The myths of high cost healthcare

[EdwardBaiamonte]

For-profit medicine has been free to charge whatever they want.

of course thats very very stupid!! You learn in Econ 101 that capitalist competition drives profits and prices lower and lower until 10,000 businesses go bankrupt in America each month.

Now you know why Americans are the richest people in human history!! THey have the most for-profit economy in the world.

 

[EdwardBaiamonte]

They love to ignore the successes we have had with programs like Social Security

too stupid by 1000% but perfectly liberal. If SS was invested in private accounts, rather than stolen by libturds, an average American would retire with $1.4 million estate not the dog food money they get from SS if they live long enough to collect a penny.

How could you not know that??????? It is almost impossible to believe, but then you are a liberal.

 

[Underhill]

They love to ignore the successes we have had with programs like Social Security

too stupid by 1000% but perfectly liberal. If SS was invested in private accounts, rather than stolen by libturds, an average American would retire with $1.4 million estate not the dog food money they get from SS if they live long enough to collect a penny.

How could you not know that??????? It is almost impossible to believe, but then you are a liberal.

Yeah, I wasn't talking to you. Fuck off.

You obviously aren't here to discuss anything.

 

[Underhill]

Nobody inside the health care industry wants single payer because they won't be able to charge whatever they want. Doctors and hospitals will have to join the AMA or some other union like association to negotiate with the state on reimbursement rates. They do that now with insurance companies, but here there would be only one negotiation with the government. The medical establishment knows that if the government is negotiating, their rates will have to come down and they don't want that.

For-profit medicine has been free to charge whatever they want. A lot of doctors and hospitals refuse to deal with Medicare or Medicaid patients because the rate of reimbursement is too low. In countries with single payer, there is only one rate of reimbursement and that's what they fear. An end to the highest doctor and hospital fees in the world.

You are mostly right. Morons believe the medical field is a free market system not thinking about the fact that most towns don't have a wealth of hospitals to choose from, or a laundry list of doctors just waiting with baited breath for you to pick them.

There is a shortage of doctors and barely enough hospitals. Anyone who knows anything about economics knows that means inflated prices.

One mistake we have made is cutting doctors fees to the point we have. The problem is not doctors fees, or at least not directly. The problem is with the cost of running a practice. My wife works in a doctors office with a total of 4 secretaries (3 full time and one part time). That's 4 staff for one surgeon. That's because of the dozens of insurers they have to deal with, not to mention everything involved with Medicare and Medicaid.

The doc makes a good paycheck. But nothing outrageous. But his overhead is easily double his pay.

This is why I am convinced we need single payer. My wife would probably be out of a job, but it would save our system a fortune just in processing cost alone.

 

[EdwardBaiamonte]

This is why I am convinced we need single payer.

dear, America is the richest because it has the most capitalism. Did you think the Girl Scouts were responsible??

Are you a commie pinko?? Do you want communism in all industries??

 

[dblack]

Then we have fundamentally different views on individual rights. What could be more fundamental than your health? Are you sure you don't want to take that back? If not, what rights DO you consider fundamental?

If you want to get into fundamental rights as they relate to importance, I would agree that their should be a fundamental right to health care. But a right to not enroll? Sorry but I don't buy that.

I'm not saying a right "to" health care is fundamental. It's not even a coherent concept. Rights are freedoms. I'm talking about preserving the freedom to manage our health care as we see fit, and not be forced into someone else's idea of what's good for us.

I do see this as a stepping stone, because like you, I don't see this plan working as well as it should. But I think for single payer to have a hope of happening, our private system will have to become nightmarish and I think our system is heading in that direction with this plan or without it.

This ...

I've seen this perspective expressed before, and frankly I find it disturbing. The idea that those we trust to lead our nation could be so underhanded as to deliberately avoid productive reform in favor of something that they know will make things worse - just to provoke a catastrophe that have us running into whatever pen they designate - is beyond the pale.

But I don't buy that narrative. I think this is a comforting bedtime story (in its twisted way) that progressives tell themselves to get past the obvious bait and switch of PPACA - but it has no resemblance to reality.

Too many people (perhaps yourself included?) seem hung up on the whole socialist issue.

I'm not "hung up" on it. I do think socialism is a fundamental misconception regarding the proper purpose of government, and a dangerous consolidation of economic and political power, but like most things, it can be done well. I can conceive of a largely socialist nation that still managed to respect (most) individual rights, and still managed to maintain rule of law and equal protection. Socialism can also step all over these things.

But what I'm trying to tell you is PPACA isn't socialism. It isn't a bridge to socialism. It's textbook corporatism. If you haven't already done so, do us both a favor and read up a little on corporatism before you respond. The wikipedia article is a pretty good place to start. The key thing to notice is that, unlike socialism, corporatism doesn't seek a classless society. Under corporatism, government aims to appease and balance the interests of all classes and corporate groups by acting as an arbiter of power - dispensing favor and assessing penalty ad-hoc to achieve its political aims.

 

[lonelygirl8]

From where is this?

 

[editec]

I'd really like to hear an honest answer to this question. Mostly it just gets dodged. If government should be responsible for making sure everyone has health care, does this imply it should be responsible for all of life's necessities?

The health care industry is SO UNLIKE every other industry that I believe it does make sense to have one insurance pool rather than many.

I cannot think of any other industry where the consumer is not the person deciding what it is they'll be buying.

Can you?

That's the problem, in bold. And you can bet, that if we let them push this model into other industries, we'll face the same problems. And I'm betting they'll try.

This problem is basically unique to certain PROFESSIONS.

Medicine and the LAW are two excellent examples.

In both cases the PROVIDER TELLS THE CONSUMER what they'll be buying.

But only medicine has an environment where most payments are third party, which makes how this society pays for HC rather unique to our mostly capitalist system.

Thinking that the same laws of economics that applies to most purchasing also apply to HC is simply missing the ASTOUNDINGLY obvious.

 

[Underhill]

This is why I am convinced we need single payer.

dear, America is the richest because it has the most capitalism. Did you think the Girl Scouts were responsible??

Are you a commie pinko?? Do you want communism in all industries??

No I am not dear. But we can keep capitalism where it is working and get rid of it where it isn't.

Only a fool would think capitalism is the answer for everything. There are plenty of examples of it failing. Hell, unregulated capitalism is screwing America over right now in the form of jobs being sent to China.

 

[Underhill]

Then we have fundamentally different views on individual rights. What could be more fundamental than your health? Are you sure you don't want to take that back? If not, what rights DO you consider fundamental?

If you want to get into fundamental rights as they relate to importance, I would agree that their should be a fundamental right to health care. But a right to not enroll? Sorry but I don't buy that.

I'm not saying a right "to" health care is fundamental. It's not even a coherent concept. Rights are freedoms. I'm talking about preserving the freedom to manage our health care as we see fit, and not be forced into someone else's idea of what's good for us.

Yeah I knew what you were saying. And I think it's a bullshit concept. Most people have no clue what is good for us. It's like claiming parents with a 6th grade education should be solely responsible for their childrens education. Decisions on treatment, sure. But what decision is there for coverage? Everyone needs it or will need it. So what decision is there? Put off paying for it? We can either start paying for health care from the day we enter the workforce, or pay more for it later. Not much of a choice.

I've seen this perspective expressed before, and frankly I find it disturbing. The idea that those we trust to lead our nation could be so underhanded as to deliberately avoid productive reform in favor of something that they know will make things worse - just to provoke a catastrophe that have us running into whatever pen they designate - is beyond the pale.

I'm not saying we should deliberately avoid or provoke anything. I'm saying the current new plan is better than what we had, since it covers more people, but doesn't fix the inherent flaw in the system.

I believe the problems with our current system cannot be fixed without control.

I'm not "hung up" on it. I do think socialism is a fundamental misconception regarding the proper purpose of government, and a dangerous consolidation of economic and political power, but like most things, it can be done well. I can conceive of a largely socialist nation that still managed to respect (most) individual rights, and still managed to maintain rule of law and equal protection. Socialism can also step all over these things.

But what I'm trying to tell you is PPACA isn't socialism. It isn't a bridge to socialism. It's textbook corporatism. If you haven't already done so, do us both a favor and read up a little on corporatism before you respond. The wikipedia article is a pretty good place to start. The key thing to notice is that, unlike socialism, corporatism doesn't seek a classless society. Under corporatism, government aims to appease and balance the interests of all classes and corporate groups by acting as an arbiter of power - dispensing favor and assessing penalty ad-hoc to achieve its political aims.

I understand, and again, agree with you. But if you think this is the beginning then you are delusional. We have been a corporatist nation for the last 40 years, maybe longer.

Virtually all our policies, from tax policy, to defense, to monetary policy and trade, are all geared towards the benefit and welfare of the corporations.

And I agree it's a problem. I've bitched about it for at least 10 years. But until the American people recognize it, we are fucked. And since the American people tune into primarily corporate controlled media, it may be a long time coming.

 

[dblack]

I'm not saying a right "to" health care is fundamental. It's not even a coherent concept. Rights are freedoms. I'm talking about preserving the freedom to manage our health care as we see fit, and not be forced into someone else's idea of what's good for us.

Yeah I knew what you were saying. And I think it's a bullshit concept. Most people have no clue what is good for us. It's like claiming parents with a 6th grade education should be solely responsible for their childrens education.

It's called freedom. Legal adults have the right and responsibility to decide what is good for them without being bullied into something against their will.

But what decision is there for coverage? Everyone needs it or will need it. So what decision is there? Put off paying for it? We can either start paying for health care from the day we enter the workforce, or pay more for it later. Not much of a choice.

Endless decisions and choices (decisions that PPACA deliberately thwarts). How much insurance do we actually need? What should be covered? What should be excluded? How much is it worth? How much should we pay for ourselves? How much risk is acceptable?

It's our delusional attempt to avoid making these decisions, and to get government to do it for us, that's painted us into this corner in the first place.

I've seen this perspective expressed before, and frankly I find it disturbing. The idea that those we trust to lead our nation could be so underhanded as to deliberately avoid productive reform in favor of something that they know will make things worse - just to provoke a catastrophe that have us running into whatever pen they designate - is beyond the pale.

I'm not saying we should deliberately avoid or provoke anything. I'm saying the current new plan is better than what we had, since it covers more people, but doesn't fix the inherent flaw in the system.

Then say that instead. Agreeing that PPACA will be a failure, and then trying to tout that as secretly a 'good thing' because it will provoke a "nightmarish" scenario just seems shifty. I don't think the current new plan is better than what we had. When the health care reform process started, I supported it because I thought they couldn't possibly make it any worse. I was wrong.

I believe the problems with our current system cannot be fixed without control.

Control of whom? By whom?

I understand, and again, agree with you. But if you think this is the beginning then you are delusional. We have been a corporatist nation for the last 40 years, maybe longer.

Sure - probably longer. The corporatist trend isn't new. My point is just that PPACA doesn't break that trend. It's another brick in the wall.

 

[Underhill]

I'm not saying a right "to" health care is fundamental. It's not even a coherent concept. Rights are freedoms. I'm talking about preserving the freedom to manage our health care as we see fit, and not be forced into someone else's idea of what's good for us.

Yeah I knew what you were saying. And I think it's a bullshit concept. Most people have no clue what is good for us. It's like claiming parents with a 6th grade education should be solely responsible for their childrens education.

It's called freedom. Legal adults have the right and responsibility to decide what is good for them without being bullied into something against their will.

Endless decisions and choices (decisions that PPACA deliberately thwarts). How much insurance do we actually need? What should be covered? What should be excluded? How much is it worth? How much should we pay for ourselves? How much risk is acceptable?

It's our delusional attempt to avoid making these decisions, and to get government to do it for us, that's painted us into this corner in the first place.

Yes but if everyone needs it, why bother? Set up a program like Medicare for all and simply allow people to purchase gap insurance if they want to. You are essentially saying everyone should be able to make poor decisions about their healthcare if they want. And I'm saying all that does it postpone the problem.

It's an awful lot like retirement. Everyone needs to be setting money aside for it. But if given the choice, a large segment of the population just wont. But if we allow them that complete freedom then we, the public, end up with a population of poor starving elderly we have to deal with.

So we came out with Social Security.

In my ideal world we would set up a system that covered 80-90% of essential care and preventative medicine cost. And limited essential care for dental or vision.

Then those who want to buy gap insurance could do so. Co-pays would go to a single government office rather than the doctors. Although it may be worthwhile to simply cover 100%. I've heard discussions with British officials who came to the conclusion that a system of co-pays would require so much additional resources to process that we may be better off covering it all. On the other hand, making people pay may reduce usage.

Anyway, that is a separate discussion.

Then say that instead. Agreeing that PPACA will be a failure, and then trying to tout that as secretly a 'good thing' because it will provoke a "nightmarish" scenario just seems shifty. I don't think the current new plan is better than what we had. When the health care reform process started, I supported it because I thought they couldn't possibly make it any worse. I was wrong.

What we had was headed for this nightmare scenario too. It's a matter of cost.

Control of whom? By whom?

Control of cost. With a single payer system you can regulate cost. Virtually everyone in the system will be getting paid from a single source, getting rid of vast mountains of paperwork.

As it is now, there is no control. The whole system is chaos.

Sure - probably longer. The corporatist trend isn't new. My point is just that PPACA doesn't break that trend. It's another brick in the wall.

We're in agreement there.

 

[lynn63]

There is no reason for these high costs except greed. In 2011 there were 138 million tax payers that paid payroll taxes for FICA. There are 40 million seniors and 10 million people on disability. There is something wrong when Medicare hospital insurance when 138 million people is not enough to support it.

 

[editec]

What's wrong with HC can be described rather easily.

Its developed into a Third-party-payment system where the consumers, the third party payers and (obviously) the HC providers
have no built-in incentive to keep costs down.

ACA does NOT address this problem at all, as far as I understand it.

To date no proponent of ACA has corrected me on that point, so I assume that I am right.

 

[dblack]

Yeah I knew what you were saying. And I think it's a bullshit concept. Most people have no clue what is good for us. It's like claiming parents with a 6th grade education should be solely responsible for their childrens education.

It's called freedom. Legal adults have the right and responsibility to decide what is good for them without being bullied into something against their will.

Endless decisions and choices (decisions that PPACA deliberately thwarts). How much insurance do we actually need? What should be covered? What should be excluded? How much is it worth? How much should we pay for ourselves? How much risk is acceptable?

It's our delusional attempt to avoid making these decisions, and to get government to do it for us, that's painted us into this corner in the first place.

Yes but if everyone needs it, why bother?

Because everyone doesn't need 'it'. Some people are rich enough they don't need health insurance. Some people refuse modern health care altogether. And the more important point, because everyone's needs are different. And because what each of us can afford is different.

You are essentially saying everyone should be able to make poor decisions about their healthcare if they want.

That's exactly what I'm saying. Because everyone's idea of what a makes 'poor' decision will be different. There's no reason to force majority consensus on the minorities who might disagree.

Control of whom? By whom?

Control of cost. With a single payer system you can regulate cost. Virtually everyone in the system will be getting paid from a single source, getting rid of vast mountains of paperwork.

Laws and regulation don't control "costs". They control people. To which I repeat my question, who's controlling whom?

Sure - probably longer. The corporatist trend isn't new. My point is just that PPACA doesn't break that trend. It's another brick in the wall.

We're in agreement there.

So why on earth make that wall any higher?

 

[Underhill]

Because everyone doesn't need 'it'. Some people are rich enough they don't need health insurance. Some people refuse modern health care altogether. And the more important point, because everyone's needs are different. And because what each of us can afford is different.

That's exactly what I'm saying. Because everyone's idea of what a makes 'poor' decision will be different. There's no reason to force majority consensus on the minorities who might disagree.

Nope sorry, everyone will need health care at some point. The rich, who cares. They can use whatever they like. The rest of us will need health care at some point. And those who put off paying for it at a young age simply end up costing the rest of us when they get older or fall on hard times.

That is my whole point. Statistically speaking virtually everyone gets sick. Everyone will need it. The sooner we can get everyone paying for it the lower the cost will be. Allowing people to put it off just shifts the burden from them to the rest of us in too many cases.

Laws and regulation don't control "costs". They control people. To which I repeat my question, who's controlling whom?

Of course regulations can control cost. Just look at Canada's drug prices if you don't believe me.

So why on earth make that wall any higher?

Because at this point it doesn't matter. The old or the new, either way we will be facing the same problem. At least this way more people are covered.

 

[EdwardBaiamonte]

To date no proponent of ACA has corrected me on that point, so I assume that I am right.

Well the ACA has many plans to control costs( liberals are only 99% stupid) but they are all socialist. For example, they plan to provide incentives to hospitals that keep readmission rates down by, for example, following up with patients to see that they stay on their meds. Another one is to make all MD's hospital employees and then do time motion studies to determine how much time each procedure should take, and then pay accordingly.

The incentive is not capitalist in that it is not based on daily capitalist self-policing wherein you have posted prices, consumers shopping with their own money, and providers competing on the basis of price and quality.

The liberal ACA system depends 100% on the intelligence and vigilance of a soviet bureaucracy in Washington and we all know how well that will work out!

 

[dblack]

Because everyone doesn't need 'it'. Some people are rich enough they don't need health insurance. Some people refuse modern health care altogether. And the more important point, because everyone's needs are different. And because what each of us can afford is different.

That's exactly what I'm saying. Because everyone's idea of what a makes 'poor' decision will be different. There's no reason to force majority consensus on the minorities who might disagree.

Nope sorry, everyone will need health care at some point.

Please don't equivocate health care and health insurance. They're not the same thing. So much of this debate is trying to get past this fixation on insurance as the only way to take care of our health, and that's just nonsense. The insurance industry certainly wants to sell that view, but it's not true. Unless, of course, it's forced on us via government.

Laws and regulation don't control "costs". They control people. To which I repeat my question, who's controlling whom?

Of course regulations can control cost. Just look at Canada's drug prices if you don't believe me.

C'mon. Don't evade the issue. WHO will control prices? ie who will control how much vendors (people) can charge and how much consumers (people) will pay? Any chance it will be the same people who control regulation currently (industry lobbyists)?

 

[EdwardBaiamonte]

Because everyone doesn't need 'it'. Some people are rich enough they don't need health insurance. Some people refuse modern health care altogether. And the more important point, because everyone's needs are different. And because what each of us can afford is different.

That's exactly what I'm saying. Because everyone's idea of what a makes 'poor' decision will be different. There's no reason to force majority consensus on the minorities who might disagree.

Nope sorry, everyone will need health care at some point.

Please don't equivocate health care and health insurance. They're not the same thing. So much of this debate is trying to get past this fixation on insurance as the only way to take care of our health, and that's just nonsense. The insurance industry certainly wants to sell that view, but it's not true. Unless, of course, it's forced on us via government.

Laws and regulation don't control "costs". They control people. To which I repeat my question, who's controlling whom?

Of course regulations can control cost. Just look at Canada's drug prices if you don't believe me.

C'mon. Don't evade the issue. WHO will control prices? ie who will control how much vendors (people) can charge and how much consumers (people) will pay? Any chance it will be the same people who control regulation currently (industry lobbyists)?

capitalism keeps prices so low that Americans are richest people in human history. Do you wonder why prices are not low in health care??
Perhaps because there is no capitalism there.

 

[Underhill]

Please don't equivocate health care and health insurance. They're not the same thing. So much of this debate is trying to get past this fixation on insurance as the only way to take care of our health, and that's just nonsense. The insurance industry certainly wants to sell that view, but it's not true. Unless, of course, it's forced on us via government.

Right, except when I ask for alternatives all you offer is "opening up the markets".

So again I ask, if you reject insurance, and reject government plans, how do you expect to get your health care? Pay as you go? Because that will work fine right up until something serious happens, then you are screwed.

C'mon. Don't evade the issue. WHO will control prices? ie who will control how much vendors (people) can charge and how much consumers (people) will pay? Any chance it will be the same people who control regulation currently (industry lobbyists)?

Who is evading anything?

The reality is that cost can be controlled by anyone we like. Industry lobbyist will have say, no doubt. But so will other interest groups like AARP, the CFA and the AMAC who will fight for consumer protections. If you think AARP doesn't have some pull, you are dreaming. It's one of the reason nobody dares touch their current health care and social security.