@freemo saying government shouldn’t be involved in infrastructure, what else is government for?

@quinn never clained government shouldnt be involved in healthcare or in infrastructure. I said it socialized healthcare has huge issues and isnt the best solution (though i also said neither is free market solutions). I never went ibto detail as to what the solution is, though happy to discuss that.

@freemo i don't know how you define socialized, but i can't see any definition of not socialized that includes care for the poor and children without cost to them, and any system that doesn't serve the poor or children while controlling costs as a successful system.

@freemo everyone gets care, no one pays more than they can afford, and providers aren't free to rent collect is pretty much socialized by definition.

@quinn thats a very fair criticism, and in my ideal sokution there is still an element of socialization, just much less so.

Basically let insurance be free market but require insurance companies to exist as co-ops (so the owners are always thr insurance holders). Otherwise free market rules apply.

The social aspect in my plan woukd be that anyone is below the poverty line would get discoubted or free insurance by being given credit equal to the averave cost of insurance.

Important in all this is that no one is required to have insurance and can opt out of the costs if they wish. Its also not single payer obviously.

@freemo but you have to have price controls, because it's not an optional or fungible good... people will pay anything to stay alive, so markets inevitably fail.

@quinn

> but you have to have price controls

This part i woukd say is incorrect.

> it's not an optional or fungible good... people will pay anything to stay alive, so markets inevitably fail.

This part is correct in a purely unregulated market. But as i said in my system all insurances are co-ops, so any profits made go back to the patients themselves. So it addresses the very problem you point out, all without needing to pice fix and maintaining free market pressures and freedom of choice.

@freemo doctors and hospitals charge by procedure and book it as income. if a neurosurgeon charges 100k for your surgery, you're going to pay, so without any regulation, why wouldn't providers charge a bunch? it's what they do in america. when governments say "this is how much we reimburse" they are essentially fixing a price, both logistically and socially. You want to might say a provider wouldn't do that but my partner got charged 140k for an appendectomy. in america.

@quinn Two reasons.. 1) the insurance companies decide what doctors are in their network and which arent. So insurance companies ultimately decide what doctors can charge and expect to still get patients (if they charge too much insurance companies drop them from their network). 2) While not needed because point #1 alone would be enough, you can also simply require hospitals to be co-ops as well and the ones participating in the hospital co-ops are the insurance companies that put them in-network in the first place.

@quinn Also your partner was almost certainky not i sured at that price. You firget even in america i surance companies pay a small fraction of the price an uninsured individual would pay... so your comparing apples and oranges.

@freemo so this doesn't actually stand up to research, and it has been researched, there's an extensive body of literature on this. one of the papers to look at is "it's still the prices stupid" which is the actual name of a journal article and it's fabulous. health policy isn't mysterious at all, and i've personally reviewed a lot of the research. the AMA is an actor here, (and ADA too) the hospital trusts, small time providers, etc.

@freemo insurance companies simply don't have the power to regulate the market, even when they have the incentive, if they did, prices would be much more in line with the rest of the world. insurance companies aren't totally the bad guys they've been made out to be, and in a well-regulated market they could made a sustainable profit, but in the weird free for all of America, all the incentives at every level are wrong.

@freemo health economics is its own field now, and it's a complicated one.

@quinn Yes it is, and one that I have worked in as a Data Scientist.

@freemo then you obviously know that the outcomes in places like france are quite good and sustainable while the US is simply bad to the point of cruelty and mired in a level of waste and corruption that doesn't exist elsewhere

@quinn No, but half right.. places like france and America both have unacceptable healthcare standards, but for different reasons. The issue in america is lack of access and unreasonable prices, the issue in france and most socialized locations are anunacceptable wait time for many types of procedures.

The latter is my problem, wait times were 5x longer in almost every socialized country for me to recieve the treatment I needed to keep my spinal cord managable and as such I was forced to get unneeded surgery due to the inadequate healthcare system throughout europe, This is, unfortunately, a common problem.

@freemo free markets don't work in medicine unless you're just fine with torturing and killing the poor. if that is fine for you, let's just never speak again.

@quinn What does that have to do with what I proposed... If healthcare is required to be co-ops than it is not a truely free market (there are restrictions in place).

@quinn As I stated BOTH systems torture and kill people.. america tortures and kills the poor, socialized medicine tortures and kills people equally... if your ok with that lets never speak again...

Luckily I'm proposing a system that solves the problems that both types of healthcare have.

@freemo the outcomes are well documented, and you are ignoring that. that takes a lot of motivated reasoning. by any score other than % of GDP the US has worse outcomes than any other high income nation in the world, and we also have the only free market system in that group. people in our peer nations live longer and healthier then we do. unless you're rich.

i suppose you've always been right group of people to get good care.

@quinn Why do you keep arguing the fact that America has worse outcomes like it has even the remotest relevance to what I am saying... I am **not** proposing an american system nor am I proposing a european system... Both are failed systems, bothhave significantly sub-optimal outcomes. The fact that america has worse outcomes than europe is in no way a counter argument to anything I said.

@freemo so if there's this better system out there, who does it?

@freemo if that's not part of your data, you're pretty bad at your job if you're a health economics data scientist.

france, for instance, is a place where the medical system, being made of people, experiences failures and problems. but i wouldn't call it a system that tortures people. the US actually does. like seeking care is punished. like good options are only available for the rich.

@quinn

Jesus christ dude you went from having a respectful argument to nothing but fallacies and hyperbole... check yourself, you are better than that if the first part of your conversations is any indiciation.

You are style of discourse sounds like im arguing with a trumper now, come on now.. either walk away or discuss in good faith, your better than this.

@quinn Insurance companies arent co-ops in america or the rest of the world, so your argument is invalid, your comparing apples and oranges.

@quinn As someone who has worked as a researcher in the health field for many years of his life I can say thats bullox.

I have never found a single example of research where co-ops have been forced by law and observing the results of this... It wouldnt even be **possible** to research this as no country exists where healthcare is exclusively co-op

How about just socialized catastrophic insurance, ban employer provided insurance (it distorts everything) allow people to join insurance co-ops (and foster them) then get out of the way as much as possible.

@threalist

that might work, but im not sure its as good as providing full insurance to the poor.

@quinn

Something catastrophic can break the finances of anyone but the most wealthy. Just ask people to cover standard costs at a 99% probability or something and provide a safety net for that when life hits hard

@threalist

Thats all true, and I dont disagree with this statement. I just feel the poor having good access to healthcare (not just emergency care) is **vital** to helping them get out of poverty and thus shouldnt be overlooked.

@quinn

@quinn ironically the reason I needed spinal surgery at all was **because** of socialized healthcare. If it wasnt due to its limitations i coukd have gotten convential treatment that woukd have avoided the need altogether.

And no all of the data isnt against my theory, quite the opposite, but for that you might need a better idea as to what my "theory" exactly is.

@quinn Again another non-sequitor.. which of the two systems is the best, and the fact that 100 or 1000 years ago systems were worse has abosolutely no relevance to the argument.

Generation after generation we look at our healthcare as the best compared to what came before, human progress is improvement... if anything the fact that healthcare now is vastly improved overall than healthcare in our past is a strong indication there are significant improvements to healthcare that have yet to be discovered. No doubt in a few generations those that look back on both american and european healthcare will see it as barbaric to the systems they use in the future, much as we feel when we look a few generations back.

@quinn You are sounding like a broken record here... for the 10th time now maybe.. being better than things that in no way resemble what im proposing, no matter how many of those things there are is completely irrelevant to the argument at hand. Yet you keep **insisting** I argue about what is better... X or Y and think that is somehow relevant to the fact that I am saying I think Z is better. You keep replacing X with everything in all of history, and yet, it still never resembles Z, so your argument is just a waste of both our time.

@freemo you are presenting Z here as a random undefined state, which is so much better than the socialized systems of europe to make them logically equivalent to to the most expensive worst system there is.

@freemo i should mention that i've also gotten care in developing nations that was far, far superior to care I got in the united states.

@quinn Ok, thanks for sharing that irrelevant fact.

@freemo well good luck to you man, because you're going to need it if you think people with good healthcare are going to let you destroy systems that work better than anything else in human history.

as least the neoliberals are trying to help you there.

@quinn The people with the best healthcare in history 100 years ago were pretty eager to let people "destroy" those systems to make way for the best healthcare in history that we have in the modern age, and they were just as eager 200 years before that... In 100 years I have no doubt looking back on today it will look just as barbaric. You dont own some singular moment in history were we finally solved an on going problem that has continually improved for thousands of years.

@quinn No Z is neither random nor undefined.. the idea of what a co-op is in healthcare is well defined and already exists, nothing random about it...

I think what you meant to say is "I (quinn) am ignorant about this model and rather than admitting I dont know enough to argure it I've been arguing it for hours and am just now admitting that in my mind it is some random undefined thing because I never researched it before"

Again, bad-faith argument and you for some bizare reason keep insisting on not arguing in good-faith.