvious challenges in their midst. And mental health in South Africa is an even more pressing issue. [2] [1] See for example: https://en.wikipedia.org/wiki/Albert_Schweitzer https://en.wikipedia.org/wiki/Albert_Schweitzer [2] Not going to share a link since they all seem written according to rather Trumpian standards. But about 90 mental health patients died in SA in one incident in 2017 due to what can maybe be termed "bureaucratic incompetence".
pitaj 7y ago
We don't, but Americans have different answers for how to fix it. Some want to liberalize and deregulate healthcare, allowing the market to actually serve consumers. Some want to make it single-payer or nationalize it, which given the track record of the federal government doesn't sound like a good idea to many.
- sunshinelackof 7y ago
  > given the track record of the federal government doesn't sound like a good idea For the vast majority of Americans, their only interactions with the federal government are through social security and through medicare--two of the most widely popular functions of government. Government has plenty of failures, but that's the nature of enterprise writ large.
  - pitaj 7y ago
    Obamacare was a massive failure for most Americans, and the VA is filled with horror stories. A large portion of young people don't think Social Security and Medicare will be around when they're older. And the financial stability of those systems doesn't look very good.
    - sunshinelackof 7y ago
      Government can with the stroke of a pen decide to fully fund any program. Even in the case of social security it's just an accounting mechanism. Anyone who says that social security and medicare depend directly on a larger taxable population today is lying. Young people being told that today are being lied to.
      - cr0sh 7y ago
        > Government can with the stroke of a pen decide to fully fund any program. This is largely true. Notice how easily our government, "with the stroke of a pen", can fully fund state-sanctioned violence and institutions of violence. And we the people have no problem with this; some of us even cheer it on; some encourage their sons and daughters to join up to these institutions of violence. Others shake the hands of those who already are a part of it, and say "thank you for your service" - in almost reverent fashion. I'm not saying we don't need these people or those institutions - they do serve a needed purpose - but let's not pretend that need is anything but ultimately for terrible violence. Yet - we and our government somehow has a problem fully funding things like healthcare, education, infrastructure, and a whole host of other programs, which again could be easily done, "with the stroke of a pen". But we'll hem and haw on that all day long... ...our teachers will never be thanked "for their service" in reverent fashion. Unless of course they were veterans of those institutions of violence.
JohnAtCC 7y ago
We reject the taxation of the common man that socialized healthcare at the rates many of the example countries have. It's less about our healthcare, than it is about the manner in which we pay for it. Don't get me wrong, it's a young man's system. You pay in when you are young, so you can have it when you are old. This is clearly the UK model after WWII and why its so popular here as an idea as our sister-mother country. Flawed? Maybe ... terrible? no.
luigibosco 7y ago
Thanks for quoting 'healthcare'. I make it a point to refer to it only as 'health insurance' because that it what it is. I think rebranding it as 'care' was a real slick move by some marketeers and absorbed by the media. Every time i see the word repeated i feel like they won their little subliminal game. Recently i read someone using the words "climate disruption" instead of "climate change" which i rather liked.
dang 7y ago
Would you please not post unsubstantive comments on divisive topics? That's flamebait, and you predictably generated a flamewar. These are tedious, low-quality discussions and we don't want them here. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html Edit: this account unfortunately has quite a history of posting like this—and we've warned you before—so I've banned it until we get some indication that you intend to follow the site guidelines in the future. We're happy to unban anyone who gives us reason to believe that they want to use HN as intended: for thoughtful, curious conversation, not political or ideological or national battle. If you'd like to commit to that, you're welcome to let us know at hn@ycombinator.com.

Cold war Era propaganda that has many people still believing that "socialism is when the government does stuff" plus a pretty frightening lack of critical thinking skills among many Americans

minikites 7y ago

Because powerful moneyed interests have convinced many of them that we have the best healthcare system in the world and any change would make it worse.

hn_throwaway_99 7y ago
True, but though this may sound arrogant, this reinforces my belief that people are generally too stupid to think about cause and effect rationally. Nearly every time I or my family have to deal with the US healthcare system I end up lamenting it's insanity, from lack of transparent pricing, lack of care follow-through when my elderly relatives are treated, the super high expense for simple visits or procedures, etc. And I'm someone with good health insurance. To go through this system and think "well it couldn't possibly get any better than this" makes me think one's capacity for either self delusion or idiocy knows no bounds.
- save_ferris 7y ago
  A big problem is that healthcare isn't often truly debated rationally. When the ACA was going through Congress, there were accusations of "death camps" flying around that the new healthcare system was going to round up and exterminate old people. These rumors were sometimes pushed by congressional candidates and high-level party officials. Fast-forward to today, and you see opponents of the ACA claiming that they're trying to protect preexisting conditions coverage too, when they're absolutely not. Our political system rewards lies and disinformation, and when a significant portion of the population believes these lies without any skepticism, then we're no longer debting rationally.
  - cr0sh 7y ago
    > Our political system rewards lies and disinformation, and when a significant portion of the population believes these lies without any skepticism, then we're no longer debting rationally. I know it's the topic under discussion, but today your statement applies to virtually everything under debate. We are in a very bad situation, that only seems to be spiralling downward, to what end is anyone's guess.
    - save_ferris 7y ago
      Not to devolve the conversation into a partisan debate, but when you have the former speaker of the house telling a reporter that how people feel is as logically true as hard data, we have a problem. And it's not going away any time soon. https://youtu.be/LrerNmwpzHY?t=59 https://youtu.be/LrerNmwpzHY?t=59
- deleted 7y ago
  [deleted]
- cr0sh 7y ago
  > one's capacity for either self delusion or idiocy knows no bounds. The fact that it's the 21st Century, and despite all the progress of science that religion still exists, should give you pause.

asveikau 7y ago

A lot of people are making a lot of money. Either through positions that shouldn't exist or taking advantage of inflated prices. Plus we have had decades of propaganda about public sector waste, that doesn't care about or ignores private sector waste.

secabeen 7y ago
> A lot of people are making a lot of money. Either through positions that shouldn't exist or taking advantage of inflated prices. Yep. Just look at health care and related salaries in other countries. There are many fewer people in pharmaceutical sales in the EU or in Asia. Likewise, while being a doctor is a comfortable career in EU countries, no doctor earns $400k+ per year, like some surgeons/specialists in the US do. The problems aren't unique to any specific role in the US system, they are ubiquitous. I am generally opposed to any major health care reform that the AMA, the AHA, PhRMA, or AHIP is in favor of.
- osullivj 7y ago
  There are plenty of consultant surgeons and specialists practicing on Harley St in London who make way more than USD400K/annum.
  - secabeen 7y ago
    Interesting. And they are making that money via just NHS, or is there additional private insurance involved? (I'm in the US, so I'm learning here)
    - osullivj 7y ago
      They work in both systems, but make the big money in private practice, which is often paid by insurers, but sometimes as cash. For instance Google Cyrus Abbasian; he works in both systems and I recently paid cash for a consultation with my son.

deleted 7y ago

[deleted]

leggomylibro 7y ago

Apparently a growing number of us aren't.

ptah 7y ago

american exceptionalism

baselined 7y ago

This is a loaded question with many different factors. One factor is privatized insurance is only concerned about turning quarterly profits over providing care. Additionally they are not held accountable for unethical practices as they continue to break the law without any ramification.

foolrush 7y ago

See Lyotard and his notion of Grand Narratives. The uniquely American Self Made Man conveniently overlooks wealth accumulated by men vis a vis free labour. To constrict these men, to suggest their wealth wasn’t “earned”, is to deny the other men of lesser social position of the “opportunity” to do so themselves. That is, the myth perpetuates the energy that permits the men running these insurance companies to make billions. All reinforced by the whimsical meth-addled pipe dream that “I could be king too, one day” of the legion of white men of lesser caste.

minikites 7y ago
"John Steinbeck once said that socialism never took root in America because the poor see themselves not as an exploited proletariat but as temporarily embarrassed millionaires. This helps explain why American culture is so hostile to the idea of limits, why voters during the last energy shortage rejected the sweater-wearing Jimmy Carter and elected Ronald Reagan who told them it was still 'morning in America.' Nowhere does the myth of progress have more fervent believers." —Ronald Wright
- foolrush 7y ago
  Precisely. Reinforced yearly, daily, and minutely by the constructs of media.

drieddust 7y ago

<sarcasm> Because they do not like it when Goverment Regulations work in their favour. They love their right to have freedom to choose guns, big corporate bailouts,poor healthcare. </sarcasm> On a seriously everything including regulations have a place in civil society.

mmanfrin 7y ago

None of the responses to your question seem to hit at what I believe the source: racism. Single payer has met resistance from the right because people have this misguided notion that they will have to pay for "other peoples mistakes", which is just dogwhistle.

fromthestart 7y ago
Way to paint with an absurdly broad stereotypical brush with absolutely no substantiation. How about small government? Maybe people are worried about turning healthcare in the U.S. into even more of a dysfunctional bureaucratic nightmare like the current VA? What about ideals like self sufficiency? Avoiding centralization of power? Wanting power over one's healthcare and the choice to go without? No, much easier to dismiss 50% of the population as "racists" without even attempting to understand that they may have perfectly reasonable values that are contrary to your own. Ironic that your own comment is a racist stereotype.
- asveikau 7y ago
  > How about small government? A lot of the small government rhetoric in the present day United States is actually rooted in racism. Google Lee Atwater's n-word quote for a 1980s GOP strategist's perspective. To summarize: overt racism becomes unpopular with some of the electorate so they come up with coded language about small government and taxation to appeal to racists.
  - dsfyu404ed 7y ago
    Well since small government is apparently racist I'll just pack up my "the government has no business telling you what not to smoke" rhetoric and leave. I know this might be hard to believe but some people actually believe that all of society would benefit from less government involvement in all manner of things. Calling all that racist looks like you're just trying to find an excuse to dismiss it without having to make an argument for why it won't work.
    - 7y ago

Taylor_OD 7y ago

What alternative do I have as an American citizen?

deleted 7y ago
[deleted]

kevin_b_er 7y ago

US conservatives. Most attempts to fix this system are stonewalled, blockaded, or hit with waves of propaganda against fixes. Some people are making good money compared to something like single payer. And profit is always more important than people.

mikorym 7y ago

I don't think there is a obvious answer to the question of what the health care system of the future should look like. In South Africa, public hospitals are terrible and private hospitals are generally good and operated as far as I understand in a similar fashion to the US counterparts. This may suggest that our future should look like the US's present. But it is a complicated subject. To start off with, many of the doctors at public hospitals are good doctors, paid well and respected. However, by a combination of being a new nation, having diverse cultures, having a high Gini coefficient (or <insert here coefficient>), having terrible rural schools (and excellent middle and upper class schools), etcetera, our public health care is frankly terrible. The hospitals are not well stocked, you'll wait for hours, they'll amputate your leg unnecessarily. In our scenario we have both the European "socialist" model, which worked well during South Africa's past. However, once the hospitals had to cater (and rightly so) for the full population, including poor and formerly disadvantaged, the system could not cope. So now we also have the American "money driven" model, but of course it is expensive and you have to have a medical fund or you are out. I don't think it is a question of idealogy. It's a simple premise. There is the world of sick people (which you are lucky if you join only a few times a year). And there is the world of healthy people. The premise is that sick people need to be treated. However you get there is perhaps politics, but I see it simply as a resource and logistic problem that need to be approached with commitment and expertise. This simple premise: to heal the sick, is how I see the early doctors that came to Africa [1]. Of course OPs topic is more complex, mental health, but my point is that idealogy is often lost on people (including myself) that have more obvious challenges in their midst. And mental health in South Africa is an even more pressing issue. [2] [1] See for example: https://en.wikipedia.org/wiki/Albert_Schweitzer https://en.wikipedia.org/wiki/Albert_Schweitzer [2] Not going to share a link since they all seem written according to rather Trumpian standards. But about 90 mental health patients died in SA in one incident in 2017 due to what can maybe be termed "bureaucratic incompetence".

pitaj 7y ago

We don't, but Americans have different answers for how to fix it. Some want to liberalize and deregulate healthcare, allowing the market to actually serve consumers. Some want to make it single-payer or nationalize it, which given the track record of the federal government doesn't sound like a good idea to many.

sunshinelackof 7y ago
> given the track record of the federal government doesn't sound like a good idea For the vast majority of Americans, their only interactions with the federal government are through social security and through medicare--two of the most widely popular functions of government. Government has plenty of failures, but that's the nature of enterprise writ large.
- pitaj 7y ago
  Obamacare was a massive failure for most Americans, and the VA is filled with horror stories. A large portion of young people don't think Social Security and Medicare will be around when they're older. And the financial stability of those systems doesn't look very good.
  - sunshinelackof 7y ago
    Government can with the stroke of a pen decide to fully fund any program. Even in the case of social security it's just an accounting mechanism. Anyone who says that social security and medicare depend directly on a larger taxable population today is lying. Young people being told that today are being lied to.
    - cr0sh 7y ago
      > Government can with the stroke of a pen decide to fully fund any program. This is largely true. Notice how easily our government, "with the stroke of a pen", can fully fund state-sanctioned violence and institutions of violence. And we the people have no problem with this; some of us even cheer it on; some encourage their sons and daughters to join up to these institutions of violence. Others shake the hands of those who already are a part of it, and say "thank you for your service" - in almost reverent fashion. I'm not saying we don't need these people or those institutions - they do serve a needed purpose - but let's not pretend that need is anything but ultimately for terrible violence. Yet - we and our government somehow has a problem fully funding things like healthcare, education, infrastructure, and a whole host of other programs, which again could be easily done, "with the stroke of a pen". But we'll hem and haw on that all day long... ...our teachers will never be thanked "for their service" in reverent fashion. Unless of course they were veterans of those institutions of violence.

JohnAtCC 7y ago

We reject the taxation of the common man that socialized healthcare at the rates many of the example countries have. It's less about our healthcare, than it is about the manner in which we pay for it. Don't get me wrong, it's a young man's system. You pay in when you are young, so you can have it when you are old. This is clearly the UK model after WWII and why its so popular here as an idea as our sister-mother country. Flawed? Maybe ... terrible? no.

luigibosco 7y ago

Thanks for quoting 'healthcare'. I make it a point to refer to it only as 'health insurance' because that it what it is. I think rebranding it as 'care' was a real slick move by some marketeers and absorbed by the media. Every time i see the word repeated i feel like they won their little subliminal game. Recently i read someone using the words "climate disruption" instead of "climate change" which i rather liked.

dang 7y ago

Would you please not post unsubstantive comments on divisive topics? That's flamebait, and you predictably generated a flamewar. These are tedious, low-quality discussions and we don't want them here. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html Edit: this account unfortunately has quite a history of posting like this—and we've warned you before—so I've banned it until we get some indication that you intend to follow the site guidelines in the future. We're happy to unban anyone who gives us reason to believe that they want to use HN as intended: for thoughtful, curious conversation, not political or ideological or national battle. If you'd like to commit to that, you're welcome to let us know at hn@ycombinator.com.