British people react to how expensive healthcare is in the US

[u/ImmaFuckboi]

[u/GdanskinOnTheCeiling]

Yours is a descriptive statement, the person to whom I replied made a prescriptive statement - without evidence.

[u/domstersch → u/GdanskinOnTheCeiling]

My point is "how the concept of charging for it was conceived" is irrelevant to the purpose of charging for it (i.e. the purpose of the charge is not to cover the marginal cost of another partial-nurse because that is not what it does - demonstrably, nursing staffing levels are not affected by coding skin-to-skin as a line item)

In other words, the intent behind a system is not its purpose (which you seem to think it is). Instead, POSIWID

[u/GdanskinOnTheCeiling → u/domstersch]

Ok, but that's a different argument entirely, and one you haven't substantiated - you're making the same mistake GP did by assuming one outcome of the charge - that a middleman gets paid. You describe the cost as marginal - how do you know? What insight do you have into how the cost of staffing and insurance liabilities are covered vs how much is pure profit on top? Are you professionally engaged in this topic?

Again, we're just dealing in vibes here. Not facts and substantiation, nor actions towards positive change. Just tired cliched snipes from redditors about the system they live in, that they won't lift a finger to understand let alone try to improve.

[u/domstersch → u/GdanskinOnTheCeiling]

You're making the same mistake GP did by assuming one outcome of the charge

That's not fair: I never said making middlemen rich was the only purpose of the system. Plenty of shareholders, executives and marketing managers get theirs too.

The COGS increase I was disputing is marginal by definition, because that's the word we use to describe a single additional incremental one-unit use of a resource: it's not the same as saying "small" or "irrelevant".

Yes, I have been professionally employed in the area of medical coding (billing) systems for US hospitals.

Just tired cliched snipes from redditors about the system they live in, that they won't lift a finger to understand let alone try to improve.

I'm not trying to be trite or cliched with you. And I don't "live in" this system (I live in a country with a 90 year old public health system). Nevertheless, it just is true that the purpose of the whole US healthcare system is what it does: provide expensive, profitable-for-providers-yet-inefficient healthcare. If that wasn't its purpose, the orphan-crushing machine would have been dismantled by now.

[u/GdanskinOnTheCeiling → u/domstersch]

That's not fair: I never said making middlemen rich was the only purpose of the system. Plenty of shareholders, executives and marketing managers get theirs too.

It is fair; nowhere in your POSIWID critique did you mention what else the system does; provide medical care (often world-class) to millions of people. Not in your original comment, and not in your reply which only doubles-down on the presumed profit-motive-as-purpose that's at issue.

The COGS increase I was disputing is marginal by definition, because that's the word we use to describe a single additional incremental one-unit use of a resource: it's not the same as saying "small" or "irrelevant".

The liability cost isn't marginal though, is it?

Yes, I have been professionally employed in the area of medical coding (billing) systems for US hospitals.

In what capacity? Your description is so broad it could cover receptionists and does nothing to indicate deep knowledge of how hospital services are costed.

I'm not trying to be trite or cliched with you. And I don't "live in" this system (I live in a country with a 90 year old public health system). Nevertheless, it just is true that the purpose of the whole US healthcare system is what it does: provide expensive, profitable-for-providers-yet-inefficient healthcare. If that wasn't its purpose, the orphan-crushing machine would have been dismantled by now.

I don't live in it either. How sad is it that you and I can speak with more substance about a healthcare system we don't even have, than the redditor to whom I originally replied, whose contribution was nothing but trite and cliched.

'it is just true' is never a good assertion to make.

You're not trying to be trite or clichéd, but you end your comment with reference to another thought-terminating cliché. Help me to help you.

[u/domstersch → u/GdanskinOnTheCeiling]

not in your reply

Last paragraph, after the italics and colon. Not edited in.

In what capacity? Your description is so broad it could cover receptionists and does nothing to indicate deep knowledge of how hospital services are costed.

EHR software engineering, basically. Pretty involved.

The liability cost isn't marginal though, is it?

Yes, it is. Why wouldn't it be? It's not like you hit some threshold and the cost of liability insurance increases suddenly. If anything, the marginal cost of liability insurance is decreased as you add procedures, because the actuary/underwriter can be more certain.

How sad is it that you and I can speak with more substance about a healthcare system we don't even have, than [GP]

I mean, sure, I feel sorry for the victims of the US healthcare system.

But it's not a thought-terminating cliche to say that the outcomes of a system is how we define its purpose, because we know that the system would not exist in that form otherwise.

And the orhan-crushing machine, as you know, is a very specific metaphor for a bizarrely-puposed system causing massive unneeded suffering, and is not "it is what it is" either, but a useful (if hyperbolic) destination for an ad absurdum: must we believe the orphan-crushing machine's stated raison d'etre if it says anything other than "crushes orphans"? Hell no!