PaulDavisThe1st 23 hours ago

> The alternative that is always there is to repeal EMTALA.

I suspect you think it's not great having homeless people on the street.

Wait till you see what it looks like when they actually start dying in the street because emergency health care is no longer available to them, nor to many of their housed neighbors, family and friends.

1
mgh95 22 hours ago

I don't see what EMTALA has to deal with homelessness in this context. It largely comes down to uninsured, even post-ACA. If we can't afford the current system, it's not a matter of if, but when, either hospitals or providers leave medicare. To put it in perspective, the AMA reports (https://www.ama-assn.org/practice-management/medicare-medica...) that physician medicare compensation has declined 29% since 2001. At a certain point, it will simply be financially unsustainable. Whataboutism to distract from the fact that medicare alone is 3.7% of gdp and is forecast to grow to 5.1% by 2033 (https://www.cato.org/blog/fast-facts-about-medicare-social-s...) doesn't fix anything.

And FWIW, US Medicare spending alone is shaping up to grow to almost as much as some EU nations on a % of GDP basis (https://ec.europa.eu/eurostat/statistics-explained/index.php...).). Medicare isn't the solution. It's the problem.

PaulDavisThe1st 14 hours ago

> If we can't afford the current system,

What we can and cannot afford is a choice, not some immutable fact of nature.

A cynical, if realist, version of this would be: if we choose to not spend any more ...

But that's still better since it acknowledges that we, as a nation, have agency in this.

inferiorhuman 21 hours ago

  And FWIW, US Medicare spending alone is shaping up to grow to almost
  as much as some EU nations on a % of GDP basis
Your source puts Austria, France, and Germany at the top, or roughly 11–13% of GDP.

https://www.bea.gov/news/2023/gross-domestic-product-fourth-...

https://crsreports.congress.gov/product/pdf/IF/IF10830

The U.S. Bureau of Economic Analysis puts the 2022 GDP at $25.46 trillion ($25,460 billion). Congress puts 2022 spending on private health insurance at $1,290 billion (5%) and Medicare at $944 billion (3.7% of GDP).

mgh95 20 hours ago

Yes, we are tracking to grow to as much as some not all or most. Emphasis on tracking to grow which you should see the source for 2033 forecast.

The fact that one program (Medicare) is growing to be as large as the NHE should be cause for pause.

inferiorhuman 17 hours ago

So your argument is that Medicare spending might potentially approach the same proportion of the GDP as a European country that doesn't spend a lot on its healthcare?

mgh95 10 hours ago

Pretty much. And that's just one program that services a small portion of the population. The issue is we can't make this level of spending work, why should we believe spending more money will be successful?