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Count Zero
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May 6th, @08:21PM
| Health Care
I'm sad you don't find it at all disturbing that among the leading industrialized nations our healthcare system is in the worst shape as far as taking care of the underprivileged is concerned.
[mod note: split from another thread as a separate topic --- fatness] | |
Count Five
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said by Count Zero :I'm sad you don't find it at all disturbing that among the leading industrialized nations our healthcare system is in the worst shape as far as taking care of the underprivileged is concerned. I find it disturbing that some people seem to feel that the best way to solve the health care "problem" is to put the government in charge of it.
You know, the same government that grossly mismanages Medicare and somehow succeeds in providing vastly inferior care at a horribly inflated cost. To say nothing of their unfunded liabilies. If you don't happen to understand what the term "unfunded liabilities" means, that's no problem: I promise that you will have a very complete and personal understanding of just what it is I'm referring to in a few years.
I can tell that anyone who advocates putting the government in sole charge of our health care system has never had to deal with the Feds on any Medicare-related matters. Because if they ever have, they would know firsthand (as I do) that those are the last people you would ever want to put in charge of life-or-death decision making for anyone you care about.
Let's face it: our government cannot even manage something as straightforward as a bank account (e.g. Social Security). Please do not try to tell me that people who demonstrate a complete inability to perform simple addition and subtraction can be relied upon to understand complex issues such as the allocation of health care. Because that just isn't so.
(Oh and who, exactly, are you referring to when you talk about the "underprivileged?" If you mean poor people, then please just say "poor people." I don't know who you're trying to kid by referring to poor people as "the underprivileged," but I think you'll find that poor people are perfectly aware that they are, in fact, poor. And that merely changing the name of their condition does nothing to actually change their condition.) | |
Count Zero
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Warner Robins, GA | Medicare is actually a handled by private companies that get contracts through the government. If I had my way we'd get rid of those companies too. | |
FiL 1
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| Look, it'd be nice if one day, we could actually try to resolve the "drug problem" in a concise way by also looking at legalization.
But so much emphasis is put on keeping all these drugs illegal, that even intelligent citizens back up the governments sentiments on keeping it illegal. Its been illegal for too long; your a crack head to think it'll change now. | |
Count Zero
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| I don't think it will change any time soon sadly, but I do believe that we need to start moving that way. We have too many conservative forces in power in our government right now. But in time we can change that and start to legalize and make progressive shifts all throughout society. | |
Count FIve
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said by Count Zero :Medicare is actually a handled by private companies that get contracts through the government. No: Medicare is paid for, and administered through, the Federal government. Do private health care providers provide care? They do. But exactly what they do, and how much they are allowed to charge the government to do it, are determined by the federal government.
Which is why Medicare has such huge cost overruns: the Feds have set up a system that a) puts the Federal government in the health care business (despite their proven track record of not being able to prudently manage any kind of business) and b)private companies have learned to game.
And why shouldn't they when the Feds are handing out money hand over fist?
The reason why you see Medicare with these huge cost overruns is simply because there is no incentive for the federal government to run it in an efficient way. Any time they mess up and spend too much money, they either steal money from other programs to pay for Medicare or, worse, have the Federal Reserve print more money to keep it going.
If you think this is a sustainable over the long term then I'm not sure you grasp the economics behind it all.
said by Count Zero :If I had my way we'd get rid of those companies too. If I had it my way, everyone who thinks that socialized medicine is a good idea would spend six months in a VA hospital. And if they survived the six months, (not necessarily a given) I'm sure that they would emerge from the experience with an entirely different perspective on health care.
People don't seem to understand that health care, like any other good in constant demand, must be rationed somehow. If you want to ration it the Free Market way, the rationing is done by price. If you want to do it the Socialized Medicine way, then you can look forward to being put on a waiting list of some kind for that critical operation you need.
And if you happen to die before you reach the top of that waiting list, that's just too bad. No government in the world has the ability to give its citizens all the health care they want, exactly when the citizens want it (rather than when the government is ready to give it to them).
But what socialized medicine advocates conveniently ignore is that the US is a popular destination for "refugees" from countries that have socialized medicine. Because they realize that by coming here, they can get the health care they want when they want it. Not months or years after they needed it.
Health care is expensive because it is something that everyone wants. I, too, wish that there was some way of magically making it cheaper.
But anyone who says that the way to solve our health care problem is to put our government completely in charge of it first needs to explain why the government cannot competently run programs like Medicare on a basis that is sustainable over the long term. | |
Count Zero
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| From wiki:
Since the beginning of the Medicare program, CMS has contracted to private companies to assist with administration. These contractors are commonly already in the insurance or health care area. Contracted processes include claims and payment processing, call center services, clinician enrollment, and fraud investigation.
A) A big part of the medicare's woe's are fraud and letting politicians touch the system in general.
B) You lose any credibility with me when you make the statement "b)private companies have learned to game.
And why shouldn't they when the Feds are handing out money hand over fist?"
Because it is morally reprehensible that the government tries to help out people who need it, but a company decides that instead of using that money to help people as the government intended them to they might as well keep it because they certainly need it. Then someone like yourself gets to come around and say "see it costs too much!".
"If you think this is a sustainable over the long term then I'm not sure you grasp the economics behind it all."
If other countries are capable of providing Universal Healthcare I don't see why the United States isn't. England has been providing Universal Healthcare since 1948.
Their system isn't perfect, but at least EVERYONE gets healthcare over there.
First of all I don't think healthcare should be FREE, obviously everyone who works is going to be paying into the system with taxes and we can attach federal taxes to cigarettes to cover the gamut of health problems smoking causes (including in the people around them breathing in the second hand smoke) - I believe there should be a co-pay for all treatment except true emergencies (and I think there should be a PENALTY for going to the ER for minor things like colds) and the co-pay could be low like $5-10 but it would be enough that people might think twice before going to the doctors for complete non-issues. And there should be co-pay for prescriptions - maybe $5 for most drugs except antibiotics and $10 for narcotic pain killers.
I've never heard the federal reserve simply "prints money" to keep Medicare going, I believe that's from someone's imagination.
Secondly, I can't believe anyone would honestly believe that a FOR PROFIT CORPORATION should be the one making choices about who receives care and who doesn't. My wife and her twin were born at 32 weeks. My sister-in-law wasn't fully baked you might say, she had to get a shunt for hydrocephalus and when she was a teenager her shunt broke and she wound up having awful seizures and other problems. Once she got into the hospital they decided they had to repair or replace the shunt, but because the family had just moved from New Hampshire to Georgia, and switched insurance providers neither provider wanted to pay for the expensive operation. She was on her death bed, and private insurance companies didn't want to foot the bill, the old one because they weren't receiving premiums from her anymore, and the new one because it was a "Pre-existing condition". To this day it amazes me that one of them finally agreed to pay for the surgery instead of letting her die.
Maybe instead of the government directly presiding over healthcare, they could appoint a not-for-profit corporation to manage insurance claims and such, and at the end of every year they'd have to prove that they weren't denying necessary claims by reporting to congress and the American people. If there were miraculously a sum of money left over it could be returned to the American People in the form of a tax break off of the next year's premiums rather than kept by the corporation and given to the CEO and board members as a bonus.
And why is healthcare 'cheaper' under the free-market model? I don't see doctors saying they'll do surgery cheaper than the next guy (except in the case of LASIK, which makes me nervous as hell anyway). I don't see hospitals advertising "Cheapest hospital beds in the state!". The ONLY part of our current system that is "free market" right now is insurance companies who will give you lower quotes than one another, but protect their bottom line by denying coverage to people who need expensive and sometimes life-saving procedures. I don't think that things could be any worse under a public healthcare system than it is under the current system.
My guess is that IF you're in the healthcare industry you're in private practice, and probably in a sub-speciality that is likely to receive reduced reimbursement under a universal system, which would hamper your luxurious lifestyle and that's why you're against it. My sister-in-law used to date this jerk who said, "If I get my thumb cut off and some black guy gets shot I don't think he should get seen in the ER before me if I've been waiting longer because I pay for my health insurance and he doesn't". I put you in the same boat as my sister-in-law's ex because obviously you're thinking about yourself over anyone else.
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Johnny
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| reply to Count FIve
OK, I turned off my "ignore all anons" button.
What's YOUR solution to the 50 million uninsured for whom you are paying through increased premiums and increased local and state taxes for the public hospitals they show up at?
And register so we can send you IMs. Stop changing your name every 2 minutes. | |
Count Zero
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| That's a good point that I didn't even touch on. Many hospitals are REQUIRED to provide stabilizing treatment in their ERs, and when uninsured people come into the ER and leave without paying the hospital either has to get reimbursed from tax monies, or go bankrupt (as in Telfair county here in Georgia only a few months ago) and close - which worsens the healthcare situation for EVERYONE and it means that people wind up having to go to counties far away, where it may already be overcrowded, to get their care.
I guess this is what some people consider rationing? | |
Johnny
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| said by Count Zero :That's a good point that I didn't even touch on. Many hospitals are REQUIRED to provide stabilizing treatment in their ERs, and when uninsured people come into the ER and leave without paying the hospital either has to get reimbursed from tax monies, or go bankrupt (as in Telfair county here in Georgia only a few months ago) and close - which worsens the healthcare situation for EVERYONE and it means that people wind up having to go to counties far away, where it may already be overcrowded, to get their care. I guess this is what some people consider rationing? Right. People who continue to insist that people should pay individually for healthcare are living in a dreamworld. No amount of tax-credits, tax-deductions, or tax-anything is going to make a difference if people have no money. Even the cheapest insurance can't be bought by people working at minimum wage, and they can't pay the deductibles either, which are the highest if you get the cheapest plan.
So all of these half-assed schemes that don't cover everybody are total non-starters. The reason there are 50 million uninsured isn't because these people don't want insurance; it's because they can't afford it.
McCain's ridiculous $5000 tax credit, even if you gave it to a McDonald's employee, wouldn't pay for a year's premiums plus deductible. It also does nothing to promote competition - since everyone would have the $5000, the insurers would just design plans that take it all, and subscribers still couldn't afford to see a doctor because of the deductibles. That means the insurers get the $5000 and pay out nothing.
Paying premiums so that insurers can make 30% profit is a huge waste of money - the insurers don't generate any productive work. Take that 30% and use it to actually buy health services instead of going to shareholders.
Nobody can choose whether to get health services - everyone needs them. Anybody could get cancer tomorrow. Any couple could have a premature baby this November. That's millions of dollars of debt, and loss of job in many cases due to illness. Loss of job = loss of insurance. Pay with a credit card and go bankrupt? Wups - the Republicans have made sure that you still have to pay it off by changing the bankruptcy laws.
And don't think that MediCare is going to help you. Need more than 90 days inpatient? Too bad. Need more than 120 days skilled nursing? Denied. Need non-skilled nursing home? Not covered.
So you are left with MediCaid. To get MediCaid you must have no more than $2000 in the bank and your house - nothing else. There goes the money you wanted your kids to inherit. Then you can get coverage. And anything they DO cover, they come after your estate once you die to reimburse themselves for the shitty care you got that you had to have mountains of paperwork sent in for each and every treatment to get it "authorized as a medical necessity", as if your doctor would order something that wasn't a medical necessity, and as if you would want a treatment or diagnostic test that wasn't medically necessary. So if your 30 year old children stood to inherit the house, they won't. The state will. | |
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said by Count Zero :From wiki: Since the beginning of the Medicare program, CMS has contracted to private companies to assist with administration. These contractors are commonly already in the insurance or health care area. Contracted processes include claims and payment processing, call center services, clinician enrollment, and fraud investigation. Yes, the key word there is "assist." Please let's not pretend that the Federal government has nothing to do with administering Medicare or footing the bills for it.
Come on, man. If private industry were completely in charge of administering Medicare, then what would we need the Federal Government for?
said by Count Zero :A) A big part of the medicare's woe's are fraud and letting politicians touch the system in general. I couldn't agree more.
And socializing health care means that health care will become even more politicized. Which means that fraud will increase (as politicians divert public funds to the private companies that have given them the most in campaign contributions).
And if you think that socializing medicine will mean less interference in health care by politicians, then you, my friend, are hopelessly naive. It may have escaped your notice that politicians make a career out of interfering in our day to day lives, (and making our choices for us) but it certainly hasn't escaped mine.
said by Count Zero :B) You lose any credibility with me when you make the statement "b)private companies have learned to game [the system]. I'm sorry that you suffer from an inability to handle reality, but "gaming the system" is what politics are all about.
And frankly, I don't care how much "credibility" I carry with you (or with anyone, for that matter). I angrily insist on calling a spade a spade and I'm sorry if you cannot bring yourself to do the same.
If you think that public programs are created by selfless politicians who don't stand to profit by their creation and administration, then it's plain you don't understand the first thing about politics (no offense).
Our government is like any other group of people: it will pursue its own interests and goals, first. If you and I happen to be outside the group, then we can look forward to getting whatever is left over after those folks have taken care to line their own pockets and satisfy their own needs.
Do you really believe that the folks running for president are doing so in the interests of helping you rather than for personal gain? I hope not.
said by Count Zero :And why shouldn't they when the Feds are handing out money hand over fist?" Because it is morally reprehensible that the government tries to help out people who need it, but a company decides that instead of using that money to help people as the government intended them to they might as well keep it because they certainly need it. I see. So companies should be condemned for pursuing their own self-interest? Last time I looked, companies were in business to make money, not to act as charities.
Companies will indeed work for money when they have to. By "work," I mean that they will provide goods and services that people are willing to part with their own hard-earned money for.
However, if there's an easier way to get money, then companies will certainly pursue it. Human beings seem fond of pursuing the path of least resistance and groups of human beings (companies) are certainly no exception.
And there's no easier way to get money then to make campaign contributions (bribes) to a politician, and then have that politicians write laws and create programs that divert money to these favored businesses.
Do you honestly think that the Tax Code is so lengthy because the politicians wanted to make sure they got it right? Well, if that's what you think, you are entirely mistaken: our tax code is so lengthy because there are thousands of exemptions written into it for corporations and wealthy individuals.
Please take a look at the Tax Code sometime, and then you will understand what I speak of when I refer to companies and people "gaming the system."
I'm sorry you're under the impression that politicians are entirely selfless and disinterested, but that just isn't so.
said by Count Zero :Then someone like yourself gets to come around and say "see it costs too much!". Prices are what we use to decide "who gets what."
Why is it that, say, open-heart surgery is so expensive? Because there is a limited number of people who can perform it, these people require specialized training and expensive machines to help them perform such a procedure, and there are many consumers who wish to have this procedure done at any given time.
After all, their life is at stake, so you can hardly blame them.
And prices are set when the people offering such services can find other people (buyers) willing to meet that price. Because if they cannot, they must either a) lower the price in the hopes of attracting buyers that will meet it or b) give up that particular line of work and go find something else to do.
So while I, like you, would love to see everyone who needs open-heart surgery get it, it's sheet madness to pretend that this surgery doesn't cost anything, and that the resources (people and machines) to provide it are not scarce relative to the number of people who would like to have it.
So we can allocate this by a) setting a price for it (the Free Market way) or b) establishing a waiting list of some kind for it (the Socialized Medicine way).
But please let's not pretend that there's some way we can magically make open-heart surgery available to everyone whenever they happen to want it at no cost. Because that demonstrates a complete ignorance of economics and an unwillingness to face the fact that we cannot schedule an infinite amount of open-heart surgeries because the machines and personnel simply do not exist to perform an infinte number of them.
said by Count Zero :"If you think this is a sustainable over the long term then I'm not sure you grasp the economics behind it all." If other countries are capable of providing Universal Healthcare I don't see why the United States isn't. Because it's obvious you lack an understanding of basic economics. Have you ever lived in the UK yourself? Do you know how high tax rates are in the UK?
Please let's not pretend that EU countries can magically provide health care at no cost to their taxpayers. Because their tax rates reflect the fact that someone, somewhere, has to pay the bills.
I know that the Scandanavian countries are often pointed to as examples of countries that provide cradle-to-grave health care. And it's no mere coincidence that the government in these countries consume more than 50% of the GDP paying for it all.
So if you're comfortable with telling people in this country that it's time that we, too, started giving the government 50% of our earnings (and that's just for starters) in taxes, then fine: go to it.
But health care has to be paid for. And the more money you throw in a pot in public programs like Medicare, the more likely you are to have people game the system.
said by Count Zero :England has been providing Universal Healthcare since 1948. I can tell that you've never been a "customer" of the NHS if you're touting it. Because as anyone who has spent time being cared for by the NHS can tell you, it isn't something you'd go around touting, that's for sure.
said by Count Zero :Their system isn't perfect, but at least EVERYONE gets healthcare over there. You're neglecting to mention two things here:
1) EVERYONE in England is also subjected to incredibly high tax rates. Because as I've mentioned before, health care has to be paid for.
2) Anyone who seeks anything more than a tongue depressor or a band-aid in the way of health care is put onto a waiting list for the procedure.
Or did you fondly imagine that, if you live in the UK and need heart surgery, that you're scheduled for it the next day? It doesn't work that way.
Even countries with "free" or "single-payer" health care systems are forced to come up with a system to allocate health care. And a waiting list is deemed to be the "fairest" way of doing this.
I'm sorry if this reality makes you uncomfortable, but I can't help that.
said by Count Zero :First of all I don't think healthcare should be FREE, No, it's obvious you simply believe in cost-shifting. That is, having Peter pay for Paul's health care.
said by Count Zero : obviously everyone who works is going to be paying into the system with taxes and we can attach federal taxes to cigarettes to cover the gamut of health problems smoking causes See, it's this kind of thinking that leads me to believe that you don't understand economics very well.
First off, cigarettes are already grossly taxed at present. If you think that the exact same number of smokers are going to smoke when cigarettes are $5 a pack (as they are now) as when cigarettes are $8 a pack, (as people like you would like to make them) then you're quite mistaken.
The states have been putting the screws to the tobacco companies for quite some time via lawsuits. The hilarious part is that they had to stop doing so, because they were winning huge judgments that the tobacco companies simply could not afford to pay when the number of smokers is steadily declining.
And, lest we forget, these numbers are declining as the result of state and federal "education" programs that are scaring people away from cigarettes.
So please make up your mind: either cigarettes are bad for you, and their use should be discouraged, or you want the number of smokers to be constant so that they can serve as a tax base that will help fund your Socialized Medicine.
Because you can't have it both ways.
said by Count Zero :(including in the people around them breathing in the second hand smoke) Well, if these people can indeed make a scientific case that they have been harmed by second-hand smoke, then fine: they are entitled to compensation by those who produced that smoke.
But if you're suggesting that these people should be compensated out of public funds, then you can expect people to game your system six ways from Sunday.
To say nothing of the fact that, since I do not smoke, there are no legal or ethical grounds to have people like me bear those costs. Only the people producing the smoke in those particular cases should be held liable for those costs.
said by Count Zero :- I believe there should be a co-pay for all treatment except true emergencies (and I think there should be a PENALTY for going to the ER for minor things like colds) and the co-pay could be low like $5-10 but it would be enough that people might think twice before going to the doctors for complete non-issues. And there should be co-pay for prescriptions - maybe $5 for most drugs except antibiotics and $10 for narcotic pain killers. And just who is it that will end up bearing the full cost of these services?
You're doing a great job telling us all about what piffling sums like co-pays "ought to" be. But you haven't done anything so far to tell us just who, exactly, is going to be picking up the tab for the other 95% of the costs involved in providing this medical care.
Unless, of course, you feel that the US ought to meet these costs by having tax rates that match those of the UK or the Scandanavian countries. In which case, it's only fair to mention this to people when you're advocating Socialized Medicine. Fair is fair, and it is simply wrong to pretend that people can get something for nothing when all that is taking place is cost-shifting.
said by Count Zero :I've never heard the federal reserve simply "prints money" to keep Medicare going, I believe that's from someone's imagination. The Federal Reserve prints money to keep the government going. And the only thing that limits the supply of money is the supply of paper on hand.
If you think that the US Dollar is anything but a fiat currency, (that is, money with no intrinsic value)
then you are engaging in some Seriously Wishful Thinking
But please do not take my word for it. I invite you to investigate the doings of the Federal Reserve for yourself. Because once you do so, then you will understand (as I do) that the US Dollar is backed by.....nothing.
Again, take a look and see for yourself.
said by Count Zero :Secondly, I can't believe anyone would honestly believe that a FOR PROFIT CORPORATION should be the one making choices about who receives care and who doesn't. I see. So the US government has an infinite supply of money to spend on healthcare and everyone can have anything they want, whenever they want to have it.
Is that what you're saying? I want to make sure I'm reading you right here.
Because, unfortunately, governments are also obligated to keep costs down in order if they want to keep things sustainable over the long-term. I've already pointed out that the government loots other programs (like Social Security) and has money printed (via the Federal Reserve) to pay for Medicare's cost overruns.
Can you please explain to me why, exactly, you feel that the government is somehow "fairer" than a private company is when it comes to deciding who gets what? Because I really would like to know the reasoning behind your way of thinking.
said by Count Zero :My wife and her twin were born at 32 weeks. My sister-in-law wasn't fully baked you might say, she had to get a shunt for hydrocephalus and when she was a teenager her shunt broke and she wound up having awful seizures and other problems. Once she got into the hospital they decided they had to repair or replace the shunt, but because the family had just moved from New Hampshire to Georgia, and switched insurance providers neither provider wanted to pay for the expensive operation. She was on her death bed, and private insurance companies didn't want to foot the bill, the old one because they weren't receiving premiums from her anymore, and the new one because it was a "Pre-existing condition". To this day it amazes me that one of them finally agreed to pay for the surgery instead of letting her die. Look, I feel for you, but you don't seem to be able to acknowledge that insurance companies do not have an infinite supply of money to pay out to people.
Insurance companies exist on the premise that not everyone paying premiums will need to file a claim. In other words: if insurance companies pay out more than they take in, they will go bankrupt.
I'm not telling you this to be cute or funny, but because that's how it is.
Insurance companies are left with little choice but to insert "pre-existing condition" clauses in their policies because if they did not, then no one would carry insurance.
Instead, they would wait until they got sick, and then and only then would they buy a policy. Leaving the insurance company holding the bag and paying the full cost of their treatment, when the policyholder has paid in next to nothing in the way of premiums.
Again, it's a matter of economics. I cannot take out more than I put in. Our government does not seem to grasp this concept, which may help to explain why the federal government is currently running a deficit of $9 trillion dollars (and growing). This has happened because our government spends money that it simply does not have to spend.
If the federal government were a private company, it would have gone under long ago. But because they have the ability to print money, (or rather, the federal reserve does) they are still "in business."
said by Count Zero :Maybe instead of the government directly presiding over healthcare, they could appoint a not-for-profit corporation to manage insurance claims and such, and at the end of every year they'd have to prove that they weren't denying necessary claims by reporting to congress and the American people. I don't get it: why are you always so anxious to have the government play middleman here?
How is it, exactly, that the government is better equipped to decide who-gets-what than the private sector is?
The private sector is bound by the laws of economics: a company cannot pay out more money than it takes in.
And all this talk about making sure that "necessary claims" are not denied does nothing to tell us just who it is that will be footing the bill for all of this.
Speaking for myself, I would want the government to deny claims that it cannot afford to meet. If you want the government to meet all "necessary claims," (whatever they are) then it is up to you to come up with some way of raising the money to meet these costs.
Please do not pretend that the government can appoint a not-for-profit corporation to oversee things and that it will all magically work out. Because you're telling us how this wonderful new system is going to be administered still doesn't tell us where the money is going to come from to fund it.
said by Count Zero :If there were miraculously a sum of money left over it could be returned to the American People in the form of a tax break off of the next year's premiums rather than kept by the corporation and given to the CEO and board members as a bonus. And government employees work for free? And never give themselves bonuses and other perks?
Honestly, you're making it sounds as though government employees and politicians show up for work out of the goodness of their hearts.
Companies perform services to make money. This money is used to pay its employees and shareholders. You'll have to explain to me how this is all wrong, and yet government employees paying themselves salaries and bonueses is all right.
And, worse, government employees get paid regardless of the results they produce. And even if the results they produce are actually of negative benefit.
Why is this okay with you?
said by Count Zero :And why is healthcare 'cheaper' under the free-market model? Why do you claim that it is cheaper under the Socialized Medicine model? I've demonstrated that all you're really doing under socialized medicine is shifting costs.
said by Count Zero :I don't see doctors saying they'll do surgery cheaper than the next guy (except in the case of LASIK, which makes me nervous as hell anyway). So all private doctors and hospitals charge the exact same amount of money for the same procedures? I don't think so.
Have you ever shopped around when you needed a procedure? It sure doesn't sound as though you have.
If you want to see health care offered on a more competitive basis, then you would do well to get the government out of the health care industry. What incentive do health care providers have to make things more cost-effective if Uncle Sam and his bottomless wallet are paying all the bills?
Besides which, I think you'll find that administrative costs add to the cost of health care. If you want to see health care costs go down, fine: stop making people fill out endless forms and jump through hoops every time a patient wants their toenails trimmed.
Paperwork is job security for the bureaucrats who process it, but it doesn't do anything to reduce costs or increase the quality of care.
said by Count Zero :I don't see hospitals advertising "Cheapest hospital beds in the state!". Hospitals do, in fact, advertise. It all depends on the part of the country you're in. If your neck of the woods sports a grand total of one hospital, then what incentive do they have to advertise? They're not any more likely to advertise than your local gas station is. Why would they spend money on ads when they have customers coming in all the time?
The other aspect of Medicare that isn't often discussed is that it puts the government in competition with the private sector for health care. IOW: the government sets a cost floor for a given procedure, much the same as our farmers are given price supports.
And if I'm a given industry that is subject to price supports, then what incentive do I have to lower my costs?
There isn't any.
said by Count Zero :The ONLY part of our current system that is "free market" right now is insurance companies who will give you lower quotes than one another, If you think that insurance companies are a great example of the Free Market in action, I have to ask how much time you spend in the insurance industry.
The insurance industry is one of the most highly regulated industries there is. If I'm an insurance company, most things I do are regulated, from the rates I am allowed to charge, to the people I am allowed to cover.
For instance, regulations now say that insurance companies cannot "discriminate" against people becuase of their genetic makeup. IOW: if I'm an insurance company, I am not allowed to ask people to undergo genetic testing that would allow me, as an insurer, to get a better idea of the diseases that they might be more susceptible to.
Which means that I have no choice but to charge everyone higher premiums.
Do you see what I'm getting at here? If insurance companies were truly run on a Free Market basis, then I as a policy holder would be able to take a genetic test, and the insurance company would be able to offer me lower rates if I could demonstrate that my genetic makeup was sound.
said by [user=Count Zero :
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but protect their bottom line by denying coverage to people who need expensive and sometimes life-saving procedures.
As I've explained before, insurance companies are not able to pay out more money than they take in.
I, too, wish that insurance companies could afford to give everyone all the medical treatment that they wanted and needed. But they are bound by the laws of economics and cannot honor claims that they can't afford.
Of course, if you feel that an insurance company is bound to honor a given claim, then you are free to sue them.
But it is up to you to prove that the insurance company did not honor the terms of the policy.
Finally, if insurance companies are truly fly-by-night outfits that can do things any old how, well, why not start up one yourself? You could call it The Fair Play Insurance company and make it a point of honor to pay out every claim that your policyholders care to make.
Why not?
said by [user=Count Zero :
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I don't think that things could be any worse under a public healthcare system than it is under the current system.
Well, I could. And I say this because every time I engage an advocate of Socialized Medicine, it's obvious that they haven't bother to give the economics of the matter even the most casual of consideration.
For them, Socialized Medicine is more "free stuff from the government." Well, nothing the government ever provides is "free" and putting them in complete charge of our health care will only serve to strengthen the grip that the government has on our lives.
And that's something that I, for one, don't care to see happen. You may feel differently and I respect that entirely.
said by [user=Count Zero :
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My guess is that IF you're in the healthcare industry you're in private practice, and probably in a sub-speciality that is likely to receive reduced reimbursement under a universal system, which would hamper your luxurious lifestyle and that's why you're against it.
I'm against universal healthcare because it's a scheme to have Peter pay for the costs of Paul's health care when it is up to Paul to pay his own way through life.
I'm also against it because it is little more than Yet Another Scheme to yank more money from taxpayers' pockets.
And if you'll pardon my saying so, I feel as though I have quite enough money yanked from my pockets already.
I make it a habit not to spend money that I do not have. And as soon as our government makes it plain that they, too, have adopted such a philosophy, then I will have no problem with giving them more money.
You will let me know when that happens, won't you?
As for my "luxurious lifestyle," you don't know the first thing about me. But suffice it to say that I make my living in the private sector and have never taken Dime One of tax money. The people who give me money feel that I have a service to offer that's worth giving money for. And I do my best to make sure that their faith in me is justified.
And I am simply tired of being told that I "ought to" give money to people merely because they are standing there with their hand out. I'll decide who should get my money and what they should get it for, thanks.
Any man who claims that they are better qualified than I am to make such decisions is, quite simply, a liar. I can't put it any plainer than that.
said by [user=Count Zero :
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My sister-in-law used to date this jerk who said, "If I get my thumb cut off and some black guy gets shot I don't think he should get seen in the ER before me if I've been waiting longer because I pay for my health insurance and he doesn't".
That depends. Is the "black guy" in question going to be paying his own bills? Or is he going to ask me to pay his way for him?
Because speaking as a "black guy," I find it hard to respect anyone, regardless of their skin tone, who makes their own choices and then expects me to foot the bill for them.
But getting back to your ER: just how should we decide who gets to be seen first by the doctor?
Should it be decided according to who has been waiting longer? Who is willing to pay the most money for their treatment? How?
And if people are getting shot all the time, are you always willing to pay for the costs associated with their treatment? Really? How about paying some of my costs, then? Offhand, I can't think of anyone who deserves money more than I do (though your own name might leap to mind if you happen to be the one doing the thinking).
said by [user=Count Zero :
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I put you in the same boat as my sister-in-law's ex because obviously you're thinking about yourself over anyone else.
Oh, and you don't think of yourself first?
If I had a family member who needed life-saving surgery, and you were in the same boat, and there was only one spot open, would you let us go first out of fear of being seen as "selfish?"
Get real: everyone in this world acts out of their own self-interest.
That's not to say that people don't ever do brave and selfless things for one another. But I don't go to work in the morning for free, and I suspect that you don't, either.
We go because we need the money that our jobs provide in order to take care of those we love. That is, we are acting in our own "selfish" interests.
Sorry if that bothers you, but there it is. And please do not let any politician ever kid you that everything that they do is done out of Sheer Love for their fellow man.
Because it just isn't so. | |
Count Five
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| reply to Johnny
said by Johnny :OK, I turned off my "ignore all anons" button. Well, you can turn it back on again. Whether you choose to read my posts or not, I don't get anything out of it.
I write in order to clarify my thoughts and see if the positions I hold will withstand logical scrutiny. If someone else reads my disjointed ramblings, the more fool they.
said by Johnny :What's YOUR solution to the 50 million uninsured for whom you are paying through increased premiums and increased local and state taxes for the public hospitals they show up at? You're mistaking me for a politician. Well, I'm not a politician, but a private citizen. And as such, I did not come here to offer some any sort of one-size-fits-small legislation to fix anything.
I'm simply one of those people who does not enjoy having his pockets picked and who also does not enjoy listening to people come up with new rationales for doing so. Particularly when it's obvious they haven't thought through the long-term implications of what they're advocating.
And it's become obvious over the 40 years that our government has mismanaged Medicare that it is nowhere near qualified to take charge of my health care. If you want to place your and yours in their charge, that's up to you.
Is the free market perfect? It is not. But it allows me to make my own choices about where my money goes and who it goes to. Anyone who advocates socialized medicine seeks to take those choices away from me, plain and simple.
And I cannot respect that. | |
Count Five
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said by Count Zero :That's a good point that I didn't even touch on. Many hospitals are REQUIRED to provide stabilizing treatment in their ERs, and when uninsured people come into the ER and leave without paying the hospital either has to get reimbursed from tax monies, or go bankrupt (as in Telfair county here in Georgia only a few months ago) and close - which worsens the healthcare situation for EVERYONE and it means that people wind up having to go to counties far away, where it may already be overcrowded, to get their care. I guess this is what some people consider rationing? [laughs]
Thanks for illustrating my point for me quite beautifully.
As you've just shown us, health care costs money. And if a hospital cannot get its patients to pay for their own care, it will have little choice but to go bankrupt because it cannot meet the costs associated with providing that care.
The reason why those other counties (the ones that still offer the "mandatory" ER care) then become crowded is because there's a constant demand for "free" ER services, yet there are no longer any such services available in Telfair county. Because the medical facilities that provided them were driven into bankruptcy by their doing so. Therefore, people seeking such care for free have to go somewhere else.
What you have yet to explain is just how, exactly, all this is fair to those people in the other counties. You know, the counties that now have all these people from Telfair County showing up and demanding care in their ERs.
All that's happening here is cost-shifting. That is, rather than the folks in Telfair County paying their own way, they are, instead, seeking to inflict those costs on people in other counties. And have them pick up the tab instead.
I take the position that the folks in Telfair County are responsible for meeting the costs of their own health care and are not entitled to shift those costs onto other people.
You seem to be of the opinion that Peter ought to pay Paul's emergency room bill no matter what. Well why, exactly, should Peter be asked to pay the bills of another person?
Case in point: English football hooligans and the NHS.
In case you weren't aware, the NHS in the UK operates under those exact conditions you describe: no one can be turned away and denied health care.
And in the case of English football hooligans, this is carte blanche for them to get into fights and smash the hell out of each other. Why? Because they know full well that the NHS is obliged to put them back together again (somewhat like Humpty Dumpty, if Humpty Dumpty was into vomiting through his nose and sported a BNP tattoo on his forehead).
Likewise, the folks in Telfair county have little incentive to take care of their own health if they can just show up at an ER, get health care, and have someone else foot the bill. And that they've managed to drive their local hospital into bankruptcy underscores the fact that they understand they can shift the costs of their health care onto others in a very real and meaningful way.
If you yourself are enthusiastic about footing the bills for other people, that's great. Perhaps you can band together with other like-minded folks and establish a private charity so that folks who can't meet their bills can get some help.
But I'm sure with the example you so kindly provided that you can now appreciate my lack of enthusiasm when it comes to picking up the tab for making health care "free" to other people. Because, as I'm sure you now understand, all that's actually taking place is that those costs are being shifted onto me. | |
Count Five
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said by Johnny :People who continue to insist that people should pay individually for healthcare are living in a dreamworld. Frankly, I'm beginning to suspect that anyone who continues to insist that Americans ought to pay their own way through life is "living in a dreamworld."
After all, why should I pay my own way when I can have other people pay my way for me?
What I'd like to know is: at what exact moment was it deemed mandatory that I pick up the tab for the health care of other people? Because I sure don't remember seeing that in the Constitution.
said by Johnny :No amount of tax-credits, tax-deductions, or tax-anything is going to make a difference if people have no money. And no amount of feel-good goobledygook is going to change the fact that all that socialized medicine really is is another wealth transfer program, where Peter is expected to pick up the tab for the costs that Paul incurs.
How is this fair, exactly? I've yet to hear an advocate of Socialized Medicine successfully rationalize the theft that is taking place here.
said by Johnny :Even the cheapest insurance can't be bought by people working at minimum wage, and they can't pay the deductibles either, which are the highest if you get the cheapest plan. I thought that ambition was all about not working for minimum wage.
And the reason why deductibles are so high when a plan calls for low premiums is because the insurance companies have costs to meet. This should not be a mystery.
said by Johnny :So all of these half-assed schemes that don't cover everybody are total non-starters. The reason there are 50 million uninsured isn't because these people don't want insurance; it's because they can't afford it. So if someone cannot afford something then the government has an automatic duty to step in and provide it for them?
Where, exactly, does it say that?
The point I'm trying to make here is that if you furnish people with everything, then they have little incentive to better themselves.
You seem to feel that just because someone cannot afford something, they still ought to have it anyway. Well, I disagree. The whole point to bettering yourself is to provide yourself and your family with the things you need. If you want the government to simply start handing things out, then you're removing the incentive for people to work harder and provide things for themselves through their own efforts.
I think that any country that decides that stealing from Peter to pay Paul is a legitimate way to do things is ultimately doomed. And that seems to be exactly what you're advocating here.
said by Johnny :McCain's ridiculous $5000 tax credit, even if you gave it to a McDonald's employee, wouldn't pay for a year's premiums plus deductible. It also does nothing to promote competition - since everyone would have the $5000, the insurers would just design plans that take it all, and subscribers still couldn't afford to see a doctor because of the deductibles. That means the insurers get the $5000 and pay out nothing. What leads you to believe that the government would be able to come up with a foolproof scheme of health care? All they're doing is handing out money here, so of course the system is going to get gamed.
Insurance companies don't make campaign contributions? Think again.
said by Johnny :Paying premiums so that insurers can make 30% profit is a huge waste of money - the insurers don't generate any productive work. Insurers don't do anything useful? I don't know about that one. If they don't do anything useful, why do people continue to give them money?
I'm confused as to what, exactly, the government is supposed to be doing in this scheme of yours that's so useful. The last time I looked, they weren't exactly generating anything in terms of "productive work" for Medicare, either.
said by Johnny :Take that 30% and use it to actually buy health services instead of going to shareholders. You're crediting the government with the ability to allocate resources efficiently here. When did that ever happen?
said by Johnny :Nobody can choose whether to get health services - everyone needs them. Hey, I need a place to live, too. Should I send you my rent bill?
Again, you're assuming that I am, somehow, obligated to pick up the tab for the expenses of other people. Once you tell me where it says that I'm obligated to do so, I'll do it.
Until then, you're making assertions that are entirely unsupported.
said by Johnny :Anybody could get cancer tomorrow. Any couple could have a premature baby this November. That's millions of dollars of debt, and loss of job in many cases due to illness. Which, presumably, is what motivates people to buy insurance.
I guess I don't understand how the insurance companies can still stay in business, what with their rates being so unaffordable and all.
said by Johnny :Loss of job = loss of insurance. Pay with a credit card and go bankrupt? Wups - the Republicans have made sure that you still have to pay it off by changing the bankruptcy laws. Oh, those dastardly Republicans. Perhaps they were bought off by the credit card companies?
And of course, if the Republicans were bought off by the credit card companies, perhaps we should wonder if the health care companies might (just might) throw some campaign contributions to the politicians and affect "universal health care" legislation by doing so.
Stranger things have happened.
said by Johnny :And don't think that MediCare is going to help you. Need more than 90 days inpatient? Too bad. Need more than 120 days skilled nursing? Denied. Need non-skilled nursing home? Not covered. Perhaps this is why insurance companies exist.
I think the fact that Medicare has the limitations you've listed helps to illustrate the fact that the government cannot afford to pick up the tab for everyone's health care all of the time. There is a finite amount of health care resources available. And getting the government involved is not going to change that.
Hey, I feel you, but I'm not convinced that involving the government more heavily in all of this is going to do anyone any good. All that's going to happen with such a scheme is that the politicians are going to line their own pockets, same as they always have. | |
Count Zero
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May 6th, @09:14AM
| reply to Count Five
"I'm against universal healthcare because it's a scheme to have Peter pay for the costs of Paul's health care when it is up to Paul to pay his own way through life.
I'm also against it because it is little more than Yet Another Scheme to yank more money from taxpayers' pockets.
And if you'll pardon my saying so, I feel as though I have quite enough money yanked from my pockets already.
I make it a habit not to spend money that I do not have. And as soon as our government makes it plain that they, too, have adopted such a philosophy, then I will have no problem with giving them more money.
You will let me know when that happens, won't you?
As for my "luxurious lifestyle," you don't know the first thing about me. But suffice it to say that I make my living in the private sector and have never taken Dime One of tax money. The people who give me money feel that I have a service to offer that's worth giving money for. And I do my best to make sure that their faith in me is justified.
And I am simply tired of being told that I "ought to" give money to people merely because they are standing there with their hand out. I'll decide who should get my money and what they should get it for, thanks.
Any man who claims that they are better qualified than I am to make such decisions is, quite simply, a liar. I can't put it any plainer than that."
And this statement right there boils down your whole view on the world.
What about all that "compassion" I'm sure you wrote about in your med school entrance essay? No, you didn't go to medical school, I'm pretty sure right now you are in management of United Healthcare, or some other insurance company and that's why you're so vehemently against Universal Healthcare, because YOU wouldn't be the one providing it.
And don't pretend I don't understand the "economics" of it. You just don't want to accept that it is possible to do something without "profits". So what if tax rates in Europe are higher, they USED to be higher in this country too, and when they cut the tax rates is when we started accumulating this massive national debt. Can't have things both ways Mr. Reagan & Bush. Wanna spend money? Gotta tax people. Don't want to tax people? Don't spend money. But I wouldn't mind if the Government were spending money on GOOD social projects like insurance for everyone. I suppose you get pissed off that you have to help pay for Paul's kids' educations, no? I bet that pisses you off that you have to actually give money into a public school system and help raise someone else's kids.
Think of it this way... suppose we fund this insurance system by cutting all the tax breaks to the rich, and as I said earlier (but you OBVIOUSLY DIDN'T READ or COMPREHEND) premiums will be added via taxes (and you obviously didn't understand my cigarettes bit either, thy mighty genius, because I wouldn't mind it if less people smoked even if it were a result of the higher tax on tobacco - since it would drastically reduce the cost in healthcare associated with tobacco related diseases. Course you only thought "money money money"). And I'm sorry that Peter will have to help out with Paul's care, but if Peter weren't such a selfish man, perhaps he would learn to accept it.
As for your quip about government employees getting paid no matter what quality work they do, you make it sound as if 90% of the people in the government do horrible work but not a single person in the private sector does... man you are in some dream world. How does it not bother you that private insurance exists solely to deny claims and thus generate profit? We're talking about everyday, honest people who paid their premiums, but are being denied coverage simply because it keeps Insurance Co. in the black.
I know I could never change your views, you're obviously wildly successful under the current regime, so what is your incentive to change? You care not for your common man, only for your pocketbook. I only hope that enough people will eventually realize that Universal Healthcare's downfalls are blown out of proportion and will better serve the greater good of our country. | |
Johnny
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| reply to Count Five
Yeah, what we have here ladies and gentlemen is an Atlas-Shrugging, Fountainheading, objectivist.
Which is fine until you consider what you have failed to realize: health care is NOT like housing or cars or any of the things you use as analogies to "what the government should provide."
If you do not have a house, you can technically live on the street. If you do not have a car you can walk.
If you do not have health coverage, somebody is going to call 911 and that starts the cash register. So the expenses WILL be generated no matter what.
Unless you are advocating a wallet biopsy on every emergency patient, and letting them die by the side of the road, then your whole idea of "everyone pays for himself" won't work for health care.
What, in your Ayn Rand world, should be done with the woman who has no money but has a premature baby at 27 weeks? Admonish her for over-extending her personal wealth? Talk about a dreamworld. Next we can admonish teens for having sex, telling them how wonderful personal responsibility is and how we aren't going to pay for their poor judgement.
Health care HAS to be paid for.
Unless, as I said, you would turn the woman in labor away, send her home to deliver there, if she had no coverage.
Would you? If not, Peter is paying Paul. | |
Johnny
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| reply to Count Five
As for my "luxurious lifestyle," you don't know the first thing about me. But suffice it to say that I make my living in the private sector and have never taken Dime One of tax money. The people who give me money feel that I have a service to offer that's worth giving money for. And I do my best to make sure that their faith in me is justified.
Right... right....
And when tomorrow you cough up some blood in the morning and much to your disappointment it turns out to be leukemia, which will cost $2 million and make you so sick you cannot work and lose your job and can't pay your premiums or your mortgage or your car payment or your kids' college tuition?
If you have $2 million, then ignore this. Otherwise should the doctor tell you that your resources are inadequate and send you away? | |
Corona
It's cool, I'm takin it back
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San Antonio, TX
| said by Johnny :As for my "luxurious lifestyle," you don't know the first thing about me. But suffice it to say that I make my living in the private sector and have never taken Dime One of tax money. The people who give me money feel that I have a service to offer that's worth giving money for. And I do my best to make sure that their faith in me is justified.
Right... right.... And when tomorrow you cough up some blood in the morning and much to your disappointment it turns out to be leukemia, which will cost $2 million and make you so sick you cannot work and lose your job and can't pay your premiums or your mortgage or your car payment or your kids' college tuition? If you have $2 million, then ignore this. Otherwise should the doctor tell you that your resources are inadequate and send you away? why the hell should the rest of us have to pay for his leukemia? | |
Count Zero
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May 6th, @11:22AM
| Because if it was YOUR leukemia you'd want everyone else to pay for it.
Of course if it was Count Five's Leukemia I'd rather not pay for it out of the personal principal of not wanting to help those who think they're above helping their common man... but if we had Universal Healthcare I would, and I'd 'accept' paying for his knowing that a lot more people were benefiting than a single bigot. | |
Johnny
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Atlanta, GA
| reply to Corona
said by Corona :why the hell should the rest of us have to pay for his leukemia? So you advocate sending him home to die? Let's talk in real terms about what really happens, rather than some fantastic dreamworld scenario where everyone magically has $2 million dollars or dies.
What if it was you? Do you agree that you should be sent home to die, when a $2 million dollar bone marrow transplant would save your life?
If your wife has a premature infant, and you can't prove you have $3 million at the front desk of the hospital, they should discharge the 750-gram baby to home?
That is what your "everyone pulls his own weight" philosophy comes down to. It's real, it happens every day, and it happens to millions. Just not to you - yet. Tomorrow is another day.
Let's drop the theoretical Ayn Rand pontifications and talk about reality. | |
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