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Raja

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  • Just cash the cheques, you're going to die one day
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  1. Can't believe we're still doing the 'incidentals' nonsense 2 years in.
  2. This AFCON tournament has been 10/10 so far.
  3. Yeah, my point on polling etc was more general as opposed to specifically focusing on the discussion in the thread. I'd be curious to read up on what the context/ public opinion was on passing other major health reforms that we've had over the last 20-30 years. Re: the Singapore health system - I lived there for 10 years so I do have a bit of experience with the system. I think there are elements of it that work well, but implmenting that in the US would be very challenging ( to be fair, as would most other systems we have brought up here) as the health system in Singapore basically has even more government oversight & control than some of the other options currently on the table. Medisave forces you to put 6-7% of your pay into a health savings account, but that account can be used for pre-approved drugs & cost effective drugs. The government in Singapore exercises a huge amount of control all across the health system ( And this is true of Singapore in general, where the government has an absurd amount of control over everything), which is something you don't see in other single payer countries.
  4. Yeah, the ACA was what I had in mind when I wrote that last bit, but I'm sure we can find more examples if we look. I agree with you that people don't know details of a lot of things, and that's one of the reasons why I'm a little iffy about using opinion polls to back legislation. Like for the No surprises Act, were were out here polling to see what everyone thought before we decided that it's a ludicrous practice that affects patients and started coming up with legislation? I feel like plenty of legislation gets passed without it being subject to this whole nothing of 'well, it does not have more than 50% approval so we shouldn't do it' - this isn't directed at you per se, just the tenor of the conversations in the various politics threads. Of course, something like this would afffect a lot of people and we're a democracy and healthcare is a big issue with voters, so I understand the reflex of turning to polling. I'm sorry, this sucks
  5. Some thoughts off the top of my head - mostly based on my health policy experience whilst I was in the US 1. The US health system is fucked - Look, I know people make arguments that some employer based insurance works really well for some people and they would loathe to give it up - but even those people can come under significant financial strain when it comes to deductibles & cost-sharing. There are policy issues within the US health system that just do not exist outside of the country - something like Surprise Medical bills or balance billing being one of them ( Congress basically *just* enacted federal legislation regarding this after years of it being an issue) - here in the UK, I don't even have to *think* about this stuff for my patients. In addition, things like prior authorizations are even worse. If a doctor thinks you need a particular investigation or treatment, sometimes prior authorizations are needed by the insurance company - this causes delays and can ( and has) resulted in significant harm for patients whilst also taking time away from the physician whilst they try and treat their patients. Make no mistake, prior authorizations harm patients all the time Like I said before, I've been practicing medicine for 3 years and I don't even think about this stuff with my patients - if I think a patient has some sort of cancer, even if I don't know what specific type, I can start the process of them getting their whole body scanned and that scan happening in 2 weeks or lesser. I think the only people who really understand how fucked up the system is are healthcare professionals who deal with it & patients. It's the patients I feel for more than anyone else, imagine going through the worst days in your life and then being stuck with a huge bill you need pay - Here is a twitter thread from a doctor who suffered a cardiac arrest at home and recovered and what he had to deal with 2. Universal healthcare is not equal to single payer - I think there are ways to get to universal coverage of a population without it being single payer, especially in a place like the US where the private insurers are huge & have significant lobbying power - a mix of private & public programs leading to universal coverage *can* work, but it requires heavy regulation from the government within these private spheres. Some countries do have a significant private insurer market, but it is heavily regulated and completely different from the current regulation landscape in the US. Realistically, I think that is what will need to happen where you still have the private insurers but they are regulated heavily by the federal government. You don't have to have single payer to get universal coverage for your population 3. Waiting on opinion polls etc - I think about this a lot especially when it comes to health policy. 95% of people have no idea about health, health policy or the specifics of how terrible things can be for both patients and physicians because of the significant information asymmetry that exists within medicine - I think waiting until you reach a certain amount of consensus in these polls is naive, to be fair, we've moved a long way on them in the last decade and the US system is built for incrementalism, but the harms are significant and are happening right now - I'm not saying I have a solution per se to the gridlock that is the senate and getting something significant through it will be tough with the way it is - but I think there is scope for passing something that might be perceived as unpopular, but then shifts public opinion after it is implemented.
  6. Sorry, I haven't recovered from 'Truss momentum' We've got a bunch of idiots in charge of this country.
  7. Wilshere - Arteta - Sambi We'll be fine
  8. Look, everyone's shitty beer of choice is shitty. I have a date tomorrow which has taken two months of scheduling
  9. Thought the Cameroon game was a lot of fun, tbh
  10. Dunno, I don't mind close games as opposed to seeing teams that are not closely matched.
  11. I mean, we can treat it with respect even if things like this happen. Of course it shouldn't happen but a similar thing happened in la liga a while back.
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