Bernie Sanders position on health care

Prices for pharmaceuticals in the US are eyewatering. On one visit to the US I went to see the doctor for a minor complaint, and he prescribed a particular product for it. It was going to cost $150 so I figured I'd live with the complaint until I went back to England, where I bought the exact same product over the counter without a prescription for $9.

Part of the problem is the way things work with insurance. On another trip my wife needed antibiotics which were going to cost nearly $80 but as soon as I told the pharmacist I didn't have insurance and would be paying in cash she went to her terminal and the price mysteriously dropped to more like $35. Essentailly what that means is that going through insurance would have literally doubled the price. That highlights just how badly broken the system is.

On the flip side attempts to impose price controls can backfire spectacularly if they are badly done, and frankly I don't trust government of any color to do anything other than a hamfisted implementation of what might have been a good idea if it had been done properly. I remember when Robert Mugabe tried to blame bakers for price gouging and fixed the price of bread by law. The bakers couldn't afford to produce bread for the price he demanded, so they just stopped selling it. Thanks to government intervention, instead of bread being available for a high price it wasn't available at any price.

The problem with something like health care is that however it is funded and provided there are problems. With a private insurance model like the US has there are people who slip through the cracks and can't get treatment because they can't afford it. When the best way to avoid bankruptcy is "don't get sick" something is badly wrong. On the other hand a publicly funded system like England's NHS struggles because when something is free at the point of use it is invariably abused.

Trying to strike a balance that provides treatment to people who need it without bankrupting them along the way, while not throwing endless money at whiners and hypochondriacs, is remarkably difficult.

jsimms435 said:

I know the insulin that I am dependent on along with many others could run over 600 dollars a month if we didn't have insurance. That's not counting test strips or the meter or tests that we need to have. I don't know how people do it who don't have insurance through work

Click to expand...

Insulin is a really good example of how the system has spun out of control. I remember reading that the people who discovered insulin were keen that their discovery should save lives without people having to hand over a fortune just to stay alive.

One question that would still need to be addressed relates to where the concept of something being a necessity should stop. I don't think anybody would dispute that diabetics need insulin to stay alive but we could say the same about heating oil in particularly cold areas. Should heating oil in a place like Minnesota be price-restricted because people need heat to stay alive?

A related question concerns the concept of the free market. Many people seem to think that the high price of insulin proves the free market doesn't work but in a free market one would expect another supplier to offer it at a more reasonable price. Using numbers pulled from the air as examples, if it costs $50 to make a vial of insulin and the cheapest supplier sells it for $600, one would expect another supplier to enter the market and sell it for maybe $200. The fact no such supplier enters the market suggests the problem is with regulation rather than the free market.

psalms 91 said:

Or the ones that care getting squeezed out

Click to expand...

Why would the ones that care get squeezed out, if they are selling a product for less money? If bigger corporations drop the price to squeeze them out only to hike the price, what stops another corporation that cares stepping back in to the gap? Chances are the answer is regulation rather than a lack of profit opportunity. After all, when prices are way too high there must be a lot of profit on the table.

psalms 91 said:

They also will buy them out whatever it takes to insure the almighty dollar and since it is apparent that people are dying because of this or being financially ruined then yes it is time to join the rest of the civilized world and give healthcare to all. For me it is provided by the VA but there are many that do not have that option

Click to expand...

You can only buy them out if they are for sale. The simple reality is that in a truly free market the big corporations could constantly buy out smaller operators, and fresh smaller operators would keep springing up to fill a gap in the market.

The trouble with healthcare for all is how to protect the system from abuse. The levels of waste and incompetence within the NHS in England are terrifying. Whereas in the US it sometimes seems that unnecessary tests are done because insurance is paying and "you can't be too safe", in the UK the trend increasingly looks like doctors send people away in the hope that conditions will go away on their own.

When someone with a suspected broken foot is expected to walk the length of the hospital to get to the X-ray clinic something is wrong, When the bathroom attached to a ward is allegedly cleaned every day but the same bar of soap hasn't moved for two weeks (you know, the cleaners don't move that sort of thing, they just wipe around it), and when the ward is cleaned every day but there's visible dust accumulating under the beds, something is wrong. When a patient can't sleep at night because another patient on the ward has their TV on loudly (because everybody knows watching TV is more important than getting better, when you're in a hospital) something is wrong. When a patient calls ahead to cancel and reschedule an appointment only to get a nasty letter from the hospital about wasting the doctor's time for not showing up for the original appointment (the one they cancelled) something is wrong. When you try to get to your hospital appointment but find the parking is full and there's literally nowhere you can legally park within two miles of the hospital, something is wrong.

The current system in the US is broken without a doubt. The critical thing is to make sure that the system is fixed, rather than fixing some issues while introducing a load more issues. The "Affordable Care Act" solved a lot of problems for a lot of people but created huge problems for a lot of other people. It's very easy to focus on what is being fixed while losing sight of what other damage is being caused.

An obvious example is the obesity problem. When you see people who are so morbidly obese they could lose half their body weight and still be morbidly obese, getting around on a mobility scooter while eating the super-jumbo size popcorn an extra large ice cream, at what point do you stop providing free care for weight-related issues? There's no way for an external observer to know whether the weight gain caused the mobility issues or the mobility issues caused the weight gain but it doesn't take a genius to figure that eating your own body weight in caramel corn isn't going to help matters.

With a private insurance based system there's at least some encouragement for people to take responsibility for their own health and consider whether they really need medical treatment. It falls down with things that are little more than chance and fate (cancer, road accidents etc). A public system offers the benefit that you don't end up homeless and destitute just because you were the one who rolled a metaphorical "snake eyes" on the dice of chance and ended up with an aggressive cancer and doesn't have you coming round in the recovery room after unexpected surgery only to be told "Surprise, your bill is $458,992, payable within 14 days please" but needs to have a way of protecting itself from abuse.

A family friend worked as a doctor's receptionist in the UK for almost her entire working life. She said that over the decades there was a clear pattern - every single time universal free prescriptions were available the doctor was swamped with people making appointments for trivial conditions. If they went to buy headache tablets they might have to pay $3-4 for them but if the doctor prescribed them they would be free. So they'd show up at the doctor's office, complain about their headache, get their prescription and save the $4. In the meantime the person who really needed to see the doctor struggled to get an appointment because of the timewasters.

Both models have strengths and weaknesses, the crucial question has to be how to get as much of the benefit as possible while minimising the downsides.

His suggestions are reasonable, and are hardly unique to him. I think they're short-term workarounds though

As a Canadian I consider this a fine start. I wish him well but knowing the sort of opposition he will have I am not terribly optomistic.

jsimms435 said:

On Bernie Sanders official web site for his campaign. He says this about health care

"The giant pharmaceutical and health insurance lobbies have spent billions of dollars over the past decades to ensure that their profits come before the health of the American people. We must defeat them, together. That means:
Joining every other major country on Earth and guaranteeing health care to all people as a right, not a privilege, through a Medicare-for-all, single-payer program.
And to lower the prices of prescription drugs now, we need to:
Allow Medicare to negotiate with the big drug companies to lower prescription drug prices with the Medicare Drug Price Negotiation Act.
Allow patients, pharmacists, and wholesalers to buy low-cost prescription drugs from Canada and other industrialized countries with the Affordable and Safe Prescription Drug Importation Act.
Cut prescription drug prices in half, with the Prescription Drug Price Relief Act, by pegging prices to the median drug price in five major countries: Canada, the United Kingdom, France, Germany, and Japan."


Do you agree or not?

Click to expand...

I will eliminate all drug costs. Zero is better than half. I'll also eliminate all housing and education costs. Because I care. More than Bernie.



https://christianityhaven.com/showthread.php?5801-JOSIAH-for-PRESIDENT-2020

psalms 91 said:

I agree with him, the greed at the cost of peoples lives is out of hand and criminal

Click to expand...

What do you think Stalinism--Bernie's ideal--is, if not "greedy" (to have all power over every aspect of your life)?

jsimms435 said:

Sounds like a good plan. You've got my vote.

Click to expand...

Unlike all my challengers for the nomination, I am the ONLY ONE who actually states how I'll PAY for all the promises and proposals I'm making. I will PAY for all this!!! Every dime!!! I will do that by putting in a printing press in the basement of the White House. There I will print one billion dollar bills (with my face on them; in full color). EVERY DINE needed to fulfill my promises will be paid for! Now notice, NONE of the others running for the nomination of the Democrat Party will say how they'll come up with the trillions of dollars needed to do what they propose. Only me.

Vote for Josiah!

One trouble with having everything run by the state, as has been proven time and again by the UK's National Health Service, is that there's only so much to go round whoever is paying for it. If private insurance companies pay then they decide what they will and won't cover but if the government is paying the only difference is that healthcare is rationed by the state instead of by the insurance company.

If your insurance company won't fund a drug you need you can choose a different insurance company. Yes, there are limitations, but at least there's some scope to move. If the government decides it won't fund the drug or the surgery you need it's just too bad. You can go private if you want, if you can afford it.

Many years ago I lived next to an elderly couple. They had paid into the system for their entire working lives, trusting that the NHS would be there for them when they needed it. When he needed major heart surgery he was told there was a 9 month waiting list. Without the surgery he'd probably have died while waiting for his surgery. So they went private, and it cost them almost their entire life's savings. Good job NHS.

Another thing we see in the UK is that there are regional health authorities that cover a specific geographic area. They have some scope to decide for themselves what they will and won't cover. Of course they have boundaries and an inevitable consequences of this is that treatment options either side of the boundary line can be very different. So you get situations where if you live on one side of the road you can get a certain treatment and if you live in the house opposite you can't, because the boundary line happens to run down the middle of the street.

There is a lot to be said in favor of a system that doesn't bring you round after the emergency surgery you needed following a major accident only to present you with a bill that you can't possibly pay and that drives you into bankruptcy. At the same time it's not as if it's a perfect system, and has many weaknesses often overlooked by the "everything should be free" brigade. Another simple reality is that nothing is free - if you receive a service and not a bill all it means is that someone else paid for it. It's important to differentiate "free" from "free at the point of use".

As another example of the problem with rationing, it used to be pretty much standard that people could get access to an NHS dentist and have their dental checkups and any dental work required done without having to pay for it. Now even the most basic NHS dental treatment often comes with some cost, and that's if you can find an NHS dentist that is taking new patients. If not, you get to find a private dentist and figure out how you're going to pay for it. Or just live with bad teeth, which is a far more affordable option.