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The darker side of being a doctor

282 points · 342 comments · Danhale93

  1. osmukka · · focus · HN ↗
    Healthcare is the last industry that should be privatized. It should be for the public good rather than for the profit of few.
    1. panick21_ · · focus · HN ↗
      By that logic all food production and distribution should not be privatized because is should be for the public good rather then the profit of the few.

      There are are arguments to be made about private or public but that logic makes no sense.

      Some system that have many private aspects outperform other public systems and the other way around. And even in a public system many people will profit as many of the companies that are your suppliers are still for profit.

      1. dwb · · focus · HN ↗
        > By that logic all food production and distribution should not be privatized because is should be for the public good rather then the profit of the few.

        Sounds like good logic to me, at least for essentials!

        1. panick21_ · · focus · HN ↗
          If you want to make the argument that anything that is essential should be publicly owned you can make that argument. But I would suggest if you want to make that argument 'nobody should make profit' shouldn't be the relevant argument. The argument should be 'this is how we can solve X problem efficiently'.
          1. ourmandave · · focus · HN ↗
            Universal healthcare solves the problem. The US is #1 in science and tech, but spends the most with worse outcomes in general healthcare than other peer countries by far.
            1. furytrader · · focus · HN ↗
              But it doesn't solve the problem. Does it sound like the nationalized healthcare in Australia is going well? How about Canada? The NHS in Great Britain?

              Why would it be any different here?

              1. ourmandave · · focus · HN ↗
                I don't know anything about those countries healthcare problems.

                Hospital bills causing bankruptcy.

                Deciding between meds or food.

                Donation jars at gas station checkouts begging for money to pay for a child's cancer treatment.

                Putting off preventative care because of endless co-pays.

                Out-of-network providers being a thing I have to worry.

                Those problems I do know.

              2. yodel_few · · focus · HN ↗
                Those countries DO have better healthcare outcomes than the US. You are so ignorant.

                The US is #1 in developed countries for infant and maternal mortality.

                Americans die from preventable and treatable causes at much higher rates than residents of peer countries, alongside a life expectancy of 79, or two to four years lower than the average for OECD countries.

                We spend 18% of our GDP on healthcare, NEARLY DOUBLE the average of other peer countries.

                The number one cause of bankruptcy is medical debt.

                When will the American people wake up and realize their private healthcare model only benefits the rich that are able to afford the care.

                1. sickofparadox · · focus · HN ↗
                  >The US is #1 in developed countries for infant mortality.

                  This is only because the United States is unique in its huge amount of preterm babies, which some other developed countries do not even count within their infant mortality statistics. If we had the same average infant gestation length as Sweden, we would be tied for fourth best with France and Portugal, which considering how obese we are is pretty impressive. If we had that and adopted more restrictive reporting categories like Poland or the Netherlands, we could very well be reporting as the lowest.

                  1. ourmandave · · focus · HN ↗
                    And depending on your insurance coverage, having a preterm baby in the US can bankrupt you.
                2. nradov · · focus · HN ↗
                  You can cherry pick particular metrics to make the US healthcare system work better or worse than other countries. The US does badly on infant and maternal issues, but that's largely caused by social and lifestyle problems unrelated to healthcare. On the other hand we're at or near the top in 5-year survival rates for most forms of cancer.

                  Medical debt is not the number one cause of bankruptcy so you're simply wrong there. Most consumers who file for bankruptcy have some medical debt but the most common cause is a sudden loss of income (like losing their job). When consumers don't have enough cash to make ends meet they prioritize paying for food, housing, and transportation, and stop paying medical bills. Thus the medical debts tend to accumulate but this didn't really cause the bankruptcy.

                  I do support measures to reduce healthcare costs and improve access for patients but let's be clear about what's actually happening.

                  1. ourmandave · · focus · HN ↗
                    It's a double whammy in the US. Lose your income (job), lose your insurance.

                    Lose your job from injury and you're well and truly screwed.

                    1. nradov · · focus · HN ↗
                      Right, having employer-sponsored health coverage as the default is a terrible system. It causes so many misaligned incentives.
                  2. yodel_few · · focus · HN ↗

                    [dead]

                3. panick21_ · · focus · HN ↗
                  Its amazing to me how Americans (and others) act as if there are only 2 things in the world the US (private) system and public system that apparently everybody else on the planet has.

                  The US system is neither fully private nor are those other systems fully public. Its a false binary people use so they don't have to actually engage in the details of how different systems operate.

                  Nobody is arguing that the US has a good or 'the right' system. And nobody should argue that the British NHS (or systems like it) is some amazing magical place that gets everything right.

                  > When will the American people wake up and realize their private healthcare model only benefits the rich that are able to afford the care.

                  And yet one of the countries wit the lowest spending % of GDP on healthcare with very good outcomes has a system that has a lot of private aspects.

                  1. yodel_few · · focus · HN ↗
                    It's a technically both a private and public healthcare. But let's make this clear, it is dominated by private health insurance. The vast majority of people are privately insured through their job. The public insurance in America is not consistent, reliable, or good.

                    The US is #3 in the world for it spending on healthcare as a percentage of it's GDP, actually 16.69% in 2023, right behind Tuvalu and Nauru.

                    Maybe do some research before you state absurdly wrong things

                    1. robocat · · focus · HN ↗
                      > The vast majority

                      Not vast. About 55% (workers and the family members) are covered by employer-sponsored health insurance. And that mostly self-selects for the younger and healthier so the coverage is less for random person.

                      Most retired people are not covered, and ironically very often the sick are not covered.

                      > absurdly wrong

                      I think you need to research the HN guidelines a bit more: <a href="https:&#x2F;&#x2F;news.ycombinator.com&#x2F;newsguidelines.html">https:&#x2F;&#x2F;news.ycombinator.com&#x2F;newsguidelines.html

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