Why Can't America Handle the Coronavirus Crisis?(mattstoller.substack.com)
mattstoller.substack.com
Why Can't America Handle the Coronavirus Crisis?
https://mattstoller.substack.com/p/why-cant-america-handle-the-coronavirus
44 comments
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?
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.
> have to go to work sick because they don't have sick days
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.
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.
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”
I don't know why you're being downvoted, you make a valid point.
People seem to hold the Dutch healthcare system in high regard, and it's private.
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.
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.
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.
It sounds quite similar to the Obamacare individual mandate. Of course that's gone now...
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.
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.
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.
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.
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.
> 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 costs aren't high because it's private - they're high because the heavily regulated government system has broken the market.
In fact the only completely private parts have reasonable prices.
In fact the only completely private parts have reasonable prices.
Ah imagination, what a wonderful world you weave.
What country has a working completely private healthcare system?
> What country has a working completely private healthcare system?
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...
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...
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.
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 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.
Privitisation of some of the profits, but not of the state-mandated signup scheme or the payments:
> 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.
> 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.
[deleted](1)
The climb acronym from the article, it is same reason we can’t build nuclear plants on time or or budget anymore.
[deleted]
The simplified answer: the US is a late-stage civilization in gradual decline since either post-WW2 or about 1960.
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
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
nine_zeros(2)
Handling it better than a lot of countries…
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.
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?
>> 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.
> 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.
Uh... Really?
... no? the US absolutely is not.
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.
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.
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?
https://www.theatlantic.com/ideas/archive/2020/02/why-democr...
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...