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#1002 Mar 29 2012 at 3:45 PM Rating: Good
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rdmcandie wrote:
gbaji wrote:
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gbaji wrote:
But that's not the choice here. The choice is between Obamacare and the health care we had before passing it. That wasn't "no care".


So the GOP isn't going to offer up a solution? Or are they happy with the current system?


That's not the issue. The issue is whether Obamacare improved our health care or not. You're excluding the middle. It's quite possible to not be happy with the current system while *also* believing that Obamacare is worse. I may not be happy with a Big Mac for lunch, but it's preferable to a pile of dung. Insisting that I should like the dung because I don't like the Big Mac really just fails to grasp the issue.


Obamacare had very little to do with improving your health care. It was largely implemented to improve access to health care for those unable to attain health care on their own. Be it due to low income, lack of income, lack of clean health (pre existing conditions). In that regard it is most certainly better, and guess what, it doesn't change what was available under the previous system. You can still go get private insurance, which may or may not offer more coverage than the basic public service.

Also your analogy is @#%^ing stupid. If you don't like Big Macs or sh*t Sandwhiches go out and get something else for lunch. Obamacare isn't forcing you on to a government system, you have to go out and buy whichever healthcare package you deem reasonable, and said package is still acceptable.


Fixed your statement. It's okay, I know you smoke a lot of weed.


Edited, Mar 29th 2012 5:46pm by Kastigir
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#1003 Mar 29 2012 at 4:34 PM Rating: Default
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As a side note, I once said that I was skeptical of Gbaji's claims that if we just didn't have insurance for regular care, prices would dramatically drop. I noted that there were multiple nurse practitioner "cash only" clinics in drugstores and department stores like Walmart & Target and they were all priced close to what my own GP charged for a cash visit. So the same $80-$100 visits that were keeping people out of the regular doctor's office were still being charged when you were being seen by a nurse practitioner at CVS.

Flash forward to a few weeks ago, something inspired me to check out the clinics again. They're still charging the same rates but... they all take insurance now. Apparently they weren't making enough money charging $80 a pop to see if you have strep so, rather than attract more customers by lowering their prices they simply widened their net by allowing someone like me to go and throw down my Humana card -- the value now is convenience rather than affordability.

I'm not so much trying to make a huge point with that but I found it very interesting.


It's the free market in action though. When you have a non-market force involved, it skews everything around it. The problem is that the system of using insurance to pay for regular (or relatively inexpensive) care distorts the normal supply/demand curve for those goods and services. In this case, I think it's wrong to assume that a cash-only clinic would set its prices based on the curve for the cash-only customers. The clinic is not operating based on the best price to give to the consumer, but the best profit margin it can make in total. If the insurance company is willing to pay $80-100, then charging less to cash-only customers represents a loss of earnings for the clinic (assuming everything else is the same). Why would they do that?

The expected free market outcome in that situation is that the clinic will charge the same amount to the cash-only customers which it *could* charge an insurance company. If that amount isn't cost effective (because it does not accurately reflect the supply/demand curve for customers paying out of their own pockets), then they will tend to lose money doing this. This in turn drives them to accepting insurance (best profit margin for them). Which appears to be what you've seen.


It's the same principle that causes prices in and around tourist areas to be higher than normal. And it doesn't matter that you're not a tourist. The store charges more because it can charge a tourist more. Why sell the same good or service for less? Now, if the locals want to go into the tourist trap to buy stuff, they can, but they can also expect to pay higher prices then the same good or service a distance away.

The mere fact that insurance is so commonly used to pay for those services means that any clinic *could* charge a higher price than people are willing to pay out of their pockets for the same thing. So the tendency will be that every clinic or hospital *will* charge that higher price. Those that don't, will lose money relative to those that do. This creates a strong market force that absolutely drives prices up. You saw it yourself. Clearly, they could not make enough money selling those services at that price to customers paying out of their own pockets. But they could make enough money selling those services (presumably at that same or even higher price) to insurance companies.


Which kinda proves my point.
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#1004 Mar 29 2012 at 4:38 PM Rating: Excellent
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The thing is, though, those preventative visits are actually a value for the insurance company.

$100 for a visit to a doctor for strep throat today, or $10,000 for an extended hospital visit for untreated strep throat turning into pneumonia?
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#1005 Mar 29 2012 at 4:42 PM Rating: Excellent
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catwho wrote:
The thing is, though, those preventative visits are actually a value for the insurance company.

$100 for a visit to a doctor for strep throat today, or $10,000 for an extended hospital visit for untreated strep throat turning into pneumonia?


On this note my insurance company discounts the cost of my coverage by 5% if I workout regularly (30 minutes of walking or other physical activity about 2-3 times a week) and have doctor chosen who I would go for basic checkups or other concerns.
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#1006 Mar 29 2012 at 4:58 PM Rating: Decent
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catwho wrote:
The thing is, though, those preventative visits are actually a value for the insurance company.

$100 for a visit to a doctor for strep throat today, or $10,000 for an extended hospital visit for untreated strep throat turning into pneumonia?


That math only works if 100% of all the people with a sore throat which *could* be strep actually have strep. What actually happens is that you save the cost of one $10,000 extended hospital stay at the cost of 10,000 $100 doctor visits to check if that sore throat is strep. Total cost increases by a couple orders of magnitude as a result.

Obviously, that cost differential changes if the preventative care can include checks for multiple things, all of which may avoid a costly hospital stay, but it's still hard to see how the total costs aren't higher in the long run. Imagine if we pay for everyone to get a check up every 6 months at a cost of $100. What percentage of people in any given 6 month period will develop some illness which will require an expensive hospitalization? What percentage of those illnesses might have been caught earlier and made less expensive as a result? The math and odds get really dicey IMO.

Doesn't it just make more sense to provide insurance which covers the expensive hospital stay and let the people pay for the regular/cheap stuff on their own? So instead of 10,000 people paying $110/year for the insurance to cover a $100 doctor visit, they just pay $1.10 each for insurance sufficient to pay for the actual cost of the one guy who will get sick (with the insurance company charging a 10% overhead charge in both cases). And if anyone wants to pay $100 for doctor's checkup, their total bill is still less than just the insurance cost for the checkup. Doesn't that make a hell of a lot more sense?


I think it does.

Edited, Mar 29th 2012 4:01pm by gbaji
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#1007 Mar 29 2012 at 4:58 PM Rating: Excellent
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If, supposedly, doctors were encumbered by the paperwork and bureaucracy of insurance to where it represented a significant fiscal burden then it would indeed make perfect sense to offer their cash services at a significant discount. If you're not paying 30% in administrative costs, you could afford to knock 30% off your billing without any loss to yourself. This is the argument Meijers makes on their website when describing their lower rates.

The reality is that the great majority of these clinics would rather shackle themselves to the insurance paperwork for a broader customer base even if it means pricing themselves out from people with fifty bucks cash in their pocket than to stick with the cash model and rely on people paying the actual market value of their services with no administrative add-on costs.
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#1008 Mar 29 2012 at 6:12 PM Rating: Excellent
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At $100 a visit though I'd rather stay home and ride it out than spend the money only to be told it isn't strep.

At a $15 copay, it was worth it to take a day off and go get it verified and get prescribed antibiotics since it IS a bacterial infection, anyway, just not strep.
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#1009 Mar 29 2012 at 7:26 PM Rating: Decent
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catwho wrote:
At $100 a visit though I'd rather stay home and ride it out than spend the money only to be told it isn't strep.

At a $15 copay, it was worth it to take a day off and go get it verified and get prescribed antibiotics since it IS a bacterial infection, anyway, just not strep.


Ok. So if you and the other 10,000 people who get a sore throat all make that same decision, and the doctor visit actually costs $100, your insurance is going to have to charge each of you the other $85 just to break even. You're forgetting that you are all collectively paying for the entire cost. The "it's just a $15 copay" is a mirage. if *everyone* goes to the doctor regularly, then *everyone* pays the full price for those doctor visits plus the cut the insurance company takes.

You just pay it in higher insurance premiums. But you still pay for it. That's why the (total) cost is higher. If you only purchased insurance that covered you *if* you got strep throat and had to go to the hospital, then you and everyone else wouldn't be paying for all those doctor visits which don't prevent someone from going to the hospital.

The problem with the preventative care model is that in order to ensure that you actually prevent an expensive hospital stay, you must check everyone who *might* end out with an expensive hospital stay. And that ends out being a really really really large number of people. Even at a relatively cheap cost like $100 for a checkup, it adds up when multiplied by that many people. Another way to look at it is that the break even point for doing this is if the dollar cost for a hospital stay is as many times more expensive than the cost to check for the condition which might cause that hospital stay as the odds among any random group of people with basic symptoms of actually having that condition. So if the odds of someone with a sore throat having strep is 1 in 10,000 (my admittedly made up example), then the cost of hospitalization must be 10,000 times as much as the cost to test for and prevent that stay. If it isn't, then you are spending more total money than you would otherwise.


The model does not work in a whole lot of cases.
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#1010 Mar 29 2012 at 10:28 PM Rating: Excellent
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I'm pretty sure my insurance company would had love it if I had went to see the doctor when I thought it was just a cold. A $100 visit might had saved me my heart and them about 700 to 800k dollars well and medicare 1mil you know damn cobra kicks you off after 2 years (took .2 and a half to find a decent heart).
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#1011 Mar 30 2012 at 12:03 AM Rating: Excellent
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RavennofTitan wrote:
I'm pretty sure my insurance company would had love it if I had went to see the doctor when I thought it was just a cold. A $100 visit might had saved me my heart and them about 700 to 800k dollars well and medicare 1mil you know damn cobra kicks you off after 2 years (took .2 and a half to find a decent heart).
Nonsense! If they did that then there'd be (your number / 100 + 1) people who'd go for that $100 checkup, it'd just cost more money. Can't you see that!?
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#1012 Mar 30 2012 at 12:39 AM Rating: Excellent
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The only way to truly get away from it is to drop this crappy health insurance thing and go to universal healthcare. Stop lollygagging and get it done properly.


I would love that. Really. It's one of the main reasons I love Dennis Kucinich. He's one of the only federal level politicians who has consistently, for years, said that we need a single payer universal health care system. I seriously do not understand why so many Americans are afraid of doing things the way the Europeans (and Canadians) do, when what they do works! I'm all for keeping some of our national identity, but the way we do education and health care in particular are @#%^ed up, and I think we'd be better off observing the way other industrialized nations do it, and figure out how we can adapt those methods so that they work for us.

I'm still pissed that the Demos cowed to the GOP when it came to the public option. We had a filibuster proof Congress and Senate. Why did we feel the need to work with the GOP when they haven't felt the need to work with us for years? It's crap like this that makes me seriously consider moving to a different country when I finish school.
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#1013 Mar 30 2012 at 7:15 AM Rating: Excellent
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Conservatives trip over themselves to pay for anything medical I need.
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#1014 Mar 30 2012 at 8:16 AM Rating: Excellent
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Conservatives trip over themselves to pay for anything medical I need.


Yeah, the VA had to pay for my father's 4 way heart bypass surgery since he had his first heart attack on duty.

Then they discovered with him, as well with all the other vets of the former 11th airborne, that maybe doing 300 jumps was actually really hard on a body's circulatory system and is probably not a good idea. Smiley: frown
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#1015 Mar 30 2012 at 9:25 AM Rating: Excellent
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I keep getting offered airborne school, and I keep telling them the same thing: I was brought into this world because of a broken rubber, I'm not leaving the same way.
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#1016 Mar 30 2012 at 10:32 AM Rating: Excellent
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gbaji wrote:
Obviously, that cost differential changes if the preventative care can include checks for multiple things, all of which may avoid a costly hospital stay, but it's still hard to see how the total costs aren't higher in the long run. Imagine if we pay for everyone to get a check up every 6 months at a cost of $100. What percentage of people in any given 6 month period will develop some illness which will require an expensive hospitalization? What percentage of those illnesses might have been caught earlier and made less expensive as a result? The math and odds get really dicey IMO.


IMO, if the math was really that dicey my insurance company wouldn't be paying us for participating in a preventative care program. It's not all stuff like doctor and dentist visits of course, there's also things like:

-smoking cessation program
-weight-management program
-monetary rewards for getting exercise
-Having a PCP

among other stuff.

Edit:

Also a bit of speculation, but this kind of thing probably only works if you're planning on keeping your employees for a long period of time. Since the monetary benefits of health later are generally later in life, and the costs more short term. As bad as it sounds if you only hold on to employees for a couple of years (or have a younger work force) it's probably cheaper to just skimp on stuff and pawn off the eventual health problems on someone else's insurance program.




Edited, Mar 30th 2012 9:52am by someproteinguy
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#1017 Mar 30 2012 at 10:45 AM Rating: Excellent
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I keep getting offered airborne school, and I keep telling them the same thing: I was brought into this world because of a broken rubber, I'm not leaving the same way.


My father said that the best thing he got, aside from learning how to jump out of perfectly good airplanes, was the most wicked badass tattoo on his leg. The P of Paratrooper was drawn in a stylized cursive and sort of looked like a parachute.
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#1018 Mar 30 2012 at 12:22 PM Rating: Good
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Oh Santorum. What are we going to do about you?
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#1019 Mar 30 2012 at 1:02 PM Rating: Excellent
*facepalm* Good grief, he's like 10x worse than Joe Biden.
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#1020 Mar 30 2012 at 5:01 PM Rating: Good
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*facepalm* Good grief, he's like 10x worse than Joe Biden.

He'll probably end up on the ticket as Mitt's veep.
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#1021 Mar 30 2012 at 5:06 PM Rating: Excellent
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I'll just give the benefit of the doubt and say he could have just tripped over a couple of words and it turned into an unfortunate sounding gaffe. While it isn't impossible one of those words was what we're all thinking, I kind of doubt even he's that dumb. Besides, it's not like he had a snowball's chance in hell anyway, so racial outrage is pretty much wasted.
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#1022 Mar 30 2012 at 8:03 PM Rating: Decent
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RavennofTitan wrote:
I'm pretty sure my insurance company would had love it if I had went to see the doctor when I thought it was just a cold. A $100 visit might had saved me my heart and them about 700 to 800k dollars well and medicare 1mil you know damn cobra kicks you off after 2 years (took .2 and a half to find a decent heart).


Still not seeing the math though. Divide the number of people who get a cold each year by the number of people who develop a heart condition which *can* be prevented (but would otherwise have required a super expensive transplant) and which will be caught and prevented by the doctor visit you went to because you had a cold. Assuming all 300 million people in the US will get a cold at least once a year, you're spending $30B/year for a $100 doctor visit for each of them each year. Assuming it costs $1m for a heart transplant (or whatever super expensive thing you're talking about), we would need to have 3000 people develop heart disease requiring a transplant every single year. Just to break even.

The math doesn't work. It's something that sounds great when some politician says it from a podium in front of an agreeable crowd. But if you actually stop and think about it, it's a pretty dumb idea. There are some areas where preventative care is worth it because the cost of the exams and the odds of actually preventing an expensive health problem if you catch it early enough combine to make it worth it. But most illnesses don't work that way. And certainly, almost no injuries work that way. No amount of you going to the doctor regularly will prevent you from falling and hurting yourself. So when we look at the total cost for "expensive hospital stays", we find that we can only really reduce this a small amount via prevention. But the total cost required to have any significant preventative effect is so high that it's almost absurd.
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#1023 Mar 30 2012 at 8:20 PM Rating: Excellent
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Debalic wrote:
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*facepalm* Good grief, he's like 10x worse than Joe Biden.

He'll probably end up on the ticket as Mitt's veep.

Speaking of running mates, I finally watched Game Change the other day.

Scary.
#1024 Mar 30 2012 at 8:24 PM Rating: Decent
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someproteinguy wrote:
IMO, if the math was really that dicey my insurance company wouldn't be paying us for participating in a preventative care program. It's not all stuff like doctor and dentist visits of course, there's also things like:

-smoking cessation program
-weight-management program
-monetary rewards for getting exercise
-Having a PCP

among other stuff.


Because the insurance company makes more money on the preventative care than on the actual care for an illness you get. You're thinking that what's less expensive for them is less expensive for you (you in this case being the whole number of people paying into that insurance company's pool). That's completely backwards though. If we assume that the insurance company takes 10% off the top for payoffs, under which condition does it make more money:

1. It covers 10,000 people for major medical only, with 1% of those people requiring a $10,000 hospital stay on average each year.

2. It covers the same 10,000 people for major medical, but now with only .5% requiring that hospital stay *plus* it covers preventative care, costing an extra $100 per person.


Remember, it's going to set its premiums to be 110% of the average cost it's paying out in order to cover administrative costs and make a profit. In the first case, the total cost is 100 hospitalizations at $10,000 each, for a total of $1m. It therefore charges $1.1m in premiums. That results in a $110 charge to each of the 10,000 people. In the second case, we've cut in half the rate of expensive hospitalizations (which would be a fantastic reduction by any measure), meaning only 50 people needed them at $10,000 each, for a total of $500,000. Plus, the insurance pays $100 for all 10,000 people at a total cost of $1m. Total cost is $1.5m in insurance payouts. Plus their 10% markup, they charge a total of $1,650,000, or $165 each.


So the total cost for your premiums went from $110 to $165, which is bad. The total number of people who got really sick went down, which is good. But the insurance company's profit increased from $100,000 in the first case to $150,000.

For 50% more profit? Of course the insurance company will do that. You have to understand that no cost the insurance company incurs actually costs them anything. They pass all costs on to the folks paying the premiums, and their profit is a percentage of that total cost. Thus, anything that makes health care more expensive is good for the insurance companies. Anything which increases the scope of things they have to cover is good for them.

I just think that most people don't realize this.

Quote:
Also a bit of speculation, but this kind of thing probably only works if you're planning on keeping your employees for a long period of time. Since the monetary benefits of health later are generally later in life, and the costs more short term. As bad as it sounds if you only hold on to employees for a couple of years (or have a younger work force) it's probably cheaper to just skimp on stuff and pawn off the eventual health problems on someone else's insurance program.



That's a separate issue, but entirely correct (as the system is set up now). This is why both Dems and GOP have been in agreement over things like allowing insurance companies to compete across state lines, and allowing customers to keep their insurer even as they change employers or move (or retire). For the most part though, the worst cases tend to work out. Remember that insurance companies are in the business of calculating total risks and costs and passing that on in the form of premiums. They'll make enough money on the healthy people to cover the costs for those who get sick. And while they do have some interest in dropping folks later on, as long as people have choices about their insurance, those companies who do that will tend to find fewer customers. The free market *can* correct for that factor (why would anyone buy health insurance if there was a high chance they'd just pay into it for 20 years then get dropped when they get sick?).

The problem is that most of those restrictions are government enforced, not free market. We've literally created cases where the insurance company you've paid for the last 20 years *can't* continue to cover you if you move or change jobs, and the new one is under little obligation to pick up the tab. And a whole hell of a lot of this stems directly from government meddling in the health care industry over the last 50 years.

Edited, Mar 30th 2012 7:37pm by gbaji
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#1025 Mar 30 2012 at 9:33 PM Rating: Excellent
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Anything which increases the scope of things they have to cover is good for them.
That's the argument for single payer health care.

Are you encouraging the government to put in place regulations that forbid insurance companies from offering coverage for daily health?
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#1026 Mar 30 2012 at 10:17 PM Rating: Excellent
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Viral cardiomyopathy is more common then you would like to think and not limited to viral infections but bacteria infections as well. sh*t my first dry run at transplant the would be donor had bacterial infection of the heart poor sob was sol any way. So that simple case of strep throat might do far more damage and cost the insurance company more then 100 dollar visit. Not to mention doctor visits are far less then ER visits. My heart transplant alone cost well over 1.8 million and it keeps on climbing with 1800 dollars a month going towards my anti-rejection meds and those are not even name brand. My other meds run 2000 a year for stuff like blood pressure and other side effects of having your heart cut out. Then I have biopsy's which for the first year was once a month at 1500 dollars a pop now I go every 6 months. So how many of cases would it take for that 100 dollar a pop visit to look like a sweet deal. Little prospective the longest living person with a heart transplant died 31 years after getting it and the avg survival time is 15 years.

Oh and there are 2300 heart transplants done every year that not including those that died before getting one but just waiting for one can rack up the bills too. A LVAD cost 500k and is used as a bridge to transplant or when transplant can not be done. So just a few cases like mine out of that 2300 would had saved millions. Early detection of problems make a 100 dollar visit worth it.



Edited, Mar 31st 2012 12:19am by RavennofTitan
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#1027 Mar 31 2012 at 3:14 AM Rating: Good
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RavennofTitan wrote:
Viral cardiomyopathy is more common then you would like to think and not limited to viral infections but bacteria infections as well. sh*t my first dry run at transplant the would be donor had bacterial infection of the heart poor sob was sol any way. So that simple case of strep throat might do far more damage and cost the insurance company more then 100 dollar visit. Not to mention doctor visits are far less then ER visits. My heart transplant alone cost well over 1.8 million and it keeps on climbing with 1800 dollars a month going towards my anti-rejection meds and those are not even name brand. My other meds run 2000 a year for stuff like blood pressure and other side effects of having your heart cut out. Then I have biopsy's which for the first year was once a month at 1500 dollars a pop now I go every 6 months. So how many of cases would it take for that 100 dollar a pop visit to look like a sweet deal. Little prospective the longest living person with a heart transplant died 31 years after getting it and the avg survival time is 15 years.

Oh and there are 2300 heart transplants done every year that not including those that died before getting one but just waiting for one can rack up the bills too. A LVAD cost 500k and is used as a bridge to transplant or when transplant can not be done. So just a few cases like mine out of that 2300 would had saved millions. Early detection of problems make a 100 dollar visit worth it.
Why bother? You know Gbaji is going to say how it's not worth it anyway because there's always more people who want that $100 checkup than whatever costs of not getting that checkup you can think of.
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#1028 Mar 31 2012 at 5:08 AM Rating: Excellent
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gbaji wrote:
RavennofTitan wrote:
I'm pretty sure my insurance company would had love it if I had went to see the doctor when I thought it was just a cold. A $100 visit might had saved me my heart and them about 700 to 800k dollars well and medicare 1mil you know damn cobra kicks you off after 2 years (took .2 and a half to find a decent heart).


Still not seeing the math though. Divide the number of people who get a cold each year by the number of people who develop a heart condition which *can* be prevented (but would otherwise have required a super expensive transplant) and which will be caught and prevented by the doctor visit you went to because you had a cold. Assuming all 300 million people in the US will get a cold at least once a year, you're spending $30B/year for a $100 doctor visit for each of them each year. Assuming it costs $1m for a heart transplant (or whatever super expensive thing you're talking about), we would need to have 3000 people develop heart disease requiring a transplant every single year. Just to break even.

The math doesn't work. It's something that sounds great when some politician says it from a podium in front of an agreeable crowd. But if you actually stop and think about it, it's a pretty dumb idea. There are some areas where preventative care is worth it because the cost of the exams and the odds of actually preventing an expensive health problem if you catch it early enough combine to make it worth it. But most illnesses don't work that way. And certainly, almost no injuries work that way. No amount of you going to the doctor regularly will prevent you from falling and hurting yourself. So when we look at the total cost for "expensive hospital stays", we find that we can only really reduce this a small amount via prevention. But the total cost required to have any significant preventative effect is so high that it's almost absurd.
A quick Google search shows approx 2200 heart transplants/year in the US. Your 3000 figure is not far fetched when you consider how many people aren't getting checked regularly.

Canada, who has universal healthcare has approx 160 heart transplants/year.

To put that in perspective, Canada's population is about 11% of the US population. Our heart transplant as a percentage of population is .00000476. The US is .0000703. Almost 50% more likely to be required.


Edited, Mar 31st 2012 8:17am by Uglysasquatch
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#1029 Mar 31 2012 at 7:26 AM Rating: Excellent
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#1030 Mar 31 2012 at 7:47 AM Rating: Good
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That is bull sh*t triple stacks here are almost 6 bucks.
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#1031 Mar 31 2012 at 8:35 AM Rating: Good
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rdmcandie wrote:
That is bull sh*t triple stacks here are almost 6 bucks.

That must be the triple stack with triple bacon. And cheese.
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#1032 Mar 31 2012 at 9:33 AM Rating: Excellent
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rdmcandie wrote:
That is bull sh*t triple stacks here are almost 6 bucks.

That's three bucks worth of taxes to pay for your heart transplants.
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#1033 Mar 31 2012 at 11:44 AM Rating: Excellent
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His Excellency Aethien wrote:
RavennofTitan wrote:
Viral cardiomyopathy is more common then you would like to think and not limited to viral infections but bacteria infections as well. sh*t my first dry run at transplant the would be donor had bacterial infection of the heart poor sob was sol any way. So that simple case of strep throat might do far more damage and cost the insurance company more then 100 dollar visit. Not to mention doctor visits are far less then ER visits. My heart transplant alone cost well over 1.8 million and it keeps on climbing with 1800 dollars a month going towards my anti-rejection meds and those are not even name brand. My other meds run 2000 a year for stuff like blood pressure and other side effects of having your heart cut out. Then I have biopsy's which for the first year was once a month at 1500 dollars a pop now I go every 6 months. So how many of cases would it take for that 100 dollar a pop visit to look like a sweet deal. Little prospective the longest living person with a heart transplant died 31 years after getting it and the avg survival time is 15 years.

Oh and there are 2300 heart transplants done every year that not including those that died before getting one but just waiting for one can rack up the bills too. A LVAD cost 500k and is used as a bridge to transplant or when transplant can not be done. So just a few cases like mine out of that 2300 would had saved millions. Early detection of problems make a 100 dollar visit worth it.
Why bother? You know Gbaji is going to say how it's not worth it anyway because there's always more people who want that $100 checkup than whatever costs of not getting that checkup you can think of.


I really should know better. It gets me because every time I go down for biopsy I meet some one else that did what I did and suffered. It not even that many people that didn't have insurance but had it and still didn't go to the doctor when their co-pays were 20 to 30 bucks so having to shell out 100 out of pocket would cause even more people to just chance it.
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#1035 Apr 03 2012 at 2:44 PM Rating: Default
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Anything which increases the scope of things they have to cover is good for them.
That's the argument for single payer health care.


No, it really isn't. Single payer health care (with the government being the payer), has all of the same associated problems that a broadly mandated private insurance system has. Even non-profit health insurance has to cover its own overhead and thus will increase the total price people pay for health care. Government as the payer will do the same thing, just that it can hide this a bit via its tax system. We are still collectively paying more for the result than we would otherwise.

Also, the larger factor is that those who sell the care itself will raise their prices if the buyer has no choice but to buy. Remember the only reason an ice cream cone doesn't cost $1000 is because no one would buy it at that price. But if you mandate that the buyer *must* buy something, you can raise prices pretty much without limit. My earlier argument was just about how insurance by its nature increases costs, but this is a bigger factor over time. And simply going to single payer doesn't affect that. You still have ever increasing costs. The only way to address that factor (once you get to single payer) is to make the health care providers all government employees as well. Then you can eliminate the profit objective entirely.

But then you have a health care system that is pushed by politics rather that costs, with all the attendant problems that entails. And let's not forget that this basically requires that we move all the way down the slippery slope to 100% government run health care. Most Americans reject that on ideological grounds so the only way left to us is to get government less involved in health care (ie: move in the opposite direction). Either direction addresses the cost issue. But one promotes low costs and high quality via a free market method, while the other does it by government fiat. Forgive me for trusting a profit motive to force people to keep costs low and quality high more than I trust political motivations to do the same.

Quote:
Are you encouraging the government to put in place regulations that forbid insurance companies from offering coverage for daily health?


No. I'm saying to remove the regulations which currently make it nearly impossible for employers to buy health insurance which *doesn't* provide coverage for daily health care and for insurers to offer health care which only provides "major medical" coverage. You seem to forget that our current system is already the result of massive government regulation.
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#1036 Apr 03 2012 at 2:52 PM Rating: Excellent
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lolgaxe wrote:
@GeorgeTakei Twitter wrote:
Women favor Obama over Romney in battleground states by 18%. In response, Republican leaders urge women to get out of the kitchen and vote.

Better than he's doing with Hispanics nationwide. 14% -- Hooray! Smiley: laugh
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#1037 Apr 03 2012 at 4:34 PM Rating: Excellent
lolgaxe wrote:
@GeorgeTakei Twitter wrote:
Women favor Obama over Romney in battleground states by 18%. In response, Republican leaders urge women to get out of the kitchen and vote.


I freaking <3 George Takei.

gbaji wrote:
Single payer health care (with the government being the payer), has all of the same associated problems that a broadly mandated private insurance system has. Even non-profit health insurance has to cover its own overhead and thus will increase the total price people pay for health care. Government as the payer will do the same thing, just that it can hide this a bit via its tax system. We are still collectively paying more for the result than we would otherwise.

Also, the larger factor is that those who sell the care itself will raise their prices if the buyer has no choice but to buy. Remember the only reason an ice cream cone doesn't cost $1000 is because no one would buy it at that price. But if you mandate that the buyer *must* buy something, you can raise prices pretty much without limit. My earlier argument was just about how insurance by its nature increases costs, but this is a bigger factor over time. And simply going to single payer doesn't affect that. You still have ever increasing costs. The only way to address that factor (once you get to single payer) is to make the health care providers all government employees as well. Then you can eliminate the profit objective entirely.

But then you have a health care system that is pushed by politics rather that costs, with all the attendant problems that entails. And let's not forget that this basically requires that we move all the way down the slippery slope to 100% government run health care. Most Americans reject that on ideological grounds so the only way left to us is to get government less involved in health care (ie: move in the opposite direction). Either direction addresses the cost issue. But one promotes low costs and high quality via a free market method, while the other does it by government fiat. Forgive me for trusting a profit motive to force people to keep costs low and quality high more than I trust political motivations to do the same.


I don't see how the government wouldn't be able to regulate the costs of health care, even if it was the only buyer in a universal health care system. If we implemented something like that, part of the law could be that health institutions are only allowed to charge x for y procedure, or something along those lines. There's a reason that every other industrialized nation in the world pays less per person for health care than we do. Part of that is because they all have universal healthcare of some sort. Hell, maybe that's even the only reason. I do think your point makes sense in regards to the national mandate for having health insurance though. I really don't like the idea myself, but I do think it's better than having over 4% of the population uninsured. The main problem with our health care system is how corrupt the health insurance companies are. They charge ridiculous rates, even for limited coverage, and then turn around and deny people the care they need, just to increase their profits. Sometimes people DIE because of this. Other times, they go bankrupt. It's incredibly messed up.

The issue I have with your last paragraph is that we don't currently have a system that promotes low costs and high quality. We have high quality of health care here in most places, I will grant you that. But as far as low costs go, that just isn't the case. For example, I've been seeing a psychiatrist at the local health clinic off and on since the end of December for my ADHD. That was when he diagnosed me, and it took nearly two months for us to find a medication and dosage that worked for me. The health insurance my mom pays for (because I can't afford it myself and she doesn't want me without health insurance) does not cover mental health issues at all, and because that's what the appointments were coded as, I have to pay full price for every one of those visits. Right now I owe the clinic close to $1500 total for all the visits. That's after the $30 co-pay I had for each visit when I thought my insurance was going to cover it. For just basic coverage, and a deductible under $10k (I can't remember if it's 3500 or 7500), my mom pays $155 a month. That's ridiculous. I am a healthy (aside from the depression and ADHD of course, lol) 28 year old female on birth control. There should be no reason my mom has to pay that much for basic coverage. The reason I mention the birth control is because insurance for women my age is usually pretty expensive, because most women are popping out kids in their twenties. I think that because I'm on birth control, my costs should be lower, but I don't think it works that way. Now, if mental health was covered, and vision and dental, I think $155 a month would be reasonable.

Anyways, my point is that health care in this country is ridiculously overpriced. I think if we had a universal health care system, we would all be better off. The government could regulate costs to keep them down, so overall it would cost less for everybody. I would be perfectly fine with doing something like what the UK does, and allow people to purchase their own private insurance or whatever, if that's what they wanted to do.
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#1038 Apr 03 2012 at 4:53 PM Rating: Excellent
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PigtailsOfDoom wrote:

The issue I have with your last paragraph is that we don't currently have a system that promotes low costs and high quality. We have high quality of health care here in most places, I will grant you that. But as far as low costs go, that just isn't the case.


PigtailsOfDoom wrote:

Anyways, my point is that health care in this country is ridiculously overpriced. I think if we had a universal health care system, we would all be better off. The government could regulate costs to keep them down, so overall it would cost less for everybody.


I'm not really sure what I want to quote of your Pigtails, but that'll do I think, since all that writing and stuff spurred me thinking.

Anyway, just a random observation. I don't know if it's just this country or what, but people I wonder how well we can make rational decisions about there health around here. Not that we're panicky idiots or anything, but somehow assigning a monetary value to something like your mental well-being, your hearing, the life of your family member, or even yourself isn't something that I think gets done remarkably well. There's such a scale of what people are willing to pay for here, and how much they're willing to pay. There's not always much great logic behind it all the time. Some will take full advantage of that, others tend to undervalue things. One's health can be an emotional issue in many cases, and it makes it really easy for things to end up way over or under priced.

Anyway, just my random thought of the day. Smiley: smile
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#1039 Apr 03 2012 at 4:56 PM Rating: Decent
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I just think the price of health care is outrageous.

My doctor basically charges somewhere around $500 per hour. I go to see him and it's $100 for a visit. During that visit he will only see and speak to me for 10-12 minutes tops. The rest of the hour it takes for a visit is spent in various waiting rooms and having some undertrained nurse type take my blood pressure with a cuff that is seemingly designed for a 12 year old girl.

Another thing I disagree with is the bargaining power health insurance have with care providers. My doctor charges $100 for a just a consultation visit (no shots or anything else). My insurance says that up, to my deductible, I pay 20%. My insurance company gets a bill for $100. They say, "Oh no, we only pay $76 for a GP visit. Oh, and the patient has a 20% responsibility." They pay $56 and I get a bill for $20. I think I should be responsible for 20% of the rates the insurance companies negotiate with the doctors. I also think all of the insurance companies should pay the same rates. I can understand charging someone without insurance higher, because you should get a discount when "buying in bulk".

I'm not sure what the answer is for rising healthcare costs and increasing numbers of uninsured people, but I don't think government paid universal healthcare is it. Higher taxes and the government using my tax dollars to pay for care for people who don't work or don't pay taxes isn't what bother me. What scares me is the government making decisions on what is "necessary care" and what isn't.
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#1040 Apr 03 2012 at 5:57 PM Rating: Decent
Bigdaddyjug wrote:


I'm not sure what the answer is for rising healthcare costs and increasing numbers of uninsured people, but I don't think government paid universal healthcare is it. Higher taxes and the government using my tax dollars to pay for care for people who don't work or don't pay taxes isn't what bother me. What scares me is the government making decisions on what is "necessary care" and what isn't.


I just don't see that as a rational argument. Thanks to the internet, we have great resources in being able to ask people from other countries around the world, how they like their healthcare. I have never seen a single person say that they were denied health care because the government found it unnecessary. I know in the UK at least, there do tend to be waiting lists for surgeries that aren't life threatening. Honestly, if I'm not having to pay for that surgery directly out of my own pocket (because yes, I recognize that universal health care isn't free), I wouldn't mind waiting a year or two if it wasn't life threatening.

As it stands right now, I have two surgeries I could stand to have, but I probably won't any time soon because I can't afford it. My right leg is an inch longer than my left leg, which causes my entire spine, hips and knees to go out of alignment. I was supposed to have surgery to fix this when I was 17. I originally saw a doctor about this problem when I was 11, and when I saw him again five years later to see if I still needed the surgery, he said I looked fine and sent me on my way. Then when I turned 20, I started having back problems, which I still have today. In combination with that particular issue, I also have very little arch in my foot. I used to be completely flat footed and pigeon toed, but wearing orthopedic inserts in my shoes while growing up helped remedy those issues for the most part. As a result of my back problems, I can't do very much physical labor, otherwise I'm in intense pain the next day and for several days after. Not that I want to do physical labor, but it would have been nice to be able to get a job as a housekeeper for a hotel - I would have gotten a job here a couple months sooner. So I could really use surgery to fix my leg/back issues, and LASIK surgery would be nice too so I don't have to deal with stupid contacts and glasses for another 15 years or so. Do I need either of these surgeries? No, not really. But they could vastly improve the quality of my life.

I am of the opinion, that it's a good idea to watch how other people do things, and if it works for them, to try doing it that way myself. Our country seems to suffer from this obsessive need to be different than the rest of the world, and I don't think it is to our benefit. Now, I am all for individuality and being different. But being different just for the sake of being different, especially when it is harmful to yourself, is just stupid. I mean really, why don't we use the metric system? We're the only country in the world who does not use the metric system (at least to my knowledge), and it's annoying. I don't like having to look up conversion rates for temperatures, weights, distances, etc. when I'm talking to someone from a different country, that way I know what they're talking about. Our units of measurement don't even make any logical sense, where as the metric system does make sense. A centimeter is 1/100th of a meter and cent = 100. A kilometer is 1000 meters and kilo = 1000. Easy peasy. Inches, feet, none of that makes any sort of logical sense. Hell, a foot doesn't even equal a foot for everyone! My feet sure as hell aren't 12 inches long. Our units of measurement aren't a big deal, it's just one of those little things that irks me when I think about it.

Don't get me wrong, I'm really not an America hater. I do love my country, and for a lot of reasons, I'm glad to have been born here. However, for a lot of reasons, I wish I had been born in Canada, or the UK or another country where people are generally healthier and happier.
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#1041 Apr 03 2012 at 6:11 PM Rating: Excellent
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someproteinguy wrote:
Anyway, just a random observation. I don't know if it's just this country or what, but people I wonder how well we can make rational decisions about there health around here.

This is a huge hurdle to changing Medicare to a privatized system (not that I'm arguing we should). Seniors don't want to find out that they picked the wrong plan or try to quantify their risks. They don't see themselves as insurance purchasers, they see themselves as potential patients. They just want a system that will ensure their coverage whether they're sick with Thing A or Condition B.

Really, it's not just seniors who don't want this but it's seniors who currently have a plan that's a good catch-all for whatever goes wrong. The rest of us are either along for the ride with our employer's plan or trying to outguess an industry based on giving you the least amount of coverage possible without making it so bad that they'll lose you entirely as a customer.
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#1042 Apr 03 2012 at 6:57 PM Rating: Decent
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PigtailsOfDoom wrote:
I don't see how the government wouldn't be able to regulate the costs of health care, even if it was the only buyer in a universal health care system.


Remember, that I'm addressing an argument that says "We're not implementing universal health care, just a single payer system so that everyone has coverage". So the actual health care providers (hospitals, doctors, clinics, etc) remain exactly as they are (and many are for-profit), but now the government will step in and pay for anyone's health bill. This creates a system where the government is paying the bill, but a private provider is setting the price. Of course the price will go up.

As I said, the only way the government can prevent costs from going up dramatically is to take pretty direct control of the whole industry (ie: socialized medicine). But that's exactly the type of system which most people in the US do not want. So it's valid to point out that the only way for the direction the Dems are taking us with regard to health care to work is the very system people don't want and which the Dems (publicly at least) insist they aren't forcing on us.

Quote:
If we implemented something like that, part of the law could be that health institutions are only allowed to charge x for y procedure, or something along those lines.


Which is socialized medicine. The seller of a good should be allowed to sell it for whatever the market will bear. Having the government step in and say "You can only charge X for that because our bureaucrats determined that was the fair price" is a gross violation of the basic principles of liberty we're supposed to enjoy. Of course, the problem is the slippery slope aspect to this. You start by the government mandating what care must be provided. This causes costs to rise, so the government steps in to "help out" by covering the costs. But this creates a "free money" condition in the free market parts of the system, causing prices to rise even more. The government then responds by putting price controls on the health care, which will effectively drive any remaining free market parts out of the system because the government can set the prices so low that only government run hospitals and clinics (funded with taxpayer dollars) can afford to run at a loss.

One step inevitably leads to the next. So it's very fair to point at the public dislike of socialized systems and ask if there's a better way. And that better way is *less* government regulation, not more.

Quote:
There's a reason that every other industrialized nation in the world pays less per person for health care than we do. Part of that is because they all have universal healthcare of some sort. Hell, maybe that's even the only reason.


Cost comparisons to right now, which is not really a free market system. As I pointed out earlier, our current system is already being heavily regulated and mandated. Either direction will reduce costs, but one involves more direct government control, and the other less. I think that most people in the US would rather have less.

Quote:
I do think your point makes sense in regards to the national mandate for having health insurance though. I really don't like the idea myself, but I do think it's better than having over 4% of the population uninsured.


I think that's a bit of monetary sleight of hand though. Think about it. Right now, if you are uninsured but need care, you can go to a hospital and get it. If you are unable to pay for the cost, the state will pick up the tab. So right now, we have a system where the taxpayer will pay for the care for those who can't pay for it themselves. That's the 4% number you talk about. But the mandate will now require that everyone have health insurance. But there's no magic that makes more people able to pay for it, right? So the same number of people will still be uninsured, we're just changing what we call it when the government pays for their care.

The biggest side effect of this though is that now the government picks up the tab for anyone who can't afford insurance, not just for those who can't afford the health care. There are many people who are today struggling to maintain their health insurance, but who will fall under the income level to qualify for the "free" insurance from the government. Those people will automatically stop paying for insurance and let the government do it. So while technically the number of insured hasn't changed, the number who are being paid for with tax dollars instead of their own income has increased. Additionally, the bill just sets a $1500/year fine for not buying health insurance. Well, that's less than the cost for most insurance right now, so most people will just drop their insurance and pay the fine instead.

The net effect is that people who would have had to pay for their own health care (either because they had insurance, or had sufficient money to pay out of pocket if/when they purchased care), will now be paid for by tax dollars. In fact, most people will. So if we change the question from "what percentage have their own health insurance" to "what percentage are having their health care paid for by the taxpayer", that number will increase dramatically.

Quote:
The main problem with our health care system is how corrupt the health insurance companies are. They charge ridiculous rates, even for limited coverage, and then turn around and deny people the care they need, just to increase their profits. Sometimes people DIE because of this. Other times, they go bankrupt. It's incredibly messed up.


Do you think that this problem is made better or worse when the government mandates that everyone must purchase health insurance? Can't you see that the best solution to providers of a good or service doing a bad job is to maximize the ability of the consumers to choose someone else? Right now our regulations make switching insurance companies very difficult if not impossible. Consumers are "stuck" with what they have. And when that's the case, the seller can take advantage of it.

Make it a real free market and insurance companies will fall over themselves to provide what the consumers want. And those who fail to do so will go out of business. That's how the free market works. When was the last time you paid $1500 for a TV from a store and then had the store refuse to give you the TV you just paid for? Doesn't happen, does it? Want to know why? Because if they did, no one would buy anything from them. How long would Amazon last if they just shipped the covers of the books you purchased to you and not the full book you paid for? Not very long, right?

That's how the free market works. And it's incredibly good at ensuring that consumers get the best product possible for the lowest price. It's only when you are at the extreme ends that this fails. Either an unchecked monopoly or too much government involvement can cause those market forces to fail. What you're seeing in the health care system in the US is absolutely because of too much government. It's just that it's happened so slowly and over a period of time likely longer than your lifetime that you didn't really notice it. To you, that's just the way it's always been.

But it hasn't always been that way. We used to have a system where pretty much anyone could afford basic medical care, and insurance for more expensive care was far far more affordable. We should move back in that direction IMO.

Quote:
The issue I have with your last paragraph is that we don't currently have a system that promotes low costs and high quality.


Correct. Which is why we need to move back to a system which has less government involvement so that those free market mechanisms will work as they should.

Quote:
For example, I've been seeing a psychiatrist at the local health clinic off and on since the end of December for my ADHD. That was when he diagnosed me, and it took nearly two months for us to find a medication and dosage that worked for me. The health insurance my mom pays for (because I can't afford it myself and she doesn't want me without health insurance) does not cover mental health issues at all, and because that's what the appointments were coded as, I have to pay full price for every one of those visits. Right now I owe the clinic close to $1500 total for all the visits.


Yup. And that high price is driven by the fact that most people are going to be paying with their insurance. If everyone had to pay for that out of their pockets, do you think they'd charge $1500? It might be expensive, but not so amazingly so. This is a tricky case because it's on the edge of what might be covered via insurance anyway. There are a number of much more clear cut cases where direct care should be relatively inexpensive, but is very pricey. It should *never* cost $100 or more just for 10 minutes of a doctors time. Yet that's pretty much the going rate now.

Quote:
Anyways, my point is that health care in this country is ridiculously overpriced. I think if we had a universal health care system, we would all be better off.


I disagree. I think that the direct costs would be less obvious so you'd think you're getting a better deal. Universal health care hides the cost from the consumer, and in my opinion that's never a good idea.

Quote:
The government could regulate costs to keep them down, so overall it would cost less for everybody. I would be perfectly fine with doing something like what the UK does, and allow people to purchase their own private insurance or whatever, if that's what they wanted to do.


That's not really a free choice though. A free choice involves the buyer choosing where to spend his money. If the government takes the money from you (in the form of taxes, or fees, or mandates) to pay for item X, no amount of saying "you're free to buy item Y instead" actually makes that a real choice.

Edited, Apr 3rd 2012 6:10pm by gbaji
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#1043 Apr 03 2012 at 7:09 PM Rating: Decent
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PigtailsOfDoom wrote:
I just don't see that as a rational argument. Thanks to the internet, we have great resources in being able to ask people from other countries around the world, how they like their healthcare. I have never seen a single person say that they were denied health care because the government found it unnecessary. I know in the UK at least, there do tend to be waiting lists for surgeries that aren't life threatening. Honestly, if I'm not having to pay for that surgery directly out of my own pocket (because yes, I recognize that universal health care isn't free), I wouldn't mind waiting a year or two if it wasn't life threatening.


We do have the internet, but it's amazing how many people don't look for examples of things they don't want to hear. A simple google search of "health care denied UK", yielded these results:

these people not happy with their care

more old people apparently not being given the choice to avoid that bad care

these people not getting care

and these people

and here's that rationing that is never supposed to happen

Oh. And here's an example of "death panels" in action in the UK

and another example of the UKs cost analysis system in action


The problem with putting the government in charge of paying for health care, is that you now put the government in charge of deciding what it will pay for. The means by which the costs savings will occur is to limit care only to those which are most cost effective. So fixing a broken arm? No problem. But anything expensive, especially if you're older? Not so much.

We can debate whether the problems in this sort of system outweigh the benefits, but you should really look at the problems instead of just pretending that since you haven't seen them, they don't exist.
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King Nobby wrote:
More words please
#1044 Apr 03 2012 at 7:18 PM Rating: Excellent
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gbaji wrote:
The problem with putting the government in charge of paying for health care, is that you now put the government in charge of deciding what it will pay for

So much worse than the guardian angels at Aetna, Humana or Blue Cross.
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Belkira wrote:
Wow. Regular ol' Joph fan club in here.
#1045 Apr 03 2012 at 8:02 PM Rating: Excellent
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Or you know the fact that they at any time can jack your rates at a whim just to get you off the books. People under group insurance don't have to worry about that to much but for those that have to buy their own you are %^&ed if you do get sick even minor treatments are enough for them to price you out. Its clear gbaji has no first hand experience with insurance companies when the sh*t hits the fan so its no shocker he is so clueless.
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#1046 Apr 03 2012 at 8:11 PM Rating: Decent
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Jophiel wrote:
gbaji wrote:
The problem with putting the government in charge of paying for health care, is that you now put the government in charge of deciding what it will pay for

So much worse than the guardian angels at Aetna, Humana or Blue Cross.


Yes. Because if those people don't deliver a service that's worth the cost, their customers (in an actual free market) can choose not to buy their service. But if the government mandates that you must buy their service, you have no choice. And if the government charges you automatically (in the form of taxes or fees) you also don't have a choice to buy the service.


If a store owner knows that you are required by law to buy something in his store, what motivation does he have to keep the price competitive? Hell. There is no such thing as competitive anymore. The entire principle behind breaking up monopolies rests on the assumption that in the absence of real competition, the provider of a good or service can charge more than he could otherwise. We have whole sections of our law dedicated to ensuring that no single provider gains too much control of a given industry specifically to avoid this.


But we think that "single payer" is a good idea? Why? It makes no sense at all.
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King Nobby wrote:
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#1047 Apr 03 2012 at 8:19 PM Rating: Decent
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RavennofTitan wrote:
Or you know the fact that they at any time can jack your rates at a whim just to get you off the books.


Then don't buy insurance from them in the first place. How much money does your mother pay for her insurance (plus including you)? How much value does she get from it in a given year? Couldn't you have saved the cost of the insurance and then used that to pay for your care directly and maybe even saved money over the course of the year? And that's assuming that the costs don't change, and I guarantee you if more people paid out of pocket for care, the prices would drop.

Quote:
People under group insurance don't have to worry about that to much but for those that have to buy their own you are %^&ed if you do get sick even minor treatments are enough for them to price you out. Its clear gbaji has no first hand experience with insurance companies when the sh*t hits the fan so its no shocker he is so clueless.


You're still arguing how it is rather than the "how it could be" condition I'm talking about. I freely acknowledge that the current system forces far too many people into insurance models which are over priced relative to what you get. The difference is that instead of arguing that we should use the government to force even more people into that same model, we should instead remove the existing regulations and mandates which force the people who are there now into it.


I'm arguing that we move away from a government mandate model and into a free market model. Let insurance companies provide as much or as little care as they want. Let employers (or even individual employees) choose which care levels they want to pay for with insurance. Remove the government controls that force care providers to work only (or primarily) for insured patients. Do you even realize that the government created this by forcing the creation of HMOs? We were pushed from a model where regular health care was cheap and affordable to all into one where everyone had to buy comprehensive health care. That's what caused the costs to keep going up. Responding to that with yet more of the same sorts of policies that got us into this mess just seems pretty darn stupid.
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King Nobby wrote:
More words please
#1048 Apr 03 2012 at 10:09 PM Rating: Excellent
gbaji wrote:
Think about it. Right now, if you are uninsured but need care, you can go to a hospital and get it. If you are unable to pay for the cost, the state will pick up the tab. So right now, we have a system where the taxpayer will pay for the care for those who can't pay for it themselves.
Please be so kind as to direct me to this magical fairyland. I need eye surgery that will cost at least 12K$ and diagnosis and treatment for the underlying cause. NO DOCTOR CLINIC OR HOSPITAL will do anything for me without either cash up front or insurance. I have neither. I will go untreated. Period.
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gbaji wrote:
I'm smarter then you. I know how to think. I've been trained in critical thinking instead of blindly parroting what I've been told.
#1049 Apr 03 2012 at 10:21 PM Rating: Excellent
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gbaji wrote:
Yes. Because if those people don't deliver a service that's worth the cost, their customers (in an actual free market) can choose not to buy their service.

Which isn't actually the case since most people are bound to the insurance chosen by their employers, Pollyanna dreams aside.
Quote:
But if the government mandates that you must buy their service, you have no choice.

Of course you do. Anyone in the UK can still go to a doctor, throw down a handful of cash and ask for a procedure. There is a private medical insurance industry in the UK, you know.
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But we think that "single payer" is a good idea? Why? It makes no sense at all.

Because, scary "government" boogey-men aside, I'd have more faith in a system without a profit motive involved in my health care than one whose pure interest is making as much money as possible which is only done by providing the least service (cost) for the most profit. For all you go on about how the government will be involved, I can say that I have had multiple experiences with insurance companies making my medical decisions for me based on what they (not me, not my doctor) thought I should have done and what they (not me, not my doctor) thought was worth paying for. You'll need a better hand than "government will control it!" to score any points here.
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Belkira wrote:
Wow. Regular ol' Joph fan club in here.
#1050 Apr 03 2012 at 10:25 PM Rating: Excellent
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Friar Bijou wrote:
gbaji wrote:
Think about it. Right now, if you are uninsured but need care, you can go to a hospital and get it. If you are unable to pay for the cost, the state will pick up the tab. So right now, we have a system where the taxpayer will pay for the care for those who can't pay for it themselves.
Please be so kind as to direct me to this magical fairyland. I need eye surgery that will cost at least 12K$ and diagnosis and treatment for the underlying cause. NO DOCTOR CLINIC OR HOSPITAL will do anything for me without either cash up front or insurance. I have neither. I will go untreated. Period.

Obviously you just need to go to the emergency room since that's what Gbaji is referring to. Of course, by "the state will pick up the tab", Gbaji means we'll all pay vastly inflated costs for people using the emergency room as a general practitioner's office and that person will be hounded by bill collectors for the cost and have their credit ruined when they can't pay. Oh, and the hospital will suffer under the missing money for a good long while since the state doesn't just cut them a check that day -- the hospital needs to put in its time (years) pursuing the bad debt before it can write it off to the state and wait for repayment.

But, yeah, great system we currently have. The sick person's life gets ruined, the hospital suffers and everyone else pays far more than the service was actually worth. Yay! Let's stick with that!

Edited, Apr 3rd 2012 11:27pm by Jophiel
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Belkira wrote:
Wow. Regular ol' Joph fan club in here.
#1051 Apr 03 2012 at 10:55 PM Rating: Excellent
Every time someone brings up the boogeyman of the goverment telling people which doctors they can go and see etc I'm amused. Right now in Canada, I can see whichever doctor I want. Most doctors actually act as a private practice. I can go to whichever hospital I want, wherever I am in Canada. If my doctor thinks I need an operation, I will get that operation based on what the doctor, and probably some specialists decide. It doesn't matter if I already had a disease and this is a complication, or if it's something new, or if I got into an accident.

Compare that with US private health care.

1) I need to go to in network hospitals.
2) I can only go to doctors that work with my particular insurance companies
3) most doctors operate not as a private practice because they can't deal with all the paperwork for all the different insurance companies.
4) if my doctor thinks I need something medical done, it has to also be approved by the insurance company, who will always try to find a way out because that's the way insurance works.

So we have one system where the mandate is to provide the best health care for people, and the monetary focus is on it costing the least, while treating everyone. It's also I might add, at least somewhat accountable.

The other system is one with a mandate to make the most money possible, and the monetary focus is on profits. This includes not treating people if at all possible. It is not really accountable. You generally don't have a choice about your insurance, silly dreaming aside.
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