|
On August 16 2009 14:28 Kwark wrote:+ Show Spoiler +
Healthcare simply isn't a business. A business wishes to maximise its turnover by maximising the number of people it treats and by the individual profit on each one. This is an impractical way to go about it and doesn't make sense economically because healthcare doesn't produce anything as a service, it's like digging holes and filling them in again. The free market will naturally try and expand the digging holes and filling them in market while trying to become the most efficient hole digger it can be whereas as a nationalised system tries to stop digging holes.
Take an overweight middle aged man with good insurance. He can go into the doctors complaining of trouble breathing and the doctor will be 90% sure it's because he's just fat and getting older but will happily order a stream of expensive tests just in case. The man will agree to them because they're covered by his insurance and he thinks it's about time he got something back from that. The tests come back negative and the insurance company increases the premiums for his demographic. Yes, he got a very good level of service. He also just burned thousands of dollars. Not in the way that if he'd bought a new car but rather the way if he'd just paid some guy to dig a hole and fill it back in again. This is why you spend the most money per person on health and still fail on every main marker of healthcare. Not only do you spend the money really inefficiently but there is actually less accountability towards spending in this than in a socialised system, amazingly enough. Doctor can say "you probably don't need this scan but it's covered by the insurance and we just want to be safe", after all, his job is to sell the service he provides and make money for his hospital. Insurance doesn't give a fuck, if people start claiming more the premiums go up and stealth tax the whole demographic on that plan. And even if you know about this you're not going to limit your insurance use just because you'll end up charging it to your entire demographic, more like "their shit goes on my insurance premiums, fuck that, i'm gonna beat the system and have more expensive shit done".
Take the same example in Britain. If he's worried he can phone up the free NHS advice line and have a qualified advisor tell him it's probably nothing. That same money can then be spent giving the vulnerable demographic free flu vaccines each winter.
Or take vaccines as an example. Public healthcare programs like that are the absolute opposite of what a business aims to do. It's spending money to decrease the market for their service. Ideally what a healthcare business wants to happen is for you to get into serious trouble, be rushed to hospital, have your life saved by their highly trained staff, be extremely grateful and be productive enough to pay their fees until it happens again. Doing so burns thousands of dollars but you did get an excellent level of service. Whereas the public model just gives you a free vaccine because you're statistically at risk and decreases its patient turnover for $2.
So essentially your argument is that you like that in the UK system, instead of seeing a doctor for something that potentially could be a fatal problem (difficulty breathing in a middle aged man), you "get" to instead call a free hotline and talk to a "qualified advisor" (whatever that means), who will tell you "it's probably nothing".
That somehow doesn't sound very nice.
EDIT: My last post was really long and thought out but ended up as the last post on a page so I will put it here again is spoiler form:
+ Show Spoiler +
Why I am against Obama's "Reform" (at least read until the line, but read it all if you actually want to understand this is a bad plan)
There are 2 aspects of the American medical system that are unique to us and contribute greatly to the reason that our medical care costs more than care does elsewhere. The 2 problems are:
1. Employer based health insurance
2. Our litigation-based national persona leading to defensive medical practices by doctors.
Obama "reform" completely ignores these 2 problems. He doesn't even touch either one of them. If you are going to do reform, why leave these 2 out? Its a waste of a plan. This doesn't even deserve to be called reform because all it does it spend more $$$ in the same way we have always been spending it. No change in tort reform, no change in selectively subsidizing employer based insurance. All it merely is is spending more money in the same way we always have. The 1 new aspect that his plan has that we haven't already been doing is the "public option" which I also have a problem with as i will explain later. But for now, let me expand on the 2 main problems in our system.
----------------------------------------------------------------------------------------------------------------------------------
1. Employer based heath insurance-->We all know by now that it was never meant to be this way and that it was an artifact of WW2. The problem with this is that it protects insurance companies from the market power of individuals. It inhibits competitive market forces because people do not actually get to choose their plan. Their employer chooses the plan and it is not easy to change.
How many of you feel like you are being price gouged by your car insurance? Is it hard to get car insurance? If you are unhappy with your car insurance, how easy is it to change plans? It is INCREDIBLY easy! That is why the car insurance market works so well. It is cheap, it works well and it is efficient. The same is true of EVERY other kind of insurance in the USA. Only health insurance doesn't work well and that is because ONLY health insurance is mostly employer based. Obama ignores this and does not plan to stop subsidizing employer based insurance. This is why his plan is bad. It does not address the main problems of our system.
The other problem with health insurance, is that it is heavily regulated by the government which makes it harder to function properly.
There are more problems with employer based heath care. When you get your insurance through your company, it lower the labor mobility of the country and that is an economic inefficiency that slows down the economy. For example, someone who has a job with insurance may find a job that better fits his skills with better pay and overall a better match, but if he changes, he loses his insurance. Therefore, he often stays in the worse job and never takes the better job. If all health insurance was privately purchased, you could change jobs all you want and it would not affect your health insurance. The labor force would not have this hurdle keeping them from taking better jobs that fit them better and the economy would run more smoothly.
But Obama has ignored all of this in his plan and just decides to spend more money in the same weird half government/half highly regulated employer based insurace system that we have that is so messed up. And then he calls this "reform".
2. The other problem is out litigation society. Many people feel that if doctors did now have to pay so much in malpractice insurance premiums, they would charge less for procedures. This may be true but I think the cost savings would be pretty small. The MAIN benefit of real tort reform is that it allows doctor's to just do what they think is medically indicated and not order extra tests/procedures (that can each costs up to thousands of dollars per person per test). Doctor's are not free of outside influence and the threat of being sued for multimillion dollar payments WILL affect doctor's behavior and make the whole system run badly. Recent studies show that 5/6 doctors admit to practicing defensive medicine and it is estimated that the defensive medicine aspect is 25% of the costs of the care they give. That is a LOT of money.
But again, there is not a single word about addressing this problem in Obama's plan. There probably never will be any word on tort reform from any democrat-controlled cnogress because....who benefits the most if there is no tort reform? Think for a second....of course it is the lawyers themselves. Well, it turns out that a HUGE percentage of all the money democrats raise comes from lawyers and law firms. Republicans have a similar problem with other industries (like oil), but the truth is that congressional democrats are huge invested in making sure their lawyer constituency is taken care of. So no "reform" there.
These are just a couple of my thoughts on the issue. This is not a good reform bill. It does nothing to lower the cost of drugs (see my post on Pharma and Obama), nothing to control defensive medicine costs, and nothing to address the problem of employer based insurance.
The truth is that health insurance COULD run just as well as any other type of insurance (and all other types really do work very well). The only reason health insurance is not doing a good job right now is because of government intervention. Government single handedly is responsible for the inefficiency of our current system and Obama's response is "well, the market isn't working so well...lets add some more regulation and see if that fixes it".
It is simply a bad plan.
|
On August 16 2009 14:32 banthistoo wrote:
hey guys, imabossdude again. Don't disagree with the liberal admins too much, they will BAN you for it.
Also, Aegraen don't try to persuade any of these guys, it won't work. They have been brainwashed by public schools/liberal media their whole lives, you must excuse them.
Fuck Team Liquid. They hate freedom of speech.
I love the ban thread:
banthistoo was just banned by SonuvBob.
That account was created on 2009-08-16 14:28:43 and had 1 posts.
Reason: BRAINWASHED, MUST BAN
|
United States43187 Posts
On August 16 2009 15:09 Savio wrote:Show nested quote +On August 16 2009 14:28 Kwark wrote:+ Show Spoiler +
Healthcare simply isn't a business. A business wishes to maximise its turnover by maximising the number of people it treats and by the individual profit on each one. This is an impractical way to go about it and doesn't make sense economically because healthcare doesn't produce anything as a service, it's like digging holes and filling them in again. The free market will naturally try and expand the digging holes and filling them in market while trying to become the most efficient hole digger it can be whereas as a nationalised system tries to stop digging holes.
Take an overweight middle aged man with good insurance. He can go into the doctors complaining of trouble breathing and the doctor will be 90% sure it's because he's just fat and getting older but will happily order a stream of expensive tests just in case. The man will agree to them because they're covered by his insurance and he thinks it's about time he got something back from that. The tests come back negative and the insurance company increases the premiums for his demographic. Yes, he got a very good level of service. He also just burned thousands of dollars. Not in the way that if he'd bought a new car but rather the way if he'd just paid some guy to dig a hole and fill it back in again. This is why you spend the most money per person on health and still fail on every main marker of healthcare. Not only do you spend the money really inefficiently but there is actually less accountability towards spending in this than in a socialised system, amazingly enough. Doctor can say "you probably don't need this scan but it's covered by the insurance and we just want to be safe", after all, his job is to sell the service he provides and make money for his hospital. Insurance doesn't give a fuck, if people start claiming more the premiums go up and stealth tax the whole demographic on that plan. And even if you know about this you're not going to limit your insurance use just because you'll end up charging it to your entire demographic, more like "their shit goes on my insurance premiums, fuck that, i'm gonna beat the system and have more expensive shit done".
Take the same example in Britain. If he's worried he can phone up the free NHS advice line and have a qualified advisor tell him it's probably nothing. That same money can then be spent giving the vulnerable demographic free flu vaccines each winter.
Or take vaccines as an example. Public healthcare programs like that are the absolute opposite of what a business aims to do. It's spending money to decrease the market for their service. Ideally what a healthcare business wants to happen is for you to get into serious trouble, be rushed to hospital, have your life saved by their highly trained staff, be extremely grateful and be productive enough to pay their fees until it happens again. Doing so burns thousands of dollars but you did get an excellent level of service. Whereas the public model just gives you a free vaccine because you're statistically at risk and decreases its patient turnover for $2.
So essentially your whole argument is that you like that in the UK system, instead of seeing a doctor for something that potentially could be a fatal problem (difficulty breathing in a middle aged man), you "get" to instead call a free hotline and talk to a "qualified advisor" (whatever that means), who will tell you it is nothing. That somehow doesn't sound very nice. EDIT: My last post was really long and thought out but ended up as the last post on a page so I will put it here again is spoiler form: + Show Spoiler +
Why I am against Obama's "Reform" (at least read until the line, but read it all if you actually want to understand this is a bad plan)
There are 2 aspects of the American medical system that are unique to us and contribute greatly to the reason that our medical care costs more than care does elsewhere. The 2 problems are:
1. Employer based health insurance
2. Our litigation-based national persona leading to defensive medical practices by doctors.
Obama "reform" completely ignores these 2 problems. He doesn't even touch either one of them. If you are going to do reform, why leave these 2 out? Its a waste of a plan. This doesn't even deserve to be called reform because all it does it spend more $$$ in the same way we have always been spending it. No change in tort reform, no change in selectively subsidizing employer based insurance. All it merely is is spending more money in the same way we always have. The 1 new aspect that his plan has that we haven't already been doing is the "public option" which I also have a problem with as i will explain later. But for now, let me expand on the 2 main problems in our system.
----------------------------------------------------------------------------------------------------------------------------------
1. Employer based heath insurance-->We all know by now that it was never meant to be this way and that it was an artifact of WW2. The problem with this is that it protects insurance companies from the market power of individuals. It inhibits competitive market forces because people do not actually get to choose their plan. Their employer chooses the plan and it is not easy to change.
How many of you feel like you are being price gouged by your car insurance? Is it hard to get car insurance? If you are unhappy with your car insurance, how easy is it to change plans? It is INCREDIBLY easy! That is why the car insurance market works so well. It is cheap, it works well and it is efficient. The same is true of EVERY other kind of insurance in the USA. Only health insurance doesn't work well and that is because ONLY health insurance is mostly employer based. Obama ignores this and does not plan to stop subsidizing employer based insurance. This is why his plan is bad. It does not address the main problems of our system.
The other problem with health insurance, is that it is heavily regulated by the government which makes it harder to function properly.
There are more problems with employer based heath care. When you get your insurance through your company, it lower the labor mobility of the country and that is an economic inefficiency that slows down the economy. For example, someone who has a job with insurance may find a job that better fits his skills with better pay and overall a better match, but if he changes, he loses his insurance. Therefore, he often stays in the worse job and never takes the better job. If all health insurance was privately purchased, you could change jobs all you want and it would not affect your health insurance. The labor force would not have this hurdle keeping them from taking better jobs that fit them better and the economy would run more smoothly.
But Obama has ignored all of this in his plan and just decides to spend more money in the same weird half government/half highly regulated employer based insurace system that we have that is so messed up. And then he calls this "reform".
2. The other problem is out litigation society. Many people feel that if doctors did now have to pay so much in malpractice insurance premiums, they would charge less for procedures. This may be true but I think the cost savings would be pretty small. The MAIN benefit of real tort reform is that it allows doctor's to just do what they think is medically indicated and not order extra tests/procedures (that can each costs up to thousands of dollars per person per test). Doctor's are not free of outside influence and the threat of being sued for multimillion dollar payments WILL affect doctor's behavior and make the whole system run badly. Recent studies show that 5/6 doctors admit to practicing defensive medicine and it is estimated that the defensive medicine aspect is 25% of the costs of the care they give. That is a LOT of money.
But again, there is not a single word about addressing this problem in Obama's plan. There probably never will be any word on tort reform from any democrat-controlled cnogress because....who benefits the most if there is no tort reform? Think for a second....of course it is the lawyers themselves. Well, it turns out that a HUGE percentage of all the money democrats raise comes from lawyers and law firms. Republicans have a similar problem with other industries (like oil), but the truth is that congressional democrats are huge invested in making sure their lawyer constituency is taken care of. So no "reform" there.
These are just a couple of my thoughts on the issue. This is not a good reform bill. It does nothing to lower the cost of drugs (see my post on Pharma and Obama), nothing to control defensive medicine costs, and nothing to address the problem of employer based insurance.
The truth is that health insurance COULD run just as well as any other type of insurance (and all other types really do work very well). The only reason health insurance is not doing a good job right now is because of government intervention. Government single handedly is responsible for the inefficiency of our current system and Obama's response is "well, the market isn't working so well...lets add some more regulation and see if that fixes it".
It is simply a bad plan.
Obviously if you still want to see a doctor you can. But in a private system the doctor profits from you wasting his time and the individual doesn't see a direct cost from him wasting your time. Hopefully you didn't read from my post that we'd gotten rid of doctors and replaced them with a helpline. I'd like to clarify that this is not the case. Just that there is way more efficient usage of the resources at the disposal of the system in a nationalised system because the emphasis isn't on maximising turnover but rather on minimising it.
In a public system a healthy man not coming into hospital is a success story. In a private it's a missed customer. In a public system. a healthy living ad campaign that stops 1000 heart attacks is a success story. In a private it's 1000 beds unfilled. Prevention is cheaper than cure.
|
On August 16 2009 15:17 Kwark wrote:Show nested quote +On August 16 2009 15:09 Savio wrote:On August 16 2009 14:28 Kwark wrote:+ Show Spoiler +
Healthcare simply isn't a business. A business wishes to maximise its turnover by maximising the number of people it treats and by the individual profit on each one. This is an impractical way to go about it and doesn't make sense economically because healthcare doesn't produce anything as a service, it's like digging holes and filling them in again. The free market will naturally try and expand the digging holes and filling them in market while trying to become the most efficient hole digger it can be whereas as a nationalised system tries to stop digging holes.
Take an overweight middle aged man with good insurance. He can go into the doctors complaining of trouble breathing and the doctor will be 90% sure it's because he's just fat and getting older but will happily order a stream of expensive tests just in case. The man will agree to them because they're covered by his insurance and he thinks it's about time he got something back from that. The tests come back negative and the insurance company increases the premiums for his demographic. Yes, he got a very good level of service. He also just burned thousands of dollars. Not in the way that if he'd bought a new car but rather the way if he'd just paid some guy to dig a hole and fill it back in again. This is why you spend the most money per person on health and still fail on every main marker of healthcare. Not only do you spend the money really inefficiently but there is actually less accountability towards spending in this than in a socialised system, amazingly enough. Doctor can say "you probably don't need this scan but it's covered by the insurance and we just want to be safe", after all, his job is to sell the service he provides and make money for his hospital. Insurance doesn't give a fuck, if people start claiming more the premiums go up and stealth tax the whole demographic on that plan. And even if you know about this you're not going to limit your insurance use just because you'll end up charging it to your entire demographic, more like "their shit goes on my insurance premiums, fuck that, i'm gonna beat the system and have more expensive shit done".
Take the same example in Britain. If he's worried he can phone up the free NHS advice line and have a qualified advisor tell him it's probably nothing. That same money can then be spent giving the vulnerable demographic free flu vaccines each winter.
Or take vaccines as an example. Public healthcare programs like that are the absolute opposite of what a business aims to do. It's spending money to decrease the market for their service. Ideally what a healthcare business wants to happen is for you to get into serious trouble, be rushed to hospital, have your life saved by their highly trained staff, be extremely grateful and be productive enough to pay their fees until it happens again. Doing so burns thousands of dollars but you did get an excellent level of service. Whereas the public model just gives you a free vaccine because you're statistically at risk and decreases its patient turnover for $2.
So essentially your whole argument is that you like that in the UK system, instead of seeing a doctor for something that potentially could be a fatal problem (difficulty breathing in a middle aged man), you "get" to instead call a free hotline and talk to a "qualified advisor" (whatever that means), who will tell you it is nothing. That somehow doesn't sound very nice. EDIT: My last post was really long and thought out but ended up as the last post on a page so I will put it here again is spoiler form: + Show Spoiler +
Why I am against Obama's "Reform" (at least read until the line, but read it all if you actually want to understand this is a bad plan)
There are 2 aspects of the American medical system that are unique to us and contribute greatly to the reason that our medical care costs more than care does elsewhere. The 2 problems are:
1. Employer based health insurance
2. Our litigation-based national persona leading to defensive medical practices by doctors.
Obama "reform" completely ignores these 2 problems. He doesn't even touch either one of them. If you are going to do reform, why leave these 2 out? Its a waste of a plan. This doesn't even deserve to be called reform because all it does it spend more $$$ in the same way we have always been spending it. No change in tort reform, no change in selectively subsidizing employer based insurance. All it merely is is spending more money in the same way we always have. The 1 new aspect that his plan has that we haven't already been doing is the "public option" which I also have a problem with as i will explain later. But for now, let me expand on the 2 main problems in our system.
----------------------------------------------------------------------------------------------------------------------------------
1. Employer based heath insurance-->We all know by now that it was never meant to be this way and that it was an artifact of WW2. The problem with this is that it protects insurance companies from the market power of individuals. It inhibits competitive market forces because people do not actually get to choose their plan. Their employer chooses the plan and it is not easy to change.
How many of you feel like you are being price gouged by your car insurance? Is it hard to get car insurance? If you are unhappy with your car insurance, how easy is it to change plans? It is INCREDIBLY easy! That is why the car insurance market works so well. It is cheap, it works well and it is efficient. The same is true of EVERY other kind of insurance in the USA. Only health insurance doesn't work well and that is because ONLY health insurance is mostly employer based. Obama ignores this and does not plan to stop subsidizing employer based insurance. This is why his plan is bad. It does not address the main problems of our system.
The other problem with health insurance, is that it is heavily regulated by the government which makes it harder to function properly.
There are more problems with employer based heath care. When you get your insurance through your company, it lower the labor mobility of the country and that is an economic inefficiency that slows down the economy. For example, someone who has a job with insurance may find a job that better fits his skills with better pay and overall a better match, but if he changes, he loses his insurance. Therefore, he often stays in the worse job and never takes the better job. If all health insurance was privately purchased, you could change jobs all you want and it would not affect your health insurance. The labor force would not have this hurdle keeping them from taking better jobs that fit them better and the economy would run more smoothly.
But Obama has ignored all of this in his plan and just decides to spend more money in the same weird half government/half highly regulated employer based insurace system that we have that is so messed up. And then he calls this "reform".
2. The other problem is out litigation society. Many people feel that if doctors did now have to pay so much in malpractice insurance premiums, they would charge less for procedures. This may be true but I think the cost savings would be pretty small. The MAIN benefit of real tort reform is that it allows doctor's to just do what they think is medically indicated and not order extra tests/procedures (that can each costs up to thousands of dollars per person per test). Doctor's are not free of outside influence and the threat of being sued for multimillion dollar payments WILL affect doctor's behavior and make the whole system run badly. Recent studies show that 5/6 doctors admit to practicing defensive medicine and it is estimated that the defensive medicine aspect is 25% of the costs of the care they give. That is a LOT of money.
But again, there is not a single word about addressing this problem in Obama's plan. There probably never will be any word on tort reform from any democrat-controlled cnogress because....who benefits the most if there is no tort reform? Think for a second....of course it is the lawyers themselves. Well, it turns out that a HUGE percentage of all the money democrats raise comes from lawyers and law firms. Republicans have a similar problem with other industries (like oil), but the truth is that congressional democrats are huge invested in making sure their lawyer constituency is taken care of. So no "reform" there.
These are just a couple of my thoughts on the issue. This is not a good reform bill. It does nothing to lower the cost of drugs (see my post on Pharma and Obama), nothing to control defensive medicine costs, and nothing to address the problem of employer based insurance.
The truth is that health insurance COULD run just as well as any other type of insurance (and all other types really do work very well). The only reason health insurance is not doing a good job right now is because of government intervention. Government single handedly is responsible for the inefficiency of our current system and Obama's response is "well, the market isn't working so well...lets add some more regulation and see if that fixes it".
It is simply a bad plan.
Obviously if you still want to see a doctor you can. But in a private system the doctor profits from you wasting his time and the individual doesn't see a direct cost from him wasting your time. Hopefully you didn't read from my post that we'd gotten rid of doctors and replaced them with a helpline. I'd like to clarify that this is not the case. Just that there is way more efficient usage of the resources at the disposal of the system in a nationalised system because the emphasis isn't on maximising turnover but rather on minimising it.
Actually as you said, "the individual doesn't see a direct cost from him wasting your time." is even more true in a nationalized system than in our system. NOBODY in a nationalized system sees a direct cost of anything since it is all paid by taxes beforehand.
But just to clarify a few things. I think that a complete moveover to a single payer system would be better than what we have now. However, I also believe (and I have thought about it seriously), that moving the other direction so that health insurance can actually behave as efficiently as insurance is supposed to and does in every other instance of insurance, it would be even better.
The reason it would be better is that each person would individually choose the EXACT plan that is best for them. As it is right now, plans are chosen by company based on which plan is best for the company with no chance at it being "right" for each individual person. With a single payer system, there are some simplicity gains, but then it is still true that plans are not individualized to individual circumstances or desires, but rather the plan is based on what is best for the country.
So best would be to remove most of government from health care. Second best is to let government take it all. And the worse outcome is to live in some weird limbo state where half of health care is government run (with no market pressures toward efficiency), and the other half to be very highly regulated, employer based insurance policies with only a small fraction of insurance being individualized.
|
United States43187 Posts
I disagree with you that it's even more true of a nationalised system. I'd feel guilty knowingly wasting a doctors time on the NHS because I know they're busy and that someone else could need them more. To me it's not a right but a privilege and should be treated with respect. Whereas I'd have no qualms about wasting a private doctors time because the insurance would pay and I have no worries about costing a big profit making business money. After all, if I'm paying my premiums then I have the right to see him, he's in my employment.
I also agree however that a completely private system would be better than the current one simply because the current system is a clusterfuck that merges the worst aspects of both. And I think this reform exacerbates that without bringing in the major benefits of a public system. But I also don't see a complete overhaul of the current system into a nationalised one happening any time soon and therefore a series of reforms is the way it's gonna have to go.
|
On August 16 2009 15:17 Kwark wrote:Show nested quote +On August 16 2009 15:09 Savio wrote:On August 16 2009 14:28 Kwark wrote:+ Show Spoiler +
Healthcare simply isn't a business. A business wishes to maximise its turnover by maximising the number of people it treats and by the individual profit on each one. This is an impractical way to go about it and doesn't make sense economically because healthcare doesn't produce anything as a service, it's like digging holes and filling them in again. The free market will naturally try and expand the digging holes and filling them in market while trying to become the most efficient hole digger it can be whereas as a nationalised system tries to stop digging holes.
Take an overweight middle aged man with good insurance. He can go into the doctors complaining of trouble breathing and the doctor will be 90% sure it's because he's just fat and getting older but will happily order a stream of expensive tests just in case. The man will agree to them because they're covered by his insurance and he thinks it's about time he got something back from that. The tests come back negative and the insurance company increases the premiums for his demographic. Yes, he got a very good level of service. He also just burned thousands of dollars. Not in the way that if he'd bought a new car but rather the way if he'd just paid some guy to dig a hole and fill it back in again. This is why you spend the most money per person on health and still fail on every main marker of healthcare. Not only do you spend the money really inefficiently but there is actually less accountability towards spending in this than in a socialised system, amazingly enough. Doctor can say "you probably don't need this scan but it's covered by the insurance and we just want to be safe", after all, his job is to sell the service he provides and make money for his hospital. Insurance doesn't give a fuck, if people start claiming more the premiums go up and stealth tax the whole demographic on that plan. And even if you know about this you're not going to limit your insurance use just because you'll end up charging it to your entire demographic, more like "their shit goes on my insurance premiums, fuck that, i'm gonna beat the system and have more expensive shit done".
Take the same example in Britain. If he's worried he can phone up the free NHS advice line and have a qualified advisor tell him it's probably nothing. That same money can then be spent giving the vulnerable demographic free flu vaccines each winter.
Or take vaccines as an example. Public healthcare programs like that are the absolute opposite of what a business aims to do. It's spending money to decrease the market for their service. Ideally what a healthcare business wants to happen is for you to get into serious trouble, be rushed to hospital, have your life saved by their highly trained staff, be extremely grateful and be productive enough to pay their fees until it happens again. Doing so burns thousands of dollars but you did get an excellent level of service. Whereas the public model just gives you a free vaccine because you're statistically at risk and decreases its patient turnover for $2.
So essentially your whole argument is that you like that in the UK system, instead of seeing a doctor for something that potentially could be a fatal problem (difficulty breathing in a middle aged man), you "get" to instead call a free hotline and talk to a "qualified advisor" (whatever that means), who will tell you it is nothing. That somehow doesn't sound very nice. EDIT: My last post was really long and thought out but ended up as the last post on a page so I will put it here again is spoiler form: + Show Spoiler +
Why I am against Obama's "Reform" (at least read until the line, but read it all if you actually want to understand this is a bad plan)
There are 2 aspects of the American medical system that are unique to us and contribute greatly to the reason that our medical care costs more than care does elsewhere. The 2 problems are:
1. Employer based health insurance
2. Our litigation-based national persona leading to defensive medical practices by doctors.
Obama "reform" completely ignores these 2 problems. He doesn't even touch either one of them. If you are going to do reform, why leave these 2 out? Its a waste of a plan. This doesn't even deserve to be called reform because all it does it spend more $$$ in the same way we have always been spending it. No change in tort reform, no change in selectively subsidizing employer based insurance. All it merely is is spending more money in the same way we always have. The 1 new aspect that his plan has that we haven't already been doing is the "public option" which I also have a problem with as i will explain later. But for now, let me expand on the 2 main problems in our system.
----------------------------------------------------------------------------------------------------------------------------------
1. Employer based heath insurance-->We all know by now that it was never meant to be this way and that it was an artifact of WW2. The problem with this is that it protects insurance companies from the market power of individuals. It inhibits competitive market forces because people do not actually get to choose their plan. Their employer chooses the plan and it is not easy to change.
How many of you feel like you are being price gouged by your car insurance? Is it hard to get car insurance? If you are unhappy with your car insurance, how easy is it to change plans? It is INCREDIBLY easy! That is why the car insurance market works so well. It is cheap, it works well and it is efficient. The same is true of EVERY other kind of insurance in the USA. Only health insurance doesn't work well and that is because ONLY health insurance is mostly employer based. Obama ignores this and does not plan to stop subsidizing employer based insurance. This is why his plan is bad. It does not address the main problems of our system.
The other problem with health insurance, is that it is heavily regulated by the government which makes it harder to function properly.
There are more problems with employer based heath care. When you get your insurance through your company, it lower the labor mobility of the country and that is an economic inefficiency that slows down the economy. For example, someone who has a job with insurance may find a job that better fits his skills with better pay and overall a better match, but if he changes, he loses his insurance. Therefore, he often stays in the worse job and never takes the better job. If all health insurance was privately purchased, you could change jobs all you want and it would not affect your health insurance. The labor force would not have this hurdle keeping them from taking better jobs that fit them better and the economy would run more smoothly.
But Obama has ignored all of this in his plan and just decides to spend more money in the same weird half government/half highly regulated employer based insurace system that we have that is so messed up. And then he calls this "reform".
2. The other problem is out litigation society. Many people feel that if doctors did now have to pay so much in malpractice insurance premiums, they would charge less for procedures. This may be true but I think the cost savings would be pretty small. The MAIN benefit of real tort reform is that it allows doctor's to just do what they think is medically indicated and not order extra tests/procedures (that can each costs up to thousands of dollars per person per test). Doctor's are not free of outside influence and the threat of being sued for multimillion dollar payments WILL affect doctor's behavior and make the whole system run badly. Recent studies show that 5/6 doctors admit to practicing defensive medicine and it is estimated that the defensive medicine aspect is 25% of the costs of the care they give. That is a LOT of money.
But again, there is not a single word about addressing this problem in Obama's plan. There probably never will be any word on tort reform from any democrat-controlled cnogress because....who benefits the most if there is no tort reform? Think for a second....of course it is the lawyers themselves. Well, it turns out that a HUGE percentage of all the money democrats raise comes from lawyers and law firms. Republicans have a similar problem with other industries (like oil), but the truth is that congressional democrats are huge invested in making sure their lawyer constituency is taken care of. So no "reform" there.
These are just a couple of my thoughts on the issue. This is not a good reform bill. It does nothing to lower the cost of drugs (see my post on Pharma and Obama), nothing to control defensive medicine costs, and nothing to address the problem of employer based insurance.
The truth is that health insurance COULD run just as well as any other type of insurance (and all other types really do work very well). The only reason health insurance is not doing a good job right now is because of government intervention. Government single handedly is responsible for the inefficiency of our current system and Obama's response is "well, the market isn't working so well...lets add some more regulation and see if that fixes it".
It is simply a bad plan.
Obviously if you still want to see a doctor you can. But in a private system the doctor profits from you wasting his time and the individual doesn't see a direct cost from him wasting your time. Hopefully you didn't read from my post that we'd gotten rid of doctors and replaced them with a helpline. I'd like to clarify that this is not the case. Just that there is way more efficient usage of the resources at the disposal of the system in a nationalised system because the emphasis isn't on maximising turnover but rather on minimising it. In a public system a healthy man not coming into hospital is a success story. In a private it's a missed customer. In a public system. a healthy living ad campaign that stops 1000 heart attacks is a success story. In a private it's 1000 beds unfilled. Prevention is cheaper than cure.
The facts of the matter disagree with your assessment:
http://www.facs.org/news/obama081209.html
Statement from the American College of Surgeons Regarding Recent Comments from President Obama
CHICAGO—The American College of Surgeons is deeply disturbed over the uninformed public comments President Obama continues to make about the high-quality care provided by surgeons in the United States. When the President makes statements that are incorrect or not based in fact, we think he does a disservice to the American people at a time when they want clear, understandable facts about health care reform. We want to set the record straight.
Yesterday during a town hall meeting, President Obama got his facts completely wrong. He stated that a surgeon gets paid $50,000 for a leg amputation when, in fact, Medicare pays a surgeon between $740 and $1,140 for a leg amputation. This payment also includes the evaluation of the patient on the day of the operation plus patient follow-up care that is provided for 90 days after the operation. Private insurers pay some variation of the Medicare reimbursement for this service.
Three weeks ago, the President suggested that a surgeon’s decision to remove a child’s tonsils is based on the desire to make a lot of money. That remark was ill-informed and dangerous, and we were dismayed by this characterization of the work surgeons do. Surgeons make decisions about recommending operations based on what’s right for the patient.
We agree with the President that the best thing for patients with diabetes is to manage the disease proactively to avoid the bad consequences that can occur, including blindness, stroke, and amputation. But as is the case for a person who has been treated for cancer and still needs to have a tumor removed, or a person who is in a terrible car crash and needs access to a trauma surgeon, there are times when even a perfectly managed diabetic patient needs a surgeon. The President’s remarks are truly alarming and run the risk of damaging the all-important trust between surgeons and their patients.
We assume that the President made these mistakes unintentionally, but we would urge him to have his facts correct before making another inflammatory and incorrect statement about surgeons and surgical care.
About the American College of Surgeons
The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and to improve the care of the surgical patient. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 74,000 members and is the largest organization of surgeons in the world.
Web site: www.facs.org
|
United States43187 Posts
That disagrees with something President Obama said, not something I said. I was not a speaker in a town hall meeting yesterday, I was at home.
|
United States43187 Posts
And don't get me wrong, I'm sure your hospitals provide an excellent level of service. I'm not a communist, I understand the benefits of the free market. The focus on increasing their turnover drives quality because they want you to come back and be their customer the next time you get ill. But even so, it's still a desire to increase turnover which is not in the public interest. Prevention is better and cheaper than cure for everyone but the private healthcare system.
|
United States20661 Posts
Regardless of the merits of the proposed Obamacare system, the way its being rammed down the American public's collective throat is disturbing at best.
|
On August 16 2009 15:42 Kwark wrote:
That disagrees with something President Obama said, not something I said. I was not a speaker in a town hall meeting yesterday, I was at home.
You said that the market prioritizes based on profit and that they don't care about patients as long as they come in. The American College of Surgeons disagrees vehemently with that as you can see in that statement.
The hippocratic oath is the same irregardless of healthcare system, and all doctors and surgeons seek not to exploit their patients, but to provide them with the utmost care they possibly can receive.
Do you still hold to your false rhetoric which 74,000 surgeons have come out and said that you are wrong. Do you know these people more than they know themselves? I'm curious.
|
On August 16 2009 15:45 Kwark wrote:
And don't get me wrong, I'm sure your hospitals provide an excellent level of service. I'm not a communist, I understand the benefits of the free market. The focus on increasing their turnover drives quality because they want you to come back and be their customer the next time you get ill. But even so, it's still a desire to increase turnover which is not in the public interest. Prevention is better and cheaper than cure for everyone but the private healthcare system.
Can you name me one advocacy group such as the AMA, or other such medical entity that advocates unhealthy behaviors? Every medical advocacy group provides guidelines to maintain a healthy lifestyle.
In a free society, people exercising their free wills can heed the advice or they cannot. They are sole arbiter of their life. Americans prefer to live a more rugged lifestyle than our counterparts in other parts of the world. It is our decision. It isn't the "evil private healthcare system that seeks to exploit patients by denying access to medical guidelines for healthy living" that creates the current unhealthy situation in America. You can't force people to take heed and prevent medical emergenices from arising less frequently in a free society nor should there be any reason to. Live and let live.
|
United States43187 Posts
On August 16 2009 15:46 Aegraen wrote:Show nested quote +On August 16 2009 15:42 Kwark wrote:
That disagrees with something President Obama said, not something I said. I was not a speaker in a town hall meeting yesterday, I was at home. You said that the market prioritizes based on profit and that they don't care about patients as long as they come in. The American College of Surgeons disagrees vehemently with that as you can see in that statement. The hippocratic oath is the same irregardless of healthcare system, and all doctors and surgeons seek not to exploit their patients, but to provide them with the utmost care they possibly can receive. Do you still hold to your false rhetoric which 74,000 surgeons have come out and said that you are wrong. Do you know these people more than they know themselves? I'm curious.
Don't get me wrong, I'm sure they care about giving people a good service. In the same way that I'm sure Starbucks cares about giving people good coffee. A good service increases market share and market share increases profit.
That doesn't change anything I've said. You are strawmaning me. Please stop. In all my posts I have accepted that the free market is good at meeting the needs of the consumer. Stop aggressively agreeing with me as if you are making an argument because you are not.
My objection is that the insurance system is good at creating business for hospitals at the indirect expense of the consumer and that the private system has no interest in healtcare efficiency (in the sense of maximum benefit for minimum consumer cost).
|
On August 16 2009 15:46 Aegraen wrote:Show nested quote +On August 16 2009 15:42 Kwark wrote:
That disagrees with something President Obama said, not something I said. I was not a speaker in a town hall meeting yesterday, I was at home. You said that the market prioritizes based on profit and that they don't care about patients as long as they come in. The American College of Surgeons disagrees vehemently with that as you can see in that statement.
Now I don't know if those are kwark's exact words, but fuck me is that an oversimplification. There is a massive difference between -- They would rather you came in and paid them -- and -- They don't care about their work unless you pay them --
and is it really necessary to turn every political topic into a heated debate that is 8 times out of 10 Aegraen vrs? I agree with you on several points, and I disagree with you on many. But a large majority of the time you just end up arguing past each other for 10 pages and polluting an otherwise decent thread.
Like right here you're just trying to deflect Kwark's totally reasonable point, when his point doesn't even really have a massive problem with your argument as a whole...
|
United States43187 Posts
Well obviously the AMA doesn't endorse unhealthy behaviors. They're doctors. I'm not suggesting that hospitals go out breaking people's legs to generate business. The fact that they don't doesn't disprove me (you're straw manning again).
Take smoking. In the UK and the US you're free to smoke if you want (although where you can is increasingly limited over here but that's a separate issue). In both places the authorities advise you not to. However the US system says you're free to get cancer and then spend vast amounts of money treating it, that is your free choice. The UK system says you're free to get cancer and the NHS will treat it but it's bad for you and if you want to stop then you can speak to one of our NHS quitting advisers for free and they'll get you on some state subsidised nicotene replacement and help you quit.
And the thing is, we spend far less for the same level of service because subsidising nicotene gum is a fair bit cheaper than training surgeons. Without imposing on the civil liberties of the individual by forcing them to live more healthily the state has still managed to help them, and in doing so has lowered the overall healthcare bill of the nation. Yes, some of that bill falls on taxation rather than the individual but it is still significantly cheaper overall. Spending money on healthcare is burning money. Whether individuals burn money or the state does it it still makes society poorer. Finding ways to burn less of it benefits everyone.
|
is awesome32277 Posts
On August 16 2009 15:46 Aegraen wrote:Show nested quote +On August 16 2009 15:42 Kwark wrote:
That disagrees with something President Obama said, not something I said. I was not a speaker in a town hall meeting yesterday, I was at home. You said that the market prioritizes based on profit and that they don't care about patients as long as they come in. The American College of Surgeons disagrees vehemently with that as you can see in that statement.
Of course, do you expect them to say: "fuck the patients, we want money" ?
|
|
|
On August 16 2009 16:04 Motiva wrote:Show nested quote +On August 16 2009 15:46 Aegraen wrote:On August 16 2009 15:42 Kwark wrote:
That disagrees with something President Obama said, not something I said. I was not a speaker in a town hall meeting yesterday, I was at home. You said that the market prioritizes based on profit and that they don't care about patients as long as they come in. The American College of Surgeons disagrees vehemently with that as you can see in that statement. Now I don't know if those are kwark's exact words, but fuck me is that an oversimplification. There is a massive difference between -- They would rather you came in and paid them -- and -- They don't care about their work unless you pay them -- and is it really necessary to turn every political topic into a heated debate that is 8 times out of 10 Aegraen vrs? I agree with you on several points, and I disagree with you on many. But a large majority of the time you just end up arguing past each other for 10 pages and polluting an otherwise decent thread. Like right here you're just trying to deflect Kwark's totally reasonable point, when his point doesn't even really have a massive problem with your argument as a whole...
If I have mischaracterized his position, then I will correct my previous statements. However, it seemed to me that in his latest succession of posts he seems to either imply unconciously or directly that in a privatized system doctors and surgeons are heartless pigs that only seek to further maximize profit by either:
Manipulating information that is readily available (See: doesn't seek to advocate prevention instead of cure. Yes, it is true, we don't force people to live a preventative lifestyle, this is a good thing.)
Exploitation or price gouging due to nature of insurance (See his: On August 16 2009 14:28 Kwark; post.)
Manipulation of patients (See:"you probably don't need this scan but it's covered by the insurance and we just want to be safe") - Doctors do not advocate excessive tests and procedures because of insurance, but because of the way Tort works and the invidiousness of trial lawyers.
Additional Comments which bugged me:
after all, his job is to sell the service he provides and make money for his hospital
- Doctors and Surgeons alike and yes, even Hospitals contribute a lot of time and effort into charitable work. A Hospitals sole goal isn't to price gouge the patients. There are many University run hospitals, charity and community hospitals, and many doctors and surgeons donate their time to charitable work.
Ideally what a healthcare business wants to happen is for you to get into serious trouble, be rushed to hospital, have your life saved by their highly trained staff, be extremely grateful and be productive enough to pay their fees until it happens again.
- Actually, insurance companies do not want you to go to the hospital, just like insurance companies do not want you to get into a wreck or your home flooded. Doctors and physicians likewise would rather there be less sick people than there are.
He made it sound like hospitals, physicians, and insurance companies are out to exploit and manipulate the population to exort from them their money because as he sees it "you have to pay or you die". Which I rebutted with the market provides for other life necessities just fine, which he didn't say anything.
So, again if this isn't your position, then I retract my previous statements, however if they are your position I do not. I think its reprehensible to label physicians as basically tycoons twisting their fu-manchu's and smiling to the bank.
|
United States43187 Posts
Saying you don't force people to live a preventative lifestyle because forcing people is bad and therefore the entire concept of preventative care is bad is the essence of a straw man. Literally, that is textbook.
Nowhere did I advocate forcing people to live more healthily. In fact, I devoted much of my last point to making that astoundingly clear, leaving me only to assume that you are deliberately misrepresenting me.
|
On August 15 2009 23:15 Jusciax wrote:Show nested quote +On August 15 2009 22:56 Aegraen wrote:
I still have no idea why people think more Government intervention especially wielding such incredible and unscrupulous power over their life and limb is a good idea. It really does boggle the mind. And what boggles my mind is that you prefer trusting your life and limb to corporations, which sole goal is to earn money to its shareholders (and in this case - signing as many people as possible and dropping them as soon as they get sick). Sure goverment doesn't do its job perfectly but atleast it's priorities are in right place - people.
The main purpose for all companies is to provide a service to people.
Second is to make a profit (otherwise you couldn't stay in business).
|
United States43187 Posts
I meant hospitals want you to come to their hospital. Not insurance companies want you to go to their hospitals. This should have been extremely clear. You have a unique talent of reading arguments into your own internal opposition. Obviously insurance companies don't want you to go to hospital.
While I'm sure doctors are generally well wishing altrustic people the industry as a whole is still based around increasing turnover. This is the essense of the free market, you can't take the good side (efficiency from achieving profitability) without the bad. Again to clarify, I'm not suggesting that doctors go out and break peoples legs. Nor that they deliberately cause car accidents. Nor that the AMA secretly recommends poison to people. Simply that the widespread application of preventative care is not in their best interests as a company.
I do not see it as you pay or you die. Also I was not involved in that particular argument, that was before I joined this topic. Also please never see me ignoring your points as me having no rebuttal for them. The opposite is generally the case. When I finally stop arguing with you it is because in the face of your world view and general closed mindedness and I have finally lost my faith in humanity and am giving up on you. When I don't reply to you it is because your arguments have gotten worse to the point of illogical and inconceivable nonsense which I simply cannot begin to relate to, not that you've made a good point.
|
|
|
|
|
|
EPT
