John Green explains the past and future of U.S. health insurance in under 10 minutes

Novelist and polymath John Green manages to cram a lot of information about the recent history, current state, and possible future of health insurance in the United States in less than ten minutes:


For sources and background information see the video description at the link above.

Here's an even shorter summary:

U.S. healthcare has mediocre outcomes in comparison with those of other wealth countries, despite the fact that those countries spend a lot less per person than we do.

In fact, they spend so much less that if we adopted, say, the French system or the Australian system, our healthcare outcomes would be about the same or better, and our current government spending on healthcare would be more than enough to pay the total cost. Green doesn't spell this out, but we could do away with deductibles, copays, coinsurance, and health insurance premiums, and we wouldn't have to spend a penny more in taxes. (Yes, that does sound too good to be true, but look at the numbers.)

Multiple independent non-partisan analyses agree that Trump's healthcare proposals would drastically increase the number of uninsured and out-of-pocket medical spending while increasing the budget deficit. Clinton's proposals would increase the deficit even more than Trump's, but would cut out-of-pocket costs and decrease the number of uninsured Americans. And overall, Clinton's tax and spending proposals would increase the deficit far less than Trump's. (The deficit figures he quotes appear to be for a frame of more than one year, but the comparison is what's important.)

One more thing: I agree with Green's praise of the Healthcare Triage YouTube channel, but I wish in the interest of full disclosure that he had mentioned that he's partly responsible for Healthcare Triage, so he's not entirely objective about it.

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Is Medicaid a better deal than we think?

Pediatrician, writer, and medical school professor Aaron Carroll MD discusses the evidence that Medicaid has a large positive return on investment.


If you're still young and healthy -- just you wait -- you might be among the people who get Medicare and Medicaid confused. Medicare pays some of the cost of medical care for people 65 and older and for people with serious kidney disease. (In the U.S., I mean; in Canada it's for everybody, and similar terms are used in other countries, but I digress.)

Medicaid is for very low-income people and for elderly persons in nursing homes who have no other way to pay for it. In fact, most Medicaid spending, like almost all Medicare spending, goes to services for the elderly, so there's overlap between the programs.

Medicare is financed by federal taxes and partly by premiums paid by the insured. Medicaid is a joint federal-state program with eligibility rules and benefits that vary state by state. The Affordable Care Act expanded Medicaid eligibility so that, for example, low-income people without dependent children could get coverage (which was not the case in many states). The additional cost of expanded Medicaid are paid almost entirely by the federal government, with states contributing at most ten percent.

However, a questionable Supreme Court decision held that states not wishing to follow the new rules could keep following the old ones even thought the law had changed. The result is that in 19 states many impoverished people have no way to pay for medical bills. Depending on their condition they go without care or they get hospital care that they don't pay for, which means the losses are passed through to the rest of us in the form of higher hospital bills or picked up by the state government. In practice, states that refuse to expand Medicaid are actually losing money, which is why a series of anti-Obamacare Republican governors and legislatures have come around to grudgingly accept Medicaid expansion.

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Seth Meyers on Trump's defenders

Late night host and alumnus of SNL's Weekend Update segment Seth Meyers talks about the odd defenses offered up by Trump's defenders (and Trump himself) against charges that he sexually harassed and assaulted women. Mike Huckabee's analogy to the film Jaws is particularly weird and unintentionally funny.


As Meyers mentions in passing, it isn't just that a number of women claim he forced unwanted attention and kisses on them, it's that Trump himself said he'd done it on the notorious Access Hollywood tape. He also told Howard Stern that a perk of owning the Miss Universe Pageants was being able to go where no other man was allowed and ogle beauty contestants in their dressing rooms, something now confirmed by several of the women who competed in the Miss Universe and Miss Teen Universe contests. One member of the latter group reportedly ogled by Trump was 15 at the time.

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Needle exchange programs save lives, so why don't we have them in the U.S.?

Even people who inject themselves with drugs almost always realize the risk of sharing needles, and they do it anyway. That's pretty much what it means to be an addict.

So some places have experimented with making clean hypodermic syringes easy to obtain through a needle exchange program. Anyone who brings in a used one can get a replacement at no charge, with no risk of arrest on drug charges. At first glance this might seem like a way of promoting drug use and a waste of tax dollars, but experience suggests it's the opposite. For one thing, when addicts come in to exchange needles they're usually offered information on treatment programs, and when there are enough openings, a lot of addicts actually do enter them and some -- not all, but enough to make it worth the effort -- wind up getting off drugs.

Of course, needle exchange programs do cost money, but so the spread of HIV, hepatitis, and other infections costs even more. Laws restricting or prohibiting needle-exchange programs are well-intentioned and based on reasonable concerns, but hard experience over decades suggests that in actual practice needle exchange programs reduce cases of dangerous infectious disease while not increasing IV drug use and saving taxpayers money.

Here's more from pediatrician and medical school professor Aaron Carroll:


For sources, click on the link and look at the video's description.

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Very useful YouTube tips

Polymath, entrepreneur, and fast talker Hank Green offers up a really very useful set of YouTube tricks and techniques.


Here are the keys he mentions:
j - Jump back 10 seconds
k - Pause and un-pause playback
l - Leap forward 10 seconds
, (comma) - Move paused video back one frame
. (period) - Move paused video ahead one frame
< (shift-comma) - Slow down playback > (shift-period - Speed up playback
M - Mute and un-mute the sound
Up arrow - Louder
Down arrow - Quieter
Left arrow - Jump back 5 seconds
Right arrow - Leap forward 5 seconds
0 - Go to the start of the video
1 - Go to a point 1/10 of the way through the video
2 - Go to a point 2/10 of the way through the video
9 - Go to a point 9/10 of the way through the video

And from comments on the video:
/ - Jump to the search box (works a lot of places in Google products)
O (shift-o) - Change the color of closed captions text
W (shift-w) - Change the color of closed captions background
(Turn on captions by mousing over the video and clicking the CC button.)

Finally, right-click on the video (or Control-click on a Mac) and you'll get a menu of options that includes "Loop" and "Copy embed code" (which copies some HTML to your computer's clipboard than can then be inserted into a web page to cause the video to appear there).

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