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T. Greg Doucette @greg_doucette
, 52 tweets, 15 min read Read on Twitter
Just read a news story on what began with this tweet. Our leaders are failing us. Goddamn.
Here's @GlobeMCramer's story in @BostonGlobe (TW: including surveillance footage)…
I think single-payer would end up being an economically disastrous policy... but I see sh*t like this and I totally understand the appeal
Crazy to me that ordinary people living ordinary lives going to ordinary jobs and paying ordinary bills can have their lives wrecked because of the financial costs of medical care for an accident
My b*tch was slightly different in that I quite literally couldn't afford it. But agreed re the "one catastrophe away" -- a Republican City Councilman made that point to me back in 2001

Premiums went up by 3x, deductible up 2x, and qualified for -$12/mo in subsidies

I suppose I could briefly afford it if I laid off staff, before the drop in revenue from having less help kicked in

I guess I appreciate the assumption all us lawyers are rich though?

How much of that gap is influenced by infant mortality, drug overdoses, and suicides?

I know we spend more per capita than everyone else for worse outcomes, but I seem to remember a relatively small number of things accounting for the life expectancy gap

Fair. My revenue is definitely higher, but take-home isn't

I guess part of the equation is whether the replacement system encourages preventative care to mitigate future urgent care. And also an adequate supply of physicians.

Predominantly population size and the cost curve. Assuming Hauser's Law is generally accurate (which I realize is debatable), you basically end up with healthcare but nothing else in relatively short order

::I read as I eat bacon cheese fries::

Well sure, accidents are still going to happen. But something is very, very wrong when someone suffering a grievous injury has to simultaneously do a cost-benefit analysis of getting an ambulance

They're criminally delicious Sonny, they have to be prosecuted

I wouldn't say anyone expects the "God of Free Markets" will fix it; the Government is already balls-deep in the healthcare industry, as it was pre-ACA, and neither Rs nor Ds will roll that back substantively because they want PAC $$$

But we need better

Not really, no. And there's ample literature over the decades illustrating it

Basic laws of economics apply here too

Study from a few months back showed the vast majority of infant mortality is tied to doctors assuming black women are lying when they report prenatal issues. Idk re the latter two, it "feels" like it's gotten markedly worse over the years but idk why

(Those are 2 replies I've added to the thread that you can see if you're under the "Tweets & Replies" part of my profile, but not if you're thread-scrolling)
How many of them have a heterogenous population of 325,145,963+?

Nah I'd make sure to tag you in the tweet if I were yelling at you, I'm not a chickensh*t like some blue checkmarks 😉

This isn't an answer to the question

"But it works everywhere it's been done on a much smaller scale" isn't exactly a compelling reason to nationalize something

I don't understand the purpose of it at all. The effect on server load can't be that great, for a tradeoff in degraded UX

So you're saying that Democrats are wrong and we should totally be able to consolidate all the things because economies of scale work well

See how easy that was? It's why snark is a generally poor substitute for thought

Yes, by ::checks notes:: not voting for Trump, I made all this possible

I clearly lived an unexciting life in college and law school, I couldn't tell you the ballpark for an Uber from anywhere in Durham to anywhere else

Some are trolls, but most are genuine questions or responses. If it were just hiding the troll ppl it wouldn't bother me

Ah, so this was all more a "All conservatives are eeeeeevil" thing on your part than any serious thoughts worth considering. Duly noted.

The incarceration system is definitely a factor weighing on the healthcare system

I'm sure most do, but I suspect we also get a positive economic network effect from being able to practically dictate global policies as a result; that aspect of the comparison should be a wash

Idk. In theory I agree, but huge portions of states' medical budgets are federal earmarks / block grants / etc. How do you implement a non-federalized system when most of the tab is getting paid federally? (Albeit in a roundabout fashion)

True story: eons ago I wanted to get a PhD in Econ and study that very issue (the benefit to US incurring military umbrella costs, IP development costs, etc)

But in retrospect I probably enjoy what I do now more lol

Already addressed at several points mid-thread. TL;DR: don't see how we finance it and everything else with a population of 325M+ and tax receipts never going above 21% GDP

Plus the ensuing criminal record makes employability difficult, leading to lack of preventive care, added stress, etc etc

CON laws are nutty, NC has a ton

(@deregulator didn't JLF have a presentation on these last year?)

The same reason my apartment only has 1 bedroom and not 2 or 3

Costs matter, and there are tradeoffs to the added spending

No, it's an inevitability of having a market economy where people can choose to do less of a thing when it's taxed at a higher rate

There's a reason pols proposed hiking cigarette taxes to deter smoking. Same concept.

Because it's not really insurance, it's healthcare

My malpractice insurance is insurance; I pay monthly on the unlikely-but-possible chance I get sued

There's a 100% chance I will need a doctor for something at some point

I'd quibble re the distinction between Republicans and conservatives on this. There've been many think pieces over the years in the standard conservative mags that something employee-based rather than employer-based would be far preferable

It's also one of the key reasons I'm in favor of UBI. We can provide a higher baseline for more people at lower cost by just dismantling the current bureaucracies trying to do the same thing
Yes, I did. Just like when I say what people call the "justice system" isn't about justice at all.

Subsidized healthcare is not insurance (distribution of risk), no matter what however many people choose to call it.

I mean that's great rhetoric, but all data since WWII – which includes both high tax and low tax eras – shows there's a ceiling in practice, regardless of the loftiness of the tweets

Our mental healthcare system is beyond f*cked. Seen it w/ my sister. Beyond. F*cked.

Mid-thread @bmelton mentioned Certificate Of Need laws, where medical providers have to get permission from other medical providers before opening new facilities, getting new machines, etc

Here's a recent presentation on why NC's CON laws are 💩

You've replaced my supposed "false dichotomy" with your own strawman. I never claimed you said we could tax at infinite levels; I said you're not going to get tax receipts above 21% GDP, period

This illustrates my point though: even with 90% tax rates, tax receipts never went above 21-22% of GDP

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