What happens after Covid?

Discussions about serious topics, for serious people
User avatar
Bird on a Fire
Princess POW
Posts: 10137
Joined: Fri Oct 11, 2019 5:05 pm
Location: Portugal

Re: What happens after Covid?

Post by Bird on a Fire » Tue Mar 31, 2020 10:43 am

Obviously any approach involving insurance is going to reduce health outcomes for poor and marginalised people.

Adding extra barriers to accessing mental health treatment will result in fewer people getting treated.

Plus, having to claim money from private insurers all the time is hugely expensive and time consuming, as they tend to resist paying. I think evidence from the US suggests that the billing department is one of the greatest expenses for hospitals.

Instead of deciding which people have to pay based on what illness they have, I propose we decide who has to pay based on how able they are to pay. The assessments shouldn't happen at the point of use, which would be massively inefficient, but automatically at a national scale.

One change I would make to the present system is to triple-lock NHS funding in a similar manner to the state pension. The UK also needs to figure out how to get a better informed, more caring populace and politicians who have some kind of backbone.

A huge (and largely unnecessary) die-off from COVID might help to etch the point in people's minds. The British public seem to be at their nicest during crises and the immediate aftermath.
We have the right to a clean, healthy, sustainable environment.

User avatar
lpm
Junior Mod
Posts: 5944
Joined: Mon Nov 11, 2019 1:05 pm

Re: What happens after Covid?

Post by lpm » Tue Mar 31, 2020 11:01 am

Under the NHS, health outcomes are worse for poor and marginalised people.

Under the NHS, there are already barriers to accessing mental health treatment and huge undertreatment.

When insurance is mentioned, don't jump to the mad USA system. Instead look at EU systems.

Politicians wanting to bribe the electorate with tax cuts is a permanent feature of democracy, not something limited to the UK Tory Party. There is constant pressure from the electorate for more of society's resources to be allocated to holidays, electronics, evenings out etc. Healthy working people making up most of the tax base tend to under-estimate the resources needed by health and social care.

I can easily imagine love and resources for the NHS over the next few years. But that relentless downwards pressure on its resources will re-emerge. Now is the crucial moment to switch from the inadequate 1945-2020 system to something robust for 2020-2095.
⭐ Awarded gold star 4 November 2021

User avatar
stańczyk
Buzzberry
Posts: 52
Joined: Mon Nov 11, 2019 1:13 pm
Location: Wawel Castle

Re: What happens after Covid?

Post by stańczyk » Tue Mar 31, 2020 11:12 am

lpm wrote:
Tue Mar 31, 2020 9:13 am
The fire brigade should be reinvented. The lack of smoking and open fireplaces, plus sofas that don't burst into flame, makes it basically a road traffic accident service with a bit of fire as a sideline. It's not clear how it can be sustained in a world of safer (or even self-driving) cars, zero smoking, zero fireplaces, zero gas. I'd guess it will become part of the police service before too long, a specialist division but with more general responsibilities.
This document (PDF) shows that fires are still a significant proportion of the work done by the fire brigade. Even ignoring false alarms, fires represent 50% of the total incidents in 2019.

User avatar
Bird on a Fire
Princess POW
Posts: 10137
Joined: Fri Oct 11, 2019 5:05 pm
Location: Portugal

Re: What happens after Covid?

Post by Bird on a Fire » Tue Mar 31, 2020 11:13 am

lpm wrote:
Tue Mar 31, 2020 11:01 am
Politicians wanting to bribe the electorate with tax cuts is a permanent feature of democracy, not something limited to the UK Tory Party. There is constant pressure from the electorate for more of society's resources to be allocated to holidays, electronics, evenings out etc. Healthy working people making up most of the tax base tend to under-estimate the resources needed by health and social care.
I think who constitutes the tax base is less important than who constitutes the vote base, which is skewed towards older folk, many of whom would be dead or crippled without the NHS already, and most of whom are going to lose friends in this pandemic.

Obviously nobody will admit they were wrong about anything, but I think it's plausible that further Johnsonomics (basically Corbynomics without any ideological rudder) will be popular with that crowd.

They need to find ways to levy tax increases that old Tory c.nts will improve of, like hitting tech firms. Use the tame press to start a narrative about young tech hipsters having secret vegan craft beer meetups and transgender sex parties during the lockdown and getting all their grannies (who lived through the Blitz and never complained about making sacrifices) infected, and then demand they pay their fare share.
We have the right to a clean, healthy, sustainable environment.

User avatar
Bird on a Fire
Princess POW
Posts: 10137
Joined: Fri Oct 11, 2019 5:05 pm
Location: Portugal

Re: What happens after Covid?

Post by Bird on a Fire » Tue Mar 31, 2020 11:34 am

Also, if anyone's got succinct explanations of different EU insurance systems (in particular, good ones that would work for the UK) that'd be interesting. A lot of my views are based on places I've lived:

USA - hugely expensive, huge number of exemptions, "co-pays" mean you have to pay for everything anyway. I couldn't afford insurance when I lived there ($600+/yr in 2012 when I was a student), but the only schemes even vaguely within reach (university subsidised ones) excluded pre-existing conditions anyway so weren't much use for me. I had travel insurance for emergency coverage. Had to pay out of pocket to see professionals. Had to change medication because I couldn't afford it. Quality of care no better than NHS but I did end up with a huge list of diagnoses, because that's normally how they ensure things will be covered by insurers. Execrable and a constant source of stress.

Portugal - very similar to NHS, despite being one of Europe's poorest countries. Next day GP appointments are available but in some surgeries you have to book them in person at 6pm. Flat fee of €4.50 for appointments and medications are paid (but capped, generally below NHS prescription charge) though there are exemptions available for those on low incomes. Long waiting lists for specialists. Private insurance is pretty affordable (from €12/month), private appointments without insurance are €25 for GP or €40 for a specialist.

France - I was using the student health service, which may be different to normal folks'. Dr appointments were free at short notice, some medications free or subsidised (don't remember) but one I was taking wasn't, so I had to stock up when I went back to the UK as otherwise it'd be over €100/month and f.ck that.

Brazil - I wangled a same-day appointment in the public system once, when I was working in a rural area, despite not actually being eligible for it. There was a long line (mostly of recent mothers) but seemed ok. Usually I used the private system, which was about £5 for an appointment and my meds were cheapish. My student stipend at the time (€500/month) was equivalent to a teacher's salary, so it's not like I was a high-roller. I seemed to be able to access much better care than in the States.

Friends living in Germany have said the system is expensive and complicated, and they mostly don't have insurance, but I don't know the details.
We have the right to a clean, healthy, sustainable environment.

User avatar
dyqik
Princess POW
Posts: 7527
Joined: Wed Sep 25, 2019 4:19 pm
Location: Masshole
Contact:

Re: What happens after Covid?

Post by dyqik » Tue Mar 31, 2020 3:41 pm

Bird on a Fire wrote:
Tue Mar 31, 2020 11:34 am
I couldn't afford insurance when I lived there ($600+/yr in 2012 when I was a student), but the only schemes even vaguely within reach (university subsidised ones) excluded pre-existing conditions anyway so weren't much use for me.
The prices have risen significantly since then, and are generally rising at 8-10% a year. Currently it would cost me $1600/month to buy insurance for me and my wife, with a $500 deductible per person, $20 co-pays for most office visits (including things like physio), and a $3000 out of pocket maximum on the open market. I actually pay about $540/month pre-tax under my employers' plan with those terms.
Last edited by dyqik on Tue Mar 31, 2020 3:42 pm, edited 1 time in total.

AMS
Snowbonk
Posts: 466
Joined: Mon Nov 11, 2019 11:14 pm

Re: What happens after Covid?

Post by AMS » Tue Mar 31, 2020 3:41 pm

A big feature of the way the NHS is funded is that the costs are mostly carried by working age people, who generally need the system least. Most people can accept this deal, because they know one day it will be their turn to be old, and so it goes. (Also, because they have empathy/elderly relatives/etc.)

Are there any insurance-based systems that replicate this, or do they all end up being more expensive for those who most in need of healthcare?

User avatar
Bird on a Fire
Princess POW
Posts: 10137
Joined: Fri Oct 11, 2019 5:05 pm
Location: Portugal

Re: What happens after Covid?

Post by Bird on a Fire » Tue Mar 31, 2020 4:05 pm

dyqik wrote:
Tue Mar 31, 2020 3:41 pm
Bird on a Fire wrote:
Tue Mar 31, 2020 11:34 am
I couldn't afford insurance when I lived there ($600+/yr in 2012 when I was a student), but the only schemes even vaguely within reach (university subsidised ones) excluded pre-existing conditions anyway so weren't much use for me.
The prices have risen significantly since then, and are generally rising at 8-10% a year. Currently it would cost me $1600/month to buy insurance for me and my wife, with a $500 deductible per person, $20 co-pays for most office visits (including things like physio), and a $3000 out of pocket maximum on the open market. I actually pay about $540/month pre-tax under my employers' plan with those terms.
f.cking hell - that would be more than my income on the open market, or ~half of it through the employer. And I wouldn't earn more as a grad student in the USA unless I had to take a part-time job like teaching to get through it.

It's insane, and thoroughly inhumane. How anyone can oppose an immediate and radical replacement of the system is beyond me (other than insurance companies and politicians funded by them, of course, as well as the chronically misinformed).

(Also I just checked my figures, and I was a bit out - back then it was ~$600 per semester, so would have been $1200 per year plus all the copays and stuff, which was still unaffordable).
We have the right to a clean, healthy, sustainable environment.

User avatar
dyqik
Princess POW
Posts: 7527
Joined: Wed Sep 25, 2019 4:19 pm
Location: Masshole
Contact:

Re: What happens after Covid?

Post by dyqik » Tue Mar 31, 2020 5:05 pm

Bird on a Fire wrote:
Tue Mar 31, 2020 4:05 pm
dyqik wrote:
Tue Mar 31, 2020 3:41 pm
Bird on a Fire wrote:
Tue Mar 31, 2020 11:34 am
I couldn't afford insurance when I lived there ($600+/yr in 2012 when I was a student), but the only schemes even vaguely within reach (university subsidised ones) excluded pre-existing conditions anyway so weren't much use for me.
The prices have risen significantly since then, and are generally rising at 8-10% a year. Currently it would cost me $1600/month to buy insurance for me and my wife, with a $500 deductible per person, $20 co-pays for most office visits (including things like physio), and a $3000 out of pocket maximum on the open market. I actually pay about $540/month pre-tax under my employers' plan with those terms.
f.cking hell - that would be more than my income on the open market, or ~half of it through the employer. And I wouldn't earn more as a grad student in the USA unless I had to take a part-time job like teaching to get through it.

It's insane, and thoroughly inhumane. How anyone can oppose an immediate and radical replacement of the system is beyond me (other than insurance companies and politicians funded by them, of course, as well as the chronically misinformed).

(Also I just checked my figures, and I was a bit out - back then it was ~$600 per semester, so would have been $1200 per year plus all the copays and stuff, which was still unaffordable).
I just checked the averages for MA, because my plan is somewhat better than average for deductibles and co-pay.

The average for 2019 was $617/month for a single person, $1687 for a family.

User avatar
dyqik
Princess POW
Posts: 7527
Joined: Wed Sep 25, 2019 4:19 pm
Location: Masshole
Contact:

Re: What happens after Covid?

Post by dyqik » Tue Mar 31, 2020 5:19 pm

Oh, and our prices change year on year based on how much our plan costs the insurers. So after COVID-19, the insurers will be trying to make back their losses in higher expenses. Since my employer is highly biased to older workers >50, that could be pretty grim.

Although the death rate US wide is reportedly down significantly in the past two weeks, probably mostly due to reductions in road traffic accidents and deaths at work. Whether that will carry over into insurer pay outs, I don't know.

User avatar
Bird on a Fire
Princess POW
Posts: 10137
Joined: Fri Oct 11, 2019 5:05 pm
Location: Portugal

Re: What happens after Covid?

Post by Bird on a Fire » Tue Mar 31, 2020 6:46 pm

Great Op-ed in Teen Vogue:

The Coronavirus Pandemic Demonstrates the Failures of Capitalism

This op-ed argues that the coronavirus outbreak has shown us how little capitalism has done for so many people in the U.S. — and that other ways of living and working are possible.
Teen Vogue wrote:Selling your labor in a capitalist marketplace so you don’t end up on the street is horrible and unnatural, and we shouldn’t have to exist this way. While many of us have long questioned the idea of working our lives away to pad a company’s bottom line, the pandemic has given us a glimpse of what an anti-capitalist society could actually look like. This isn’t to romanticize what is happening — after all, people are gravely ill and dying every day. But if we are to fully examine the crisis for what it is, then we must recognize that COVID-19 is not the only virus that must be destroyed. We also have to confront capitalism and the world that sustains it.

Combating the disease has normalized working from home, instead of slogging through daily commutes, for those who have the privilege to do so. It convinced some Republicans to support some form of universal basic income, and caused some companies to temporarily bring down their paywalls. Adobe is offering free two-month subscriptions to help struggling freelancers, proving that open source of expensive software is possible. And without sounding like an eco-fascist, the environment is perhaps getting a chance to recover while humans are forced to pause our ever-growing carbon output — the starkest articulation yet of why we should never return to our “normal” pre-virus life.
Recommended. https://www.teenvogue.com/story/coronav ... capitalism
We have the right to a clean, healthy, sustainable environment.

User avatar
Little waster
After Pie
Posts: 2385
Joined: Tue Nov 12, 2019 12:35 am
Location: About 1 inch behind my eyes

Re: What happens after Covid?

Post by Little waster » Wed Apr 01, 2020 8:16 am

Bird on a Fire wrote:
Tue Mar 31, 2020 6:46 pm
Great Op-ed in Teen Vogue:

The Coronavirus Pandemic Demonstrates the Failures of Capitalism

This op-ed argues that the coronavirus outbreak has shown us how little capitalism has done for so many people in the U.S. — and that other ways of living and working are possible.
Teen Vogue wrote:Selling your labor in a capitalist marketplace so you don’t end up on the street is horrible and unnatural, and we shouldn’t have to exist this way. While many of us have long questioned the idea of working our lives away to pad a company’s bottom line, the pandemic has given us a glimpse of what an anti-capitalist society could actually look like. This isn’t to romanticize what is happening — after all, people are gravely ill and dying every day. But if we are to fully examine the crisis for what it is, then we must recognize that COVID-19 is not the only virus that must be destroyed. We also have to confront capitalism and the world that sustains it.

Combating the disease has normalized working from home, instead of slogging through daily commutes, for those who have the privilege to do so. It convinced some Republicans to support some form of universal basic income, and caused some companies to temporarily bring down their paywalls. Adobe is offering free two-month subscriptions to help struggling freelancers, proving that open source of expensive software is possible. And without sounding like an eco-fascist, the environment is perhaps getting a chance to recover while humans are forced to pause our ever-growing carbon output — the starkest articulation yet of why we should never return to our “normal” pre-virus life.
Recommended. https://www.teenvogue.com/story/coronav ... capitalism
Although I appreciate the sentiment I'm not sure painting a global pandemic as a glimpse into an anti-capitalist future is a particularly good sell.

It feeds too easily into the narrative that living in a communitarian eco-topia means essentially enforced sitting at home bored while your economy tanks, worrying that starvation or disease may kill your loved ones all under the aegis of a totalitarian police state with democracy suspended "for the greater good".
This place is not a place of honor, no highly esteemed deed is commemorated here, nothing valued is here.
What is here was dangerous and repulsive to us.
This place is best shunned and left uninhabited.

User avatar
Bird on a Fire
Princess POW
Posts: 10137
Joined: Fri Oct 11, 2019 5:05 pm
Location: Portugal

Re: What happens after Covid?

Post by Bird on a Fire » Wed Apr 01, 2020 11:33 am

AMS wrote:
Tue Mar 31, 2020 3:41 pm
Are there any insurance-based systems that replicate this, or do they all end up being more expensive for those who most in need of healthcare?
In places where insurance is arranged through the government, or there is a public option, governments can waive charges for those in need. I don't have any specific examples but it rings a bell.
We have the right to a clean, healthy, sustainable environment.

User avatar
Bird on a Fire
Princess POW
Posts: 10137
Joined: Fri Oct 11, 2019 5:05 pm
Location: Portugal

Re: What happens after Covid?

Post by Bird on a Fire » Wed Apr 01, 2020 11:38 am

Little waster wrote:
Wed Apr 01, 2020 8:16 am
Bird on a Fire wrote:
Tue Mar 31, 2020 6:46 pm
Great Op-ed in Teen Vogue:

The Coronavirus Pandemic Demonstrates the Failures of Capitalism

This op-ed argues that the coronavirus outbreak has shown us how little capitalism has done for so many people in the U.S. — and that other ways of living and working are possible.
Teen Vogue wrote:Selling your labor in a capitalist marketplace so you don’t end up on the street is horrible and unnatural, and we shouldn’t have to exist this way. While many of us have long questioned the idea of working our lives away to pad a company’s bottom line, the pandemic has given us a glimpse of what an anti-capitalist society could actually look like. This isn’t to romanticize what is happening — after all, people are gravely ill and dying every day. But if we are to fully examine the crisis for what it is, then we must recognize that COVID-19 is not the only virus that must be destroyed. We also have to confront capitalism and the world that sustains it.

Combating the disease has normalized working from home, instead of slogging through daily commutes, for those who have the privilege to do so. It convinced some Republicans to support some form of universal basic income, and caused some companies to temporarily bring down their paywalls. Adobe is offering free two-month subscriptions to help struggling freelancers, proving that open source of expensive software is possible. And without sounding like an eco-fascist, the environment is perhaps getting a chance to recover while humans are forced to pause our ever-growing carbon output — the starkest articulation yet of why we should never return to our “normal” pre-virus life.
Recommended. https://www.teenvogue.com/story/coronav ... capitalism
Although I appreciate the sentiment I'm not sure painting a global pandemic as a glimpse into an anti-capitalist future is a particularly good sell.

It feeds too easily into the narrative that living in a communitarian eco-topia means essentially enforced sitting at home bored while your economy tanks, worrying that starvation or disease may kill your loved ones all under the aegis of a totalitarian police state with democracy suspended "for the greater good".
I agree - nobody wants to live under lockdown conditions forever.

But, on the other hand, the crisis is revealing that certain alternatives to the prevailing sociooeconomic paradigm or not just possible but preferable (despite the hugely unfortunate circumstances in which that has been demonstrated). It would be, I think, a good thing if those issues are highlighted, and the crisis can be used to push for changes with long-term benefits; obviously the presentation has to be careful, without looking like it's exploiting a tragedy. But the tragedy will happen anyway - some good may at least come of it.

I'm reminded of Marx's observation that was subsequently borne out by events in the 20th century - there are no revolutions without crises, but there can be crises without revolutions. What a waste of a crisis that would be.
We have the right to a clean, healthy, sustainable environment.

User avatar
EACLucifer
Stummy Beige
Posts: 4177
Joined: Fri Dec 13, 2019 7:49 am
Location: In Sumerian Haze

Re: What happens after Covid?

Post by EACLucifer » Wed Apr 01, 2020 10:30 pm

"What this crisis does is confirm my existing beliefs and emphasise how they must be implemented immediately"

Seeing a lot of that around lately, and it is both annoying and short sighted

ETA: As for the asinine suggestion that we should be using the crisis as cause for a revolution, no, seriously. f.ck off with that sh.t. What the crisis emphasises is that it is the vulnerable and marginalised that are most affected by crisis - and the history of revolution shows that revolutions often lead to crises of their own, in which the vulnerable and marginalised are hit harder.

Millennie Al
After Pie
Posts: 1621
Joined: Mon Mar 16, 2020 4:02 am

Re: What happens after Covid?

Post by Millennie Al » Thu Apr 02, 2020 2:11 am

Bird on a Fire wrote:
Tue Mar 31, 2020 6:46 pm
Great Op-ed in Teen Vogue: https://www.teenvogue.com/story/coronav ... capitalism

The Coronavirus Pandemic Demonstrates the Failures of Capitalism
It's an ignorant and stupid article.

From the first paragraph:
Getting laid off during a pandemic isn’t the best thing that could have happened, but I’m coping.
You've just had an article published in Teen Vogue. What sort of layoff is that?
the pandemic has given us a glimpse of what an anti-capitalist society could actually look like
How? The resources being drawn on are the result of centuries of capitalism. There have been far longer attempts at societies which are non-capitalist (I don't know what an "anti-capitalist" society is), and they don't look promising.
Adobe is offering free two-month subscriptions to help struggling freelancers, proving that open source of expensive software is possible.
No. Proving that the author doesn't know what "open source" actually means.
We now have a moment to consider what a rapid global response to the climate emergency would look like ...
I doubt you'll have many supporters for your chosen solution to climate change if it looks anything like the measures used against Covid19.
how we could build a society that completely transforms our social order toward something that is in equilibrium with the biosphere and gives to each according to their needs.
"In equilibrium with the biosphere" - what does that even mean? "gives to each according to their needs" - the grim promise of leftie nonsense.
As millennials and Gen Z’ers, our lives have been shaped by one crisis after another, and an array of trends, from the worsening climate crisis to increased workforce automation, suggest that things will keep getting worse.
What a narrow view of history. Only 30 years ago a journalist could not have made money by writing an aricle for a website, because the WWW didn't exist. Similarly, there were no Youtubers, Instagramers etc. If you wanted to phone someone you had to wait until they were in a predictable location as they wouldn't have had a mobile phone (unless they were very wealthy, and a further decade eliminates even that). Back a few decades more and you had to do your own dishwashing and laundry, unless you were rich and had servants, or a man and got your wife to do it. At the beginning of the 20th century, you couldn't watch TV and having type 1 diabetes was a death sentence. An infected wound which was life-threatening and might require amputation can now be treated with antibiotics. Today the ordinary citizen of our wealthy countries has an array of food available that would be the envy of emperors of ancient times. They have entertainment available from the world's top entertainers, even those who are now dead - something that nobody could have had until modern times. There is no realistic chance that any of this is going to go away. Things are certainly not going to keep getting worse except in the eyes of those extremely privileged m0odern people who do not realise just how much they have.
What the coronavirus pandemic has demonstrated is that our cheapskate government can provide far more in social programs than it has. We could afford life-changing, comprehensive legislation like the Green New Deal and Medicare for all.
The USA spends more on Medicare and Medicaid than England does on the NHS (scaled by total population). The US government is not "cheapskate" it is squandering money by not using it efficiently - which is why the USA spends so much more per person than other developed countries while getting worse results. This is not an issue with capitalism - Canada provides healthcare through insurance, but it's paid for by the state rather than a mixture of individuals and employers. What the US needs is not more money - it could have the best healthcare in the world on less money - it's sensible policy, not driven by ideologies.

Post Reply