# RPGs Have a Health Problem



## LuisCarlos17f (Oct 7, 2019)

And there are little children becoming rich, filthy rich, only because they are in youtube videos opening toy boxes.

Maybe the future of the industry is in something like the sponsorpay where you get points watching advertising videos, and you spend those points in the store of a videogame (for example clothes, hair and furnitures for the sims 3), or PDFs of TTRPGs. I think this is the best strategy because the spot is linked with a positive stimulus, a reward, and then we are more receptive than when the movie in the TV is interrupted for the advertising.


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## eyeheartawk (Oct 7, 2019)

It's a niche market with easy access, meaning it's small but there is also alot of noise. To truly make a living in this industry you have to get very lucky. I wouldn't count on anything in the RPG field being a full time career type job, just given the chances. 

That all being said, it's almost as if the prevalence of gofundme campaigns for medical expenses is the sign of some larger systemic problem in America  rather than anything unique to the RPG industry.  It's weird how I don't see any medical fundraising for European designers . I can't figure this one out, fellas.


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## Morrus (Oct 7, 2019)

eyeheartawk said:


> That all being said, it's almost as if the prevalence of gofundme campaigns for medical expenses is the sign of some larger systemic problem in America  rather than anything unique to the RPG industry.  It's weird how I don't see any medical fundraising for European designers . I can't figure this one out, fellas.




We're not going to get into a general discussion about US politics, thanks, guys. Stay on target. I know the topic veers close.


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## Xenonnonex (Oct 7, 2019)

This is really a fundamental problem of the American healthcare system.
The American healthcare system has a health problem.

Another issue is that minimum wages are too low.

Another issue is the sense of entitlement from RPG consumers. Who try to justify piracy. People worked hard on those books. F balking at spending an amount for RPG books.


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## Reynard (Oct 7, 2019)

Morrus said:


> We're not going to get into a general discussion about US politics, thanks, guys. Stay on target. I know the topic veers close.



I honestly dont think you can discuss this issue without talking about the healthcare system in America, and you can't do that without talking about politics in America. They are all fundamentally tied together.


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## lowkey13 (Oct 7, 2019)

*Deleted by user*


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## Morrus (Oct 7, 2019)

Reynard said:


> I honestly dont think you can discuss this issue without talking about the healthcare system in America, and you can't do that without talking about politics in America. They are all fundamentally tied together.




Update - I've changed my mind. This is an important conversation to have, but it will be closed without notice if it drifts into a full-fledged politics thread and doesn't stay on topic. And I don't want to hear any political jabs at the opposing team(s).


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## DWChancellor (Oct 7, 2019)

I don't see how this market is much different than art, or performance in that there are many many more really talented people who are driven to create than there are people driven to pay full price for value.

I walk into a Morton Arboretum (a non-profit taken over by MBA parasites but that's another discussion) Artist's Guild show and see fully masterful pieces by two dozen people only two or three of whom have ever made much money off of it.

Street performers around my city perform at a very high level and... get to perform in the street.

I don't see a difference for game designers and RPG writers.  The internet has only exacerbated this by making access to the public trivial while at the same time making access _by_ the public trivial.  Without any gating, huge numbers of hopefuls jump in and design/write their hearts out.

You might say, "why doesn't my society better support the people who can't help themselves trying to make the world richer and more wonderful," but it isn't like Europe and every other continent isn't covered in hopeful never-makes it too.  I just don't see how this boils down to anything more than the fundamental question: do we as a society want to "liberate" people from their base needs so they can freely and without dire consequence "do."


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## Ulfgeir (Oct 7, 2019)

eyeheartawk said:


> That all being said, it's almost as if the prevalence of gofundme campaigns for medical expenses is the sign of some larger systemic problem in America rather than anything unique to the RPG industry. It's weird how I don't see any medical fundraising for European designers




Well, we had here in Sweden one case where a crowdfunding-campaign was used for medical reasons (it was cancelled though due to possible conflicts of policies).  One of the makers of the Swedish game Western (and the largest Swedish roleplaying magazine Fenix) is relatively ill (terminally as far as I know), and they set up a kickstarter to get money so that her partner could take a leave of absence from his job, and take care of her, while they worked on finishing as much material as possible for the game while she still has the strength to do so.


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## Sacrosanct (Oct 7, 2019)

It’s like the saying, “The best way to end up with a million dollars in the RPG industry is to start with two.”

I don’t think I’ve ever made money as a whole putting out products, and that includes my game that went into full distribution (Impressions distribution) with a 5,000 print run. But I am OK with being a hobby publisher. I do it because I like to do it.  For example, the superdungeon in my sig has sold roughly 1000 copies so far, mostly pdf with some hard copy. But not even counting my own time and effort, I spent over $3000 to get it completed. Almost all freelance art and editing. I did all the writing and layout myself, or the costs would have been much higher. And those 1000 copies are over a five year period.

So unless you have boat loads of money to build up a huge library of products right up front, it takes a long, long time to have produced enough to make a total business profit, let alone enough to do this as your sole source of income. Or you have to be lucky to catch the right attention at the right time and have your product become viral.

It just isn’t that big enough of a hobby. And like any other hobby (like crafting, or woodworking, or leatherworking (two of my other hobbies), it’s near impossible to make a decent living, let alone be able to pay for good healthcare and retirement.  Until we go to universal healthcare, I don’t see that changing.


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## Sacrosanct (Oct 7, 2019)

lowkey13 said:


> In addition, people tend to undervalue how much effort and time creative efforts cost. For example, if an attorney tells you that they charge $500/hr, that's the cost of doing business. However, if an artist tries to sell you a painting for $5,000.00 (a large one), do you consider how much time and effort went int the painting, let alone the cost of supplies?
> 
> TLDR; people suck.




There’s a popular meme in my woodworking circles: I’m not charging you for the 30 minutes of work, I’m charging you for the 30 years of time and effort I did to get to the point where I could do this job well in 30 minutes.


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## Scarlet.Knight (Oct 7, 2019)

DWChancellor said:


> I don't see how this market is much different than art, or performance in that there are many many more talented people who are driven to create than there are people driven to pay full price for value.
> 
> I walk into a Morton Arboretum (a non-profit taken over by MBA parasites but that's another discussion) Artist's Guild show and see fully masterful pieces by two dozen people only two or three of whom have ever made much money off of it.
> 
> ...



I like your analysis of the situation.

I live in Canada. These healthcare-related issues are fairly different here. When it comes to medication, we're mostly in the same boat: can't pay, can't have.

In my experience, artists, in general, do not make a huge chunk of money in Canada. Same situation. I studied graphic arts, about 20 years ago. I was the only graduate of my class that found a job in this field. Even then, my pay was close to minimum wage, with no benefits whatsoever. We're talking graphic arts here: the most commercial application of visual arts. Nowadays, anybody with a computer can download Adobe Creative Suite and play with it to create stuff. It won't be, generally, very well thought out. It won't exactly match what the client needs. But most clients simply do not care. It's all about costs and most just don't care or can't see the difference if the thing is "50% pretty vs 80% pretty". This has kept salaries and conditions fairly low (there are some exceptions and I did not put together a full study on it, so this conclusion contains my experiences and my biases). That is partly why I left that field.

I see direct parallels with RPG writing here. Actual authors with skills pushing products in a sea of other products pushed by authors or non-authors of various skills. Amateur authors able to do the work (lower quality but hey, will they see the difference?) bringing salaries down. When Monte Cook Games publishes a game with such high production value as Cypher System Revised and charges $60+ for it, people are shocked. Lots of lower price tags on the same shelf. Are we ready to pay for quality? I am. But in general... I'm unsure.

Other trades, such as plumbing or factory work, have seen a significant increase in salaries and work conditions. Why is that? Well, because in a capitalist society, usefulness - real or perceived - is key. At every turn, it seems like our world is more and more concerned with bottom dollars and profit. The school system has gone through several reforms to make kids - ultimately working adults - more adaptable, flexible and able to solve the complex problems of the modern world. Utilitarianism vs humanism. Increasing profit for shareholders in spite of everything else, ethics included. It should come as no surprise that arts, in general, are not considered very high on the scale of usefulness in such a system. Tell your dad you're gonna become a professional dancer; or tell him you're gonna become an electrician. Your mileage may vary, but I suspect that he might value one over the other. My dad did anyway...

How many singers, authors and actors struggle to make ends meet waiting for their breakthrough? It may never come. When it comes, the whole thing becomes a business. Facelifts, agents, promotion tours, contacts, Instagram... Gathering fans by the million to generate money for that big hungry machine. But for authors? RPG authors? Gee, the pool of interested people grows thinner. Do people still read nowadays? Some do, but in general, I feel books are not that popular anymore (cooking books excluded!). My kids would rather watch stupid Youtube videos as opposed to reading The Hobbit or even Tintin comics. I have to force them to do so... and they're very smart kids with superior reading skills.

I guess what I'm trying to say is that art, in general, has a lower value than other activities, in our society based on profits and reduced costs. Because of our proximity to our hobby, this issue hits close to home. But other trades and careers are in the same boat. I do not feel a person who plays hockey or baseball for a living should earn 100 times what a doctor who saves lives earns. I do not feel a person who entertains people for a living should be left out to die when illness comes. There is a real lack of human decency in our current society. I don't pretend to know what we need as a society, but I think we need to put back some ethics into it.


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## Rhianni32 (Oct 7, 2019)

RPGs suffer the same problem that a lot of industries have encountered with the rise of the internet. Low entry barrier. People will create content for free because to them its a fun passion or they are doing it for their own table and then can offer it up for others to use. Its not realistic to expect to do this as your single source of income. 

However the internet also brings the power of leverage. Not only with the size of audience for Twitch, youtube, and patreon income but more importantly the tools available. Once you learn the tricks of the trade and some time saving steps, creating quality RPG content isn't that hard. Look at battlemap Patreons. The successful ones create 4-6 versions of a map. I imagine some 80% of their total time is creating the first basic map. Then the last 20% is toggling light setting, shadowing, and swapping out plant models (while leaving in walls and rocks) so that now you have day, night, summer, winter versions.
My own usage of GIMP photoediting software has a massive up front time cost to learn. Now though I can crank through a lot of great visual aids for my table in about 1/10th the time the first few times took.

This is where I think it is most realistic to see RPGs as a source of income. Get good at a quick process, work on it 1 hour a day after your day job or 6ish hours on the weekend and focus on supplemental income.


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## billd91 (Oct 7, 2019)

I don't think this is just a problem within the RPG hobby for the producers, but also the consumers. How many GoFundMe campaigns do you think are out there for the health care of gamers? I'll bet there are quite a few more than there are for the producers. 

In some ways, that's just the effect of America's terrible health care distribution system. In other ways, it's the nature of a hobby that attracts and retains people who are seeking an escape from their normal day woes and/or prefer a more cerebral, table-top hobby because of their own physical health issues compared to more active hobbies.


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## Rhianni32 (Oct 7, 2019)

Sacrosanct said:


> There’s a popular meme in my woodworking circles: I’m not charging you for the 30 minutes of work, I’m charging you for the 30 years of time and effort I did to get to the point where I could do this job well in 30 minutes.




I'm an IT server and cybersecurity admin and I say something similar. Yes you can pay entry level people to cover most of the day to day support. However my 20+ years of experience means your equipment is built and maintained so that you don't have problems in the first place vs that entry level tech needing to google each and every error code they didn't know how to prevent in the first place.


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## generic (Oct 7, 2019)

Rhianni32 said:


> I'm an IT server and cybersecurity admin and I say something similar. Yes you can pay entry level people to cover most of the day to day support. However my 20+ years of experience means your equipment is built and maintained so that you don't have problems in the first place vs that entry level tech needing to google each and every error code they didn't know how to prevent in the first place.



A 302 error has occurred.  Please re-type your post.


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## Umbran (Oct 7, 2019)

lowkey13 said:


> In addition, people tend to undervalue how much effort and time creative efforts cost. For example, if an attorney tells you that they charge $500/hr, that's the cost of doing business. However, if an artist tries to sell you a painting for $5,000.00 (a large one), do you consider how much time and effort went int the painting, let alone the cost of supplies?




Well, there's rather a difference between engaging legal assistance on an important matter, and buying an artwork - if I am engaging the lawyer, it is generally because I have something else that is, in some way, worth much more to me than the lawyer's costs that hangs in the balance.  If I buy a painting... it is because I like the painting.

So, if a lawyer tells us they have fees that amount to $5000, we pay because we kind of have to for some larger reason.  If an artists tells us the painting costs $5000... you know, in this audience, most of us probably sigh, shrug, and walk away, because we cannot afford that amount on a single luxury item*, regardless how how much it took to produce.

We talk about this in reference to artists, but it is by no means an issue of artists - art is a business, and this issue affects all small businesses - a bit of searching on statistics suggests to me that about 50% of all small businesses fail within the first five years of operation.  

So, while we look at RPG creators, the issue really isn't one of RPGs, or artists.  The same problems apply to any small businessperson - in general, _going into business for yourself is financially very risky_.  Flip a coin as to whether you will be able to make it for five years, much less be well-financed for medical issues as you age.

So, if you are concerned about RPG producers... maybe you should also be concerned about your dog groomer, or the folks who opened that new bagel shop up the street, too.




*Or, that luxury item does not provide, for us, the bang for the buck - given that $5000 is also akin to a week's vacation for two.


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## Sacrosanct (Oct 7, 2019)

I also don’t think the health care issue is limited to RPGs or other small niche jobs. Last year, when my son was on a band trip, he split his nose open when the bus storage door fell on his face. It was a band trip to another city, so out of network. Between the hospital bill and the doctors own separate bill, it was $6000 for fifteen minutes of stitches. After insurance because out of network. How many people, even with “regular” jobs, can afford that. And that was for something minor, god forbid if you have a serious medical emergency


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## Sacrosanct (Oct 7, 2019)

Umbran said:


> So, while we look at RPG creators, the issue really isn't one of RPGs, or artists.  The same problems apply to any small businessperson - in general, _going into business for yourself is financially very risky_.  Flip a coin as to whether you will be able to make it for five years, much less be well-financed for medical issues as you age.
> 
> So, if you are concerned about RPG producers... maybe you should also be concerned about your dog groomer, or the folks who opened that new bagel shop up the street, too.
> 
> ...




Absolutely agree with this. It really comes down to what is the market willing to pay a person for X. Love it or hate it, it’s capitalism.


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## Morrus (Oct 7, 2019)

Umbran said:


> So, if you are concerned about RPG producers... maybe you should also be concerned about your dog groomer, or the folks who opened that new bagel shop up the street, too.




Sure. It's just that we're an RPG site, not a dog grooming site.


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## lowkey13 (Oct 7, 2019)

*Deleted by user*


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## Sacrosanct (Oct 7, 2019)




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## Umbran (Oct 7, 2019)

Morrus said:


> Sure. It's just that we're an RPG site, not a dog grooming site.




Yes, Morrus - the point is that when we talk about this, if we consider causes or courses of action that are RPG-specific, we are likely barking up the wrong tree.  If what one suggests does not apply to the dog groomer too, it is probably inaccurate or not helpful.


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## Umbran (Oct 7, 2019)

lowkey13 said:


> On the other hand, if an artist charges an amount for their time, I can guarantee you that clients do not value their time, that clients will want extensive edits "on the house," that clients will not understand how something could have taken X hours, and so on.




I don't expect this is really art-specific.

My wife is a veterinarian.  Highly comparable to lawyers - post-graduate degree and licensing required, for example.  The clients regularly do not value the doctor's time, call for extensive workups "on the house" (typically phrased as ,"can't you just take a 'quick look' without charging me?"), argue over costs, and so on. 

I don't know how often lawyers get the equivalent, but while she was in regular clinical work, several times a week she'd get, "if you really cared, you give your services for free!" as if she didn't have to eat or pay a mortgage, or anything, trying to outright shame her into giving away her time and rather expensive medical products and services.


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## lowkey13 (Oct 7, 2019)

*Deleted by user*


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## Aaron L (Oct 7, 2019)

It's just a reprehensible situation that people are forced to go to crowd funding to cover medical expenses they need just to stay alive.

I live on disability income, which makes things extremely hard to do anything (andmy father died suddenly last week, making things even harder on our household and now we don't know how we're even going to make it.)  I have Degenerative Disc Disease and have had to undergo 3 surgeries on my spine since I was 19 (I'm 43 now) with a neurogenic spastic bladder and permanent nerve damage in several other locations resulting from the DDS, Tourette Syndrome with tics that have given me arthritis in my elbows and wrists, ADHD, Irritable Bowel Syndrome, clinical depression, social anxiety problems, and I'm in the middle of being tested for the Autism Spectrum.  If I didn't have medical insurance provided by the government (US, in live in Pennsylvania) I would have died years ago, after first becoming paralyzed from the waist down and then suffering through however many years of agony as my bladder killed me.  I would have died in agony without that help.

We all need to try to help the people who make the games that we love and give us hours and hours of joy.  I think D&D has exploded in popularity the past few years because people have grown sick of all their communications with friends being online through social media, and instead want real face-to-face interactions with a structured environment/game.  I've done what I could in the past through Patreon to help give money to the creators I love the most (such as Michael Swaim's Small Beans, made up mostly of people formerly from Cracked, and Team Four Star, the creators of Dragon Ball Z Abridged, although that will unfortunately have to end due to my family's current situation.)  But as great as Patreon is, I think it's just a stop-gap and not a permanent solution; I just read an article about the creator of Patreon, and hope I'm wrong and the platform can grow into something wonderful to provide permanent funding home for creators, but I don't know.


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## Doctor Futurity (Oct 7, 2019)

I work in the medical insurance industry in the US and can assert that it's a horrifying mess. This is a bipartisan issue, beyond the ability of either political party to fix easily. At a bare minimum we need serious regulation on medical costs aimed at hospitals and big pharma. That would be a start; until profit is removed from the equation, however, the US healthcare system is going to continue spiraling down the drain and change won't happen until it hits rock bottom. Some form of universal healthcare would be welcome in the US, but actually figuring out how to do this is a huge hurtle right now.

I personally work in the industry I do out of necessity as everyone in my family has a condition which guarantees we can't afford not to have good health coverage. Even with such coverage and a decent job I labor under a mountain of lingering debt from years of prior health costs. I would not want to be in the position to have to beg on a Gofundme account for help, and empathize with those who do.

Its laudable that if a game designer had 1,000 fans and those fans all paid $100/year that it could be enough, but in truth that probably isn't actually enough when real health problems arise, and most of those fans are also facing their own associated health cost issues as well. It doesn't help that this is an industry that often considers $20 way too much for a PDF of a game, and a significant number of RPGers are in the hobby because they have little income and need something that doesn't drain their finances much to begin with.


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## eyeheartawk (Oct 7, 2019)

Doctor Futurity said:


> Its laudable that if a game designer had 1,000 fans and those fans all paid $100/year that it could be enough, but in truth that probably isn't actually enough when real health problems arise, and most of those fans are also facing their own associated health cost issues as well.




This is true. Without getting into a wider political debate, it is a fact that the number 1 cause of personal bankruptcies in the US are medical expenses. A not insignificant amount of those people also had insurance.

Let's say you have good insurance, and they cover 95% of your hospital stay for something serious and lengthy. You leave with a $600,000 bill. Most people don't have a liquid $30,000 sitting around to cover that remainder. Giving somebody enough money to pay the premiums to begin with doesn't insulate one from the inherent fact that even with insurance you can go broke and turn to Gofundme.

Again, this is broken.


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## dragoner (Oct 7, 2019)

Medicare for all, problem solved.


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## Ancalagon (Oct 7, 2019)

This is not a RPG problem. 

This is a "why the hell doesn't the USA have universal health care" problem.


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## Dire Bare (Oct 7, 2019)

Ancalagon said:


> This is not a RPG problem.
> 
> This is a "why the hell doesn't the USA have universal health care" problem.




It's not a problem limited to game designers, yes, and many folks regardless of profession struggle under the US healthcare system, but it is a particular problem for those who work independently and don't hold regular jobs, which includes most artists. If you don't have a health plan through work, and you aren't putting away for retirement, you can find yourself in a very bad situation when you're older.

This has been happening to aging scifi authors also, with similar calls for crowdfunded help to cover medical expenses. I'm sure it happens in many creative fields. What brings it to our attention is that these folks are famous and well-respected in their fields, we are shocked to learn they are penniless and facing signficant healthcare issues in their golden years. It seems wrong, and it is (although not really more wrong than others who suffer).

When you are a young, struggling artist in your 20s . . . you aren't making much, you have no benefits, you are putting away for retirement, but you might be making more money than you ever have before and you're getting paid for your art! It's a awesome rush and it's easy to push future problems to deal with later. As you continue into your 30s, 40s, and maybe even 50s, you've gotten into some bad habits and suddenly you are in your 60s facing serious healthcare and/or living issues with no benefits or savings to cover them. Our country's healthcare system exasperates the problem, but it is also a problem often stemming from choices we made when we were young.

People who choose to go into the creative fields really need to consider these issues and ask themselves, "Do I really need to work full-time as an independent game designer?" Having a more mundane "day job" with benefits (health and 401k) is probably the wiser long-term choice. I'm a teacher, and I explore my creative side nights, weekends, and over that summer break. It's hard to focus on my creative endeavors, but I have a good health plan and retirement plan, and it's a good balance for me. God help me if I ever sell a novel or something and feel that temptation to ditch the day job and go full-time writing.


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## talien (Oct 7, 2019)

Dire Bare said:


> When you are a young, struggling artist in your 20s . . . you aren't making much, you have no benefits, you are putting away for retirement, but you might be making more money than you ever have before and you're getting paid for your art! It's a awesome rush and it's easy to push future problems to deal with later. As you continue into your 30s, 40s, and maybe even 50s, you've gotten into some bad habits and suddenly you are in your 60s facing serious healthcare and/or living issues with no benefits or savings to cover them. Our country's healthcare system exasperates the problem, but it is also a problem often stemming from choices we made when we were young.



I was going to add this, but you did it so well I'll just quote it. This is the concern -- the industry is getting mature enough that we can now see what happens to our elders, and it is a worrying trend.


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## Stacie GmrGrl (Oct 7, 2019)

One thing I noticed from this article is that it states that D&D has spiked in popularity and seen a dramatic increase... But does that actually translate to the rest of the rpg medium of products not D&D? 

IMHO, the popularity of D&D is only for D&D. Everybody else still scrapes by.


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## Sacrosanct (Oct 7, 2019)

D&D 6e will need to come with a coupon for a free ER visit and insulin shot...

The next evolution over crowdfunding healthcare.


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## B1okHead (Oct 7, 2019)

This would be less of an issue if more people invested in smaller games instead of exclusively playing D&D.


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## lowkey13 (Oct 7, 2019)

*Deleted by user*


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## dragoner (Oct 7, 2019)

B1okHead said:


> This would be less of an issue if more people invested in smaller games instead of exclusively playing D&D.




Pretty much no; the US would have a 60% savings on Healthcare if it followed the French model, by eliminating administrative costs. So what is actually happening is a shakedown, it's not like one can chose anything about your healthcare or treatment when you are unconscious or dying in the ER; so in economic terms, there is very low frangibility. It's sort of a disease in itself, the ballooning "administrative costs" scam, spend a dollar to save a dime.


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## Beleriphon (Oct 7, 2019)

lowkey13 said:


> Unfortunately, the "I wish people would do {insert unpopular thing} instead of {popular thing}" is an argument that, while oft-repeated and lauded in theory, is even more often ignored in practice.
> 
> See also: Why can't people listen to opera instead of that darned hippity-hop music?




Because opera is 200 year old hippity-hop music. 

As for health coverage, as much as we like to bag on the American health system as Canadians ours is not as universal as we'd like. I still have to pay for medication, mind you its about 20% the cost of the same thing in the US since we have price caps, and most provincial governments will pay for super expensive stuff if it is life saving.


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## Mercador (Oct 7, 2019)

It will be worse as the life goes by. Within a few years, we might be faced to difficult society choices as UBI and the likes. When 20% of the population have nothing else to do than create arts and an AI can do it better, I'm not too sure where it will goes.


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## Pixelllance (Oct 7, 2019)

dragoner said:


> Medicare for all, problem solved.




This is probably true. Its an systemic reason and also cause RPG are (still) a niche.
E.g. here in Germany (80 mio people / public health system for all) there are only 12-20 people employed in the RPG "industry" centered around two to three small companies (one of them , Ulisses, does the DnD translation and publish Germanys largest RPG The Dark Eye). All other publisher I know of have a day job and publish "just for fun".

Also RPG is a hobby you dont need much. The rule book, your imagniation, paper and pencil, dices. Thats all.
So people arent really dependent to buy a lot of stuff to enjoy their hobby, so its not easy to make real profit in this field of business.
----
RPG PIXELART at https://twitter.com/pixellance


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## dragoner (Oct 7, 2019)

Pixelllance said:


> So people arent really dependent to buy a lot of stuff to enjoy their hobby ...




In economic terms, it is called "Discretionary Income" dependent:

_Discretionary income is the amount of an individual's income that is left for spending, investing, or saving after paying taxes and paying for personal necessities, such as food, shelter, and clothing. Discretionary income includes money spent on luxury items, vacations, and nonessential goods and services. Because discretionary income is the first to shrink amid a job loss or pay reduction, businesses that sell discretionary goods tend to suffer the most during economic downturns and recessions. _









						What Is Discretionary Income?
					

Discretionary income is the amount of an individual's income that is left for spending, investing, or saving after taxes and necessities are paid.




					www.investopedia.com


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## Sacrosanct (Oct 7, 2019)

On a somewhat related note, I heard something a few days ago that definitely get the deep thoughts churning. 

We know that universal healthcare would actually be cheaper for business because they pay a lot for their portion of health insurance. So why do business campaign against it, when you wouldn’t think it’s in their best interests?

It’s because having health insurance keeps people from quitting bad jobs and work environments, or from rocking the boat asking for better working conditions or pay.  A single medical emergency can bankrupt you, and not having insurance to afford medication can literally kill you. So people won’t quit bad jobs. And companies know that.


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## billd91 (Oct 7, 2019)

Sacrosanct said:


> On a somewhat related note, I heard something a few days ago that definitely get the deep thoughts churning.
> 
> We know that universal healthcare would actually be cheaper for business because they pay a lot for their portion of health insurance. So why do business campaign against it, when you wouldn’t think it’s in their best interests?
> 
> It’s because having health insurance keeps people from quitting bad jobs and work environments, or from rocking the boat asking for better working conditions or pay.  A single medical emergency can bankrupt you, and not having insurance to afford medication can literally kill you. So people won’t quit bad jobs. And companies know that.




That may be part of it - I also think it's a question of personal self-interest. They know their own income taxes will go up to provide health care for all and so they put the power of the companies they run or have a stake in behind those interests.


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## dragoner (Oct 7, 2019)

Businesses are against it for ideological reasons, people shouldn't be given something for free, nevermind that isn't true (it isn't free), except that never stopped anyone before. Same as the minimum wage shouldn't be raised because minimum wage earners don't deserve it. Somehow I think a lot of this goes back to bad education.


----------



## der_kluge (Oct 7, 2019)

This article is interesting, but I think there are a myriad of problems with making money in the game industry. Politics and economic discussions aside, for whatever reason, gamers have always notoriously been very cheap people. You need only look at the number of poor people sleeping on the floor at Gen Con to see this. I think there's historical precedence for the hobby being very cheap, and the barriers to entry into that have always been extremely low. It's not like software where you have to hire specialized talent - literally anyone who is literate can write a gaming PDF and sell it. So you have complete market saturation, and a ton of noise. That's probably the biggest problem. 

On top of that problem, you've got individuals trying to actually earn a living doing this (and some do), but those are in the minority. But the fact that some do, and then others try (and fail), continues to exacerbate the problem. Others found solutions to the healthcare issue by moving out of the country (see: Joseph and Suzi of Expeditious Retreat Press) - they also don't do gaming products, and have ventured into novels as well. 

Others are probably successful because it's not their sole income, and they might rely on the income of a spouse to get by. Years ago, when I ventured into freelance work, I got paid a nice amount for it - but even that amount wouldn't equal a teacher's salary, assuming I could do it full time.


----------



## Umbran (Oct 7, 2019)

Sacrosanct said:


> It’s because having health insurance keeps people from quitting bad jobs and work environments, or from rocking the boat asking for better working conditions or pay




Note: this only holds for very large businesses, for whom the contribution they make to employee insurance isn't a big deal.  Small to medium businesses, that often struggle to be able to afford offering insurance, would be happy if they didn't have to handle employee health benefits.


----------



## Umbran (Oct 7, 2019)

der_kluge said:


> Politics and economic discussions aside, for whatever reason, gamers have always notoriously been very cheap people.




They have always notoriously been young and poor people - until perhaps recently, the bulk of gamers have been high school and college students - people with time, but not a whole lot of money.


----------



## Sacrosanct (Oct 7, 2019)

dragoner said:


> Businesses are against it for ideological reasons, people shouldn't be given something for free, nevermind that isn't true (it isn't free), except that never stopped anyone before. Same as the minimum wage shouldn't be raised because minimum wage earners don't deserve it. Somehow I think a lot of this goes back to bad education.




A couple of things. Firstly, people aren’t wanting it for free. They want the taxes they pay to go towards that instead of tax breaks for the rich and said businesses. Secondly, if businesses were against getting something for free, then it’s pretty odd that they keep taking free money in the form of said tax breaks and subsidies  

But you’re right. Bad education is probably the cause for one of our arguments...


----------



## Sacrosanct (Oct 7, 2019)

Umbran said:


> They have always notoriously been young and poor people - until perhaps recently, the bulk of gamers have been high school and college students - people with time, but not a whole lot of money.




I don’t know about a lot of time. But we do have a lot of opinions


----------



## dragoner (Oct 7, 2019)

Sacrosanct said:


> Secondly, if businesses were against getting something for free, then it’s pretty odd that they keep taking free money in the form of said tax breaks and subsidies




Nobody is against getting something for free, they are against someone getting something for free. Get it? lol

It doesn't have to make sense, reality is pesky that way.

In my experience of running businesses, generally there is support for medical care as it's cheaper for businesses. Then we wouldn't have to offer healthcare to be competitive.


----------



## Kramodlog (Oct 7, 2019)

RPG problem? A lack of socialized health care is the problem for USians, not just RPG designers.


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## 3catcircus (Oct 7, 2019)

The problem isn't due to any particular government or healthcare system when you are specificallyb talking about artists.  The problem is really the fundamental fact that being an artist and expecting to make a great living at it requires patronage.  It's no different than in ye oldest tymes when an artist would find a wealthy patron.  Now access to art is easier, but that access comes at the price of having more patrons but less of them able to provide you a living.  With a niche like TTRPGs, the quantity of patrons is low.

This is exacerbated by distribution channels that own the copyright rather than the artist.

These two things mean that to be successful, you either need to control your own copyrights or have RPG products as only a part of your portfolio.

Now if you are talking healthcare amongst the US genpop, the issue isn't healthcare per se, it's the fact that health insurance makes healthcare so much more expensive, coupled with a US government that refuses to allow price negotiations with big pharma - the US pharma consumer subsidizes the rest of the world's pharma prices.


----------



## TheObserver (Oct 7, 2019)

Hello, just adding my two cents as an example.  I'm not a writer or designer by any means but I do make a good living working in Information Technology.  I have health insurance for my wife and myself and over the summer while I was working on crafting some terrain for D&D I cut one of my finger tips almost off doing something stupid instead of taking the time to be safe.

Well long story short my wife takes me to one of the new satellite Emergency Centers and not an Urgent Care facility.  Come to find out I didn't cut bone and didn't need even need stitches just answered questions got a shot and bandage.  Almost a month later a bills show up for close to $1500 and another one I'm assuming just showed up for $99 for the being seen by a Nurse.

To say that the US Healthcare system is broken is an understatement, but like others state there a lot of moving pieces, from Lawyers, to Doctors, nurses, insurance brokers, and the government.


----------



## Xenonnonex (Oct 7, 2019)

3catcircus said:


> The problem isn't due to any particular government or healthcare system



The issue is specifically tied to the American way of doing things. In other countries there is no where near the imbalance.


----------



## generic (Oct 7, 2019)

Xenonnonex said:


> The issue is specifically tied to the American way of doing things. In other countries there is no where near the imbalance.



The American Way of doing healthcare is complicated.  While the U.S. has one of the best medical systems in terms of technology, doctors, and medical skill, it's very difficult for many people to access these systems.


----------



## 3catcircus (Oct 7, 2019)

Xenonnonex said:


> The issue is specifically tied to the American way of doing things. In other countries there is no where near the imbalance.



No, you just have people who don't have access to healthcare at all or wait and wait.  Despite it costing more, there is a reason well-to-do people travel to the US for lifesaving procedures - better that than dying while on a waiting list (or worse, being told to just go home and die).


----------



## Xenonnonex (Oct 7, 2019)

Aebir-Toril said:


> it's very difficult for many people to access these systems.



And this frankly is ludicrous. And downright criminal and disgusting.


----------



## Xenonnonex (Oct 7, 2019)

3catcircus said:


> No, you just have people who don't have access to healthcare at all or wait and wait.  Despite it costing more, there is a reason well-to-do people travel to the US for lifesaving procedures - better that than dying while on a waiting list (or worse, being told to just go home and die).



 Greed and wealth should not be qualifiers for the access of health care.


----------



## generic (Oct 7, 2019)

Xenonnonex said:


> And this frankly is ludicrous. And downright criminal and disgusting.



In the U.S., healthcare is not considered a human right, and it is not guaranteed by the U.S. Constitution.


----------



## Xenonnonex (Oct 7, 2019)

Aebir-Toril said:


> In the U.S., healthcare is not considered a human right, and it is not guaranteed by the U.S. Constitution.



 All praise the American dream.


----------



## MGibster (Oct 7, 2019)

A lot of gamers get their start as adolescents who typically have a limited discretionary spending budgets but I don't believe we're all that cheap.  Tons of people who play D&D own all three core books and there aren't many Warhammer 40k players who I'd classify as cheap.


----------



## generic (Oct 7, 2019)

Xenonnonex said:


> All praise the American dream.



As far as I can tell, many other countries do not offer adequate healthcare systems.  In almost all countries that have healthcare systems, the rich receive higher-quality care.  Is the U.S. system broken?  Seemingly.


----------



## generic (Oct 7, 2019)

MGibster said:


> A lot of gamers get their start as adolescents who typically have a limited discretionary spending budgets but I don't believe we're all that cheap.  Tons of people who play D&D own all three core books and there aren't many Warhammer 40k players who I'd classify as cheap.



Warhammer 40k?  Expensive?  Never.

_proceeds to hide five 60 dollar boxes of minis._


----------



## 3catcircus (Oct 7, 2019)

Xenonnonex said:


> Greed and wealth should not be qualifiers for the access of health care.



It isn't. I can walk into any ER in the US and get very good care.  If I have insurance, I'll likely pay a co-payment of $100 or so.  The hospital will bill my insurance company for every doctor that sees me, every procedure performed, etc.  The bill will be for 3-4x the actual cost of care because insurance companies are in business to make money.  Those costs _also_ are inflated because of every person without insurance or other means to pay a hospital bill who decide they need an ambulance ride to the ER for a common cold.  The insurance company will accept whatever contracted costs they've negotiated with the insurance company.  The insurance company will bill me for whatever deductible is left up to my maximum out of pocket costs for the year.  The hospital will bill me for the remainder of what they claim is still owed on the bill.  I am under no obligation to pay that because they've already accepted a contracted rate from the insurance company co.

Eliminate health insurers as the gatekeepers and you solve the issue you are referring to.


----------



## Xenonnonex (Oct 7, 2019)

Aebir-Toril said:


> As far as I can tell, many other countries do not offer adequate healthcare systems.  In almost all countries that have healthcare systems, the rich receive higher-quality care.  Is the U.S. system broken?  Seemingly.



My country Australia offers adequate healthcare. The Scandinavian countries offer adequate healthcare. The UK offers adequate healthcare. These countries all offer universal medical care. It is extremely dishonest to say in these countries the rich are given higher quality care. 

In the face of this the American system is undeniably and fundamentally broken.


----------



## MGibster (Oct 7, 2019)

Not all health insurance companies are for profit entities.  The Blue Cross Clue Shield Association and Mutual of Omaha are both mutual companies.  There are no investors and by law roughly 80-85% of every dollar they bring in has to be paid out to their members.


----------



## Xenonnonex (Oct 7, 2019)

Aebir-Toril said:


> As far as I can tell, many other countries do not offer adequate healthcare systems.  In almost all countries that have healthcare systems, the rich receive higher-quality care.  Is the U.S. system broken?  Seemingly.



And how many can afford insurance or who are offered insurance? How many employers hold this insurance over employees to treat them like shite?
The health insurance systems in America are a scam really.


----------



## generic (Oct 7, 2019)

Xenonnonex said:


> My country Australia offers adequate healthcare. The Scandinavian countries offer adequate healthcare. The UK offers adequate healthcare. These countries all offer universal medical care. It is extremely dishonest to say in these countries the rich are given higher quality care.
> 
> In the face of this the American system is undeniably and fundamentally broken.



The wealthy are always given higher-quality care.  Do countries such as Australia have good healthcare systems?  Somewhat.  The U.S. system is different in that you actually have to pay for things, and citizens don't have to pay taxes to support other patients.  Many of the healthcare costs are not actually very high, although the system could surely be improved upon.


----------



## MGibster (Oct 7, 2019)

Xenonnonex said:


> And how many can afford insurance or who are offered insurance? How many employers hold this insurance over employees to treat them like shite?
> The health insurance systems in America are a scam really.




Let me put on my HR hat.  The answer is very few.  While a benefits plan is pretty important, most employees are attracted to base pay and other incentives.  Emphasizing your health plan isn't considered a good strategy for attracting or keeping talent.


----------



## generic (Oct 7, 2019)

Xenonnonex said:


> And how many can afford insurance or who are offered insurance? How many employers hold this insurance over employees to treat them like shite?
> The health insurance systems in America are a scam really.



Employer health insurance is generally very good.  Often, the U.S. makes up for its inferior medical healthcare system by virtue of its technological superiority.  The U.S. has the best medical resources of any country, this cannot be honestly refuted.


----------



## Xenonnonex (Oct 7, 2019)

Aebir-Toril said:


> The wealthy are always given higher-quality care.  Do countries such as Australia have good healthcare systems?  Somewhat.  The U.S. system is different in that you actually have to pay for things, and citizens don't have to pay taxes to support other patients.  Many of the healthcare costs are not actually very high, although the system could surely be improved upon.



You can buy higher quality care. But that is a choice. Not imposed on you by how wealthy you are. In the countries I cited everyone is treated equally in their quality of care. 
I work in the Australian healthcare system and we have an extremely high quality of healthcare system. 

The American healthcare system needs overhauling from the ground up because frankly it is a piece of shite.


----------



## Xenonnonex (Oct 7, 2019)

MGibster said:


> Let me put on my HR hat.  The answer is very few.  While a benefits plan is pretty important, most employees are attracted to base pay and other incentives.  Emphasizing your health plan isn't considered a good strategy for attracting or keeping talent.



We have laws to protect our workers.


----------



## generic (Oct 7, 2019)

Xenonnonex said:


> You can buy higher quality care. But that is a choice. Not imposed on you by how wealthy you are. In the countries I cited everyone is treated equally in their quality of care.
> I work in the Australian healthcare system and we have an extremely high quality of healthcare system.
> 
> The American healthcare system needs overhauling from the ground up because frankly it is a piece of shite.



I'm sure, as a healthcare professional, you don't have any personal bias.


----------



## 3catcircus (Oct 7, 2019)

Xenonnonex said:


> My country Australia offers adequate healthcare. The Scandinavian countries offer adequate healthcare. The UK offers adequate healthcare. These countries all offer universal medical care. It is extremely dishonest to say in these countries the rich are given higher quality care.
> 
> In the face of this the American system is undeniably and fundamentally broken.



I beg to differ - specifically to Australia.

I've of my co-workers had a medical emergency while over there.  Not immediately life-threatening, but required surgery within a few days or it would become life-threatening.  First (public) hospital turned him away because of too many people waiting.  The 2nd (public) hospital temporarily fixed him, gave him medical supplies and told him to fix it himself - there was a 3month waiting list if he wanted them to operate on him to fix permanently.  Third (private) hospital told him they could operate, but it would cost several thousand $$ unless he had private Australian health insurance.

In the US, it would have taken a few hours at any ER and then they would have had him follow up with his GP who would refer him to a specialist.  He would have been in surgery within 2 weeks.


----------



## Xenonnonex (Oct 7, 2019)

Aebir-Toril said:


> Employer health insurance is generally very good.  Often, the U.S. makes up for its inferior medical healthcare system by virtue of its technological superiority.  The U.S. has the best medical resources of any country, this cannot be honestly refuted.



 Even if the technological level is superior but very few can access essentially means that is useless.


----------



## MGibster (Oct 7, 2019)

Xenonnonex said:


> We have laws to protect our workers.




That's kind of a weird response, but, okay.  We also have laws to protect workers as well.  But that discussion is likely beyond the scope of this thread.


----------



## generic (Oct 7, 2019)

Xenonnonex said:


> Even if the technological level is superior but very few can access essentially means that is useless.



I don't think the lack of healthcare access is quite the epidemic it's often thought to be.  It's certainly bad, but it's not that bad.


----------



## 3catcircus (Oct 7, 2019)

MGibster said:


> Not all health insurance companies are for profit entities.  The Blue Cross Clue Shield Association and Mutual of Omaha are both mutual companies.  There are no investors and by law roughly 80-85% of every dollar they bring in has to be paid out to their members.



Fair enough.  But too many of them are for-profit and have near-monoplies.  Many employees and individual insurance buyers can't get access to them uniformly.


----------



## Xenonnonex (Oct 7, 2019)

Aebir-Toril said:


> I'm sure, as a healthcare professional, you don't have any personal bias.



 Yeah. We treat everyone equally despite how rich or poor they are.


----------



## Xenonnonex (Oct 7, 2019)

3catcircus said:


> I beg to differ - specifically to Australia.
> 
> I've of my co-workers had a medical emergency while over there.  Not immediately life-threatening, but required surgery within a few days or it would become life-threatening.  First (public) hospital turned him away because of too many people waiting.  The 2nd (public) hospital temporarily fixed him, gave him medical supplies and told him to fix it himself - there was a 3month waiting list if he wanted them to operate on him to fix permanently.  Third (private) hospital told him they could operate, but it would cost several thousand $$ unless he had private Australian health insurance.
> 
> In the US, it would have taken a few hours at any ER and then they would have had him follow up with his GP who would refer him to a specialist.  He would have been in surgery within 2 weeks.



 Is he an Australian citizen? The governmental structures are designed to cater to citizens as a priority. 

And then in the US he would be hammered with the medical bill.


----------



## 3catcircus (Oct 8, 2019)

Aebir-Toril said:


> I don't think the lack of healthcare access is quite the epidemic it's often thought to be.  It's certainly bad, but it's not that bad.



It's not that bad at all.  Are you gonna wait in an ER unless you have life-threatening conditions?  Yep.  Is it gonna cost you a few clams to pay for convenience of any urgent care center?  Yep.  Do many insurance companies require you to see your GP and obtain a referral to see a specialist? Yep.  Is a homeless person or illegal alien gonna be turned away from the ER to die in the streets?  Not likely.


----------



## Xenonnonex (Oct 8, 2019)

MGibster said:


> That's kind of a weird response, but, okay.  We also have laws to protect workers as well.  But that discussion is likely beyond the scope of this thread.



As in we have structures to protect a worker's pay. We have structures for universal healthcare. We have structures for retirement. Certainly many employers abuse this and try to treat people like shite. But we have laws to try to prevent this.


----------



## Xenonnonex (Oct 8, 2019)

Aebir-Toril said:


> I'm sure, as a healthcare professional, you don't have any personal bias.



I am sure that your claim was based on evidence.


----------



## Xenonnonex (Oct 8, 2019)

3catcircus said:


> It's not that bad at all.  Are you gonna wait in an ER unless you have life-threatening conditions?  Yep.  Is it gonna cost you a few clams to pay for convenience of any urgent care center?  Yep.  Do many insurance companies require you to see your GP and obtain a referral to see a specialist? Yep.  Is a homeless person or illegal alien gonna be turned away from the ER to die in the streets?  Not likely.



And then they will all get slugged with a massive healthcare bill. Good on them all I guess.


----------



## JacktheRabbit (Oct 8, 2019)

No there is nothing we can do. It is called market economy. 

There are lots of people in the world who wish they could live off their hobbies. Wanting to live off bring a game designer sounds like fun. A vast majority find it doesn't work, there is nothing inherently wrong with that truth.


----------



## 3catcircus (Oct 8, 2019)

Xenonnonex said:


> Is he an Australian citizen? The governmental structures are designed to cater to citizens as a priority.
> 
> And then in the US he would be hammered with the medical bill.



Hammered with the bill?  Nope.  He had to use a credit card to pay for surgery in Australia.  $6500.

Had it happened at home, he'd have had to pay a $150 co-pay at the ER, a $30 co-pay for the followup with his GP and a $50 copay to see the referred specialist before scheduling surgery - and a deductible of up to $2500 minus whatever he had already paid for the year for the surgery.

I've had to take my kids to the ER multiple times this year (sports/pkayground injuries primarily).  $150 each visit, and I get a bill from the insurance co for the deductible which averaged $125 each time.  Had to see orthopaedics for them as a follow- up.  $50/visit.  That's it.  I also pay premiums each month, but those are pre-tax dollars, so it is essentially the same as taxes.

The difference is your Australian healthcare costs are baked into your taxes already.  And you still have to pay for private insurance to get the same access as people in the US get to our healthcare system.


----------



## JacktheRabbit (Oct 8, 2019)

Reynard said:


> I honestly dont think you can discuss this issue without talking about the healthcare system in America, and you can't do that without talking about politics in America. They are all fundamentally tied together.



This topic is not about either of them. 

You try to make a career out of something that pays very poorly and this is what happens. You become unable to handle financial hardship when it happens. 

Trying to blame politics and the current medical system because it does not allow you to follow your dreams no matter how poorly funded those dreams are does not mean the system is broken.


----------



## Xenonnonex (Oct 8, 2019)

3catcircus said:


> Hammered with the bill?  Nope.  He had to use a credit card to pay for surgery in Australia.  $6500.
> 
> Had it happened at home, he'd have had to pay a $150 co-pay at the ER, a $30 co-pay for the followup with his GP and a $50 copay to see the referred specialist before scheduling surgery - and a deductible of up to $2500 minus whatever he had already paid for the year for the surgery.
> 
> ...



If he was an Australian citizen and underwent emergency surgery he would have had to pay nothing. Zilch. In a public hospital. 
Our health insurance is for other things not for fundamental healthcare. That is the fundamental difference.


----------



## 3catcircus (Oct 8, 2019)

Xenonnonex said:


> If he was an Australian citizen and underwent emergency surgery he would have had to pay nothing. Zilch. In a public hospital.
> Our health insurance is for other things not for fundamental healthcare. That is the fundamental difference.



That isn't true.  Your taxes pay for Medicare, which is funded by general revenue and a 2% mandatory levy unless you are poor.  And you pay an additional levy if you are a high-income earner and don't buy private insurance.  Your costs are all upfront but you are still paying.


----------



## Xenonnonex (Oct 8, 2019)

3catcircus said:


> That isn't true.  Your taxes pay for Medicare, which is funded by general revenue and a 2% mandatory levy unless you are poor.  And you pay an additional levy if you are a high-income earner and don't buy private insurance.  Your costs are all upfront but you are still paying.



I never claimed that our taxes are not high. But with regards to surgery and healthcare in general we do not need to pay for. And importantly everyone has a right to. 
You are not paying on top of anything. 

And yes there are some systems to protect the poor unlike the States which are more likely to make more people poor.


----------



## generic (Oct 8, 2019)

Xenonnonex said:


> I am sure that your claim was based on evidence.



It was, actually.  My expertise is not in economics, but, I think it's plain to see, if you read any study conducted by honest groups, that my claims were, in fact, not fraudulent.


----------



## Xenonnonex (Oct 8, 2019)

Aebir-Toril said:


> It was, actually.  My expertise is not in economics, but, I think it's plain to see, if you read any study conducted by honest groups, that my claims were, in fact, not fraudulent.



As evidenced though they are not true.


----------



## generic (Oct 8, 2019)

Xenonnonex said:


> As evidenced though they are not true.



What?  I'm sorry, maybe I misunderstood you.  But, are you saying that all of these studies are awful and fraudulent, or are you remarking on my post?


----------



## Xenonnonex (Oct 8, 2019)

Aebir-Toril said:


> What?  I'm sorry, maybe I misunderstood you.  But, are you saying that all of these studies are awful and fraudulent, or are you remarking on my post?



Your claim that the wealthy are always given higher quality care is untrue. And countries like Australia do have good healthcare systems. 

I agree that the American healthcare system surely needs to be improved upon.


----------



## generic (Oct 8, 2019)

Xenonnonex said:


> Your claim that the wealthy are always given higher quality care is untrue. And countries like Australia do have good healthcare systems.
> 
> I agree that the American healthcare system surely needs to be improved upon.



Australia has a fine and decent system, agreed.  However, the wealthy are always able to afford better insurance, private insurance, immediate or prolonged medical aid unless private insurance is abolished entirely.

Maybe that's what's needed, but it does bring up certain difficulties.


----------



## 3catcircus (Oct 8, 2019)

Xenonnonex said:


> I never claimed that our taxes are not high. But with regards to surgery and healthcare in general we do not need to pay for. And importantly everyone has a right to.
> You are not paying on top of anything.
> 
> And yes there are some systems to protect the poor unlike the States which are more likely to make more people poor.



How can you not see that you are paying for your healthcare costs through higher taxes?  You don't need to pay at time of service for surgery or healthcare _because_ you've prepayed it.  

The truly poor in the US are protected because those of us who have health insurance pay more than we ought to because the higher cost covers uninsured patients.  No one gets turned away from the ER in the US.


----------



## Xenonnonex (Oct 8, 2019)

Aebir-Toril said:


> Australia has a fine and decent system, agreed.  However, the wealthy are always able to afford better insurance, private insurance, immediate or prolonged medical aid unless private insurance is abolished entirely.
> 
> Maybe that's what's needed, but it does bring up certain difficulties.



However everyone is guaranteed quite a high quality of healthcare regardless of your social level in Australia. Being wealthy in Australia gives you the same level of care as someone really poor. You can choose to go private but that is your choice.


----------



## generic (Oct 8, 2019)

Xenonnonex said:


> However everyone is guaranteed quite a high quality of healthcare regardless of your social level in Australia. Being wealthy in Australia gives you the same level of care as someone really poor. You can choose to go private but that is your choice.



Can you honestly say that?  Choosing to use private insurance offers an inherent benefit.  Also, in the U.S., no one is refused emergency care, and U.S. taxes are far lower than in Australia.  I agree that the U.S. system is not great, and has many flaws, but it really isn't as unbearable and ponderous as you propose.


----------



## Xenonnonex (Oct 8, 2019)

3catcircus said:


> How can you not see that you are paying for your healthcare costs through higher taxes?  You don't need to pay at time of service for surgery or healthcare _because_ you've prepayed it.
> 
> The truly poor in the US are protected because those of us who have health insurance pay more than we ought to because the higher cost covers uninsured patients.  No one gets turned away from the ER in the US.



We are paying all sorts of things with our higher taxes. Roads, schools, the healthcare system, the military, etc. The imbalance is where the taxes are going. In America they are not going to the healthcare system. They are even really going to schools. They are going to the military. 

I am not saying no one is turned away. I am saying they were hit really hard with the bill as the aftermath. Which is why so many in the middle class have gone to poverty after entering the American healthcare system. 
In Australia you would not need or even have a gofundme for health issues.


----------



## Xenonnonex (Oct 8, 2019)

Aebir-Toril said:


> Can you honestly say that?  Choosing to use private insurance offers an inherent benefit.  Also, in the U.S., no one is refused emergency care, and U.S. taxes are far lower than in Australia.  I agree that the U.S. system is not great, and has many flaws, but it really isn't as unbearable and ponderous as you propose.



Yes. I can. I work in the public health system. Our catchment has lots of well off patients. And lots of poor patients. And homeless patients. We and our hospital treats them all equally. We cannot prevent people from absconding but everyone is given the same quality of care.
Just because you believe that is not possible does not mean it does not happen.


----------



## generic (Oct 8, 2019)

Xenonnonex said:


> Yes. I can. I work in the public health system. Our catchment has lots of well off patients. And lots of poor patients. And homeless patients. We and our hospital treats them all equally. We cannot prevent people from absconding but everyone is given the same quality of care.
> Just because you do not believe that is not possible does not mean it does not happen.



The exact same thing occurs in the U.S., but you have to pay for it. 

I think we can both see the flaw here.


----------



## Xenonnonex (Oct 8, 2019)

Aebir-Toril said:


> The exact same thing occurs in the U.S., but you have to pay for it.
> 
> I think we can both see the flaw here.



You do get the unequal distribution in America. Choosing to use private insurance has inherent benefit there.
Choosing to use private insurance in Australia carries a choice only but has no inherent benefit. 

I think we can both see the flaw here.


----------



## generic (Oct 8, 2019)

Xenonnonex said:


> You do get the unequal distribution in America. Choosing to use private insurance has inherent benefit there.
> Choosing to use private insurance in Australia carries a choice only but has no inherent benefit.
> 
> I think we can both see the flaw here.



Explain, with evidence, please.  How does having private insurance not benefit you in Australia?


----------



## Xenonnonex (Oct 8, 2019)

Aebir-Toril said:


> Explain, with evidence, please.  How does having private insurance not benefit you in Australia?



I am saying private health insurance in Australia has no inherent benefit to the universal and attention to high quality of care in public hospitals.

A lot of people choose not to have private health insurance in Australia as evidenced on patient records. And still receive the same quality of care.


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## generic (Oct 8, 2019)

Xenonnonex said:


> I am saying private health insurance in Australia has no inherent benefit to the universal and attention to high quality of care in public hospitals.



It is identical in the U.S., but costs are transferred to the person in need of care, rather than the taxpayer base.


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## Xenonnonex (Oct 8, 2019)

Aebir-Toril said:


> It is identical in the U.S., but costs are transferred to the person in need of care, rather than the taxpayer base.



A lot of people choose not to have private health insurance in Australia as evidenced on patient records. And still receive the same quality of care.

Explain then the phenomenon of people made destitute after entering the American healthcare system. Not just destitute but homeless.

Explain the high amount of gofundme campaigns for health issues in America. You would not have this in Australia.


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## generic (Oct 8, 2019)

Xenonnonex said:


> A lot of people choose not to have private health insurance in Australia as evidenced on patient records. And still receive the same quality of care.
> 
> Explain then the phenomenon of people made destitute after entering the American healthcare system.



*Mod Edit:* Folks, this poster was apparently working off data from the 1960s.  The author has recognized that this is not an accurate representation of today.  Please do not jump down their throat about it further.  Thanks.  ~Umbran


Yes.

People. Receive. The. Same. Quality. Of. Care.

Regardless of income, in the U.S.

Being made destitute by healthcare costs is an uncommon, and unfortunate occurrence.  Once again, the system of the U.S. should be changed, but it's dishonest to say that people are often made destitute by healthcare costs.

The average cost of an ER operation is (I believe) $350, not including the fraction of cost deducted as a result of deduction eligibility.


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## Xenonnonex (Oct 8, 2019)

Aebir-Toril said:


> Yes.
> 
> People. Receive. The. Same. Quality. Of. Care.
> 
> ...



The costs inherent in that quality of care is extremely unequal. And it is extremely curious that you are trying to downplay this.
My point is that in America you actually need health insurance to alleviate the costs of healthcare. This is not needed in Australia.

My point is that in America people wait and wait and wait to enter the healthcare system. Because it is prohibitive in ways. In Australia everyone enters the healthcare system equally.

My point is that in America people actually need to resort to gofundme campaigns to be able to afford services for health issues. 

Claiming that everyone receives the same quality of healthcare in America is disingenuous.

My point is that being made destitute because of healthcare costs in America is something that should not happen. At all.
You have a dishonest reading of people often made destitute by the American healthcare system. I just wanted an explanation for the phenomenon of it happening.

Even our tax payer base is organized more equally.


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## dragoner (Oct 8, 2019)

America has +50% or more higher medical costs due to administrative costs that countries like Australia do not have in their system. Americans also pay more because the American medical system is a for profit industry. The care that the poor get is minimal, but that too gets price gouged when the palliative care costs 100 times the preventive care would have. The rich leave the US for medical care, going to places like Singapore for medical tourism. Ryan went to Canada for example.


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## Xenonnonex (Oct 8, 2019)

dragoner said:


> America has +50% or more higher medical costs due to administrative costs that countries like Australia do not have in their system. Americans also pay more because the American medical system is a for profit industry. The care that the poor get is minimal, but that too gets price gouged when the palliative care costs 100 times the preventive care would have. The rich leave the US for medical care, going to places like Singapore for medical tourism. Ryan went to Canada for example.



Careful though. You might get Aebir-Toril saying "People. Receive. The. Same. Quality. Of. Care. Regardless of income in the US" again.


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## dragoner (Oct 8, 2019)

Xenonnonex said:


> Careful though. You might get Aebir-Toril saying "People. Receive. The. Same. Quality. Of. Care. Regardless of income in the US" again.




Right, because the rich would be fine with going to some crumbling, understaffed, mersa filled bedlam. Certainly people in America are in denial about how bad poverty is in America, tens of millions live in 3rd world conditions. Extreme poverty in America: read the UN special monitor's report


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## Xenonnonex (Oct 8, 2019)

dragoner said:


> Right, because the rich would be fine with going to some crumbling, understaffed, mersa filled bedlam. Certainly people in America are in denial about how bad poverty is in America, tens of millions live in 3rd world conditions. Extreme poverty in America: read the UN special monitor's report



That is quite damning. And extremely alarming.


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## Reynard (Oct 8, 2019)

JacktheRabbit said:


> This topic is not about either of them.
> 
> You try to make a career out of something that pays very poorly and this is what happens. You become unable to handle financial hardship when it happens.
> 
> Trying to blame politics and the current medical system because it does not allow you to follow your dreams no matter how poorly funded those dreams are does not mean the system is broken.




This actually helps bring the thread back on topic. Thank you.

Careers in the arts are often considered bad choices and people are expected to willingly receive substandard compensation for choosing careers in the arts compared to, say, finance? Why? Well, our culture worships money, so that's part of it. But video games make billions, and still most of the rank and file designers - most extremely talented in their disciplines - are terribly under paid for their efforts ( especially during lead up to launch "crunch") and are stymied at every turn to organize.

It isn't just that America has a bad health care system. It's also that America devalues the arts and therefore people in the arts are more impacted than other industries.


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## Greatwyrm (Oct 8, 2019)

Xenonnonex said:


> We are paying all sorts of things with our higher taxes. Roads, schools, the healthcare system, the military, etc. The imbalance is where the taxes are going. In America they are not going to the healthcare system. They are even really going to schools. They are going to the military.




I don't care where anybody is on the health insurance part, but this "all the spending is Military" thing is a very popular misconception.

USAspending.gov  select FY 2018, since that's the last year with complete data.

Medicare (generally healthcare for old people) $1.1T
National Defense $995.6B

So, we spend very similar amounts for Defense and Medicare.  This doesn't include spending on Medicaid (generally for the poor or disabled) which is funded jointly by the Federal and State governments.

"But the U.S. only spent $129.5B on Education!"  Yes, at the Federal level.  Most Education spending is by State and Local governments.  The most recent official document I could find quickly is for FY 2017.

U.S. School Spending Per Pupil Increased for Fifth Consecutive Year

"In 2017, public elementary and secondary education revenue, from all sources, amounted to $694.1 billion, up 3.4% from $671.2 billion in 2016."

Which is roughly 2/3 of Defense spending, and doesn't include college spending.


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## Sacrosanct (Oct 8, 2019)

Aebir-Toril said:


> .
> 
> The average cost of an ER operation is (I believe) $350, not including the fraction of cost deducted as a result of deduction eligibility.




This is simply not true. I have what is considered good insurance (the most expensive Kaiser plan). Last October, my son had to go to the ER for splitting his nose open. 15 stitches. 15 minutes of work. The hospital billed $4000 and then the doctor billed $2000 additional. My deductible is $6000 a year per family, and since they happened to be out of network, I was pretty much stuck with the whole thing. For a minor procedure.  My situation isn’t that uncommon. An ambulance ride costs $10K, god forbid if anyone has to take one. 

Sorry, but you’re grossly mistaken on your assumption.


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## Ace (Oct 8, 2019)

This is a sad outcome for all 

This is a combination of our so called RPG industry actually being a hobby with only a miniscule number of decently paid positions and the fact the US (and note other nations do not have this issue) not having a national health care system like pretty much every other developed and many less developed nations do. 

The industry itself  is beyond changing and going back to the 90's say where a small RPG publisher of something like Talislanta could make a decent living is simply not possible for a great many reasons. 

As for   changing the US healthcare system? That  isn't impossible buts it's difficult as soon as any real change looks to take place a flood of money from vested interests  puts an end to that.  You need to have people in office who are smarter than the current crowd,  resistant to campaign contributions and the rest of our essentially legalized bribery   well liked enough to avoid the massive flows of money that every challenger will get when they try  and dedicated to actual reform.

Keep in mind that national health care will gut the profits of big pharma (cost controls are integral to such systems) and the health insurance industry both of whom are larger than actual industry 

That's a lot of opposition and vested interests and limitless cash opposing you. They can and would spend billions so the opposition would have to be more plucky than any resistance. 

Basically to do this  you need FDR 2 x 400 or so

This is not a party issue however 

 Certainly the Democratic party has been proven  more amenable to national health care that the Republicans but the Affordable Care Act which demonstratively showed the Democrats  can't do it right either. 

After all the Democrats on a party line vote controlling the House, Senate and Presidency could not manage a good bill and the health care problems we have may have even gotten worse. The bill was essentially rewritten by lobbyists and in order to pass something, they passed a bill they didn't read and that isn't working as intended.


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## Ace (Oct 8, 2019)

Sacrosanct said:


> Absolutely agree with this. It really comes down to what is the market willing to pay a person for X. Love it or hate it, it’s capitalism.




This is why many nations have a national health care system and a welfare state, This  serves to buffer the effects of the market and someone in the UK for example won't go without basic healthcare or  food  no matter how they make a living.

The US culture is rather different though. It's not European and it may not be possible to impose solutions that would work great in the UK or Sweden or France here.   

There are a ton of reasons for this, none of them up for discussion but I think it's not too controversial to say that nearly everyone agrees  that the US  political system is poor at problem solving.

Massive amounts of political involvement might be able to fix it  but this won't help folks now and that leaves aid up to this community.


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## Xenonnonex (Oct 8, 2019)

dragoner said:


> Americans also pay more because the American medical system is a for profit industry.



This is another fundamental difference with the Australian public healthcare system. Our KPIs are patient focused and patient driven.


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## Xenonnonex (Oct 8, 2019)

Sacrosanct said:


> This is simply not true. I have what is considered good insurance (the most expensive Kaiser plan). Last October, my son had to go to the ER for splitting his nose open. 15 stitches. 15 minutes of work. The hospital billed $4000 and then the doctor billed $2000 additional. My deductible is $6000 a year per family, and since they happened to be out of network, I was pretty much stuck with the whole thing. For a minor procedure.  My situation isn’t that uncommon. An ambulance ride costs $10K, god forbid if anyone has to take one.
> 
> Sorry, but you’re grossly mistaken on your assumption.



Something that requires $6000 is a massive blowout from the $350 average that is being disingenuously claimed.

Even discounting the cost of an ambulance ride that is an absurd amount just for stitching. Imagine if it was a transplant or an ORIF operation. Imagine if it was a more serious OR operation.


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## Sacrosanct (Oct 8, 2019)

Xenonnonex said:


> Something that requires $6000 is a massive blowout from the $350 average that is being disingenuously claimed.
> 
> Even discounting the ambulance ride that is an absurd amount just for stitching. Imagine if it was a transplant or an ORIF operation. Imagine if it was a more serious OR operation.





He never had an ambulance ride. That would have been 10k just by itself. The $4000 was from the hospital just to use the building. The $2000 was from the doctor for the actual procedure. 

And it’s doubly problematic when hospitals and doctors don’t have to tell you costs up front, and don’t have to itemize charges. 

That was $6000 for stitches. So yeah, medical issues in the US absolutely can bankrupt someone, and it doesn’t take much. To claim otherwise is simply ignorance of the health care system


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## Xenonnonex (Oct 8, 2019)

Sacrosanct said:


> He never had an ambulance ride. That would have been 10k just by itself. The $4000 was from the hospital just to use the building. The $2000 was from the doctor for the actual procedure.
> 
> And it’s doubly problematic when hospitals and doctors don’t have to tell you costs up front, and don’t have to itemize charges.
> 
> That was $6000 for stitches. So yeah, medical issues in the US absolutely can bankrupt someone, and it doesn’t take much. To claim otherwise is simply ignorance of the health care system



Yeah I know. My post regarding that was a bit unclear though. I have edited my post. 

Yeah. I have heard the hospital slaps the patient with quite an obscene medial bill after the fact. And can lead to quite a number of people being made homeless simply for using medical and surgical services.  
That is fundamentally wrong.


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## Sacrosanct (Oct 8, 2019)

“The average cost for a visit to the emergency room was $1,389 in 2017, according to a study by Health Care Cost Institute, which reviewed millions of claims over a 10-year period.”

It’s more now, I guarantee lol. Those are claims being factored from 2007 to 2017. Costs have skyrocketed since 2007, so I wouldn’t be surprised to assume its $2000 on average now. For basic things like infections and strep (things people go to the ER for)


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## Xenonnonex (Oct 8, 2019)

Sacrosanct said:


> “The average cost for a visit to the emergency room was $1,389 in 2017, according to a study by Health Care Cost Institute, which reviewed millions of claims over a 10-year period.”
> 
> It’s more now, I guarantee lol. Those are claims being factored from 2007 to 2017. Costs have skyrocketed since 2007, so I wouldn’t be surprised to assume its $2000 on average now. For basic things like infections and strep (things people go to the ER for)



Frankly that is really F'd up.

And it just cements that his claim was pulled out of his Uranus.


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## billd91 (Oct 8, 2019)

Sacrosanct said:


> This is simply not true. I have what is considered good insurance (the most expensive Kaiser plan). Last October, my son had to go to the ER for splitting his nose open. 15 stitches. 15 minutes of work. The hospital billed $4000 and then the doctor billed $2000 additional. My deductible is $6000 a year per family, and since they happened to be out of network, I was pretty much stuck with the whole thing. For a minor procedure.  My situation isn’t that uncommon.




I have a sneaking suspicion that the ER might also have been designated a trauma center and a trauma team, or part of one, was activated for potential need. That drives ER fees up dramatically.


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## Michael O'Brien (Oct 8, 2019)

TheObserver said:


> Well long story short my wife takes me to one of the new satellite Emergency Centers and not an Urgent Care facility.  Come to find out I didn't cut bone and didn't need even need stitches just answered questions got a shot and bandage.  Almost a month later a bills show up for close to $1500 and another one I'm assuming just showed up for $99 for the being seen by a Nurse.




Whereas here in Australia our 15 yo son recently broke his collarbone playing soccer, which required a visit to the ER with x-rays etc, and several follow-up visits to the fracture clinic with more x-rays. Total cost was $12, and that's only because we bought an extra sling to the one the hospital provided. Otherwise it would have been zero. No worries about deductibles, or if any of the medical staff were somehow "out of network", or if the insurance company's rules had changed, and so on. I am happy to pay for that certainty and peace of mind through the Medicare levy in my taxes (and help pay for those in our society who would otherwise not be able to afford it, usually through no fault of their own).

To tie this back to the topic at hand, in 2015 I took on a great risk giving up my career in higher ed to become part of the new management at Chaosium, which was in very bad shape at the time. In part, my family and I could take this risk because, living in Australia, there is the medical safety net of a universal health care system that is not tied to employment and has no pre-existing conditions, annual caps etc. so we'd all be covered if any health issues arose.


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## jedijon (Oct 8, 2019)

I wonder how pastors feel. Or the small business owner. Or anyone else self-employed. Heck, even those folks on corners.

I know my grandpa stressed a lot at the end of his life that his pension earned by working for twenty plus years at a low-wage factory job would last. That was after stints as a tavern owner and cabbage farmer.

Like him, I’d have a hard time asking people to support me financially just because they liked/pitied me—but I’m glad there’s a format for some subset of the needy to get their needs met.


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## Reynard (Oct 8, 2019)

jedijon said:


> I wonder how pastors feel. Or the small business owner. Or anyone else self-employed. Heck, even those folks on corners.
> 
> I know my grandpa stressed a lot at the end of his life that his pension earned by working for twenty plus years at a low-wage factory job would last. That was after stints as a tavern owner and cabbage farmer.
> 
> Like him, I’d have a hard time asking people to support me financially just because they liked/pitied me—but I’m glad there’s a format for some subset of the needy to get their needs met.



If the folks we are talking about here were fairly compensated for their work and provided lifelong royalties on the continued monetization of that work, it would be less of an issue. Gig economy. Work for hire. Freelance. It's all for the benefit of the company, not the worker or creator.


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## jasper (Oct 8, 2019)

Michael O'Brien said:


> ...
> 
> To tie this back to the topic at hand, in 2015 I took on a great risk giving up my career in higher ed to become part of the new management at Chaosium, which was in very bad shape at the time. In part, my family and I could take this risk because, living in Australia, there is the medical safety net of a universal health care system that is not tied to employment and has no pre-existing conditions, annual caps etc. so we'd all be covered if any health issues arose.



So the taxpayers and government help paid one of your business expenses. 
In general all small businesses, artists, and self employed people are living on the edge. And we do respect some artists. How much money did Michael Jackson estate,  Prince estate, Beyoncé, bring in last year? 1% of the artists are going to make 99% of the dough. 
Possible solutions other than fund raisers. Artists Union or Co-op or what ever, where you band together to buy health care plans. Find out what a health care plan costs per year and add that into your prices.


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## eyeheartawk (Oct 8, 2019)

jedijon said:


> I wonder how pastors feel.




Probably pretty good, I imagine. With churches not having to pay any kind of tax.



jasper said:


> So the taxpayers and government help paid one of your business expenses.
> In general all small businesses, artists, and self employed people are living on the edge. And we do respect some artists. How much money did Michael Jackson estate,  Prince estate, Beyoncé, bring in last year? 1% of the artists are going to make 99% of the dough.
> Possible solutions other than fund raisers. Artists Union or Co-op or what ever, where you band together to buy health care plans. Find out what a health care plan costs per year and add that into your prices.




Yikes. 

What you call a business expense I call a fundamental human right, but you know, tomato tomatoe. 

If we want to talk about who's living large off of the government hog it would be the corporations who benefit massively from sanctioned tax breaks and loopholes and pay often zero income tax (see GE, Amazon, Walmart etc).

Plus, think about how many small business don't get started, or inventions not invented because people couldn't take the risk of losing access to healthcare via their current employer's health coverage. 

Also, keep in mind, with automation coming and eliminating a large amount of jobs-with nothing in the pipe to replace them- in the not so distant future having a system where healthcare is provided by employers will no longer be tenable as far more people will be unemployed then there are now. From a purely practical standpoint this would need to change. 

That is of course, if one cares about poor people having access to quality healthcare. As it is, and has always been, a fundamentally moral question.


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## generic (Oct 8, 2019)

Sacrosanct said:


> This is simply not true. I have what is considered good insurance (the most expensive Kaiser plan). Last October, my son had to go to the ER for splitting his nose open. 15 stitches. 15 minutes of work. The hospital billed $4000 and then the doctor billed $2000 additional. My deductible is $6000 a year per family, and since they happened to be out of network, I was pretty much stuck with the whole thing. For a minor procedure.  My situation isn’t that uncommon. An ambulance ride costs $10K, god forbid if anyone has to take one.
> 
> Sorry, but you’re grossly mistaken on your assumption.



Apologies, I was looking at old data.  As far as I can tell, the data I was looking at is a *lot *older than I initially thought, sorry.

I still agree with @Xenonnonex that the American healthcare system should be socialized.  It simply isn't fair the way its organized right now.


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## Michael O'Brien (Oct 8, 2019)

jasper said:


> So the taxpayers and government help paid one of your business expenses.




No, health care in Australia isn't a "business expense" - it is funded through our taxation system. There is a levy of 2%, part of income taxes.



jasper said:


> Possible solutions other than fund raisers. Artists Union or Co-op or what ever, where you band together to buy health care plans.




Hey, good idea! In Australia everyone*, *the *entire population* that is, banded together to set up our universal health care system about 50 years ago. Such "banding together" brings the costs of health care down dramatically, for *everyone*.



eyeheartawk said:


> Plus, think about how many small business don't get started, or inventions not invented because people couldn't take the risk of losing access to healthcare via their current employer's health coverage.




Yep, exactly my point about being able to take the risk of changing careers and undertake the risky venture of helping bring Chaosium back from the brink of disaster, in part because I didn't have to worry about health care coverage for me or my family due to Australia's universal health care system.


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## jasper (Oct 8, 2019)

Michael O'Brien said:


> No, health care in Australia isn't a "business expense" - it is funded through our taxation system. There is a levy of 2%, part of income taxes.
> 
> 
> 
> Hey, good idea! In Australia everyone*, *the *entire population* that is, banded together to set up our universal health care system about 50 years ago. Such "banding together" the costs of health care down dramatically, for *everyone*.



The whole point of the OP is talking about U.S.A. health care and RPG producers being unable to afford it.


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## Reynard (Oct 8, 2019)

eyeheartawk said:


> That is of course, if one cares about poor people having access to quality healthcare. As it is, and has always been, a fundamentally moral question.




Not necessarily. it is actually a fundamentally economic question, because an unhealthy population is unproductive and workers that are tied to their jobs because that's where they get their benefits can't easily move throughout the economy when conditions change. Most of the world understands this, but the brand of American capitalism that saw the rise of the Gilded Age remains influential here. Our culture is twisted up with a "great man" mythology that actively hampers progressive development. We call Jeff Bezos a genius even though he is using infrastructure built by everyone else's effort and taxes, and we call the homeless man a lazy slob even though the system we designed put him on the street. It's the American way.


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## Reynard (Oct 8, 2019)

jasper said:


> The whole point of the OP is talking about U.S.A. health care and RPG producers being unable to afford it.




Yeah. And he said it was the health care system in Australia that allowed him to go all in to the RPG business. It's called a counter example.


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## generic (Oct 8, 2019)

Reynard said:


> Not necessarily. it is actually a fundamentally economic question, because an unhealthy population is unproductive and workers that are tied to their jobs because that's where they get their benefits can't easily move throughout the economy when conditions change. Most of the world understands this, but the brand of American capitalism that saw the rise of the Gilded Age remains influential here. Our culture is twisted up with a "great man" mythology that actively hampers progressive development. We call Jeff Bezos a genius even though he is using infrastructure built by everyone else's effort and taxes, and we call the homeless man a lazy slob even though the system we designed put him on the street. It's the American way.



Meanwhile, while we call Jeff Bezos a genius, we defund actual research, and spend more on maintaining our outdated military infrastructure than we spend on NASA.  We spend more on *lip gloss* than NASA and new medical research combined.


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## eyeheartawk (Oct 8, 2019)

Michael O'Brien said:


> Yep, exactly my point about being able to take the risk of changing careers and undertake the risky venture of helping bring Chaosium back from the brink of disaster, in part because I didn't have to worry about health care coverage for me or my family due to Australia's universal health care system.




Yeah, thanks Australia! 

Seriously, your guys' work to bring Chaosium back to where it should be from the shambling corpse of most of the Krank era is most appreciated!


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## cmad1977 (Oct 8, 2019)

Ancalagon said:


> This is not a RPG problem.
> 
> This is a "why the hell doesn't the USA have universal health care" problem.




It’s called ‘freedom’.


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## billd91 (Oct 8, 2019)

Aebir-Toril said:


> Meanwhile, while we call Jeff Bezos a genius, we defund actual research, and spend more on maintaining our outdated military infrastructure than we spend on NASA.  We spend more on *lip gloss* than NASA and new medical research combined.




And, honestly, whether in a mixed economy or in a laissez-faire capitalist economy, it's not unreasonable that collectively more money gets spent on lip gloss than NASA. There's nothing inherently wrong with a lot of people liking lip gloss (unless it's really environmentally damaging) and buying it with their discretionary incomes.
The problems really come from prioritization at the political level - specifically, prioritizing maximizing incomes at the higher levels vs directing society's riches toward developing science and technology via grants and improving collective health.


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## Dire Bare (Oct 8, 2019)

So, what can be done?

We can advocate to our political representatives to improve our national healthcare system, perhaps the "Medicare for All" plan Bernie's put forth. But even if Bernie or Warren gets to be our next president, making that big of a change is going to be tough.

Those of us considering careers as creatives, game designers or otherwise, can go in with our eyes wide open and try to better manage our current and future financial and healthcare situations. We can demand to be paid fairly and/or try to leverage self-publishing. Get educated on wise financial practices and healthcare options for those who don't get benefits through work. Consider keeping that "day job". Or move to Australia! 

Consumers can support gaming companies that pay their employees and freelancers fairly. Dig for the info on how a company compensates and treats their creatives and reward the good companies and avoid the bad ones. Stop being cheap bastards and accept that a quality product is going to cost some money. We have folks on these boards who are offended simply by the existence of "luxury" gaming products, regardless of whether they are interested in the product itself or can afford it.


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## Robyo (Oct 8, 2019)

Medicare for all.


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## Dire Bare (Oct 8, 2019)

Robyo said:


> Medicare for all.




This is the political aspect of our discussion, of course. But if we did have "universal healthcare" or "socialized healthcare", we would be creating a society where folks don't have to worry about healthcare the way we do now in America. You could choose any career, make any amount of money, or even have severe mental/physical handicaps that limit your options and put you onto the street . . . . and you would not have to worry about receiving quality, basic healthcare. Those aging creatives who never made enough money for good preventative healthcare when they were young, and have no savings now for healthcare as they get older, they would be okay (at least, their health would be).

And of course, under the current system, even those of us with good jobs and good health plans are one health disaster away from financial ruin. Even a simple visit to the ER for stitches can put a severe financial strain on a family.

Medicare for All sounds pretty good to me. Will my taxes go up? Yes. But my high deductible, co-pays, and out-of-pocket expenses for healthcare would (mostly) go away and I'd be better off in the balance. Will my taxes go to support the healthcare of folks who "don't deserve it"? No, because everyone, including the most incompetent and lazy humans on the planet, deserve quality healthcare. I'm totally cool with my taxes supporting that! Much more comfortable than I am with my taxes going to the many never-ending wars my country is involved in that don't really improve the safety of American citizens.

It's fun to get that out on ENWorld!


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## generic (Oct 8, 2019)

billd91 said:


> And, honestly, whether in a mixed economy or in a laissez-faire capitalist economy, it's not unreasonable that collectively more money gets spent on lip gloss than NASA. There's nothing inherently wrong with a lot of people liking lip gloss (unless it's really environmentally damaging) and buying it with their discretionary incomes.
> The problems really come from prioritization at the political level - specifically, prioritizing maximizing incomes at the higher levels vs directing society's riches toward developing science and technology via grants and improving collective health.



Correct, the lip gloss example is a commonly-cited, but somewhat silly, statistic.  I agree completely.


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## GrahamWills (Oct 8, 2019)

dragoner said:


> Businesses are against it for ideological reasons,



This is getting perilously close to being pure politics, but as a point of fact businesses are not against it. Small businesses in fact are generally way in favor of it (for obvious reasons). However health care businesses tend to be against it (again for obvious reasons) and they have significant political power in the US, whereas small businesses have almost none.


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## GrahamWills (Oct 8, 2019)

Aebir-Toril said:


> it's dishonest to say that people are often made destitute by healthcare costs.
> 
> The average cost of an ER operation is (I believe) $350, not including the fraction of cost deducted as a result of deduction eligibility.



66.5 percent of all bankruptcies were tied to medical issues (This is the real reason most Americans file for bankruptcy)

500,000 people go bankrupt every year because they cannot pay their  medical bills (https://www.washingtonpost.com/poli...s-flawed-statistic-medical-bankruptcies-year/)

The average emergency room expense for uninsured persons in 2008 was $1,265. This includes $150-$3,000 for the base visit;Services, diagnostic tests and laboratory fees which will add to that; doctor's fees, and which are added separately (How Much Does an Emergency Room Visit Cost? - CostHelper.com). This does not include ambulance fees ($400-$1,200) and assume the patent does not stay overnight.


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## GrahamWills (Oct 8, 2019)

eyeheartawk said:


> _> How are pastors feeling_
> Probably pretty good, I imagine. With churches not having to pay any kind of tax.




I dunno. Our church is in a pretty well off area, and yet when I look at our 2019 budget, we budget $112,000 for out three pastors (http://onecumc.net/wp-content/uploads/2019-Budget-Approved.pdf) which isn't exactly a stunning amount each. We pay $220,000 for our other salaries (which are not exempt from tax).

We pay $12,369 FICA tax; and $45,000 for health insurance (you can see full details in the linked form). I'm not sure I'd characterize anyone's feelings as "pretty good".

Bringing this back on track though; I do agree that pastors are not really in the same "gig economy" as writers. It's really the other salaries/wages our church pays out that are comparable, basically part-time / gig work for Child care providers, Band / Musicians, Organists, Teachers and a few other roles.

I was on the HR committee and it's a pretty awful feeling looking at people who are working their asses off for the good of others, making barely more than minimum wages and realizing that of the amount you're paying them, a huge percentage is being eaten up by health care insurance. I imagine many roleplaying companies have the same feeling when they look at their end of year books and have to decide how many cents they are going to pay per-word, knowing it means many of their authors will have to forge insurance and just try really hard not to stay healthy next year.


----------



## GrahamWills (Oct 8, 2019)

Dire Bare said:


> Medicare for All sounds pretty good to me. Will my taxes go up? Yes. But my high deductible, co-pays, and out-of-pocket expenses for healthcare would (mostly) go away and I'd be better off in the balance.




You'd be much better off.  In the US pure taxes are relatively low. But in addition to taxes, there are payments workers and employers are legally compelled to pay to private parties. They function just like taxes, but they aren't taxes. NTCPs are no different from taxes except that NTCPs are made to private corporations like health insurance companies rather than to the government. When you add those into the mix, you find that the US is nearly the highest "taxed" nation in the world. 

A lot of that is due to the extreme costs of health insurance. Stupid things like the US having 8% of all health care costs being administrate as opposed to a typical 1% in a universal system. 






Unless we can provide basic safety nets to people, then many people will be unable to pursue careers in roleplaying or other creative endeavors; As M.O.B. said, it's just too risky to do it under the US system of healthcare


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## generic (Oct 8, 2019)

GrahamWills said:


> 66.5 percent of all bankruptcies were tied to medical issues (This is the real reason most Americans file for bankruptcy)
> 
> 500,000 people go bankrupt every year because they cannot pay their  medical bills (https://www.washingtonpost.com/poli...s-flawed-statistic-medical-bankruptcies-year/)
> 
> The average emergency room expense for uninsured persons in 2008 was $1,265. This includes $150-$3,000 for the base visit;Services, diagnostic tests and laboratory fees which will add to that; doctor's fees, and which are added separately (How Much Does an Emergency Room Visit Cost? - CostHelper.com). This does not include ambulance fees ($400-$1,200) and assume the patent does not stay overnight.



I'm not sure if you saw my earlier post, but I acknowledged that I was working off very old data, unintentionally, that was taken from a paper.


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## Xenonnonex (Oct 8, 2019)

Aebir-Toril said:


> I'm not sure if you saw my earlier post, but I acknowledged that I was working off very old data, unintentionally, that was taken from a paper.



Just how old was your data? Surely the study would have cited a time frame of dates.


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## generic (Oct 8, 2019)

Xenonnonex said:


> Just how old was your data? Surely the study would have cited a time frame of dates.



Pretty old, I can't find it now, but it may have been from the 1960s(?).  I was also a bit tired, and a tad in need of caffeine, when I wrote my original post.  I pretty much agree with you in terms of the benefits of socialized healthcare.


----------



## Xenonnonex (Oct 8, 2019)

Aebir-Toril said:


> Pretty old, I can't find it now, but it may have been from the 1960s(?).  I was also a bit tired, and a tad in need of caffeine, when I wrote my original post.  I pretty much agree with you in terms of the benefits of socialized healthcare.



You were using figures from the 1960s to try to claim current stats. What the colossal F. Are you frigging serious. This is beyond tiredness and lack of caffeine.

I am glad we agree on socialized healthcare.


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## generic (Oct 8, 2019)

Xenonnonex said:


> You were using figures from the 1960s to try to claim current stats. What the colossal F. Are you frigging serious. This is beyond lack of caffeine.
> 
> I am glad we agree on socialized healthcare.



Well, you're certainly being "the colossal rude".  And, my original post said that it was $350 after deductions.  I do agree with you, and I apologize for not checking the date of my study.  As I said, my scientific expertise isn't in economics or healthcare.


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## Xenonnonex (Oct 9, 2019)

Aebir-Toril said:


> Well, you're certainly being "the colossal rude".  And, my original post said that it was $350 after deductions.  I do agree with you, and I apologize for not checking the date of my study.  As I said, my scientific expertise isn't in economics or healthcare.



I am sure your "Yes. People. Receive. The. Same. Quality. Of. Care. Regardless of income, in the U.S." was the height of civility. 
Regardless of what your scientific expertise is you tried to claim that healthcare costs are low in the States. When they are demonstrably not. 
You knowingly used a study from the 1960s to form a basis for current figures. And tried to also claim that not many people become bankrupt due to healthcare costs. 

This does not require scientific expertise. This is not just a symptom of tiredness and lack of caffeine.


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## generic (Oct 9, 2019)

Xenonnonex said:


> I am sure your "Yes. People. Receive. The. Same. Quality. Of. Care. Regardless of income, in the U.S." was the height of civility.
> Regardless of what your scientific expertise is you tried to claim that healthcare costs are low in the States. When they are demonstrably not.
> You knowingly used a study from the 1960s to form a basis for current figures. And tried to also claim that not many people become bankrupt due to healthcare costs.
> 
> This does not require scientific expertise. This is not just a symptom of tiredness and lack of caffeine.



I used the study accidentally, actually.  And yes, I did dare to make claims based on my opinions, combined with what I expected to be true.  Good day, sir.


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## Xenonnonex (Oct 9, 2019)

Aebir-Toril said:


> I used the study accidentally, actually.  And yes, I did dare to make claims based on my opinions, combined with what I expected to be true.  Good day, sir.



When it is something that wrecks people's lives downplaying it and trying to justify the status quo based on figures frankly pisses me off.


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## Sacrosanct (Oct 9, 2019)

They apologized for using bad data and admitted they were incorrect. Which almost never happens on the internet. So give benefit of doubt and move on. Don’t continue to lampoon the person. Poor form.


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## Dire Bare (Oct 9, 2019)

Xenonnonex said:


> When it is something that wrecks people's lives downplaying it and trying to justify the status quo based on figures frankly pisses me off.




Dude. You and I might agree on the benefits of universal healthcare. But you are being unnecessarily and "colossally" rude. In the immortal words of Elsa, "Let it go!"


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## dragoner (Oct 9, 2019)

GrahamWills said:


> This is getting perilously close to being pure politics ...




Mostly pure sarcasm, mostly.


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## Umbran (Oct 9, 2019)

*Mod Note:*
Yes, bad information was used.  They admitted it.  Now please move on.


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## Michael O'Brien (Oct 9, 2019)

Reynard said:


> Yeah. And he said it was the health care system in Australia that allowed him to go all in to the RPG business. It's called a counter example.




Yes, if we lived in the US I may not have been able to take the risk.



eyeheartawk said:


> Yeah, thanks Australia!
> 
> Seriously, your guys' work to bring Chaosium back to where it should be from the shambling corpse of most of the Krank era is most appreciated!




Thanks. It's been a wild ride for us, these past several years, pulling Chaosium back from the brink - but (mostly) a lot of fun and with a lot of goodwill from the wider RPG community. It was very sad that our company founder Greg Stafford died last year, but he was part of the efforts to get Chaosium back on better a footing, and he lived to see that happen, including a seeing a new edition of RuneQuest and also Pendragon returning to Chaosium. It's the anniversary of Greg's passing tomorrow in fact.


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## Xenonnonex (Oct 9, 2019)

Sacrosanct said:


> I don’t know about a lot of time. But we do have a lot of opinions



"That Fry meme -> "SHUT UP AND TAKE MY OPINIONS!"


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## pemerton (Oct 9, 2019)

Michael O'Brien said:


> No, health care in Australia isn't a "business expense" - it is funded through our taxation system. There is a levy of 2%, part of income taxes.
> 
> 
> 
> Hey, good idea! In Australia everyone*, *the *entire population* that is, banded together to set up our universal health care system about 50 years ago. Such "banding together" brings the costs of health care down dramatically, for *everyone*.



Just a couple of comments from a fellow Australian (who still works in higher education):

* The funds raised via the Medicare levy don't come anywhere close to covering the full cost of public health provision in Australia;​
* The modern system of Medicare was introduced by Hawke's government following the 1983 election, although was broadly inspired at least (I'm less sure about technical details) by the Whitlam government's Medibank, which Fraser's government repealed;​
* The public health system rests on a combination of (i) government-provided insurance for doctor's visits, pathology services, pharmaceuticals etc (Medicare + the Pharmaceutical Benefits Scheme) and (ii) government-provided hospitals, in which rationing is achieved via urgency-determined waiting lists rather than ability to pay.​
Speaking for my own family, which does not have private health insurance, we have had two children born, had me hospitalised and receiving emergency treatment for over a week when I had encaphilitis, my partner being hospitalised and undergoing surgery three times for various conditions, and one of my children being hospitalised and undergoing surgery to treat a minor infection, without ever paying a cent. When we visit a GP we make a copayment that is pretty modest relative to our incomes - these probably amount to two or three hundred dollars a year at most.

The striking contrast for us is dental care, which - for reasons dating back to the dentists' union falling out with the Hawke government when Medicare was introduced - mostly sits outside the scheme. That is much closer to a US-style system. Hence the level of oral health in Australia is, I believe, noticeably below that of the general health of the population, particularly in lower-income sectors.


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## JacktheRabbit (Oct 9, 2019)

All of this skips the point. This should not be a discussion of politics and national healthcare. It should be about whether it is anyone's fault except the game creator who chooses a career path that cannot financially support him. 

Starving artists have existed since the time of the Renaissance it is no one's problem but their own and no one is obligated to support them so they can continue their starving artist life comfortably.


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## eyeheartawk (Oct 9, 2019)

JacktheRabbit said:


> All of this skips the point. This should not be a discussion of politics and national healthcare. It should be about whether it is anyone's fault except the game creator who chooses a career path that cannot financially support him.
> 
> Starving artists have existed since the time of the Renaissance it is no one's problem but their own and no one is obligated to support them so they can continue their starving artist life comfortably.




Yeah, I don't want to live in a world where we gate _services literally required to continue living_ based on their chosen profession. 

But, you know, you do you.


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## Umbran (Oct 9, 2019)

JacktheRabbit said:


> Starving artists have existed since the time of the Renaissance it is no one's problem but their own and no one is obligated to support them so they can continue their starving artist life comfortably.




"That is the way it has always been, so we should not change it!"  From a person typing on a computer the likes of which didn't exist 50 years ago.

That people in the past suffered is not a justification for people doing so in the present or future.

Progress.  Improvement of the human condition.  It's a thing.  Embrace it.


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## JacktheRabbit (Oct 9, 2019)

eyeheartawk said:


> Yeah, I don't want to live in a world where we gate _services literally required to continue living_ based on their chosen profession.
> 
> But, you know, you do you.




Okay, I would like to quit my current job and start a new career where I dont play video games, I dont rate video games, I watch other people play video games and the rate the games and the players.

Please make sure that I am financially secure with full access to everything to make my life fulfilling while I live out my dream in the worlds most absurd nitch profession.

If YOU want to chose a profession that most find little worth in then it does not become MY problem that you have financial difficulties.


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## JacktheRabbit (Oct 9, 2019)

Umbran said:


> "That is the way it has always been, so we should not change it!"  From a person typing on a computer the likes of which didn't exist 50 years ago.
> 
> That people in the past suffered is not a justification for people doing so in the present or future.
> 
> Progress.  Improvement of the human condition.  It's a thing.  Embrace it.




Yep because comparing computers and nitch hobby activities are the same thing. Try a comparison that actually makes sense.


----------



## eyeheartawk (Oct 9, 2019)

JacktheRabbit said:


> Okay, I would like to quit my current job and start a new career where I dont play video games, I dont rate video games, I watch other people play video games and the rate the games and the players.
> 
> Please make sure that I am financially secure with full access to everything to make my life fulfilling while I live out my dream in the worlds most absurd nitch profession.
> 
> If YOU want to chose a profession that most find little worth in then it does not become MY problem that you have financial difficulties.




Who's arguing for that exactly? 

Perhaps some strawman of your own creation, because I certainly haven't. 

Nobody is saying that we should guarantee a wage or a standard of living in this thread. It's simply about having access to healthcare. Which should not be dependent on how much money you make. In the same way that _everybody_ has access to the public roads regardless of income _everybody_ should have access to healthcare. That's it.


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## JacktheRabbit (Oct 9, 2019)

Maybe one day we can all live in a world like the Expanse where everyone who does not want to work or does not want to work on things society values can live on Basic with a guarantee of a certain level of living and free universal healthcare good enough that someone dying in their 80s is unusual enough to notice.

We do not have that right now. This means people need to chose professions that allow them to financially care for themselves and leave low paying hobby activities as hobby activities.


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## lordabdul (Oct 9, 2019)

pemerton said:


> The striking contrast for us is dental care, which - for reasons dating back to the dentists' union falling out with the Hawke government when Medicare was introduced - mostly sits outside the scheme.



I think this is very common throughout the world. My 2 home countries, Canada and France, also have dental care and eye care depending vastly on private/employer-provided insurance coverage (to varying degrees between the 2 countries but still quite different from other types of health insurance).

I don't want to speak too much for him but another example similar to @Michael O'Brien is Dennis Detwiller, the co-author of Delta Green. He's very vocal on Twitter about politics in general of course but, particularly, about the stark differences between Canadian and US healthcare -- he indeed specifically moved to Canada (and to a relatively low-cost-of-living part of BC as opposed to Vancouver) in order to work on RPGs full time.


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## eyeheartawk (Oct 9, 2019)

This seems appropriate.


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## pemerton (Oct 9, 2019)

JacktheRabbit said:


> Starving artists have existed since the time of the Renaissance it is no one's problem but their own and no one is obligated to support them so they can continue their starving artist life comfortably.



However, it does seem perhaps a little exploitative to benefit from the work of starving artists while sitting back and doing nothing as they starve.


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## pemerton (Oct 9, 2019)

lordabdul said:


> I think this is very common throughout the world. My 2 home countries, Canada and France, also have dental care and eye care depending vastly on private/employer-provided insurance coverage (to varying degrees between the 2 countries but still quite different from other types of health insurance).



In Australia optometry is within the national health insurance scheme - so for us it's only dental. In fact, it's very common here for optometrists not to charge a copayment, so eye checks are free at the point of service provision (ie the optometrist only gets the amount they are entitled to from the national insurer). I don't know why it is that it is more common for optometrists than GPs not to charge a copayment. I also don't know what exactly happened in the early 1980s, in the negotiations that accompanied the introduction of Medicare, that led to optometry coming in while dentistry stayed out.

We have had some gradual extensions of Medicare to cover dentristy over the past 10 or so years, but targetted only at particular (eg low income) sectors of the population. The Opposition had a plan to expand this at the last national election (earlier this year) but the Government was returned and so I don't think it will happen.


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## 3catcircus (Oct 9, 2019)

pemerton said:


> In Australia optometry is within the national health insurance scheme - so for us it's only dental. In fact, it's very common here for optometrists not to charge a copayment, so eye checks are free at the point of service provision (ie the optometrist only gets the amount they are entitled to from the national insurer). I don't know why it is that it is more common for optometrists than GPs not to charge a copayment. I also don't know what exactly happened in the early 1980s, in the negotiations that accompanied the introduction of Medicare, that led to optometry coming in while dentistry stayed out.
> 
> We have had some gradual extensions of Medicare to cover dentristy over the past 10 or so years, but targetted only at particular (eg low income) sectors of the population. The Opposition had a plan to expand this at the last national election (earlier this year) but the Government was returned and so I don't think it will happen.




Again - everyone in Australia who keeps claiming that healthcare is "free" is being willfully ignorant of the fact that it _isn't_ free - the costs are just shifted from point of service to prepay via taxes.

In the US the indigent, in fact, do have health insurance via Medicaid (whether or not it sucks is a different conversation).  Likewise retired people can apply for Medicare.  

The real problems with healthcare access in the US are that large corporations can self-insure their employees through various insurance companies.  The insurance companies negotiate costs with hospital networks, state/fed govt, and pharmaceutical companies.  It's essentially one big racket that is also negatively impacted by doctors and patients engaged in insurance fraud.  

Those who lose are people working for smaller companies or the self-employed who aren't part of the network of collusion.

It isn't healthcare that is the issue in the US, it's the health insurance and big pharma racket that profits off of managing rather than curing or preventing illness.


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## billd91 (Oct 9, 2019)

3catcircus said:


> Again - everyone in Australia who keeps claiming that healthcare is "free" is being willfully ignorant of the fact that it _isn't_ free - the costs are just shifted from point of service to prepay via taxes.
> 
> <snip>
> 
> ...




The healthcare is free - at the point of distribution (or for a relatively small copay). That makes it extremely convenient and removes barriers to people seeking the care they need in a timely and effective fashion. Nobody's actually ignorant about it coming from their taxes.

And you're right that it isn't health*care* that's the problem (barring issues for women and minorities for whom care is regularly substandard). It's distribution - and it's more than just big pharma and health insurance at fault. Not all health care providers are non-profit either. Others are limited by self-imposed "moral" stands like expanding Catholic health care organizations. And still more are struggling to provide good geographic coverage so that services are well distributed as population distribution changes.


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## GreyLord (Oct 9, 2019)

JacktheRabbit said:


> All of this skips the point. This should not be a discussion of politics and national healthcare. It should be about whether it is anyone's fault except the game creator who chooses a career path that cannot financially support him.
> 
> Starving artists have existed since the time of the Renaissance it is no one's problem but their own and no one is obligated to support them so they can continue their starving artist life comfortably.




Possibly...

But the world would be a FAR lesser place without art and artists.

Many of the writers and artists that have impacted us, history, and how we think about things were those same starving artists.  The impact they have had on the world was not commensurate with the amount of money they made or living in style, rather many struggled with poverty and died relatively young.

While they died young but their impact was large, many wealthy individuals who made a LOT of money are mainly remembered for the tyrannical nature of how they made that wealth and the bad effects they had on the world (and even more today with the concern of climate change upon us).

So...yes...starving artists have existed since BEFORE the Renaissance and no one is really obligated to support them...

Yet, ironically, those same starving artists probably have had a more positive impact on the world in the long run than the powerful and wealthy who have started wars and other such things in the pursuit of wealth and power. 

In our modern age the dream has to overcome these violent and terrible tendencies to become more of a higher individual in a better society, but yes...nature still exists and survival of the meanest and toughest still is something many hold too as being their path of choice.  Nature still exists...and some still feel what nature is and how it does things is the best way to proceed.

I don't necessarily think that may be the BEST course of action at all times, as one could also see nature as something we have struggled to exceed and conquer, putting down the natural emotional state of man in pursuit of something higher and more evolved.


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## GreyLord (Oct 9, 2019)

I try to make my way as one of those starving artists these days, though my output is not as great as many others.  I have been lucky in that I currently (that's currently, we'll see what happens in the future with the stock market and other things that currently allow me to stay afloat financially) am retired and have medical coverage from that (as well as a pretty steady income currently).

It would be very tough in today's working environment in many ways to have writing as my only means of income.  That applies to most locations, not just the US.  IT is obviously hard in regards to medical costs in the US, but there are many other hidden costs as well, even with medical coverage that can make it hard also.

In other nations many times you get medical leave, but as a freelancer there is no such thing.  If you are not working or producing something, you may have medical coverage, but you still aren't bringing in money on which to live off of. 

I think it is good to have medical available to all so that none have to suffer and that helps alleviate a LOT of the costs of a medical emergency or situation, but sometimes in severe emergencies, it still isn't enough for the low paid writer or artists.  For those who are not with a big company or on a pension, if you aren't working, you have other difficulties associated with not being able to work during that time period or having lesser ability to create and produce the art, writing, or other material that you freelance.


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## Reynard (Oct 9, 2019)

JacktheRabbit said:


> We do not have that right now. This means people need to chose professions that allow them to financially care for themselves and leave low paying hobby activities as hobby activities.




Gating creative professions behind affluent birth circumstances means that you necessarily restrict creative voices to those affluent people. In America that's primarily white people. Doing so doesn't just homogenize creative expression, it turns it stagnant. You know how everyone complains all movies look the same and are just reboots of remakes? it's because it is all the same people making movies now that were making them 40 years ago (or worse, their kids making them now).

In context of this discussion, what something like a national health care system does is lower the bar for that "profession that lets [people] financially care for themselves" you mentioned. Healthcare costs, especially in an emergency or unexpected illness, are a massive source of debt and financial ruin. If you have a terrible idea -- say, reviewing video game reviewers -- such a system won't make you suddenly successful. But it will give you a better opportunity to try a thing and see if it successful.

Above and beyond that, such a system all makes it easier for folks to try their hands in other sorts of business, creative or otherwise. People NEED health insurance and many people feel trapped by their professions or even just bad employers. But then, I guess, some people like the idea of keeping a collar on the workforce, especially the lower income tier of it.


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## dragoner (Oct 9, 2019)

In the Soviet Union, it was said that if you cannot be a great artist, be a great scientist.


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## Reynard (Oct 9, 2019)

dragoner said:


> In the Soviet Union, it was said that if you cannot be a great artist, be a great scientist.



I am curious what you think the relevance of this adage is to this discussion.


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## dragoner (Oct 9, 2019)

That art was considered good, and maybe why art is considered bad in capitalist countries.


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## pemerton (Oct 9, 2019)

3catcircus said:


> everyone in Australia who keeps claiming that healthcare is "free" is being willfully ignorant of the fact that it _isn't_ free - the costs are just shifted from point of service to prepay via taxes.



I'm not _ignorant_ wilfully or otherwise. I've published on the topic of income tax;

But the number of people who go bankrup in Australia due to medical bills is not very high. (In fact I've never heard of such a thing happening.) A single national purchaser of health services creates a very significant downward pressure on prices. (There is no legal cap on doctor's salaries - the Australian Consitution expressly excludes the possibility of civil conscription.)



3catcircus said:


> It isn't healthcare that is the issue in the US, it's the health insurance and big pharma racket that profits off of managing rather than curing or preventing illness.



My understanding is that, of OECD countries, the US has one of the highest levels of expenditure on healthcare but some of the poorest results. Whether that's a sign of a healthcare problem or not maybe isn't as obvious as it looks?


----------



## Xenonnonex (Oct 9, 2019)

pemerton said:


> My understanding is that, of OECD countries, the US has one of the highest levels of expenditure on healthcare but some of the poorest results.



Where you have a system that spends one of the highest amounts in the world and you get so little benefit for the people. Where so many people go bankrupt because of healthcare costs. Where you need goddamn frigging gofundme campaigns just to cover healthcare costs. This is not just a fundamentally broken system. This is not just a fundamentally useless system. This is a fundamentally goddamn malignant system.


----------



## Ovinomancer (Oct 10, 2019)

Xenonnonex said:


> Where you have a system that spends one of the highest amounts in the world and you get so little benefit for the people. Where so many people go bankrupt because of healthcare costs. Where you need goddamn frigging gofundme campaigns just to cover healthcare costs. This is not just a fundamentally broken system. This is not just a fundamentally useless system. This is a fundamentally goddamn malignant system.



1.  The outcome differential between the US healthcare system and other OECD countries is actually very small.  It's played up for politics.  So, calling it broken or malignant is hyperbole born of ignorance.

2.  I'll actually agree the US system is badly flawed, though, despite 1) above (I don't agree the stats show the flaws well).  However, the solution isn't single payer or remaining flawed -- this is a narrow policy preference that is only grounded in personal beliefs.

2a.  I say this because the current US system is so badly flawed because of government intrusion into the system.  Not that there should be none, because that's silly, but the specific intrusions made into the system are actively damaging to cost control or quality of outcomes.  This is what happens when the laws governing your health are made by politicians without knowledge instead of being between patient and doctor.  Add to it that the US politician is well captured by the large medical organizations that are built to take advantage of the current system and also by the insurance market which does the same.  Neither wants the system to become more transparent.

2b.  The idea that the solution to this problem in the US is to rely on those same captured politicians to create a sweeping change in system that will have good outcomes.  The very suggestion that they're capable is ridiculous.  The only form of socialized medicine that might work would be to have the Federal government step out of regulation altogether and let the states work out their own systems, creating at least a 50 member think tank with real outcomes to find a reasonable solution.  Any federal system will be worse that what we currently have.

3.  The biggest problem I have with socialized medicine programs is that your medical choices are constrained by non-doctor politicians.  There's a persistent canard that doctors direct care, but it's bogus -- they direct care within the bureaucrats' guidelines of what's to be available.  Faceless bureaucrats determine if this disease is worth spending on or if you'll just get palliative care if unlucky.  Supply is determined by the bureaucrat, not the patients or doctors.  There are problems with market based health care systems, sure, but the blind faith that papa government will do the right thing has been shown to be endlessly misplaced throughout history.

4.  To create a market based health care system in the US, we need to get off the insurance pays for routine care model.  Having insurance pay for a office visit obscures the costs entirely, allowing the system to create byzantine ways of hiding costs which leads to both doctors advising unnecessary procedures to cover malpractice suits (tort reform is also necessary) and the patient failing to understand the full cost ramifications of accepting the procedures.  Just trying to get cost information before agreeing to a procedure is often met with 'but you have insurance, don't worry about it.'  It's decidedly flawed because at the point of service, costs are completely hidden (I've noticed most doctors don't know actual costs at all).   Transparent pricing at point of service will act to reduce overall costs greatly, as people will be able to make informed choices about procedures and require doctors to justify the procedures as medically necessary to the customer rather than the bureaucrats at the insurance office (and, to be fair, he hires someone to do this).

Socialized health care is not the only model possible.  Pretending it is just betrays political leanings.  If the goal is actually good care, the method achieved should not matter.  Sadly, the health care fight is more about displaying political bona fides in supporting specific policy outcomes than discussing ways to find better care.  

Some things about me:  I've been hospitalized twice without insurance in the US.  Both were life-threatening and required weeklong stays in the hospital.  The first was acute appendicitis and the second was a runaway staph infection in my left arm (that almost had to be amputated).  I am not wealthy, nor are my parents.  I was unemployed the second time (just went back to school).  I did not have to declare bankruptcy, and, while I carried medical bills for a few years, did not have to skimp terribly to make it through.  Both times I was able to work with the hospitals and doctors to get cash pricing instead of insurance pricing, which drastically reduced my bills to workable amounts.  I've been there, and done the hard work of finding out what costs and prices actually are to negotiate better cost/benefit for me.  It took a lot of time in billing offices, and would have been well served by having the system be less obscure to everyone involved.


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## Xenonnonex (Oct 10, 2019)

Ovinomancer said:


> 1.  The outcome differential between the US healthcare system and other OECD countries is actually very small.  It's played up for politics.  So, calling it broken or malignant is hyperbole born of ignorance.
> 
> 2.  I'll actually agree the US system is badly flawed, though, despite 1) above (I don't agree the stats show the flaws well).  However, the solution isn't single payer or remaining flawed -- this is a narrow policy preference that is only grounded in personal beliefs.
> 
> ...



My bona fide opinion is 'everyone is worthy and deserving of an equal quality of healthcare'. Not 'only the wealthy has a right to a higher quality of healthcare'. Not 'only those who know how to work the system should have a higher quality of healthcare'. But you absolutely need the right supports and structures in place for this. The socialized healthcare model is one solution for this. 

My opinion is not born of ignorance. Namely for the high number of people filing bankruptcy due to healthcare costs. The OCED countries with socialized healthcare all do not have barriers to healthcare. Whereas the States does. The OCED countries all have equal access to healthcare for their population. But the States does not. 
The OCED countries nearly all have outcomes that do not result in bankruptcy of the patient. In the States a great number of the population files for bankruptcy because of the outcomes of healthcare.

I did not claim a socialized healthcare model is the only solution. And claiming it is my position that it is the only solution is complete and willful misinterpretation and ignorance of my position. 
What you have in the States is actually too little governmental oversight and too little governmental regulation. Where you have corporate entities and margins of profit dictating patient healthcare that is entirely and utterly F'd up. 
The for profit model of healthcare is entirely to blame for the sorry situation the States is in.


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## Ovinomancer (Oct 10, 2019)

Xenonnonex said:


> My bona fide opinion is 'everyone is worthy and deserving of an equal quality of healthcare'. Not 'only the wealthy has a right to a higher quality of healthcare'. Not 'only those who know how to work the system should have a higher quality of healthcare'. But you absolutely need the right supports and structures in place for this. The socialized healthcare model is one solution for this.



This is a wonderfully pithy statement that doesn't actually do anything.  I think everyone should be rich.  How is that a statement of actual utility?

Equal access is absolutely a right -- no one should be denied access to healthcare because of who they are.  But access is not the same as outcome -- I strongly disagree that everyone deserves equal outcome on the basis that this is impossible to achieve.  Healthcare is not infinite, it must be rationed.  You disagree with ability to pay as the rationing factor, fine, that's your prerogative.  But don't pretend you have a higher horse than others that say that things should be determines by market forces.  Market forces have done the most for elevating people out of abject poverty and providing levels of healthcare undreamed of 100 years ago.  



> My opinion is not born of ignorance. Namely for the high number of people filing bankruptcy due to healthcare costs.



"High" is a relative term with little meaning.  The reality is that it's very hard to disentangle medical costs from bankruptcies.  The leading cited studies all hail from the Great Recession, so that certainly skews data, but, interestingly, how you count medical bankruptcy depends on how much medical debt load is part of the bankruptcy.  For instance, the leading cite on social media is from a study that considered ANY medical debt as part of a bankruptcy filing to be a medical bankruptcy.  The average amount of medical debt counted was about 10% of total debt load.  Hardly the main driver, although any stress is unwelcome.  A similar study done at the same time only counted medical debt loads of 50% of total load or over 50% of yearly income.  That study found about a third of the total medical bankruptcy rate as the other study.

So, yeah, "high" depends on what you make of it.  Also interesting, during the same years as the above studies, bankruptcy rates in Canada were the same as in the US, presumably absent almost all medical debt, right?  Don't take the first set of numbers that pleases your assumptions -- it's almost always more complicated than that.



> The OCED countries with socialized healthcare all do not have barriers to healthcare.



Sure they do, it's just not how much money you have.


> Whereas the States does. The OCED countries all have equal access to healthcare for their population. But the States does not.



Actually, you cannot be refused service at a hospital with an emergency room in the US for inability to pay.  They have to get you fixed.  So, access is absolutely universal.  You just then get a bill for it.



> The OCED countries nearly all have outcomes that do not result in bankruptcy of the patient. In the States a great number of the population files for bankruptcy because of the outcomes of healthcare.



I talk about the distortions of this above, but wanted to say that "bankruptcies" when you're alive is kinda a weird pill.  I mean, aggressive taxation means many will have about as much buying power as the bankruptcy filer in the US, with equivalent health outcomes (better in the US if it's cancer), but "bankruptcies" are treated like the person died or something.  It sucks, and medical bills suck, but you're alive and can try again.  Recall, I've been on the no-job, no-insurance having expensive hospital stays thing -- I'd gladly have taken a medical bankruptcy rather than die, and, luckily for me, that wasn't even a choice in the US system -- they had to fix me.



> I did not claim a socialized healthcare model is the only solution. And claiming it is my position that it is the only solution is complete and willful misinterpretation and ignorance of my position.



I'm sorry, but page after page of you saying that the US will only be fixed once they've socialized healthcare led me astray.  Where did you discuss another option? I'd like to review your ideas.



> What you have in the States is actually too little governmental oversight and too little governmental regulation. Where you have corporate entities and margins of profit dictating patient healthcare that is entirely and utterly F'd up.



This is very ignorant of what actually has happened over here, and points directly at you saying more government involvement is the way to go (presumably single payer, but, hey, you say there are other options you'd consider).  The government and health care regulations are the large part of how the system over here works.  It's covered in government regulation, smothered in it.  I actually think some single payer systems have less government involvement than the current US model.  Don't confuse lack of single payer to be lack of government involvement.

But, this statement goes right back to the weird idea that more government always the best answer.  It never looks at what's already there and how the system actually works before deciding that more bureaucrats and non-doctors should be involved to solve the healthcare problem.  You're moving medical decisions away from the doctor and patient and onto people that have no stake in your health and saying this is an unabashed good.  It might be, but you've done no work to show that it is true. 



> The for profit model of healthcare is entirely to blame for the sorry situation the States is in.




It isn't, at all.  This is like saying that it's the rules of footy that allowed Carlton to take the wooden spoon last year.  Market based systems are the rules, but you can still have a terrible game, especially with bad umps.  It's not the rules that did it.


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## Tom B1 (Oct 10, 2019)

Scarlet.Knight said:


> I like your analysis of the situation.
> 
> I live in Canada. These healthcare-related issues are fairly different here. When it comes to medication, we're mostly in the same boat: can't pay, can't have.




Also Canadian.

I've had family that have went through horrible, expensive medical regimes here and I know some friends who have faced comparable scenarios in the US. In my family's case, dual mastectomies, then a catastrophic car accident plus bones almost invisible on scans on the one hand and heart attacks, stents, stroke, loss of limb, prosthetics, and cancer treatment on the other. I compare that with my cousin's wife's son who got married, had a kid arrive, and then passed from while waiting for dual lung and heart transplant and another friend whose wife has a chronic and expensive conditions who lost coverage when she changed jobs. My folks weren't out of pocket too much (some meds, a few bits of equipment, a few co-pays) and my cousin and his wife are still paying for $100K US they put in trying to save her son and my other friends have debt now because their 'pre-existing condition' isn't covered now. 

Scenarios vary a lot by where you live. The US simply does not, as a whole (some states do more than others) provide much of a safety net for the less wealthy members of society for health or retirement.

Interesting fact: The friend with a condition no longer covered used to work for the state gov't in Louisianna in reconciling State - HMO billings. 

Louisiana did a study and determined that 42% of the state's medical budget was going to the legal/arbitration processes with the HMOs. 

You have to have a _vastly, epically_ inefficient single payer to consume 50% of the pool of a state or province's budget for health. You can be 20% less efficient and it still ends up looking much more cost-effective.

[/QUOTE]

Other trades, such as plumbing or factory work, have seen a significant increase in salaries and work conditions. Why is that? 

Because those skilled trades are an absolute legal requirement - plumbing especially - anytime you touch a pipe of any sort for any reason, you require a plumber, a permit and an inspection. That helps their business a lot. 



> I guess what I'm trying to say is that art, in general, has a lower value than other activities




...and perhaps justly so. Most other highly paid groups (doctors, lawyers, nurses, engineers, and skilled trades) all have extensive education and professional certification requirements as well as dues and upgrading requirements. Where's that in the art world? It's not a necessity and art is not covered by acts of parliament as are professionals and skilled trades - they have colleges that they must answer to and if they don't, they can lose their ability to work in the field. Never seen that in art or most other creative endeavors. 

Perhaps more pertinently, most of these trades fall into:

shelter and infrastructure creation
keeping people alive and bringing new ones into the world
helping deal with the law (or with the tax man)

The first two seem like foundational blocks in the pyramid of needs. Art is more up the pyramid and its urgent day to day survival aspect is almost non-existent. Societies need it, but they don't tend to need it with the urgency of doctors or builders. 

I am friends with a fair few game developers - some that make a living at it, some that have it as a side hobby that sometimes generates a bit of revenue. Those who dabble at it and don't have a full time company they own where they are publishing and producing all the time, those casuals tend to roll a project every so often and it takes years to recoup costs and make profits for a print run. 

Any creative endeavour will always be subject to tastes, to competition and to the varying amounts of excess wealth to be spent in a society. That limited amount of luxury wealth comes after all the spending for critical things (professions and skilled trades). Then it gets split between different products and producers in ways that vary over time. 

To succeed in that environment, you have to frequently roll out new product which is compelling and in line with current tastes. And even then, you are still subject to overall economic situations. 

I know people talk about paying X or Y for games - video, board, card. I can't anymore afford to buy $150 game orders every two months or $400 of miniatures 1/year. I can't even justify $30 books or $40 Blu-Ray seasons anymore. I've probably spent no more than $120 in an entire year for RPG products now, vs. doing that every 1-2 months years back when my circumstances were better. More calls on a much smaller pool of money and more dependents now. And everything is going up - fresh vegetables went up 11% year to year here. Salaries didn't. 

So when I see producers cranking out $60-100 hardcovers, there's no way I'll get them unless I see a clearance for $30 someday or see a PDF for $25 one day. And even then, not more than 1 a quarter. And I don't have $5/month to contribute to patreons of web artists and authors I highly respect. I can't even afford the $13 softcover book price. Things are that much harder and I'm not alone. 

So the overall economic situation also impacts RPG authors. And expecting those of us with little or no money to kick out $50 for an adventure path book or $30 for 6 minis.... well, won't be doing much of that, sorry. It's not disagreeing the artists' work should be worth that, it's not having it to spend. 

So now I update old modules, use old minis, and free maps, and design my own adventures. Works for my folks and lets me play even when I can't support hardly anybody like I'd like to. 

It's not just the 'I want it free' culture, it's the 'things aren't as easy as they once were financially' for an awful lot of people.


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## Dire Bare (Oct 10, 2019)

Tom B1 said:


> It's not just the 'I want it free' culture, it's the 'things aren't as easy as they once were financially' for an awful lot of people.




You make a lot of good points. It's arguable whether we should create a society that mitigates risk for artists excessively, so they can pursue art full time without starving. I'd argue for it actually, but I don't think my POV is "obvious" or "right".

However, there is a difference in saying, "I can't afford your product, therefore I'm not going to buy it" and saying, "Charging that much is unfair, because I cannot afford it". Or as others have argued recently, "Charging that much is unfair because teenagers can't afford it."

Like you, I've had to drastically reduce my "fun" budget and I purchase much less gaming products than I used to. I also always take price into account, if something looks amazing and I wants it, it still might be priced out of my affordable range. Oh well. But I'll never complain about high, but reasonable, pricing on gaming products just because my financial circumstances don't allow for me to indulge.

I didn't purchase the fairly recent Conan board game (from a Kickstarter) that was jam-packed with Conan miniature goodness, because even the basic package was really expensive. I really wanted that game too, and every once and a while I stumble across a good review of the game and I sigh wistfully. Their pricing was very high, but very fair for what you got. I couldn't afford it anyway. Oh well. Should the publisher have created a version of the game that included less toys and be more affordable? Should the publisher paid the various artists involved less so that my pocket book could be more happy? Or taken a smaller profit margin? No. They created a luxury product for a high price that was none the less fair, knowing not every body would be able to purchase the game. And that's okay.

Gaming companies (and other creative industries) NEED to pay their staff and artists fair and livable wages so these folks can at least hope they don't end up an aging creative with a Go Fund Me page to pay for their cancer treatments. There's a lot more to it than that, of course, but it starts there.

Should artists be able to expect to work creatively full time and meet their overall financial and health needs? Or pursue their art as a side-gig next to their more traditional well-paying jobs? Should our society manipulate things so they can? (Universal Basic Income, Universal Education, Universal Healthcare, etc). I think this doesn't really have a "right" answer and it comes down to what kind of society do we want to have. I'm on the progressive side of things where I WANT a society where we take care of everyone at a basic level, regardless of how much they "contribute" back to society and what their contributions are "worth" (artistic vs trades).


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## Tom B1 (Oct 10, 2019)

Dire Bare said:


> I didn't purchase the fairly recent Conan board game (from a Kickstarter) that was jam-packed with Conan miniature goodness, because even the basic package was really expensive. I really wanted that game too, and every once and a while I stumble across a good review of the game and I sigh wistfully. Their pricing was very high, but very fair for what you got. I couldn't afford it anyway. Oh well. Should the publisher have created a version of the game that included less toys and be more affordable? Should the publisher paid the various artists involved less so that my pocket book could be more happy? Or taken a smaller profit margin? No. They created a luxury product for a high price that was none the less fair, knowing not every body would be able to purchase the game. And that's okay.




To be a bit progressive, as you say you are below, should you and others encourage elitism in the gaming community? Making of games and products only for those with lots of disposable cash? That's exclusionary. 

(Really, just speaking to a point that it isn't obvious what is the 'right' or 'good' option in many of these cases and it can be sliced a lot of ways)

As a gamer, I find nobody is doing what the original TSR modules did: 

For $8, with a PHB at $12 and a DMG at $18, I could have an adventure module that usually lasted multiple sessions and took characters up a level or 2. And most of them were fairly generic and relocatable. And their production (maps, art) were sufficient for use in the ways modules are used - maps to be gamed on or drawn to be gamed on, text to be readable, just enough art to illustrate key points. One way or another - a one way tour through a product that may well not be revisited (unlike PHB/DMG). 

So now what do I get? $50-70 hardcovers with complete campaign arcs, tightly coupled to a location and a particular overarching arc that I may or may not like and whose individual adventures I may or may not like. 
Most don't usually fit in a home brew world easily, the layout and paper choice makes pages sometimes hard to read and hard to justify annotating with a pencil.... and maps are often not done in simple line art for use in the game or for redrawing. And $8 then is not $70 now. $8 then was about 2 weeks allowance for an early teenager who did chores. My 12 year old step daughter now gets $15 on a good week _$10-12 otherwise_ and so that'd be 4-5 weeks allowance for her to get a hardcover adventure path. 

I'm an old school D&D player - not nostalgic for the obscure, pointlessly-divergent mechanics and the clunky tables.... but the old school gave us Sandbox Gaming - a setting, some factions and some interesting NPCs and enemy groups, and then off you went - including going in ways fairly different than the modules suggested (join the Caves and help them take the Keep or wait until they try and rip off the Vault and the Castellan's Room, rob the moneychanger in Hommlet and join the Temple's forces, or whatever). Most new games are 3-act or scripted arc on a railroad. That robs players of true agency although that is useful for GMs who don't want to do the design work or aren't comfortable with Apocalypse World style reactive game mastering.

Turning our hobby into a have/have not in a big way with $200-600 kickstarters and $70-100 hardcovers and core book boxed sets at $130+... maybe not the best idea for opening up the games to new players and definitely leaving out a lot of demographics that could use a bit of constructive fantasy with good role models...



> Should artists be able to expect to work creatively full time and meet their overall financial and health needs? Or pursue their art as a side-gig next to their more traditional well-paying jobs? Should our society manipulate things so they can? (Universal Basic Income, Universal Education, Universal Healthcare, etc). I think this doesn't really have a "right" answer and it comes down to what kind of society do we want to have. I'm on the progressive side of things where I WANT a society where we take care of everyone at a basic level, regardless of how much they "contribute" back to society and what their contributions are "worth" (artistic vs trades).




I have a friend who is in a band in the US. They tour. They sell their own music. They'll never be the Beatles, but they can easily make a modest living at it. They say  people who complain about the music consumer market now are just people who don't want to get out and tour and provide experiences. 

I think art has to be a thing you want to do if you're to really follow it. 

I think there isn't an obligation for society to support whatever thing you decide to pursue. That's a choice and the choice can be not to (by individual).

I'm progressive, but mostly in terms of helping the least advantaged to have better opportunities, not those who made life choices that pretty much guarantee that. 

Art can't have a value assigned by some odd sense of universalism. It's too subjective. And we just don't have enough wealth to do all the important things we need to be doing (mental health resourcing, dental care, protection of children, education without massive class sizes, healthy eating/exercise education for kids, etc) so we'd better be careful about rewarding life choices people make to go into less secure employment - that was a choice they made. They could have pursued other courses. 

I have a friend who competes in Art Battles (speed painting competitions) - He could easily crank out a $500-750 painting in 2-3 hours and it would be amazing. He's won several. He has chosen to step away from video game computer art to teaching art classes with paintbrushes and so on to interested people because that's more rewarding, but not monetarily. He made that choice. I'll support him when I can but that's because I like his art and I like him. If it was done through some tax (such as the bogus tax on all blank media to feed the music industry), I'd have an entirely different view of that support and it wouldn't be favourable. 

People choose their paths. We can't and probably shouldn't try to make them all equivalent. Some highly paid jobs are miserable experiences so people surrender some enjoyment and satisfaction for money. Others go the other route. You can't make that across the board equivalent and trying might be worse than not. 

I think Patreons are a brilliant approach. But with so many people out there wanting to get into creative endeavours, it is hard to draw in enough to make the bills get paid. Better have a part time plan B just like some of us did in university to pay for school. 

Good discussion, but I think art will always be a commodity. It used to sponsored by nobles and similar rich merchants and religious figures. Even MIchelangelo had to satisfy his patrons. That didn't stop great art being made nor will it in the future.


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## Dire Bare (Oct 10, 2019)

Tom B1 said:


> To be a bit progressive, as you say you are below, should you and others encourage elitism in the gaming community? Making of games and products only for those with lots of disposable cash? That's exclusionary.




No, it's not. Making an expensive product that not everyone can afford is hardly elitism or exclusionary. Making a product that targets those with low disposable incomes is fine, but offering more expensive products is also fine.



> As a gamer, I find nobody is doing what the original TSR modules did:
> 
> For $8, with a PHB at $12 and a DMG at $18, I could have an adventure module that usually lasted multiple sessions and took characters up a level or 2. And most of them were fairly generic and relocatable. And their production (maps, art) were sufficient for use in the ways modules are used - maps to be gamed on or drawn to be gamed on, text to be readable, just enough art to illustrate key points. One way or another - a one way tour through a product that may well not be revisited (unlike PHB/DMG).
> 
> ...




Take those old modules and adjust them for inflation . . . . . WotC could produce similar products, but usually don't, because they are producing what the majority of their customers want. It's hardly elitism or shutting out new players. And there are other companies that do produce products similar to "old school" D&D modules, I think the subgenre even has a name . . . . A product that doesn't suit your tastes and is more expensive that you would like is again, hardly elitism. Not all teenagers can afford the full-color WotC hardcovers? Oh well. The market has changed. And actually, I think WotC's current line up is very much in reach of the average middle class teenager, which has always been the core of their "new" market



> I have a friend who is in a band in the US. They tour. They sell their own music. They'll never be the Beatles, but they can easily make a modest living at it. They say  people who complain about the music consumer market now are just people who don't want to get out and tour and provide experiences.




Your musician pal probably makes enough to survive and keep touring. But does he make enough to truly LIVE without financial worry, both now and in the future? Decent health plan? Putting away 15% or more into a 401k? Got a healthy investment package? Making the choice (with eyes wide open) to pursue art full time is cool, but mocking other musicians who make other choices is pretty lame.



> Art can't have a value assigned by some odd sense of universalism.




Sure it can. Not a hard dollar value, like "Rock musicians are worth $30,000 per year". But society very much could say, "We want to encourage more people to pursue art full time without financial worry" and provide free education, free healthcare, and a minimum income to all citizen. And of course, it would not be all about supporting the arts, but supporting all citizens who find themselves in poverty for whatever reason. It's not a choice we HAVE to make as a society, but it's a choice I think we SHOULD.


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## GrahamWills (Oct 10, 2019)

There are two different issues being conflated in this thread, one is the state of health care in the US. it was stated that it isn’t really fundamentally much different than other OECD countries. That is simply wrong. It is fundamentally different , and worse, in many well known ways. A simple internet search will let you easily discover that it:

It wastes more money than single payer systems with up to eight times as much spent on administrative costs
it is less effective than other countries by a lot; it takes much more money in the US to improve someone’s health by the same amount
But this thread is not about how appallingly bad the US health system is. That is a known bad thing. It’s about how the way it is used makes it hard for RPG creators or other contact workers to survive.


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## lowkey13 (Oct 10, 2019)

*Deleted by user*


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## Xenonnonex (Oct 10, 2019)

GrahamWills said:


> There are two different issues being conflated in this thread, one is the state of health care in the US. it was stated that it isn’t really fundamentally much different than other OECD countries. That is simply wrong. It is fundamentally different , and worse, in many well known ways. A simple internet search will let you easily discover that it:
> 
> It wastes more money than single payer systems with up to eight times as much spent on administrative costs
> it is less effective than other countries by a lot; it takes much more money in the US to improve someone’s health by the same amount
> But this thread is not about how appallingly bad the US health system is. That is a known bad thing. It’s about how the way it is used makes it hard for RPG creators or other contact workers to survive.



It seems some people are willfully and knowingly spreading misinformation and lies about the state of US healthcare. In their minds someway somehow they do not think the US healthcare system is appallingly bad.


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## drl2 (Oct 10, 2019)

I struggle to understand how any company outside the WotC/GW/Paizo triumvirate can possibly make enough money to offer reasonable pay to full-time employees, let alone afford US healthcare coverage.  Sure., the market has grown a lot and become more mainstream, but it seems like the growth is mainly from the big 3... with _hundreds_ of smaller companies competing over the scraps.

How many people outside those organizations are really able to make a decent living as game publishers?  I generally assume most of the small-time publishers do it as a side gig - passionate hobbyists trying to make a little extra to help support their hobbies.


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## Umbran (Oct 10, 2019)

Tom B1 said:


> Perhaps more pertinently, most of these trades fall into:
> 
> shelter and infrastructure creation
> keeping people alive and bringing new ones into the world
> ...




That argument makes a lot of sense... if you live in a world of actual scarcity.  If a society has problems meeting the day-to-day requirements of its members, you have to prioritize, and the things that you need are higher value than the nice-to-haves.

But... there's a very big question as to whether that's the case any more.  The US has a gross domestic product, per capita, of something like $80K per year.  The economy, on the whole, has more than enough wealth to meet the basic needs of all the individuals within it.  In terms of what we can and do produce, our economy is post-scarcity.  Meeting the needs of the individuals should not be an issue.  

But, of course, as a practical matter, we obviously do have an issue meeting the needs of the individuals.  We are, in fact, so broadly incapable at meeting the needs of all the members that the fault of this cannot reasonably be laid on those whose needs are not met.   We are quibbling over whether the artist is to blame for their condition when they choose art - but the people buillding and maintaining homes, or providing food or basic resources, are not doing well either!

That, in effect, is what single-payer health care is about - recognizing that the economy is more than capable of providing care for all the individuals, and making that happen.



> It's not just the 'I want it free' culture, it's the 'things aren't as easy as they once were financially' for an awful lot of people.




Yeah.  A bit of web-searching finds that something over 10% of the US population lives below the poverty line.  Something like half if the population is "low income", without sufficient resources to build wealth, living basically paycheck-to-paycheck. And, those with middling income likely have student debt and high housing costs (in either rent or mortgage) to achieve or maintain that income.


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## Randomthoughts (Oct 10, 2019)

talien said:


> *The Scope of the Problem*
> For some designers, yearly deductibles have crept up to the $10,000 range; with game designers often working as freelancers without insurance, costs are even higher. Incidental expenses, like wound care supplies, specialized diets, and transportation all add to these costs. To address these expenses, GoFundMe (and it is usually GoFundMe, which accounts for 1 in 3 crowdfunding campaigns for medical costs) has become the crowdfunding platform of choice, with over 250,000 medical campaigns raising over $650 million each year.
> <snip>



I normally lurk on these boards but wanted to comment about an important aspect of the US healthcare system that I believe plays a principal role in the problems designers and creative types face today: health insurance is primarily gained as a benefit for employment and highly subsidized by your employer. This is something that should absolutely change, though personally I'm not sure what the best solution is (but acknowledging that the current US healthcare system needs to improve). 

The Patient Protection and Affordable Care Act (passed in 2010) was an attempt to rectify this by creating marketplace exchanges. I agree with the concept despite its flaws because health insurance became person-based versus employer-based.

That being said, have designers and those in the RPG industry considered the following options:


Purchasing health insurance through the exchanges? I have a few friends who are tradesman who were initially against the ACA but found that it allowed them to remain as independent business owners.
Enrolling in health insurance through professional associations? Many of us I presume are part of professional associations through our day jobs, some/many of whom may offer health insurance to its members. If one does not exist for the RPG industry, could one be created?
Finally, could a charitable organization be appropriate for this (justified by supporting the arts, perhaps)? I'm not a tax(-exempt) attorney but it might be worth a shot. I'm particular wary of gofundmes and such for a few reasons, just like I am with donating to charitable organizations without knowing how the money is distributed.

Anyway, some suggestions since this topic comes up every so often, and its disheartening really.


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## Umbran (Oct 10, 2019)

Randomthoughts said:


> That being said, have designers and those in the RPG industry considered the following options:
> 
> 
> Purchasing health insurance through the exchanges? I have a few friends who are tradesman who were initially against the ACA but found that it allowed them to remain as independent business owners




At various points, I have worked as a contractor through an agency not headquartered in my home state.  As the agency didn't meet my state's requirements for insurance, I turned to the exchange, and it was a major help.  But, I was making too much money to get any of the state subsidies.  So, I was effectively paying the _full_ price for insurance, with no corporate contribution.  And I gotta tell you, the plans I could afford were pretty pitiful.  They got us basic health visits, and would have been some cushion for major acute issues.  But, if anything really serious and long lasting had come up, that wouldn't have been a pretty picture.



> Enrolling in health insurance through professional associations? Many of us I presume are part of professional associations through our day jobs, some/many of whom may offer health insurance to its members. If one does not exist for the RPG industry, could one be created?




GAMA (the Game Manufacturer's Association) does this, I believe.  But I don't know any details.

Could one be created?  Sure... by someone who wanted to make it their full-time job.  Professional associations large enough to have insurance bargaining power don't just grow on trees!


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## generic (Oct 10, 2019)

Xenonnonex said:


> It seems some people are willfully and knowingly spreading misinformation and lies about the state of US healthcare. In their minds someway somehow they do not think the US healthcare system is appallingly bad.



You have repeatedly demonstrated that you lack the ability to empathize with the arguments of other posters, refusing to even listen to them.

How would you feel if I simply stated that "the Canadian system is basically fascist, and is a socialist dictatorship, and you're a fool if you can't see that"?

Obviously, I don't believe that, but it's essentially the equivalent of what you're doing.  Screaming at people and calling them idiots generally accomplishes little.


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## Xenonnonex (Oct 11, 2019)

Aebir-Toril said:


> You have repeatedly demonstrated that you lack the ability to empathize with the arguments of other posters, refusing to even listen to them.
> 
> How would you feel if I simply stated that "the Canadian system is basically fascist, and is a socialist dictatorship, and you're a fool if you can't see that"?
> 
> Obviously, I don't believe that, but it's essentially the equivalent of what you're doing.  Screaming at people and calling them idiots generally accomplishes little.



And some posters have repeatedly demonstrated the inability to empathize with the plight of the populace that have been greatly and adversely affected by the healthcare model in America. So good on us all I guess.
I cannot empathize with the arguments of some posters who argue in bad faith. Not when people's lives are being wrecked because of the healthcare model. To say otherwise means I lack humanity. 

Your conflation is really something is not? Unless your comprehension ability is being severely affected something to that effect is not being put forward as an argument.
Woe and hambug to us who dare criticize the statistics and arguments brought up by people who think the American healthcare model is not appallingly bad. How dare we say in America everyone is not treated equally.


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## generic (Oct 11, 2019)

Xenonnonex said:


> And some posters have repeatedly demonstrated the inability to empathize with the plight of the populace that have been greatly and adversely affected by the healthcare model in America. So good on us all I guess.
> I cannot empathize with the arguments of some posters who argue in bad faith. Not when people's lives are being wrecked because of the healthcare model. To say otherwise means I lack humanity.
> 
> Your conflation is really something is not? Unless your comprehension ability is being severely affected something to that effect is not being put forward as an argument.
> Woe and hambug to us who dare criticize the statistics and arguments brought up by people who think the American healthcare model is not appallingly bad. How dare we say in America everyone is not treated equally.



So, you and only you engage in good-faith arguments?  Good day sir, I'm done here.  Try using logic to understand other posters, rather than calling them evil or stupid.


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## Xenonnonex (Oct 11, 2019)

Aebir-Toril said:


> So, you and only you engage in good-faith arguments?  Good day sir, I'm done here.  Try using logic to understand other posters, rather than calling them evil or stupid.



What. That is your reading into it. I have not said that. At all. 

Conflating and then arguing current situations are not bad as they seem is a bad faith argument. Saying that everyone has equal access to healthcare in America is a bad faith argument. Saying that the health outcomes in America by cost expenditure are similar to other OCED countries is a bad faith argument. When many posters have emphasized with actually valid statistics is not the situation at all.


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## generic (Oct 11, 2019)

Xenonnonex said:


> What. That is your reading into it. I have not said that. At all.
> 
> Conflating and then arguing current situations are not bad as they seem is a bad faith argument. Saying that everyone has equal access to healthcare in America is a bad faith argument. Saying that the health outcomes in America by cost expenditure are similar to other OCED countries is a bad faith argument. When many posters have emphasized with actually valid statistics is not the situation at all.



To quote an idiot in America: "Sad".

YOUR statistics are correct.  Arguments that YOU don't make are wrong.  Am I interpreting your posts incorrectly, or, do you hate people with opinions other than YOUR own?

This is frankly ridiculous.  I'm someone who, for the most part, AGREES with you, for Loviatar's sake!  Your inability to recognize the arguments of others as anything but bad-faith is pathetic.


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## Xenonnonex (Oct 11, 2019)

Aebir-Toril said:


> To quote an idiot in America: "Sad".
> 
> YOUR statistics are correct.  Arguments that YOU don't make are wrong.  Am I interpreting your posts incorrectly, or, do you hate people with opinions other than YOUR own?
> 
> This is frankly ridiculous.  I'm someone who, for the most part, AGREES with you, for Loviatar's sake!  Your inability to recognize the arguments of others as anything but bad-faith is pathetic.



Okay. You might want to take some time for coffee. You are now reading into things that is simply not true. 

I have agreed with you that the American healthcare model needs improvement. Arguments are being put forward about the current state of the American healthcare model and it is not appallingly bad. Others have showed through statistics and coherent logic that it is. 
My post addresses the reasons these arguments are used in bad faith. You are free to dismiss these reasons and read into what you want to.


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## generic (Oct 11, 2019)

Xenonnonex said:


> Okay. You might want to take some time for coffee. You are now reading into things that is simply not true.
> 
> I have agreed with you that the American healthcare model needs improvement. Arguments are being put forward about the current state of the American healthcare model and it is not appallingly bad. Others have showed through statistics and coherent logic that it is.
> My post addresses the reasons these arguments are used in bad faith. You are free to dismiss these reasons and read into what you want to.



Statistics and coherent knowledge have been utilized by the other side as well, can you not see this?

Sorry, I'm far past coffee.  I should probably go back to math stuff.


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## Xenonnonex (Oct 11, 2019)

Aebir-Toril said:


> Statistics and coherent knowledge have been utilized by the other side as well, can you not see this?
> 
> Sorry, I'm far past coffee.  I should probably go back to math stuff.



 When it is well past it's due date. Okay I guess.


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## Xenonnonex (Oct 11, 2019)

Aebir-Toril said:


> the other side as well



Argue against this however you want. Read into this however you want. But really I do not think there should be an "other side" to healthcare.


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## generic (Oct 11, 2019)

Xenonnonex said:


> Argue against this however you want. Read into this however you want. But really I do not think there should be an "other side" to healthcare.



As far as I have seen (I'm not being aggressive here, emotion can be hard to read online) it isn't that there's 'another side' to the idea that people should have healthcare, it's that certain people have differing views on how healthcare should work.

Using experiential knowledge, it seems that many of the US posters have had good experiences with the US system, and see no problem with people having to pay for expensive operations, rather than being taxed.

I don't really agree with them here, but, I think you may be reading the words of others without proper mercy, as _ahem_ some of us (namely me) have done in the past.


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## Xenonnonex (Oct 11, 2019)

Aebir-Toril said:


> As far as I have seen (I'm not being aggressive here, emotion can be hard to read online) it isn't that there's 'another side' to the idea that people should have healthcare, it's that certain people have differing views on how healthcare should work.



I and others have also been arguing the current healthcare model is simply not adequate or even working well for its population.
As you say this is a complex issue. And requires a fundamental rethink and a restructure of the structures underlying the healthcare system.



> Using experiential knowledge, it seems that many of the US posters have had good experiences with the US system, and see no problem with people having to pay for expensive operations, rather than being taxed.



I am not sure this is even the case for even the posters in this thread. Let alone "many" US posters. I do not know how you have reached this. Your post speaks of simply ignoring the experiences of the posters who have been through the US healthcare system. You already have examples from US posters who have experienced the US healthcare system that the costs involved are too disproportionate to the care received.


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## generic (Oct 11, 2019)

Xenonnonex said:


> I am not sure this is even the case for even the posters in this thread. Let alone "many" US posters. I do not know how you have reached this. Your post speaks of simply ignoring the experiences of the posters who have been through the US healthcare system. You already have examples from US posters who have experienced the US healthcare system that the costs involved are too disproportionate to the care received.



Fair enough, Xenonnonex, fair enough.


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## Umbran (Oct 11, 2019)

Xenonnonex said:


> Saying that everyone has equal access to healthcare in America is a bad faith argument. Saying that the health outcomes in America by cost expenditure are similar to other OCED countries is a bad faith argument.




With respect, here you seem to conflate, "entirely incorrect," with, "bad faith".

An argument is in "bad faith" when the speaker _makes a deceptive argument, or argues for duplicitous or fraudulent reasons_.  If you enter into an argument with no intent of actually listening to anyone else, while you say you actually might have your mind changed, you are arguing in bad faith.  

It is not in bad faith to be wrong.  

It is bad faith to be shown to be wrong, and then move the goalposts so that being wrong is not of consequence.  It is in bad faith to use "bait and switch" forms, where, when proven wrong, you switch to another meaning of a term so that you are still correct.  And so on.


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