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[smjjames]

As for your other point, I have family that handle insurance negotiations for hospitals. That is EXACTLY how every insurance company works, according to them.

Maybe it's a regional thing?  I am friends with a VP of an insurance company, and have worked providing analytics software to insurance companies.  The insurance companies I've worked with/know about are stuck between population health mandates and the providers - and the people I know are all trying to really help people while dealing with the madness that is unreasonable expectations from the population (we don't want to pay anything) and the providers (sorry we are trying to rent seek as hard as we can!) - I would not wish the responsibility of being an insurance provider on my worst enemies.

This here seems to be the point where everyone is talking past each other. The key part of a national health service isn't just the insurance / payer side of things. That's half the equation. The other half is that those places have publicly owned hospitals. for example, UK's NHS isn't actually an "insurance scheme" the way Americans would understand it, it's a network of publicly funded medical facilities, which guarantee equitable access to medical care for all citizens.

So both the providers and the payer are public. if you have public money but private providers, you just get profit-gouging: the industry reshapes itself to work out how to extract the maximum limit of public money, while providing the least actual service. That's why you get medicines that "cost" $200 on American Medicare, but only $15 if you buy them at a pharmacy. When people question the "costs" they get told by the providers not to worry about it: after all, it's the "governments" money, not "your money", right ?

The provides have worked out pricing schemes to guarantee they extract that exact limit of medicare benefits each person is entitled to, regardless of how much treatment they actually need. That's the equation they've optimized: extract the exact maximum amount of benefit money possible. If you double the medicare allowances, they just basically double all prices, since the amount of treatment people needed didn't really change, but they still want to optimize to extract the maximum amount of money. That's why it's a broken system.

Public money + private providers = corruption. That's the reason America's system is so costly. First, you need well-run state hospitals. If you have state hospitals, then at least any profits are going to get spent on infrastructure.

So you're right single payer alone won't fix the problem, because it's private hospitals with no regulation on prices combined with a "feeding frenzy" to get the most share of the public money that's mainly responsible.

In fact, this identical structural problem plagues a ton of things in the USA. Since you have so many private colleges, and you have publicly funded student loans, there's a similar distortion and massive cost blowout in the student loan sphere, because private colleges set their fees based on how much student loan money they can extract from each student: that is their entire business model: extracting the maximum amount of government money per student, not providing a decent education.

The take-home lesson here is that you can't just have governments throwing money into a private sector and expect the amount of service to magically increase: the private service providers just ramp up prices to match the influx of cash until equilibrium is reached again. You need the government to build actual state-owned infrastructure with that money, and compete with the private sector. That's how social democratic societies actually make things better: state-owned enterprises compete against private-owned enterprises thus keeping costs low. It's normal supply/demand economics.

Pumping taxpayers money into the private sector isn't "socialism" at all, it's actually crony-capitalism:

https://en.wikipedia.org/wiki/Crony_capitalism

Nobodys calling pumping taxpayer (public) money into the private sector 'socialism' though as far as I'm aware...

Not sure what conservatives have against a public 'Medicare for All' system that co-exists with private ones, that's Australias system isn't it? If people don't want to get into an 'AAAA!! COMMUNIST SOCIALIST ARGLEBARGLE!' healthcare system, they have an option not to.

[Iduno]

Not sure what conservatives have against a public 'Medicare for All' system that co-exists with private ones, that's Australias system isn't it? If people don't want to get into an 'AAAA!! COMMUNIST SOCIALIST ARGLEBARGLE!' healthcare system, they have an option not to.

I think Reelya explained it in the bit you quoted. State-owned competition means private industry can no longer steal as much from the tax-payers. If it's bad for the 1%, it must be communist.

Now, why they can manage to get significantly above 1% of the vote for things that benefit so few is the part I'm unsure of. I assume it's willful ignorance.

[MrRoboto75]

conserves only like to pretend they like poor people

[McTraveller]

Yes, thanks Reelya!  That is the crux of what I was trying to say but couldn't find the words. The US "fixes" to the situation won't work because they are funneling public money to private businesses.  It's definitely supported by the observed effects on health care and education.

[Reelya]

conserves only like to pretend they like poor people

you mean, "not rich yet" people.

You're demeaning the poor with your petty words which assume they're not on the road to riches.

[Bumber]

Not sure what conservatives have against a public 'Medicare for All' system that co-exists with private ones

The cost, which they cite the failure of Obamacare as proof.

[EnigmaticHat]

You are wrong. They charge that because they have to give massive discounts to the insurance companies, so they inflate their prices to the point where they can still make a profit after said discount.

No - that's not how insurance works in the US*.  Insurance companies don't "demand an 80% discount".  Insurance providers establish reasonable prices for procedures, and are only willing to pay that much - it's NOT a percentage off a list price.

No insurance companies don't demand an 80% discount.  They just don't pay for all of a procedure.  Let's say they pay for half of a procedure so the hospital (slowly) doubles the price.  Well now the insurance slowly moves towards paying only a quarter of the price.  Meanwhile people who don't have insurance are screwed by the rising prices.  Hospital finances are infamously complicated and the price negotiations with insurance companies are known to be handled primarily by computers in an opaque process no one human understands.

Insurance companies sign a contract with the customer that limits how much that customer's liability is for medical expenses.  To go to the customer and be like "yeah you've gone through your deductible but you have to pay more than your co-pay anyway" would be breaching the contract.  But going to the provider and being like "of course we'll pay for the procedure... we think it costs ___" is kind-of-sort-of-not-really honoring the contract with the customer.  Now the provider is left in a weird place... they can either try to charge the customer for the difference, they can take the hit, or they can jack up price.  This is, for the reason Lord Shonus explained, partly the fault of how medical education works in the US.  Medical doctors operate on a "go way into debt, stress yourself out, party hard and eventually get rich" mindset.  They have no choice.  A whole generation of doctors went bankrupt and then got rich and instead of consumers/lenders/the government going after med schools instead the government adjusted bankruptcy laws so for future generations the debt would not be forgiven by bankruptcy.

Doctors can either go for a small practice or a hospital.  Hospitals are famously miserable to work in for medical professionals and of course they also have no control over billing, meanwhile again if you have you're an MD and you get your own practice you MUST charge a lot for your services.  It has nothing to do with choice on the part of doctors.  Those that actually want to help people provide some kind of sliding scale but that's almost certainly because people who don't have insurance simply aren't a profit source to begin with (much like how grocery stores make coupons annoying as hell so only poor people will use them).

Medical insurance companies in the US can be reasonable or unreasonable.  That doesn't change the fact that they're unnecessary middlemen and thus economic parasites.  The fact of the matter is that private insurance can NEVER save money; it can shift how medical care is provided and reduce individual risk for individuals.  But the basic reality is that the doctor has to get paid and the health insurance company has to get paid.  That's always going to cost more money than just the doctor.

This isn't even getting into the unbelievable power insurance companies have to fuck around if they want to.  Which is its own topic but let's just say that my insurance company has for years been intentionally disabling client's insurance for a couple months every year or two.

[Reelya]

Heh, this is kinda hilarious. A number of major US tech companies have worked out ways to circumvent Trump's ban on selling American gear to Huawei: shift production overseas then it doesn't count as American-made, so you're in the clear. Since stuff not made in the USA doesn't count as American as far as Trump goes, it's also not subject to the ban, get it?

https://yro.slashdot.org/story/19/06/25/2211214/us-tech-companies-sidestep-a-trump-ban-to-keep-selling-to-huawei

The silliest thing here is that even if they're successful blocking all Intel / AMD / ARM chips being sold to China, all they do is open up a niche in the market for a new completely non-American player to come in and supply those chips with no worry about competition. The logic here is like banning Coca Cola and Pepsi from selling to China then saying "haha! now China won't have any soda!" when in reality all you just did is open up the market for the creation of a strong Chinese soda company.

[Telgin]

While that's true, China or whoever would have a very, very long road ahead of them to try to catch up.

In the end though, we'd probably end up in a similar boat where after a few decades there are Chinese made alternatives to American made x86 processors that are cheaper but have dubious security because they're made in China.

[Reelya]

I suspect that aspect of it is exaggerated. I've been following that topic on Slashdot, and when people ask for proof there are backdoors in Huawei gear, the same links always get angrily provided as "proof" but those links are always complete non-sequiters - usually lawsuits against Huawei for infringing other companies IP. Sure, stealing trade secrets is a bad thing, but I fail to see how it's evidence that the network gear they're selling the consumer is secret spy-gear. Additionally, China uses Huawei gear. A backdoor is a backdoor for anyone, including America.

Also, forensics can look at ROMs and see what's in there. Whatever backdoor you put in there is effectively public record in the wild and you can no longer control it once it's in the physical possession of the other side. The gains to China by having sneaking backdoors in gear they sold are actually worth less than the potential losses they would incur if there was proof of the backdoor being there. And also, the corporate espionage charges against Huawei reveal why it doesn't make a lot of sense. There are cheaper and easier and less-liable means of engaging in espionage, such as social engineering,  or exploiting vulnerabilities in other people's gear. You definitely wouldn't want an easily-exploited backdoor in your own gear, and if it was only in the American-sold gear then people could easily get the China version and America version then work out there's something fishy because the firmware is different.

[Telgin]

I don't really disagree, but I still wouldn't discount the possibility entirely.  It's not impossible that the Chinese government gets specially sourced hardware with different firmware, which wouldn't be available to anyone else.

I imagine some of the fear is also the possibility of later firmware upgrades introducing such backdoors or spying software, and possibly in a targeted manner.  Especially since I'd expect that the firmware would be different for English vs. Chinese localization.  Sure, if you spent enough time decompiling the firmware you could find a backdoor if one were introduced, but damage could be done by then, and any backdoor introduced like that would be engineered in such a way to look plausibly deniable as a bug that could be exploited.

[LordBaal]

Bottom line never trust a commie.

[Zangi]

Bottom line never trust a commie.

At least you can trust a capitalist to look out for numero uno.

[scriver]

Bottom line never trust a commie.

Except the Oxford comma

[Bumber]

What is even the purpose of blocking sales to Huawei? Shouldn't it just be a ban on them selling their shady goods to western nations?