|
On February 25 2013 05:04 Dawski wrote:Show nested quote +On February 25 2013 05:01 sam!zdat wrote:On February 25 2013 05:00 Dawski wrote:On February 25 2013 04:57 sam!zdat wrote:I don't know what system you think it is I'm accepting. but you seem like an ideologue and a child so I don't know if I want to get into it with you On February 25 2013 04:56 Jormundr wrote:On February 25 2013 04:54 sam!zdat wrote:On February 25 2013 04:53 Jormundr wrote:
The best one in my opinion would be to show kids the engineering behind chicken nuggets and fast food beef. mandatory field trips to industrial agriculture facilities, 90 percent of your kids become vegetarians, ezpz. As a meat eater who has done this (a lot), I have to say that that percentage seems awfully high. However, it would definitely provide food for thought or vice versa. it's just hyperbole. i also eat meat You're accepting the system by keeping the way things are but just imposing that they pay a (unaccountable) amount of money towards medicare for being bad people. I recommend you go read what I said, because that's the opposite of what I'm saying. When have I ever on this board advocated "keeping things the way they are." LOL i suggest not ending your posts with "LOL". Comes off incredibly rude. All you suggested was that they pay an amount of money towards medicare. Does that dictate a change in that companies policies? no it doesn't. You still haven't said how we'd calculate how much money these companies would have to pay towards medicare
you mistook a polemical attack against industrial agriculture as a serious policy suggestion. of course we shouldn't just have industrial agriculture keep making people unhealthy and then tax them to pay for it. we should outlaw industrial agriculture and fix the problem at its source. we should teach people how to eat healthily and provide them with access to wholesome, healthy foodstuffs. we have huge subsidies for producing hamburgers, and then we subsidize the medical care for people who eat too many hamburgers. fast food isn't actually as cheap as it seems - the taxpayer helps you buy your mcdonald's, and then they help buy your healthcare for being unhealthy and obese.
|
Capitalism is not some sacred infallible law like many of my fellow Americans like to believe. There are certain areas of society in which capitalist theory does not work. Healthcare is one of them. Like many people have said before me, asymmetric information, lack of competition, and price inelasticity of demand prevent a capitalist approach from being at all effective in healthcare.
Five things:
I'm of the opinion that health insurance should be a zero-sum business where profit margins are purposely designed to be absolutely minimal, and any profit that does come out of it should go back to the people paying in. Administrative costs should be kept to a minimum and there should be a strong focus on efficiency. People should not be making huge profits by gambling with people's health in a rigged system. A single-payer system is the only morally acceptable option, period.
Health insurance should not cover routine visits. Consumers should be more intimately connected with healthcare pricing, at the routine level especially. Insurance is there in case something truly unforeseen happens (cancer, car accident, etc.). This also gives people incentive to reduce healthcare usage by living a healthier lifestyle, because they see the monetary effects on their pocket book.
Tort reform. Like the author points out in the article, we should not be incentivizing over testing because doctors and hospitals feel like they have to cover their asses from multi-million dollar lawsuits. Shit happens in every industry, it just has far more serious consequences in healthcare, and you should be compensated, but there comes a point when ever more enormous sums of money will not bring back that wrongly amputated limb. Shit happens and there should be caps to payout amounts.
Hospitals should be far more transparent with their finances. They are very much public-service institutions and should be treated as much. I should be able to call up any hospital and ask them the prices of a list of procedures, and they should be able to tell me, straight up.
Medicare should be able to aggressively negotiate drug-prices and durable medical equipment. This is quite straight forward and the case for this was clearly made in the article. Pharma companies are insanely profitable, which is great, but they are insanely profitable not because they make incredible products (see side effects), but because they operate in a healthcare system that allows them to charge whatever they feel like to consumers who are not choosing to be consumers (see first paragraph).
That's my two cents.
|
On February 25 2013 05:45 Elegance wrote:Show nested quote +On February 25 2013 05:41 Enki wrote:On February 25 2013 05:14 rusedeguerre wrote:On February 25 2013 05:05 Elegance wrote:
Dunno why everyone always flames universal health care. Not letting people die is pretty good. http://en.wikipedia.org/wiki/False_dilemmaThe ironic thing is, not letting people die is one of the major sources of our high costs. Sam!zdat made a good point about end-of-life care. We expect everyone to live forever at any cost. End of life care does cost a huge amount of money. There are actually a really good Frontline episode about this....it does seem rather ridiculous to have someone sick and old go through an expensive surgery, that she didn't even say she wanted (her daughters made the decision), only to die one week later. I understand that we should give people a chance to live and everything but at some point enough is enough and you just cause them more pain. Not to mention the real problem is that so many people shun preventative care as it isn't always cheap (MRI's and the like) then the illness that could have been caught and dealt with in its infantile stages is now a full blown disease or cancer and will require several times more money to fix.
I would bet that if preventative care and tests in this country were more affordable, more people would them done and would end up saving a shitload of money in the end. People don't seem to understand this though and just view everything that actually helps people as handouts. Until people stop thinking like this, I don't see the situation in this country changing for the better.
Edit: Link to said Frontline episode: http://www.pbs.org/wgbh/pages/frontline/facing-death/ This is actually a very good point.
Yeah but that means we actually have to think about the future.
|
On February 25 2013 05:58 Kyrao wrote:
Capitalism is not some sacred infallible law like many of my fellow Americans like to believe. There are certain areas of society in which capitalist theory does not work. Healthcare is one of them. Like many people have said before me, asymmetric information, lack of competition, and price inelasticity of demand prevent a capitalist approach from being at all effective in healthcare.
Five things:
I'm of the opinion that health insurance should be a zero-sum business where profit margins are purposely designed to be absolutely minimal, and any profit that does come out of it should go back to the people paying in. Administrative costs should be kept to a minimum and there should be a strong focus on efficiency. People should not be making huge profits by gambling with people's health in a rigged system. A single-payer system is the only morally acceptable option, period.
Health insurance should not cover routine visits. Consumers should be more intimately connected with healthcare pricing, at the routine level especially. Insurance is there in case something truly unforeseen happens (cancer, car accident, etc.). This also gives people incentive to reduce healthcare usage by living a healthier lifestyle, because they see the monetary effects on their pocket book.
Tort reform. Like the author points out in the article, we should not be incentivizing over testing because doctors and hospitals feel like they have to cover their asses from multi-million dollar lawsuits. Shit happens in every industry, it just has far more serious consequences in healthcare, and you should be compensated, but there comes a point when ever more enormous sums of money will not bring back that wrongly amputated limb. Shit happens and there should be caps to payout amounts.
Hospitals should be far more transparent with their finances. They are very much public-service institutions and should be treated as much. I should be able to call up any hospital and ask them the prices of a list of procedures, and they should be able to tell me, straight up.
Medicare should be able to aggressively negotiate drug-prices and durable medical equipment. This is quite straight forward and the case for this was clearly made in the article. Pharma companies are insanely profitable, which is great, but they are insanely profitable not because they make incredible products (see side effects), but because they operate in a healthcare system that allows them to charge whatever they feel like to consumers who are not choosing to be consumers (see first paragraph).
That's my two cents.
All of that sounds good and well but doesnt even begin to discuss people with Chronic Conditions.
Also, you can't do the bolded until you after you start capping profits in the medical industry.
|
On February 25 2013 06:05 Tarot wrote:Show nested quote +On February 25 2013 05:45 Elegance wrote:On February 25 2013 05:41 Enki wrote:On February 25 2013 05:14 rusedeguerre wrote:On February 25 2013 05:05 Elegance wrote:
Dunno why everyone always flames universal health care. Not letting people die is pretty good. http://en.wikipedia.org/wiki/False_dilemmaThe ironic thing is, not letting people die is one of the major sources of our high costs. Sam!zdat made a good point about end-of-life care. We expect everyone to live forever at any cost. End of life care does cost a huge amount of money. There are actually a really good Frontline episode about this....it does seem rather ridiculous to have someone sick and old go through an expensive surgery, that she didn't even say she wanted (her daughters made the decision), only to die one week later. I understand that we should give people a chance to live and everything but at some point enough is enough and you just cause them more pain. Not to mention the real problem is that so many people shun preventative care as it isn't always cheap (MRI's and the like) then the illness that could have been caught and dealt with in its infantile stages is now a full blown disease or cancer and will require several times more money to fix.
I would bet that if preventative care and tests in this country were more affordable, more people would them done and would end up saving a shitload of money in the end. People don't seem to understand this though and just view everything that actually helps people as handouts. Until people stop thinking like this, I don't see the situation in this country changing for the better.
Edit: Link to said Frontline episode: http://www.pbs.org/wgbh/pages/frontline/facing-death/ This is actually a very good point. Yeah but that means we actually have to think about the future.
yeah that's just too bad
|
On February 25 2013 06:05 Sadist wrote:Show nested quote +On February 25 2013 05:58 Kyrao wrote:
Capitalism is not some sacred infallible law like many of my fellow Americans like to believe. There are certain areas of society in which capitalist theory does not work. Healthcare is one of them. Like many people have said before me, asymmetric information, lack of competition, and price inelasticity of demand prevent a capitalist approach from being at all effective in healthcare.
Five things:
I'm of the opinion that health insurance should be a zero-sum business where profit margins are purposely designed to be absolutely minimal, and any profit that does come out of it should go back to the people paying in. Administrative costs should be kept to a minimum and there should be a strong focus on efficiency. People should not be making huge profits by gambling with people's health in a rigged system. A single-payer system is the only morally acceptable option, period.
Health insurance should not cover routine visits. Consumers should be more intimately connected with healthcare pricing, at the routine level especially. Insurance is there in case something truly unforeseen happens (cancer, car accident, etc.). This also gives people incentive to reduce healthcare usage by living a healthier lifestyle, because they see the monetary effects on their pocket book.
Tort reform. Like the author points out in the article, we should not be incentivizing over testing because doctors and hospitals feel like they have to cover their asses from multi-million dollar lawsuits. Shit happens in every industry, it just has far more serious consequences in healthcare, and you should be compensated, but there comes a point when ever more enormous sums of money will not bring back that wrongly amputated limb. Shit happens and there should be caps to payout amounts.
Hospitals should be far more transparent with their finances. They are very much public-service institutions and should be treated as much. I should be able to call up any hospital and ask them the prices of a list of procedures, and they should be able to tell me, straight up.
Medicare should be able to aggressively negotiate drug-prices and durable medical equipment. This is quite straight forward and the case for this was clearly made in the article. Pharma companies are insanely profitable, which is great, but they are insanely profitable not because they make incredible products (see side effects), but because they operate in a healthcare system that allows them to charge whatever they feel like to consumers who are not choosing to be consumers (see first paragraph).
That's my two cents. All of that sounds good and well but doesnt even begin to discuss people with Chronic Conditions. Also, you can't do the bolded until you after you start capping profits in the medical industry.
Chronic conditions fall under two major categories, with some gray area inbetween. First are the chronic conditions that we acquire through no fault of our own (ie. genetic/congenital). Second we have chronic conditions which we acquire largely through our own carelessness, with a bit of bad luck (ie. emphysema through smoking, type two diabetes, etc.).
Ideally, the first category should be fully covered by a social safety net since everyone is at risk regardless of their own actions, while the second category should be partially covered since there is a definite gray area here. If you choose an unhealthy lifestyle, you should feel the effects of that on your pocket book. It should not bankrupt you, but you should be expected to bear a heavier burden.
In other words, insurance should have high deductibles for chronic conditions that fall into category two, and low deductibles for category one. Obviously there is a ton of gray area here, in which we should err on the side of giving people the benefit of the doubt. But seriously, if you smoke, you should have a higher deductible for respiratory related issues later in life than someone who has never smoked a day in their life... that's just common sense.
|
On February 25 2013 05:58 Kyrao wrote:
Capitalism is not some sacred infallible law like many of my fellow Americans like to believe. There are certain areas of society in which capitalist theory does not work. Healthcare is one of them. Like many people have said before me, asymmetric information, lack of competition, and price inelasticity of demand prevent a capitalist approach from being at all effective in healthcare.
Those roadblocks could just be removed. The only one which we're stuck with is inelastic demand when it comes to real insurance events (broken limb, cancer, etc.) as you say later on that's where insurance should come in to play.
In parts of the US system those roadblocks don't exist and things work fine (ex. laser eye correction or non-regulated drugs) so I'm not sure why that couldn't be extended to many other parts of healthcare.
|
On February 25 2013 07:22 JonnyBNoHo wrote:Show nested quote +On February 25 2013 05:58 Kyrao wrote:
Capitalism is not some sacred infallible law like many of my fellow Americans like to believe. There are certain areas of society in which capitalist theory does not work. Healthcare is one of them. Like many people have said before me, asymmetric information, lack of competition, and price inelasticity of demand prevent a capitalist approach from being at all effective in healthcare.
Those roadblocks could just be removed. The only one which we're stuck with is inelastic demand when it comes to real insurance events (broken limb, cancer, etc.) as you say later on that's where insurance should come in to play. In parts of the US system those roadblocks don't exist and things work fine (ex. laser eye correction or non-regulated drugs) so I'm not sure why that couldn't be extended to many other parts of healthcare.
Asymmetric information will also remain. And market mechanisms can work in some parts of medicine, like elective plastic surgery (with exceptions), but not in most of it.
|
One of the things that I quickly learned after coming to the US, is to never get sick and try to live a healthy life style by learning by myself about healthy foods and lifestyle. A doctor's visit cost me around 500 for the doctor, 200 for hospital, 150 for exams. The hospital was covered by medicaid or something like that but the rest i had to pay out of my own pocket. All that and the doctor said that there was nothing wrong with me. I hate medicine in the United States and i will travel to my country to get attention next time.
|
On February 25 2013 07:31 mcc wrote:Show nested quote +On February 25 2013 07:22 JonnyBNoHo wrote:On February 25 2013 05:58 Kyrao wrote:
Capitalism is not some sacred infallible law like many of my fellow Americans like to believe. There are certain areas of society in which capitalist theory does not work. Healthcare is one of them. Like many people have said before me, asymmetric information, lack of competition, and price inelasticity of demand prevent a capitalist approach from being at all effective in healthcare.
Those roadblocks could just be removed. The only one which we're stuck with is inelastic demand when it comes to real insurance events (broken limb, cancer, etc.) as you say later on that's where insurance should come in to play. In parts of the US system those roadblocks don't exist and things work fine (ex. laser eye correction or non-regulated drugs) so I'm not sure why that couldn't be extended to many other parts of healthcare. Asymmetric information will also remain. And market mechanisms can work in some parts of medicine, like elective plastic surgery (with exceptions), but not in most of it.
Would you really say elective plastic surgery is medicine, though?
|
On February 25 2013 07:31 mcc wrote:Show nested quote +On February 25 2013 07:22 JonnyBNoHo wrote:On February 25 2013 05:58 Kyrao wrote:
Capitalism is not some sacred infallible law like many of my fellow Americans like to believe. There are certain areas of society in which capitalist theory does not work. Healthcare is one of them. Like many people have said before me, asymmetric information, lack of competition, and price inelasticity of demand prevent a capitalist approach from being at all effective in healthcare.
Those roadblocks could just be removed. The only one which we're stuck with is inelastic demand when it comes to real insurance events (broken limb, cancer, etc.) as you say later on that's where insurance should come in to play. In parts of the US system those roadblocks don't exist and things work fine (ex. laser eye correction or non-regulated drugs) so I'm not sure why that couldn't be extended to many other parts of healthcare. Asymmetric information will also remain. And market mechanisms can work in some parts of medicine, like elective plastic surgery (with exceptions), but not in most of it.
Sure, but other markets have plenty of asymmetric information too and they work fine. Systems (competition for one) can be put in place to keep those with more information honest.
|
On February 25 2013 07:22 JonnyBNoHo wrote:Show nested quote +On February 25 2013 05:58 Kyrao wrote:
Capitalism is not some sacred infallible law like many of my fellow Americans like to believe. There are certain areas of society in which capitalist theory does not work. Healthcare is one of them. Like many people have said before me, asymmetric information, lack of competition, and price inelasticity of demand prevent a capitalist approach from being at all effective in healthcare.
Those roadblocks could just be removed. The only one which we're stuck with is inelastic demand when it comes to real insurance events (broken limb, cancer, etc.) as you say later on that's where insurance should come in to play. In parts of the US system those roadblocks don't exist and things work fine (ex. laser eye correction or non-regulated drugs) so I'm not sure why that couldn't be extended to many other parts of healthcare.
I think one of the biggest obstacles is that while in big cities you may have 3-4 or more hospitals in a metro area, any medium to small sized cities will only have one (though some may have two). This is due to the massive cost of providing comprehensive medical care, which only a hospital is truly capable of providing. This creates a scenario where a single hospital can basically monopolize a regional area. In other industries where this is the case such as electricity, as was mentioned in the article, the government is able to heavily restrict prices, since the inherent monopoly makes the industry essentially immune to market pressures. If the government were able to do that, as they already do with medicare pricing, then that would be a completely different story and in which case you might as well just go with a single-payer system to consolidate and normalize insurance plans, increasing efficiency.
|
people want to make money and when theres money to be made and people who are willing to pay(yeah yeah i know theyre sick) its not going to change. if everything was perfect the world would either be boring or collapse entirely. i have no idea why everyone gets so worked on stuff like this... i mean seriously its like some people are only happy when theyre mad.
|
this is why leading a healthy lifestyle is important...
|
On February 25 2013 08:25 MattMannion wrote:
people want to make money and when theres money to be made and people who are willing to pay(yeah yeah i know theyre sick) its not going to change. if everything was perfect the world would either be boring or collapse entirely. i have no idea why everyone gets so worked on stuff like this... i mean seriously its like some people are only happy when theyre mad.
You do realize that there are tons of countries (basically all developed ones...) have a national healthcare system except USA? Some people just like doing things efficiently and intelligently.
|
On February 25 2013 08:25 MattMannion wrote:
people want to make money and when theres money to be made and people who are willing to pay(yeah yeah i know theyre sick) its not going to change. if everything was perfect the world would either be boring or collapse entirely. i have no idea why everyone gets so worked on stuff like this... i mean seriously its like some people are only happy when theyre mad.
Civil discourse is what this country is founded on. It is not about complaining, it is about trying to navigate the complicated nature of healthcare in order to make it better (more accessibility and efficiency, less waste, higher quality of care). We should always strive to do things better. Your argument against this discussion because "if everything was perfect the world would either be boring or collapse entirely" is simply pathetic. That is all.
|
On February 25 2013 08:18 Kyrao wrote:Show nested quote +On February 25 2013 07:22 JonnyBNoHo wrote:On February 25 2013 05:58 Kyrao wrote:
Capitalism is not some sacred infallible law like many of my fellow Americans like to believe. There are certain areas of society in which capitalist theory does not work. Healthcare is one of them. Like many people have said before me, asymmetric information, lack of competition, and price inelasticity of demand prevent a capitalist approach from being at all effective in healthcare.
Those roadblocks could just be removed. The only one which we're stuck with is inelastic demand when it comes to real insurance events (broken limb, cancer, etc.) as you say later on that's where insurance should come in to play. In parts of the US system those roadblocks don't exist and things work fine (ex. laser eye correction or non-regulated drugs) so I'm not sure why that couldn't be extended to many other parts of healthcare. I think one of the biggest obstacles is that while in big cities you may have 3-4 or more hospitals in a metro area, any medium to small sized cities will only have one (though some may have two). This is due to the massive cost of providing comprehensive medical care, which only a hospital is truly capable of providing. This creates a scenario where a single hospital can basically monopolize a regional area. In other industries where this is the case such as electricity, as was mentioned in the article, the government is able to heavily restrict prices, since the inherent monopoly makes the industry essentially immune to market pressures. If the government were able to do that, as they already do with medicare pricing, then that would be a completely different story and in which case you might as well just go with a single-payer system to consolidate and normalize insurance plans, increasing efficiency.
You'd need to explain that a bit more. Healthcare is provided for on many fronts (hospitals, pharmacies, doctor's offices, clinics, etc.) so I'm not sure what you are referring to exactly. If certain parts of healthcare lend to natural monopolies then yeah you'd need to regulate that pricing. But I can't see that as true for all healthcare.
|
On February 25 2013 07:53 Roe wrote:Show nested quote +On February 25 2013 07:31 mcc wrote:On February 25 2013 07:22 JonnyBNoHo wrote:On February 25 2013 05:58 Kyrao wrote:
Capitalism is not some sacred infallible law like many of my fellow Americans like to believe. There are certain areas of society in which capitalist theory does not work. Healthcare is one of them. Like many people have said before me, asymmetric information, lack of competition, and price inelasticity of demand prevent a capitalist approach from being at all effective in healthcare.
Those roadblocks could just be removed. The only one which we're stuck with is inelastic demand when it comes to real insurance events (broken limb, cancer, etc.) as you say later on that's where insurance should come in to play. In parts of the US system those roadblocks don't exist and things work fine (ex. laser eye correction or non-regulated drugs) so I'm not sure why that couldn't be extended to many other parts of healthcare. Asymmetric information will also remain. And market mechanisms can work in some parts of medicine, like elective plastic surgery (with exceptions), but not in most of it. Would you really say elective plastic surgery is medicine, though?
Well the pricing and models should be comparable. The big difference is the necessity. As said before, nobody is stopping anyone from setting up shop and filling that niche, nobody is stopping that competetion.
I would bet the mark up on cosmetic surgery is comparable to essential surgery though.
|
On February 25 2013 08:34 Aveng3r wrote:
this is why leading a healthy lifestyle is important...
I'm sure everyone is all for eating healthy, and having the actual food producers stop putting so much shit into the foot supply. A Healthy diet can only take you so far. If you get into bad car accident it doesn't matter how much fruit you eat...most likely you need hospital care and surgery, both of which can destroy your financial well-being for years. Not to mention cancer does not discriminate and has struck down perfectly healthy people.
I think it is a good start though. People should be more educated about proper food choices, but part of the responsibility has to go to the actually producers of the food as they are ultimately in control of what goes into it. Also, people would love to eat healthier and organic and all that shit but the fact is that it's more expensive and a lot of families can't afford it in this economy, especially with food prices to get even higher.
|
On February 25 2013 08:44 JonnyBNoHo wrote:Show nested quote +On February 25 2013 08:18 Kyrao wrote:On February 25 2013 07:22 JonnyBNoHo wrote:On February 25 2013 05:58 Kyrao wrote:
Capitalism is not some sacred infallible law like many of my fellow Americans like to believe. There are certain areas of society in which capitalist theory does not work. Healthcare is one of them. Like many people have said before me, asymmetric information, lack of competition, and price inelasticity of demand prevent a capitalist approach from being at all effective in healthcare.
Those roadblocks could just be removed. The only one which we're stuck with is inelastic demand when it comes to real insurance events (broken limb, cancer, etc.) as you say later on that's where insurance should come in to play. In parts of the US system those roadblocks don't exist and things work fine (ex. laser eye correction or non-regulated drugs) so I'm not sure why that couldn't be extended to many other parts of healthcare. I think one of the biggest obstacles is that while in big cities you may have 3-4 or more hospitals in a metro area, any medium to small sized cities will only have one (though some may have two). This is due to the massive cost of providing comprehensive medical care, which only a hospital is truly capable of providing. This creates a scenario where a single hospital can basically monopolize a regional area. In other industries where this is the case such as electricity, as was mentioned in the article, the government is able to heavily restrict prices, since the inherent monopoly makes the industry essentially immune to market pressures. If the government were able to do that, as they already do with medicare pricing, then that would be a completely different story and in which case you might as well just go with a single-payer system to consolidate and normalize insurance plans, increasing efficiency. You'd need to explain that a bit more. Healthcare is provided for on many fronts (hospitals, pharmacies, doctor's offices, clinics, etc.) so I'm not sure what you are referring to exactly. If certain parts of healthcare lend to natural monopolies then yeah you'd need to regulate that pricing. But I can't see that as true for all healthcare.
Good point. In this case I am referring to having things like a CT scanner, MRI, Angio equipment, Nuclear medicine, and other expensive, non-mobile machinery all in one general location. Most doctor's offices refer patients to the hospital when he/she needs one of these tests done, rather than bearing the expense on a piece of equipment that will take far too long to pay off with his/her expected usage to be feasible. This is a powerful way to reduce medical expenses for a regional population, so while you might be able to fragment this kind of equipment between a network of doctors' offices, it would be far more ideal to have a central hospital to house these (which is also especially important in emergency medicine). Also, drugs will always be a separate case because of their mobility (you can bring them to the patient rather than the other way around). The real barrier to reducing drug prices outside of a hospital (where it is heavily marked up for some god forsaken reason) seems to be patent rights, which at its core is necessary for a pharma company's R&D to pay off. I'm not saying there couldn't be better ways of rewarding/regulating patents, but that would be a totally different discussion that I feel completely noobish trying to even talk about.
|
|
|
|
|
|
EPT
