Somehow, I think there's a difference between eating filet mignon and being treated for cancer. I could eat a good steak every day, but I wouldn't want chemotherapy unless I was pretty sure I had cancer in the first place.
Most people are just trying to get the treatment necessary to keep them at a high level of function. Why should anyone be denied that? Almost no one goes into a hospital and demands thousands of dollars worth of unnecessary tests for diseases they couldn't possibly have-- and those who do are often mentally ill hypochondriacs, given inappropriate treatment because (surprise!) health insurers are generally shitty about MH issues.
The conclusion of the study is that health care you are unwilling to pay for out of pocket doesn't help more than it harms (on average).
A specific example of care people don't need but will get: mammograms. They are pointless (benefits don't outweigh harms) for people under 50. I mentioned this to a few women I know, but all said they intend to continue getting them.
[wow, down to -1 in 20 minutes from citing an expert opinion and an experiment. I should go back to reddit.]
Any time you want to talk about cancer, you have to acknowledge the fact that it's actually over a hundred diseases. Cancer treatment is phenomenally effective for some cancers, for some classes of patients, and ineffective for others.
I can name eight people, off the top of my head, I've known who've had cancer. (I'm sure I could list more.) Three died, four are alive and well, and one was diagnosed last month. We're talking about a disease that would have killed all 8 a few decades ago.
Also, even if the improvements in cancer treatment are only interative (8 months instead of 3) that's still a major gain, from a research perspective. Look at HIV/AIDS; in 1985, it was an incurable and fatal disease. Due to a series iterative improvements, someone who contracts HIV today in the developed world will very likely be alive in 15 years, and by then, there may be a cure.
You guys can have a big long emotional conversation about cancer care, but cancer isn't where all the cost is in the system, and cancer treatment may not even be where all the cost is in cancer care (tests, many of which have been demonstrated to be ineffective, may be the major component instead).
People absolutely go to the hospital to seek treatment thy don't need. We see it in the US already - people flooding emergency rooms with the sniffles looking for antibiotics. That's entirely the reason triage exists, to seperate out the people looking for clinic care and the people with real emergencies.
You are correct about cancer and major surgeries - almost no one is going to elect to have these if they can avoid it. The only exception is obeseity cases where people would rather have a gastric bypass then have to suffer through diet and exercise.
1. Uninsured people who go to the ER because they legally can't be turned away there.
2. Panic attacks. Untreated anxiety/panic disorders are a huge burden on the hospitals. Most repeat panic visitors have never had a specialist (a) tell them what they're experiencing, and that it's non-fatal (and that there's absolutely no benefit in going to the ER for a panic attack) and (b) prescribe them medicines that can actually help them. Any guess as to why this is the case? Because those people are uninsured.
You compared free high-end foods to free healthcare, which frankly just seems bizarre.
Nobody wants to use healthcare. Even when I lived in the UK, and I could have visited the doctor for free every single day if I had chosen to, I did not. Neither did I ever hear of anyone ever doing that or anything close to it.
Having lived in both the US and the UK, I haven't changed my habits. I visit the doctor when I feel I really need to. The only difference is that in the US, an insurance bureaucrat then sends me a letter telling me they're not paying up because <insert random excuse here>.
And in the US, you get the privilege of paying for the paper on which the denial letter was printed... and, to make it better, the bureaucrat's salary.
If you buy private health insurance, you're literally paying the salary of the asshole who pores over people's medical records looking for reasons to deny care (e.g. undisclosed insomnia prescription from 1982 as a "pre-existing condition").
Just to play devil's advocate, here's a mind bender for you: we should be grateful to that asshole.
The insurance company is paying his salary because it costs them less than would the care that he manages to deny. If he didn't exist, the insurance company's costs would increase. This means that insurance premiums would have to increase. Whether you buy your insurance directly, or it's deducted from your paycheck, or your employer pays for it in full, that increased cost of insurance premiums would trickle down to you in the end.
Just to play devil's advocate, here's a mind bender for you: we should be grateful to that asshole.
Until you or I get cancer, that is.
Last I checked, the probability of you and I having at least one life-threatening health problem in the next 100 years was pretty close to 1.0.
What's actually happening, regarding that asshole, is that you're paying 95% premiums for 85% care. It gets worse than that, because the 15% being shaved off is at the high-cost end, which is precisely where you need your insurance.
There are no inherent costs to the consumer in eating fine foods.
There are enormous inherent costs to medical care. Most patients want to be treated with minimal pain, risk, and time lost, so they can get back to their regular lives. Their incentive is already, in virtually all cases, in the cost-minimizing direction.
It's not inappropriate. The point is that when people perceive something as free, they intrinsically opt for the most expensive option. They also will get costly tests and procedures that have at best an extremely remote chance of being useful. The whole reason tort reform, which the original author did mention, is needed is because doctors know this and then prescribe expensive, unneeded tests simply to cover their asses. Between that perverse incentive (which he did address) and the patient's lack of fiscal accountability, enough people have an MRI done every time they sneeze to have a huge impact on health care prices.
When insurance companies instituted even very small patient copays on non-generics, usage rates of generics skyrocketed. Just having to pay $5 more (for a product that actually costs hundreds more, but is chemically identical) aligned people with their economic incentives and caused a massive shift in consumer behavior.
Brand name pharma companies fought back by giving vouchers to doctors to pass out to patients that covered their co-pays. Brand name medicine market share went right back up. Insurance companies have no effective way to combat vouchers and are forced instead to raise health care rates.
Also you're just plain wrong because you're applying rational thought to people who are in a panicked state. When someone has a health problem, they'll do anything and everything to fix it. We all value our own lives as effectively worth infinite dollars, which makes any treatment rational from our perspective. Society, on the other hand, cannot afford to be so generous.
Most people are just trying to get the treatment necessary to keep them at a high level of function. Why should anyone be denied that? Almost no one goes into a hospital and demands thousands of dollars worth of unnecessary tests for diseases they couldn't possibly have-- and those who do are often mentally ill hypochondriacs, given inappropriate treatment because (surprise!) health insurers are generally shitty about MH issues.