Debate Now An Unhappy Birthday for Obamacare?

[Wyatt earp]

One way to do that is to force them to buy their own insurance so they aren't just seeing a doctor when they show up at the emergency room.

People ought to be held accountable for their bills, but where do you get off telling them how to go about it? This is just a sales pitch by the insurance industry.

Okay, play that out to the end game. Here is what happens. Ms. Jane Doe has to have an emergency appendectomy because she doesn't have insurance and doesn't go to the doctor unless she is sick; no check-ups. So she goes to County General and has an operation that would cost her $25,000 conservatively. Great. Now the County Hospital funded by your tax money has to try to collect that $25K that she isn't going to ever re-pay. Now not only are you funding a county hospital, you're funding a collections branch. And gee, when she doesn't pay, you gonna throw her in jail for theft of services? Good idea.

FYI South Carolina garnishes people's wages for hospital bills, they have been doing it since I moved here 10 years ago, how come no other? States do it?

 

[candycorn]

What the federal government does is consistently provide assistance. If you give X amount to charity when you can afford to, you probably give less when you can't--say you had a life event that required those funds or simply were saving up for something. Nobody is saying you shouldn't but what those who are on public assistance need is to be able to plan on the assistance being there.

The State does it because it is the only one who can. I'm happy it does.

I believe we are morally obligated to fulfill our obligations for those made dependent on government. And I believe that a moral government does not make people dependent on that government.

I'm not sure what you mean by the first part but agree with you on the second part. There should be no government dependency/generational welfare. The best way to ween people off? That is a matter for debate.

One way to do that is to foce them to buy their own insurance so they aren't just seeing a doctor when they show up at the emergency room.

How about expecting and requiring people to pay the bills they run up? That would be a pretty good incentive to buy insurane. I believe government forcing people to buy a product dictated by government is just as immoral as making people dependent on government.

Hasn't worked in the past...hence medical costs being the #1 source of personal bankruptcy in the nation.

Medical Bills Are the Biggest Cause of US Bankruptcies Study

Additionaly in the past, you couldn't get insurance if you had some PECs, and lifetime caps rendered insurance benefits almost worthless.

That became the case after government started meddling with healthcare and taking it over for large segments of the population. It was not tthe case before.

 

[Wyatt earp]

I believe we are morally obligated to fulfill our obligations for those made dependent on government. And I believe that a moral government does not make people dependent on that government.

I'm not sure what you mean by the first part but agree with you on the second part. There should be no government dependency/generational welfare. The best way to ween people off? That is a matter for debate.

One way to do that is to foce them to buy their own insurance so they aren't just seeing a doctor when they show up at the emergency room.

How about expecting and requiring people to pay the bills they run up? That would be a pretty good incentive to buy insurane. I believe government forcing people to buy a product dictated by government is just as immoral as making people dependent on government.

Hasn't worked in the past...hence medical costs being the #1 source of personal bankruptcy in the nation.

Medical Bills Are the Biggest Cause of US Bankruptcies Study

Additionaly in the past, you couldn't get insurance if you had some PECs, and lifetime caps rendered insurance benefits almost worthless.

That became the case after government started meddling with healthcare and taking it over for large segments of the population. It was not tthe case before.

I just looked it up, South Carolina unlike the US IRS you can file for bankruptcy if it is not more then 3 years old, preatty sneaky of them they don't start sending out letters till 5 years latter.

 

[Ravi]

Has it ever occurred to you that caring and advocacy of state welfare are different concerns?

Well, as I understood the question posed by Sun Devil 92 Devil 92, I was supposed to state what I thought the winning position was (aka the right thing).

If we're going to spend money on welfare, we should aim at the truly defenseless...

I'm just commenting on the claim that people opposed to state welfare are hateful and selfish.

Exactly. Most of us who have been influenced by a JudeoChristian culture, even if we are not religious ourselves, still mostly support the concept that a moral society takes care of the truly helpless among us. But that does not translate that the state is the best or even a good means of doing that. It is not hateful and selfish to believe the central government is not a good or best means of doing that.

Likewise, most of us believe that a moral society makes access to healthcare available to everybody. But it is not hateful and selfish to believe the central government is not a good or best means of doing that.

And yet our society hasn't made access to healthcare available to everyone.

Of course it has. Nobody is denied ability to access healthcare anywhere and nobody is denied ability to live someplace where healthcare is within driving distance. People do what they have to do to build medical clinics, hospitals, and attract doctors where they are needed. Providing healthcare and making it accessible are two different things. Our society does not provide food for all, shelter for all, clothing for all, heating for all, transportation for all, etc. etc. either because most are perfectly capable of providing for themselves and their loved ones to have such necessities of life and they should provide that for themselves.

Most people can't afford to pay for a hospital stay.

 

[Foxfyre]

Well, as I understood the question posed by Sun Devil 92 Devil 92, I was supposed to state what I thought the winning position was (aka the right thing).

If we're going to spend money on welfare, we should aim at the truly defenseless...

I'm just commenting on the claim that people opposed to state welfare are hateful and selfish.

Exactly. Most of us who have been influenced by a JudeoChristian culture, even if we are not religious ourselves, still mostly support the concept that a moral society takes care of the truly helpless among us. But that does not translate that the state is the best or even a good means of doing that. It is not hateful and selfish to believe the central government is not a good or best means of doing that.

Likewise, most of us believe that a moral society makes access to healthcare available to everybody. But it is not hateful and selfish to believe the central government is not a good or best means of doing that.

And yet our society hasn't made access to healthcare available to everyone.

Of course it has. Nobody is denied ability to access healthcare anywhere and nobody is denied ability to live someplace where healthcare is within driving distance. People do what they have to do to build medical clinics, hospitals, and attract doctors where they are needed. Providing healthcare and making it accessible are two different things. Our society does not provide food for all, shelter for all, clothing for all, heating for all, transportation for all, etc. etc. either because most are perfectly capable of providing for themselves and their loved ones to have such necessities of life and they should provide that for themselves.

Most people can't afford to pay for a hospital stay.

Which is a pretty good incentive to get insurance. But if there is liberty it is left up to the person how much risk he/she is willing to assume, and what kind of insurance best serves his/her needs at any given time. That should not be a dictate of the federal government.

 

[RKMBrown]

But since you brought it up, tell us what is your limit for caring?

Has it ever occurred to you that caring and advocacy of state welfare are different concerns?

Well, as I understood the question posed by Sun Devil 92 Devil 92, I was supposed to state what I thought the winning position was (aka the right thing).

If we're going to spend money on welfare, we should aim at the truly defenseless...

Why do you think being in one of the two age groups you specified makes you "truly defenseless?"

Most kids do not have insurance. A great amount of seniors have to decide between medicine and food. Real life example; when I worked at Target back in the day...one lady bought cat food for herself to eat.

Most kids do not have insurance? Huh? First off provide support for this claim. Secondly, why do I need insurance when I can pay for my health care in cash? I thought the idea was we needed health care, not insurance for health care.

Drugs are expensive because our government is creating monopolies for drug suppliers.

Cat food is expensive. Your real life example would have saved money and eaten healthier by buying different products. I suspect your real life example was lying to you.

 

[RKMBrown]

Well, as I understood the question posed by Sun Devil 92 Devil 92, I was supposed to state what I thought the winning position was (aka the right thing).

If we're going to spend money on welfare, we should aim at the truly defenseless...

I'm just commenting on the claim that people opposed to state welfare are hateful and selfish.

Exactly. Most of us who have been influenced by a JudeoChristian culture, even if we are not religious ourselves, still mostly support the concept that a moral society takes care of the truly helpless among us. But that does not translate that the state is the best or even a good means of doing that. It is not hateful and selfish to believe the central government is not a good or best means of doing that.

Likewise, most of us believe that a moral society makes access to healthcare available to everybody. But it is not hateful and selfish to believe the central government is not a good or best means of doing that.

And yet our society hasn't made access to healthcare available to everyone.

Of course it has. Nobody is denied ability to access healthcare anywhere and nobody is denied ability to live someplace where healthcare is within driving distance. People do what they have to do to build medical clinics, hospitals, and attract doctors where they are needed. Providing healthcare and making it accessible are two different things. Our society does not provide food for all, shelter for all, clothing for all, heating for all, transportation for all, etc. etc. either because most are perfectly capable of providing for themselves and their loved ones to have such necessities of life and they should provide that for themselves.

Most people can't afford to pay for a hospital stay.

And the reason they can't afford it is because the hospital is charging that one person enough to cover the costs for the people who don't have to pay, and for the federally mandated lower cost medicare folk.

 

[RKMBrown]

One way to do that is to force them to buy their own insurance so they aren't just seeing a doctor when they show up at the emergency room.

People ought to be held accountable for their bills, but where do you get off telling them how to go about it? This is just a sales pitch by the insurance industry.

Okay, play that out to the end game. Here is what happens. Ms. Jane Doe has to have an emergency appendectomy because she doesn't have insurance and doesn't go to the doctor unless she is sick; no check-ups. So she goes to County General and has an operation that would cost her $25,000 conservatively. Great. Now the County Hospital funded by your tax money has to try to collect that $25K that she isn't going to ever re-pay. Now not only are you funding a county hospital, you're funding a collections branch. And gee, when she doesn't pay, you gonna throw her in jail for theft of services? Good idea.

Yeah cause free clinics don't exist. Oh wait nvm they do exist.

 

[RKMBrown]

Exactly. Most of us who have been influenced by a JudeoChristian culture, even if we are not religious ourselves, still mostly support the concept that a moral society takes care of the truly helpless among us. But that does not translate that the state is the best or even a good means of doing that. It is not hateful and selfish to believe the central government is not a good or best means of doing that.

Likewise, most of us believe that a moral society makes access to healthcare available to everybody. But it is not hateful and selfish to believe the central government is not a good or best means of doing that.

What the federal government does is consistently provide assistance. If you give X amount to charity when you can afford to, you probably give less when you can't--say you had a life event that required those funds or simply were saving up for something. Nobody is saying you shouldn't but what those who are on public assistance need is to be able to plan on the assistance being there.

The State does it because it is the only one who can. I'm happy it does.

I believe we are morally obligated to fulfill our obligations for those made dependent on government. And I believe that a moral government does not make people dependent on that government.

I'm not sure what you mean by the first part but agree with you on the second part. There should be no government dependency/generational welfare. The best way to ween people off? That is a matter for debate.

One way to do that is to foce them to buy their own insurance so they aren't just seeing a doctor when they show up at the emergency room.

How about expecting and requiring people to pay the bills they run up? That would be a pretty good incentive to buy insurane. I believe government forcing people to buy a product dictated by government is just as immoral as making people dependent on government.

Hasn't worked in the past...hence medical costs being the #1 source of personal bankruptcy in the nation.

Medical Bills Are the Biggest Cause of US Bankruptcies Study

Additionaly in the past, you couldn't get insurance if you had some PECs, and lifetime caps rendered insurance benefits almost worthless.

Government involvement is the reason health care costs are so high. Duh!

 

[RKMBrown]

I believe we are morally obligated to fulfill our obligations for those made dependent on government. And I believe that a moral government does not make people dependent on that government.

I'm not sure what you mean by the first part but agree with you on the second part. There should be no government dependency/generational welfare. The best way to ween people off? That is a matter for debate.

One way to do that is to foce them to buy their own insurance so they aren't just seeing a doctor when they show up at the emergency room.

How about expecting and requiring people to pay the bills they run up? That would be a pretty good incentive to buy insurane. I believe government forcing people to buy a product dictated by government is just as immoral as making people dependent on government.

Hasn't worked in the past...hence medical costs being the #1 source of personal bankruptcy in the nation.

Medical Bills Are the Biggest Cause of US Bankruptcies Study

Additionaly in the past, you couldn't get insurance if you had some PECs, and lifetime caps rendered insurance benefits almost worthless.

That became the case after government started meddling with healthcare and taking it over for large segments of the population. It was not tthe case before.

Everybody dies Candy. Leading cause of death... getting old. Insurance won't stop you from getting old. No amount of money will reverse the aging process. But yes, we can certainly go bankrupt trying.

 

[Foxfyre]

I believe we are morally obligated to fulfill our obligations for those made dependent on government. And I believe that a moral government does not make people dependent on that government.

I'm not sure what you mean by the first part but agree with you on the second part. There should be no government dependency/generational welfare. The best way to ween people off? That is a matter for debate.

One way to do that is to foce them to buy their own insurance so they aren't just seeing a doctor when they show up at the emergency room.

How about expecting and requiring people to pay the bills they run up? That would be a pretty good incentive to buy insurane. I believe government forcing people to buy a product dictated by government is just as immoral as making people dependent on government.

Hasn't worked in the past...hence medical costs being the #1 source of personal bankruptcy in the nation.

Medical Bills Are the Biggest Cause of US Bankruptcies Study

Additionaly in the past, you couldn't get insurance if you had some PECs, and lifetime caps rendered insurance benefits almost worthless.

That became the case after government started meddling with healthcare and taking it over for large segments of the population. It was not tthe case before.

That is a false statement on your part.

Sorry, but I was in the medical field, actually dealing with hospital bills before Medicare went into effect. And I witnessed the fraud kicking in on day one that Medicare went into effect and watched the very sharp escalation in prices after that. Prior to Medicare the hospitals did a lot of pro bono services for those who were destitute but there weren't a lot of those. The low income folks would be set up on payment plans that they could afford--even $10/month. If somebody was faced with an expensive operation he/she could not afford and insurance didn't cover, the community rallied and raised the money to help.

Since Medicare and Medicare were enacted in 1965, the government has passed much more legislation trying to control insurance companies and medical costs and each time has only made things worse.

See here:

Considering how much the technology has increased for toasters and washing machines (or think the cost of electronics like calculators or computers that are a fraction of what they once cost):

The Cost of Health Care 1958 vs. 2012

Or this:

. . .The increasing share of medical bills paid by third-party payers (insurance companies and governments) and the disastrous consequences are documented. Patients overuse medical resources since those resources appear to be free or almost free. Producers of medical equipment create new and more expensive devices, even if they are of only marginal benefit, since third-party payers create a guaranteed market. Attempts to rein in those costs have led to a blizzard of paperwork but proven ineffective in controlling costs.

The cure for the present problems is straightforward: the patient must once again be made the central actor in the medical marketplace. Patients need to be given the same motivations to economize on medical care that they have to economize in other markets. Tax laws need to be rewritten. The use of medical savings accounts needs to be promoted. High-deductible health insurance should be encouraged.

Returning the patient, and normal market principles, to center stage is all that is necessary to bring the costs of health care under control.
Why Health Care Costs Too Much​

. . .Congress enacted Medicaid and Medicare as part of the Great Society program in 1965.

The passage of these bills had two immediate effects. First, they substantially enlarged the U.S. health care market. Millions of Americans who previously lacked health insurance now enjoyed coverage under one of these publicly funded plans. Second, they altered the composition of health care spending. As the government covered a larger portion of the health care bill, the share of out-of-pocket spending decreased. The combined effects of the increase in federal funding and the decrease in out-of-pocket spending generated sharp increases in the price of health care. . . .
An Introduction to the Health Care Crisis in America How Did We Get Here ​

 

[RKMBrown]

I'm not sure what you mean by the first part but agree with you on the second part. There should be no government dependency/generational welfare. The best way to ween people off? That is a matter for debate.

One way to do that is to foce them to buy their own insurance so they aren't just seeing a doctor when they show up at the emergency room.

How about expecting and requiring people to pay the bills they run up? That would be a pretty good incentive to buy insurane. I believe government forcing people to buy a product dictated by government is just as immoral as making people dependent on government.

Hasn't worked in the past...hence medical costs being the #1 source of personal bankruptcy in the nation.

Medical Bills Are the Biggest Cause of US Bankruptcies Study

Additionaly in the past, you couldn't get insurance if you had some PECs, and lifetime caps rendered insurance benefits almost worthless.

That became the case after government started meddling with healthcare and taking it over for large segments of the population. It was not tthe case before.

That is a false statement on your part.

Sorry, but I was in the medical field, actually dealing with hospital bills before Medicare went into effect. And I witnessed the fraud kicking in on day one that Medicare went into effect and watched the very sharp escalation in prices after that. Prior to Medicare the hospitals did a lot of pro bono services for those who were destitute but there weren't a lot of those. The low income folks would be set up on payment plans that they could afford--even $10/month. If somebody was faced with an expensive operation he/she could not afford and insurance didn't cover, the community rallied and raised the money to help.

See here:

Considering how much the technology has increased for toasters and washing machines (or think the cost of electronics like calculators or computers that are a fraction of what they once cost):

The Cost of Health Care 1958 vs. 2012

Or this:

. . .The increasing share of medical bills paid by third-party payers (insurance companies and governments) and the disastrous consequences are documented. Patients overuse medical resources since those resources appear to be free or almost free. Producers of medical equipment create new and more expensive devices, even if they are of only marginal benefit, since third-party payers create a guaranteed market. Attempts to rein in those costs have led to a blizzard of paperwork but proven ineffective in controlling costs.

The cure for the present problems is straightforward: the patient must once again be made the central actor in the medical marketplace. Patients need to be given the same motivations to economize on medical care that they have to economize in other markets. Tax laws need to be rewritten. The use of medical savings accounts needs to be promoted. High-deductible health insurance should be encouraged.

Returning the patient, and normal market principles, to center stage is all that is necessary to bring the costs of health care under control.
Why Health Care Costs Too Much​

. . .Congress enacted Medicaid and Medicare as part of the Great Society program in 1965.

The passage of these bills had two immediate effects. First, they substantially enlarged the U.S. health care market. Millions of Americans who previously lacked health insurance now enjoyed coverage under one of these publicly funded plans. Second, they altered the composition of health care spending. As the government covered a larger portion of the health care bill, the share of out-of-pocket spending decreased. The combined effects of the increase in federal funding and the decrease in out-of-pocket spending generated sharp increases in the price of health care. . . .
An Introduction to the Health Care Crisis in America How Did We Get Here ​

Ding Ding Ding Fox hit the nail on the head. My daughter, an RN as a trauma one center, tells me that well over half of the people that show up in their Emergency Room are daily and weekly regulars that show up with self inflicted injuries and/or made up problems to get free pain meds, free food and such. These people go from hospital to hospital filling up the beds. Why? Cause they know the hospitals have to take them in.

 

[Greenbeard]

The cure for the present problems is straightforward: the patient must once again be made the central actor in the medical marketplace. Patients need to be given the same motivations to economize on medical care that they have to economize in other markets. Tax laws need to be rewritten. The use of medical savings accounts needs to be promoted. High-deductible health insurance should be encouraged.

You railed against the ACA for nudging people toward high-deductible plans and HSAs for pages and pages in this thread.

Now you're endorsing the idea that this is "the cure" to the cost problem?

 

[Foxfyre]

The cure for the present problems is straightforward: the patient must once again be made the central actor in the medical marketplace. Patients need to be given the same motivations to economize on medical care that they have to economize in other markets. Tax laws need to be rewritten. The use of medical savings accounts needs to be promoted. High-deductible health insurance should be encouraged.

You railed against the ACA for nudging people toward high-deductible plans and HSAs for pages and pages in this thread.

Now you're endorsing the idea that this is "the cure" to the cost problem?

The high deductible plans under the ACA are tantamount to having no insurance at all due to the exhorbitant costs of healthcare that I believe government has mostly created.

Before government started meddling in healthcare, high deductibles made sense. The free market took care of the costs of a visit to the doctor's office, a shot of penicillin or an ordinary prescription, because people could afford to pay for this out of pocket or at least pay it off on a short term payment plan. The free market charges no more than customers are able to pay, otherwise there is no market for products and services. So we all had insurance policies that kicked in when there were high costs involved and otherwise expected to pay for routine maintenance just as we expected to pay to fix the broken window at our house or for the oil change or fix the brakes on our car. Insurance usually did pay for one general physical each year, but otherwise we all paid out of pocket for routine stuff. And healthcare costs for such things were affordable as was basic insurance.

 

[Greenbeard]

The high deductible plans under the ACA are tantamount to having no insurance at all due to the exhorbitant costs of healthcare that I believe government has mostly created.

Before government started meddling in healthcare, high deductibles made sense. The free market took care of the costs of a visit to the doctor's office, a shot of penicillin or an ordinary prescription, because people could afford to pay for this out of pocket or at least pay it off on a short term payment plan. The free market charges no more than customers are able to pay, otherwise there is no market for products and services. So we all had insurance policies that kicked in when there were high costs involved and otherwise expected to pay for routine maintenance just as we expected to pay to fix the broken window at our house or for the oil change or fix the brakes on our car. Insurance usually did pay for one general physical each year, but otherwise we all paid out of pocket for routine stuff. And healthcare costs for such things were affordable as was basic insurance.

What are you saying? Does moving to high deductible plans now make sense or not? The article you quoted suggests that's what needs to happen, but you've routinely attacked the ACA for facilitating that happening.

So where exactly do you stand on this?

 

[Foxfyre]

The high deductible plans under the ACA are tantamount to having no insurance at all due to the exhorbitant costs of healthcare that I believe government has mostly created.

Before government started meddling in healthcare, high deductibles made sense. The free market took care of the costs of a visit to the doctor's office, a shot of penicillin or an ordinary prescription, because people could afford to pay for this out of pocket or at least pay it off on a short term payment plan. The free market charges no more than customers are able to pay, otherwise there is no market for products and services. So we all had insurance policies that kicked in when there were high costs involved and otherwise expected to pay for routine maintenance just as we expected to pay to fix the broken window at our house or for the oil change or fix the brakes on our car. Insurance usually did pay for one general physical each year, but otherwise we all paid out of pocket for routine stuff. And healthcare costs for such things were affordable as was basic insurance.

What are you saying? Does moving to high deductible plans now make sense or not? The article you quoted suggests that's what needs to happen, but you've routinely attacked the ACA for facilitating that happening.

So where exactly do you stand on this?

I say let the free market determine what insurance will be available to people and let the people choose whatever insurance plan works best for them. Get the government out of it except in cases where it is necessary to enforce RICO or anti trust laws.

THEN we will see medical costs, like all other technology, become affordable for most because there will always be those who see a way to to make a decent profit by filling a need and they'll have to fill it at a price people are able and willing to pay. We can figure out ways to take care of the truly helpless, but that does not need to be a federal function.

That is where I stand.

 

[Greenbeard]

Right, that's what's happening right now. You're talking about this as if it's some theoretical aspiration when it's happening all over the place.

Patients are increasingly having to pay higher “deductibles” out of their own pockets, before the insurance kicks in, to keep the cost of the cover down. So for minor ailments and simple tests, it makes sense for such patients to go to one of the increasing numbers of walk-in clinics, staffed by well-qualified nurses, on the premises of retail pharmacies such as CVS and Walgreens (see chart). The prices are clear, the care is cheap and the service is quick. Walgreens has a partnership with Theranos, a diagnostics firm, which offers customers a range of tests from a tiny drop of blood. Walmart, a giant supermarket chain with many in-store pharmacies, also intends to become one of the leading sellers of affordable health services, says Alex Hurd, its product-development chief.

Hospital operators are now facing a classic “innovator’s dilemma”, as described by Clay Christensen, a Harvard business professor. If they persist with their high-cost business model even as their customers discover that cheaper alternatives are good enough, they will be in trouble. According to Strata Decision Technology, an analytics firm, many hospital groups saw what was coming and started to cut their costs well before the provisions of Obamacare started to bite. One of the fastest movers is Advocate Health Care, a hospital operator from Illinois, which says it now earns two-thirds of its revenues from value-based payments.

Cohealo offers a “sharing economy” solution for hospitals and clinics wanting to make the best use of expensive equipment, in much the same way as Airbnb helps people with spare rooms fill them with paying guests. Doximity is trying to be a Facebook for doctors, letting them refer patients and discuss treatments securely without the blizzard of faxes they rely on today. Grand Rounds is a sort of medical Match.com: an online matchmaker that pairs patients with specialists. As in other industries, administrators are being tempted to switch to renting software and data storage in the online “cloud”: Athenahealth, a seller of medical back-office software, is trying to get doctors and hospitals to move patients’ health records onto its cloud-based service.

Innovation--from start-ups to restructuring of existing industry leaders--to reduce costs is popping up all over precisely because the cost burden is shifting from third party payers to individuals. Or, as your article put it, "the patient must once again be made the central actor in the medical marketplace."

 

[Foxfyre]

Right, that's what's happening right now. You're talking about this as if it's some theoretical aspiration when it's happening all over the place.

Patients are increasingly having to pay higher “deductibles” out of their own pockets, before the insurance kicks in, to keep the cost of the cover down. So for minor ailments and simple tests, it makes sense for such patients to go to one of the increasing numbers of walk-in clinics, staffed by well-qualified nurses, on the premises of retail pharmacies such as CVS and Walgreens (see chart). The prices are clear, the care is cheap and the service is quick. Walgreens has a partnership with Theranos, a diagnostics firm, which offers customers a range of tests from a tiny drop of blood. Walmart, a giant supermarket chain with many in-store pharmacies, also intends to become one of the leading sellers of affordable health services, says Alex Hurd, its product-development chief.

Hospital operators are now facing a classic “innovator’s dilemma”, as described by Clay Christensen, a Harvard business professor. If they persist with their high-cost business model even as their customers discover that cheaper alternatives are good enough, they will be in trouble. According to Strata Decision Technology, an analytics firm, many hospital groups saw what was coming and started to cut their costs well before the provisions of Obamacare started to bite. One of the fastest movers is Advocate Health Care, a hospital operator from Illinois, which says it now earns two-thirds of its revenues from value-based payments.

Cohealo offers a “sharing economy” solution for hospitals and clinics wanting to make the best use of expensive equipment, in much the same way as Airbnb helps people with spare rooms fill them with paying guests. Doximity is trying to be a Facebook for doctors, letting them refer patients and discuss treatments securely without the blizzard of faxes they rely on today. Grand Rounds is a sort of medical Match.com: an online matchmaker that pairs patients with specialists. As in other industries, administrators are being tempted to switch to renting software and data storage in the online “cloud”: Athenahealth, a seller of medical back-office software, is trying to get doctors and hospitals to move patients’ health records onto its cloud-based service.

Innovation--from start-ups to restructuring of existing industry leaders--to reduce costs is popping up all over precisely because the cost burden is shifting from third party payers to individuals. Or, as your article put it, "the patient must once again be made the central actor in the medical marketplace."

If that was happening all over the place, the insurance companies would not have had to restructure a lot of their less expensive policies into more expensive ones to accommodate Obamacare requirements. And millions of happily insured Americans would not have found themselves without insurance and forced into the exchanges as a result of it.

If free market concepts were happening all over the place as you suggest, the totalitarian dictates would never have been forced on the people.

 

[candycorn]

I'm not sure what you mean by the first part but agree with you on the second part. There should be no government dependency/generational welfare. The best way to ween people off? That is a matter for debate.

One way to do that is to foce them to buy their own insurance so they aren't just seeing a doctor when they show up at the emergency room.

How about expecting and requiring people to pay the bills they run up? That would be a pretty good incentive to buy insurane. I believe government forcing people to buy a product dictated by government is just as immoral as making people dependent on government.

Hasn't worked in the past...hence medical costs being the #1 source of personal bankruptcy in the nation.

Medical Bills Are the Biggest Cause of US Bankruptcies Study

Additionaly in the past, you couldn't get insurance if you had some PECs, and lifetime caps rendered insurance benefits almost worthless.

That became the case after government started meddling with healthcare and taking it over for large segments of the population. It was not tthe case before.

That is a false statement on your part.

Sorry, but I was in the medical field, actually dealing with hospital bills before Medicare went into effect. And I witnessed the fraud kicking in on day one that Medicare went into effect and watched the very sharp escalation in prices after that. Prior to Medicare the hospitals did a lot of pro bono services for those who were destitute but there weren't a lot of those. The low income folks would be set up on payment plans that they could afford--even $10/month. If somebody was faced with an expensive operation he/she could not afford and insurance didn't cover, the community rallied and raised the money to help.

Since Medicare and Medicare were enacted in 1965, the government has passed much more legislation trying to control insurance companies and medical costs and each time has only made things worse.

See here:

Considering how much the technology has increased for toasters and washing machines (or think the cost of electronics like calculators or computers that are a fraction of what they once cost):

The Cost of Health Care 1958 vs. 2012

Or this:

. . .The increasing share of medical bills paid by third-party payers (insurance companies and governments) and the disastrous consequences are documented. Patients overuse medical resources since those resources appear to be free or almost free. Producers of medical equipment create new and more expensive devices, even if they are of only marginal benefit, since third-party payers create a guaranteed market. Attempts to rein in those costs have led to a blizzard of paperwork but proven ineffective in controlling costs.

The cure for the present problems is straightforward: the patient must once again be made the central actor in the medical marketplace. Patients need to be given the same motivations to economize on medical care that they have to economize in other markets. Tax laws need to be rewritten. The use of medical savings accounts needs to be promoted. High-deductible health insurance should be encouraged.

Returning the patient, and normal market principles, to center stage is all that is necessary to bring the costs of health care under control.
Why Health Care Costs Too Much​

. . .Congress enacted Medicaid and Medicare as part of the Great Society program in 1965.

The passage of these bills had two immediate effects. First, they substantially enlarged the U.S. health care market. Millions of Americans who previously lacked health insurance now enjoyed coverage under one of these publicly funded plans. Second, they altered the composition of health care spending. As the government covered a larger portion of the health care bill, the share of out-of-pocket spending decreased. The combined effects of the increase in federal funding and the decrease in out-of-pocket spending generated sharp increases in the price of health care. . . .
An Introduction to the Health Care Crisis in America How Did We Get Here ​

And????

What you said was a false statement. Medical bills were and are the #1 cause of personal bankruptcy.

 

[RKMBrown]

How about expecting and requiring people to pay the bills they run up? That would be a pretty good incentive to buy insurane. I believe government forcing people to buy a product dictated by government is just as immoral as making people dependent on government.

Hasn't worked in the past...hence medical costs being the #1 source of personal bankruptcy in the nation.

Medical Bills Are the Biggest Cause of US Bankruptcies Study

Additionaly in the past, you couldn't get insurance if you had some PECs, and lifetime caps rendered insurance benefits almost worthless.

That became the case after government started meddling with healthcare and taking it over for large segments of the population. It was not tthe case before.

That is a false statement on your part.

Sorry, but I was in the medical field, actually dealing with hospital bills before Medicare went into effect. And I witnessed the fraud kicking in on day one that Medicare went into effect and watched the very sharp escalation in prices after that. Prior to Medicare the hospitals did a lot of pro bono services for those who were destitute but there weren't a lot of those. The low income folks would be set up on payment plans that they could afford--even $10/month. If somebody was faced with an expensive operation he/she could not afford and insurance didn't cover, the community rallied and raised the money to help.

Since Medicare and Medicare were enacted in 1965, the government has passed much more legislation trying to control insurance companies and medical costs and each time has only made things worse.

See here:

Considering how much the technology has increased for toasters and washing machines (or think the cost of electronics like calculators or computers that are a fraction of what they once cost):

The Cost of Health Care 1958 vs. 2012

Or this:

. . .The increasing share of medical bills paid by third-party payers (insurance companies and governments) and the disastrous consequences are documented. Patients overuse medical resources since those resources appear to be free or almost free. Producers of medical equipment create new and more expensive devices, even if they are of only marginal benefit, since third-party payers create a guaranteed market. Attempts to rein in those costs have led to a blizzard of paperwork but proven ineffective in controlling costs.

The cure for the present problems is straightforward: the patient must once again be made the central actor in the medical marketplace. Patients need to be given the same motivations to economize on medical care that they have to economize in other markets. Tax laws need to be rewritten. The use of medical savings accounts needs to be promoted. High-deductible health insurance should be encouraged.

Returning the patient, and normal market principles, to center stage is all that is necessary to bring the costs of health care under control.
Why Health Care Costs Too Much​

. . .Congress enacted Medicaid and Medicare as part of the Great Society program in 1965.

The passage of these bills had two immediate effects. First, they substantially enlarged the U.S. health care market. Millions of Americans who previously lacked health insurance now enjoyed coverage under one of these publicly funded plans. Second, they altered the composition of health care spending. As the government covered a larger portion of the health care bill, the share of out-of-pocket spending decreased. The combined effects of the increase in federal funding and the decrease in out-of-pocket spending generated sharp increases in the price of health care. . . .
An Introduction to the Health Care Crisis in America How Did We Get Here ​

And????

What you said was a false statement. Medical bills were and are the #1 cause of personal bankruptcy.

No. You are failing to find the root cause. The root cause, IMO and as the evidence shows, is government run amok that has forced the costs of medical care to go through the roof. But I do find it humorous that you are correcting the medical professional telling her that she does not know what she's talking about.

What are your qualifications in this matter?