|
This topic is not about the American Invasion of Iraq. Stop. - Page 23 |
On April 01 2012 11:55 HeavOnEarth wrote:
Politics aside, id be happy with some healthcare. Haven't been to a doctor/dentist/dermatologist in ages
You're not the only one. 
EDIT: Scratch that- I've been (for sleep studies), but only because my father is wealthy. Shouldn't be that way though (ffs I'm 42 years old).
|
On April 01 2012 11:33 liberal wrote:Show nested quote +On April 01 2012 11:01 Defacer wrote:On April 01 2012 10:42 liberal wrote:On April 01 2012 10:16 Defacer wrote:+ Show Spoiler +On April 01 2012 07:03 liberal wrote:
The United State's rations care by cost, socialized medicine seems to ration care by waiting lists. Personally, I think it is better for an individual to have their life saved and yet be financially damaged than to have the care rationed to begin with. The time spent waiting is often worth more to a person than the price they would pay otherwise. Getting effective and timely treatment for a deadly condition is certainly worth the cost of declaring bankruptcy.
I understand and respect your position. However, specialized and timely treatment for real illness or injury is not the problem. It can be argued that people being prescribed non-essential drugs, or going for unnecessary diagnostic treatments and elective surgery that is contributing to the increasing the cost of health insurance. From the Wall Street Journal Blog: Mindful of concerns about health-care’s spiraling costs, the Health Blog was struck by some new research on what the investigators identified as wasteful practices by family doctors and general practitioners.
Not being doctors, we can’t vouch for the clinical appropriateness of the findings, but there’s no harm in triggering a discussion, right?
What did the researchers say was the No. 1 most over-used activity by primary care physicians? Prescribing a brand-name cholesterol-lowering drug without trying a less expensive generic first, according to the research posted online by the Archives of Internal Medicine.
Doctors’ prescribing a brand-name statin, without first checking to see if a lower-priced generic drug would cut a patient’s cholesterol sufficiently, results in $5.8 billion in excess health-care spending, according to the research letter published Oct. 1.
The authors found $6.76 billion in what they said was non-recommended health-care spending after analyzing surveys of patient visits to certain primary care doctors’ offices and hospital outpatient departments in 2009.
Other practices deemed inappropriate by the authors: bone density scans for women ages 40 to 64 years, costing $527.4 million; ordering CT Scans or MRI’s for lower back pain, amounting to $175.4 million; and prescribing antibiotics to children with sore throats caused by a virus, worth $116.3 million.
Although these sums aren’t chump change, the authors write that achieving affordable but high-quality health-care will really depend on finding ”‘high value’ targets” in specialty areas.
There is also the argument that American health care providers are simply overcharging for everything. For example, an appendectomy -- a common emergency medical procedure -- costs $13000 in the US, more than double the cost of next most expensive countries, Switzerland and Canada ($5000 to 5800). Here's a link to an interactive graphic comparing the cost of specific medical procedures across countries, via the Washington Post: http://www.washingtonpost.com/wp-srv/special/business/high-cost-of-medical-procedures-in-the-us/
There is another simple reason health care in the United States costs more than it does anywhere else: The prices are higher.
That may sound obvious. But it is, in fact, key to understanding one of the most pressing problems facing our economy. In 2009, Americans spent $7,960 per person on health care. Our neighbors in Canada spent $4,808. The Germans spent $4,218. The French, $3,978. If we had the per-person costs of any of those countries, America’s deficits would vanish. Workers would have much more money in their pockets. Our economy would grow more quickly, as our exports would be more competitive.
There are many possible explanations for why Americans pay so much more. It could be that we’re sicker. Or that we go to the doctor more frequently. But health researchers have largely discarded these theories. As Gerard Anderson, Uwe Reinhardt, Peter Hussey and Varduhi Petrosyan put it in the title of their influential 2003 study on international health-care costs, “it’s the prices, stupid.”
Prices don’t explain all of the difference between America and other countries. But they do explain a big chunk of it. The question, of course, is why Americans pay such high prices — and why we haven’t done anything about it.
“Other countries negotiate very aggressively with the providers and set rates that are much lower than we do,” Anderson says. They do this in one of two ways. In countries such as Canada and Britain, prices are set by the government. In others, such as Germany and Japan, they’re set by providers and insurers sitting in a room and coming to an agreement, with the government stepping in to set prices if they fail.
In America, Medicare and Medicaid negotiate prices on behalf of their tens of millions of members and, not coincidentally, purchase care at a substantial markdown from the commercial average. But outside that, it’s a free-for-all. Providers largely charge what they can get away with, often offering different prices to different insurers, and an even higher price to the uninsured.
Full Washington Post article about high US Healthcare CostsSo while you've convinced me that the individual mandate is not solution, I'm not sure what could be done to possibly reel in these costs, other than a socialized system. Yes, this is one of the factors I've been mentioning regarding higher costs. The normal system of supply and demand is breaking down because we have third and fourth parties acting as intermediaries in every transaction. The person consuming the service is not faced with the direct cost, except perhaps a small deductible, and so they have no incentive at all to seek cheaper doctors, to forego unnecessary visits or care, and most importantly, to hold the suppliers accountable for fraudulent charges or prices... It is far more expensive for a company to try and police all of these millions of transactions instead of having the individual consumer police their own behavior based upon prices. This is the brilliance of the concept of the "invisible hand" that probably serves as the butt of a joke for most people here. Millions of people being influenced by personal incentives as dictated by price will always be more effective than paying a third party to try and manage it for them. Could you imagine how expensive it would be for you to pay an adviser to tell you what to buy at the supermarket instead of just buying it yourself? The situation is exacerbated by the fact that most people are now getting their third party insurance through a fourth party, their employer, due of course to government regulation in the matter. The more middle men you insert in the equation and the more you separate the actual consumers and suppliers from the price mechanism, the more waste, inefficiency, and direct fraud and abuse will arise. I'm just so skeptical that general public would somehow, given the opportunity to select their own health care providers and insurers in a free market, be able to "force" them lowering the cost of health care in any meaningful way. Just look at what happened to amount of bad mortgages people bought that lead to the crisis in your country. This is absolutely cynical, but the average person is simply not objective enough or well-informed to challenge insurers or providers. Compound that with the fact that health care providers and insurers have your health to use as leverage. The individual mandate was a band aid solution that would give more people access to overpriced healthcare. It's a compromise, that's for sure. But I have no idea how you would approach the problem the other way, and force healthcare providers to charge less. I know you attribute that partially to wasteful bureaucracy, but the cynicism in me finds it hard to imagine that the health care industry wouldn't exploit less regulation for more profit. Edit: I might be misunderstanding what you're trying to say. Here's another way of looking at it, it might clarify what I mean. Personally, when I hear that a visit to the doctor costs upwards of $150, that an ambulance ride costs upwards of $1,200, that some minimally invasive surgery costs some ridiculous amount like $75,000.... it sounds absurd to me. After all, the costs should not be anywhere near any of those numbers. I know for a fact that I could get the education necessary to do any of these things and charge people significantly less for any of these services. So what's stopping me, or anyone else? Suppose I wanted to get in the health care market myself. Suppose I wanted to start an ambulance company and give people rides to the hospital with all the care of a normal ambulance. I know for a fact I could provide such a ride for much less than $1,200 a trip. So what's stopping me? What's stopping anyone from getting in these markets and undercutting costs? When a doctor in India can do the same surgery for $8,000 that we charge for $75,000, what's stopping him from moving to America and opening up shop? The answer can only be one thing: The myriad system of regulations we have in place. I'm not saying that aren't sometimes good or desired, but are the people willing to pay the costs that we are bearing now? No, we aren't. You can tell that just by the rising medical tourism, where people are willing to forego the safety of our system to simply save themselves from bankruptcy. Show nested quote +On April 01 2012 11:25 DoubleReed wrote:On April 01 2012 11:03 liberal wrote:On April 01 2012 10:56 screamingpalm wrote:
@ liberal-
I'm not following your logic. Regulation is obviously not to blame here, as has already been stated. If this was the case, insurers would not be getting away with denying coverage to those with pre-existing conditions, for example. As has been stated, it is a case of crony capitalism. The greatest way to seperate consumers and suppliers from the "price mechanism" or free market, is to get rid of all of the middle men and reform the industry into a single payer system. Perhaps I am misunderstanding your point, but I am getting some contradictions from what you are suggesting. Your claim that regulation isn't to blame because insurers "get away" with denying coverage to those with pre existing conditions doesn't make sense... Insurance is designed to insure people who are healthy. You cannot insure someone who is already sick, anymore than you can insure a home that is already on fire. Forcing insurance companies to accept people with pre-existing conditions is effectively outlawing the insurance business. I agree with you that part of the problem is "crony capitalism," but it doesn't make sense that you then support greater regulation. Crony capitalism means businesses colluding with government through harmful regulation. So if you agree there is crony capitalism, then you agree with me that there must be much harmful regulation. So the first paragraph is a great example as to why health insurance does not make sense in the for-profit market. You are denying healthcare to the people that actually need it. No, we aren't denying health care to anyone. What's being denied is health INSURANCE. Those are very different things. If you want to claim that people simply aren't capable of paying for health care without insurance, then once again we are back at square one: the problem of high costs.
Healthcare is incredibly expensive every where though. Its not like other places charge considerably less its just some or most of the cost gets covered by insurance in one way or another. Really that's the whole purpose of insurance, paying to be protected by things that might end up costing you colossal amounts of money. For example collision on your car, while a repair may cost upwards of fifteen grand because you have invested in the insurance you save yourself from having to pay for all of it. Really insurance is just a gamble of whether or not something might not happen. So really the problem is high costs, but there are high costs because of the lack of coverage. Please if I'm wrong about something explain. I don't claim to be an expert this is just my view from up North
|
On April 01 2012 11:58 screamingpalm wrote:
Politics aside, id be happy with some healthcare. Haven't been to a doctor/dentist/dermatologist in ages
My dad hasn't had a checkup in years and he goes to the dentist even less... Kind of makes me feel sick to my stomach when there's so many people in your situation
|
On April 01 2012 11:05 Defacer wrote:Show nested quote +On April 01 2012 10:57 meatbox wrote:On March 31 2012 23:16 Vulture174 wrote:
The government being able to run your life and force you to buy things is never a step in the right direction do you realize that you are willfully giving up the right to run your own life and make your own choices be they good or bad when you give the government this type of power? How can people support this type of thing? They know no better. If people knew how much less other countries were paying for the exact same quality of healthcare, they would strongly consider supporting socialized medicine. A single person doesn't have much bargaining power with a healthcare provider. A government that represents 500 million people has much more leverage.
Yep, I can see a doctor everyday and not pay a single cent!
|
On April 01 2012 12:01 Sublimation wrote:Show nested quote +On April 01 2012 11:33 liberal wrote:On April 01 2012 11:01 Defacer wrote:On April 01 2012 10:42 liberal wrote:On April 01 2012 10:16 Defacer wrote:+ Show Spoiler +On April 01 2012 07:03 liberal wrote:
The United State's rations care by cost, socialized medicine seems to ration care by waiting lists. Personally, I think it is better for an individual to have their life saved and yet be financially damaged than to have the care rationed to begin with. The time spent waiting is often worth more to a person than the price they would pay otherwise. Getting effective and timely treatment for a deadly condition is certainly worth the cost of declaring bankruptcy.
I understand and respect your position. However, specialized and timely treatment for real illness or injury is not the problem. It can be argued that people being prescribed non-essential drugs, or going for unnecessary diagnostic treatments and elective surgery that is contributing to the increasing the cost of health insurance. From the Wall Street Journal Blog: Mindful of concerns about health-care’s spiraling costs, the Health Blog was struck by some new research on what the investigators identified as wasteful practices by family doctors and general practitioners.
Not being doctors, we can’t vouch for the clinical appropriateness of the findings, but there’s no harm in triggering a discussion, right?
What did the researchers say was the No. 1 most over-used activity by primary care physicians? Prescribing a brand-name cholesterol-lowering drug without trying a less expensive generic first, according to the research posted online by the Archives of Internal Medicine.
Doctors’ prescribing a brand-name statin, without first checking to see if a lower-priced generic drug would cut a patient’s cholesterol sufficiently, results in $5.8 billion in excess health-care spending, according to the research letter published Oct. 1.
The authors found $6.76 billion in what they said was non-recommended health-care spending after analyzing surveys of patient visits to certain primary care doctors’ offices and hospital outpatient departments in 2009.
Other practices deemed inappropriate by the authors: bone density scans for women ages 40 to 64 years, costing $527.4 million; ordering CT Scans or MRI’s for lower back pain, amounting to $175.4 million; and prescribing antibiotics to children with sore throats caused by a virus, worth $116.3 million.
Although these sums aren’t chump change, the authors write that achieving affordable but high-quality health-care will really depend on finding ”‘high value’ targets” in specialty areas.
There is also the argument that American health care providers are simply overcharging for everything. For example, an appendectomy -- a common emergency medical procedure -- costs $13000 in the US, more than double the cost of next most expensive countries, Switzerland and Canada ($5000 to 5800). Here's a link to an interactive graphic comparing the cost of specific medical procedures across countries, via the Washington Post: http://www.washingtonpost.com/wp-srv/special/business/high-cost-of-medical-procedures-in-the-us/
There is another simple reason health care in the United States costs more than it does anywhere else: The prices are higher.
That may sound obvious. But it is, in fact, key to understanding one of the most pressing problems facing our economy. In 2009, Americans spent $7,960 per person on health care. Our neighbors in Canada spent $4,808. The Germans spent $4,218. The French, $3,978. If we had the per-person costs of any of those countries, America’s deficits would vanish. Workers would have much more money in their pockets. Our economy would grow more quickly, as our exports would be more competitive.
There are many possible explanations for why Americans pay so much more. It could be that we’re sicker. Or that we go to the doctor more frequently. But health researchers have largely discarded these theories. As Gerard Anderson, Uwe Reinhardt, Peter Hussey and Varduhi Petrosyan put it in the title of their influential 2003 study on international health-care costs, “it’s the prices, stupid.”
Prices don’t explain all of the difference between America and other countries. But they do explain a big chunk of it. The question, of course, is why Americans pay such high prices — and why we haven’t done anything about it.
“Other countries negotiate very aggressively with the providers and set rates that are much lower than we do,” Anderson says. They do this in one of two ways. In countries such as Canada and Britain, prices are set by the government. In others, such as Germany and Japan, they’re set by providers and insurers sitting in a room and coming to an agreement, with the government stepping in to set prices if they fail.
In America, Medicare and Medicaid negotiate prices on behalf of their tens of millions of members and, not coincidentally, purchase care at a substantial markdown from the commercial average. But outside that, it’s a free-for-all. Providers largely charge what they can get away with, often offering different prices to different insurers, and an even higher price to the uninsured.
Full Washington Post article about high US Healthcare CostsSo while you've convinced me that the individual mandate is not solution, I'm not sure what could be done to possibly reel in these costs, other than a socialized system. Yes, this is one of the factors I've been mentioning regarding higher costs. The normal system of supply and demand is breaking down because we have third and fourth parties acting as intermediaries in every transaction. The person consuming the service is not faced with the direct cost, except perhaps a small deductible, and so they have no incentive at all to seek cheaper doctors, to forego unnecessary visits or care, and most importantly, to hold the suppliers accountable for fraudulent charges or prices... It is far more expensive for a company to try and police all of these millions of transactions instead of having the individual consumer police their own behavior based upon prices. This is the brilliance of the concept of the "invisible hand" that probably serves as the butt of a joke for most people here. Millions of people being influenced by personal incentives as dictated by price will always be more effective than paying a third party to try and manage it for them. Could you imagine how expensive it would be for you to pay an adviser to tell you what to buy at the supermarket instead of just buying it yourself? The situation is exacerbated by the fact that most people are now getting their third party insurance through a fourth party, their employer, due of course to government regulation in the matter. The more middle men you insert in the equation and the more you separate the actual consumers and suppliers from the price mechanism, the more waste, inefficiency, and direct fraud and abuse will arise. I'm just so skeptical that general public would somehow, given the opportunity to select their own health care providers and insurers in a free market, be able to "force" them lowering the cost of health care in any meaningful way. Just look at what happened to amount of bad mortgages people bought that lead to the crisis in your country. This is absolutely cynical, but the average person is simply not objective enough or well-informed to challenge insurers or providers. Compound that with the fact that health care providers and insurers have your health to use as leverage. The individual mandate was a band aid solution that would give more people access to overpriced healthcare. It's a compromise, that's for sure. But I have no idea how you would approach the problem the other way, and force healthcare providers to charge less. I know you attribute that partially to wasteful bureaucracy, but the cynicism in me finds it hard to imagine that the health care industry wouldn't exploit less regulation for more profit. Edit: I might be misunderstanding what you're trying to say. Here's another way of looking at it, it might clarify what I mean. Personally, when I hear that a visit to the doctor costs upwards of $150, that an ambulance ride costs upwards of $1,200, that some minimally invasive surgery costs some ridiculous amount like $75,000.... it sounds absurd to me. After all, the costs should not be anywhere near any of those numbers. I know for a fact that I could get the education necessary to do any of these things and charge people significantly less for any of these services. So what's stopping me, or anyone else? Suppose I wanted to get in the health care market myself. Suppose I wanted to start an ambulance company and give people rides to the hospital with all the care of a normal ambulance. I know for a fact I could provide such a ride for much less than $1,200 a trip. So what's stopping me? What's stopping anyone from getting in these markets and undercutting costs? When a doctor in India can do the same surgery for $8,000 that we charge for $75,000, what's stopping him from moving to America and opening up shop? The answer can only be one thing: The myriad system of regulations we have in place. I'm not saying that aren't sometimes good or desired, but are the people willing to pay the costs that we are bearing now? No, we aren't. You can tell that just by the rising medical tourism, where people are willing to forego the safety of our system to simply save themselves from bankruptcy. On April 01 2012 11:25 DoubleReed wrote:On April 01 2012 11:03 liberal wrote:On April 01 2012 10:56 screamingpalm wrote:
@ liberal-
I'm not following your logic. Regulation is obviously not to blame here, as has already been stated. If this was the case, insurers would not be getting away with denying coverage to those with pre-existing conditions, for example. As has been stated, it is a case of crony capitalism. The greatest way to seperate consumers and suppliers from the "price mechanism" or free market, is to get rid of all of the middle men and reform the industry into a single payer system. Perhaps I am misunderstanding your point, but I am getting some contradictions from what you are suggesting. Your claim that regulation isn't to blame because insurers "get away" with denying coverage to those with pre existing conditions doesn't make sense... Insurance is designed to insure people who are healthy. You cannot insure someone who is already sick, anymore than you can insure a home that is already on fire. Forcing insurance companies to accept people with pre-existing conditions is effectively outlawing the insurance business. I agree with you that part of the problem is "crony capitalism," but it doesn't make sense that you then support greater regulation. Crony capitalism means businesses colluding with government through harmful regulation. So if you agree there is crony capitalism, then you agree with me that there must be much harmful regulation. So the first paragraph is a great example as to why health insurance does not make sense in the for-profit market. You are denying healthcare to the people that actually need it. No, we aren't denying health care to anyone. What's being denied is health INSURANCE. Those are very different things. If you want to claim that people simply aren't capable of paying for health care without insurance, then once again we are back at square one: the problem of high costs. Healthcare is incredibly expensive every where though. Its not like other places charge considerably less its just some or most of the cost gets covered by insurance in one way or another. Really that's the whole purpose of insurance, paying to be protected by things that might end up costing you colossal amounts of money. For example collision on your car, while a repair may cost upwards of fifteen grand because you have invested in the insurance you save yourself from having to pay for all of it. Really insurance is just a gamble of whether or not something might not happen. So really the problem is high costs, but there are high costs because of the lack of coverage. Please if I'm wrong about something explain. I don't claim to be an expert this is just my view from up North
To an extent I'd agree, but I did find a statistic a while back that Canada spends 10% GDP on healthcare while the US spends 16%, which I found interesting... Using those numbers Canada does have cheaper healthcare; albeit there is no arguing that the US does have the best healthcare if you can afford it.
|
The difference between health insurance and all other forms of insurance, for example car insurance, is simple.
Car insurance protects you against the risk of being in an accident. You can easily not own a car if you don't want to pay insurance.
Health insurance safeguards you against the certainty that you will get ill or injured at some point in your life.
You can certainly argue that insurers exist in a free market, and should have the right to deny insuring people with pre-existing conditions. But you should also be prepared to argue against forcing health care providers to give emergency medical care to the uninsured.
It's simply too low a moral standard for America, and a critical impairment to "the pursuit of happiness" for too many people.
|
A silly fun fact you Canadians might (or not) enjoy:
Keifer Sutherland plays a right wing crusader on 24, and is touted on Fox & Friends as a hero (nevermind that it is a fictional character). Sutherland's grandfather was Tommy Douglas, who was dubbed "The Greatest Canadian" for bringing universal healthcare to Canada. I wonder if our Canadian posters can verify if this is the popular spin on this, or have I been subjected to bias?
Life's ironies are often funny.
|
On April 01 2012 12:01 Sublimation wrote:Show nested quote +On April 01 2012 11:33 liberal wrote:On April 01 2012 11:01 Defacer wrote:On April 01 2012 10:42 liberal wrote:On April 01 2012 10:16 Defacer wrote:+ Show Spoiler +On April 01 2012 07:03 liberal wrote:
The United State's rations care by cost, socialized medicine seems to ration care by waiting lists. Personally, I think it is better for an individual to have their life saved and yet be financially damaged than to have the care rationed to begin with. The time spent waiting is often worth more to a person than the price they would pay otherwise. Getting effective and timely treatment for a deadly condition is certainly worth the cost of declaring bankruptcy.
I understand and respect your position. However, specialized and timely treatment for real illness or injury is not the problem. It can be argued that people being prescribed non-essential drugs, or going for unnecessary diagnostic treatments and elective surgery that is contributing to the increasing the cost of health insurance. From the Wall Street Journal Blog: Mindful of concerns about health-care’s spiraling costs, the Health Blog was struck by some new research on what the investigators identified as wasteful practices by family doctors and general practitioners.
Not being doctors, we can’t vouch for the clinical appropriateness of the findings, but there’s no harm in triggering a discussion, right?
What did the researchers say was the No. 1 most over-used activity by primary care physicians? Prescribing a brand-name cholesterol-lowering drug without trying a less expensive generic first, according to the research posted online by the Archives of Internal Medicine.
Doctors’ prescribing a brand-name statin, without first checking to see if a lower-priced generic drug would cut a patient’s cholesterol sufficiently, results in $5.8 billion in excess health-care spending, according to the research letter published Oct. 1.
The authors found $6.76 billion in what they said was non-recommended health-care spending after analyzing surveys of patient visits to certain primary care doctors’ offices and hospital outpatient departments in 2009.
Other practices deemed inappropriate by the authors: bone density scans for women ages 40 to 64 years, costing $527.4 million; ordering CT Scans or MRI’s for lower back pain, amounting to $175.4 million; and prescribing antibiotics to children with sore throats caused by a virus, worth $116.3 million.
Although these sums aren’t chump change, the authors write that achieving affordable but high-quality health-care will really depend on finding ”‘high value’ targets” in specialty areas.
There is also the argument that American health care providers are simply overcharging for everything. For example, an appendectomy -- a common emergency medical procedure -- costs $13000 in the US, more than double the cost of next most expensive countries, Switzerland and Canada ($5000 to 5800). Here's a link to an interactive graphic comparing the cost of specific medical procedures across countries, via the Washington Post: http://www.washingtonpost.com/wp-srv/special/business/high-cost-of-medical-procedures-in-the-us/
There is another simple reason health care in the United States costs more than it does anywhere else: The prices are higher.
That may sound obvious. But it is, in fact, key to understanding one of the most pressing problems facing our economy. In 2009, Americans spent $7,960 per person on health care. Our neighbors in Canada spent $4,808. The Germans spent $4,218. The French, $3,978. If we had the per-person costs of any of those countries, America’s deficits would vanish. Workers would have much more money in their pockets. Our economy would grow more quickly, as our exports would be more competitive.
There are many possible explanations for why Americans pay so much more. It could be that we’re sicker. Or that we go to the doctor more frequently. But health researchers have largely discarded these theories. As Gerard Anderson, Uwe Reinhardt, Peter Hussey and Varduhi Petrosyan put it in the title of their influential 2003 study on international health-care costs, “it’s the prices, stupid.”
Prices don’t explain all of the difference between America and other countries. But they do explain a big chunk of it. The question, of course, is why Americans pay such high prices — and why we haven’t done anything about it.
“Other countries negotiate very aggressively with the providers and set rates that are much lower than we do,” Anderson says. They do this in one of two ways. In countries such as Canada and Britain, prices are set by the government. In others, such as Germany and Japan, they’re set by providers and insurers sitting in a room and coming to an agreement, with the government stepping in to set prices if they fail.
In America, Medicare and Medicaid negotiate prices on behalf of their tens of millions of members and, not coincidentally, purchase care at a substantial markdown from the commercial average. But outside that, it’s a free-for-all. Providers largely charge what they can get away with, often offering different prices to different insurers, and an even higher price to the uninsured.
Full Washington Post article about high US Healthcare CostsSo while you've convinced me that the individual mandate is not solution, I'm not sure what could be done to possibly reel in these costs, other than a socialized system. Yes, this is one of the factors I've been mentioning regarding higher costs. The normal system of supply and demand is breaking down because we have third and fourth parties acting as intermediaries in every transaction. The person consuming the service is not faced with the direct cost, except perhaps a small deductible, and so they have no incentive at all to seek cheaper doctors, to forego unnecessary visits or care, and most importantly, to hold the suppliers accountable for fraudulent charges or prices... It is far more expensive for a company to try and police all of these millions of transactions instead of having the individual consumer police their own behavior based upon prices. This is the brilliance of the concept of the "invisible hand" that probably serves as the butt of a joke for most people here. Millions of people being influenced by personal incentives as dictated by price will always be more effective than paying a third party to try and manage it for them. Could you imagine how expensive it would be for you to pay an adviser to tell you what to buy at the supermarket instead of just buying it yourself? The situation is exacerbated by the fact that most people are now getting their third party insurance through a fourth party, their employer, due of course to government regulation in the matter. The more middle men you insert in the equation and the more you separate the actual consumers and suppliers from the price mechanism, the more waste, inefficiency, and direct fraud and abuse will arise. I'm just so skeptical that general public would somehow, given the opportunity to select their own health care providers and insurers in a free market, be able to "force" them lowering the cost of health care in any meaningful way. Just look at what happened to amount of bad mortgages people bought that lead to the crisis in your country. This is absolutely cynical, but the average person is simply not objective enough or well-informed to challenge insurers or providers. Compound that with the fact that health care providers and insurers have your health to use as leverage. The individual mandate was a band aid solution that would give more people access to overpriced healthcare. It's a compromise, that's for sure. But I have no idea how you would approach the problem the other way, and force healthcare providers to charge less. I know you attribute that partially to wasteful bureaucracy, but the cynicism in me finds it hard to imagine that the health care industry wouldn't exploit less regulation for more profit. Edit: I might be misunderstanding what you're trying to say. Here's another way of looking at it, it might clarify what I mean. Personally, when I hear that a visit to the doctor costs upwards of $150, that an ambulance ride costs upwards of $1,200, that some minimally invasive surgery costs some ridiculous amount like $75,000.... it sounds absurd to me. After all, the costs should not be anywhere near any of those numbers. I know for a fact that I could get the education necessary to do any of these things and charge people significantly less for any of these services. So what's stopping me, or anyone else? Suppose I wanted to get in the health care market myself. Suppose I wanted to start an ambulance company and give people rides to the hospital with all the care of a normal ambulance. I know for a fact I could provide such a ride for much less than $1,200 a trip. So what's stopping me? What's stopping anyone from getting in these markets and undercutting costs? When a doctor in India can do the same surgery for $8,000 that we charge for $75,000, what's stopping him from moving to America and opening up shop? The answer can only be one thing: The myriad system of regulations we have in place. I'm not saying that aren't sometimes good or desired, but are the people willing to pay the costs that we are bearing now? No, we aren't. You can tell that just by the rising medical tourism, where people are willing to forego the safety of our system to simply save themselves from bankruptcy. On April 01 2012 11:25 DoubleReed wrote:On April 01 2012 11:03 liberal wrote:On April 01 2012 10:56 screamingpalm wrote:
@ liberal-
I'm not following your logic. Regulation is obviously not to blame here, as has already been stated. If this was the case, insurers would not be getting away with denying coverage to those with pre-existing conditions, for example. As has been stated, it is a case of crony capitalism. The greatest way to seperate consumers and suppliers from the "price mechanism" or free market, is to get rid of all of the middle men and reform the industry into a single payer system. Perhaps I am misunderstanding your point, but I am getting some contradictions from what you are suggesting. Your claim that regulation isn't to blame because insurers "get away" with denying coverage to those with pre existing conditions doesn't make sense... Insurance is designed to insure people who are healthy. You cannot insure someone who is already sick, anymore than you can insure a home that is already on fire. Forcing insurance companies to accept people with pre-existing conditions is effectively outlawing the insurance business. I agree with you that part of the problem is "crony capitalism," but it doesn't make sense that you then support greater regulation. Crony capitalism means businesses colluding with government through harmful regulation. So if you agree there is crony capitalism, then you agree with me that there must be much harmful regulation. So the first paragraph is a great example as to why health insurance does not make sense in the for-profit market. You are denying healthcare to the people that actually need it. No, we aren't denying health care to anyone. What's being denied is health INSURANCE. Those are very different things. If you want to claim that people simply aren't capable of paying for health care without insurance, then once again we are back at square one: the problem of high costs. Healthcare is incredibly expensive every where though. Its not like other places charge considerably less its just some or most of the cost gets covered by insurance in one way or another. Really that's the whole purpose of insurance, paying to be protected by things that might end up costing you colossal amounts of money. For example collision on your car, while a repair may cost upwards of fifteen grand because you have invested in the insurance you save yourself from having to pay for all of it. Really insurance is just a gamble of whether or not something might not happen. So really the problem is high costs, but there are high costs because of the lack of coverage. Please if I'm wrong about something explain. I don't claim to be an expert this is just my view from up North
One of the points I made is that health care is not incredibly expensive everywhere. Countries like Panama, Costa Rica, Brazil, and India can provide excellent care and some of the most difficult surgeries for amounts that people can afford without a dime of health insurance.
For example, Apollo Hospital in New Delhi charges $4,000 for cardiac surgery, while the same procedure would cost about $30,000 in the U.S. It really is possible to provide people with medical care for all but the most extreme of conditions without health insurance, which is a point everyone seems to be missing when they suggest that mandated insurance coverage for those with pre-existing conditions is the only possible option.
|
I guess the US is just more focused on the individual rather than the collective. While this is not necessarily a bad thing, I just think it clears a path for companies and privatization to grow furiously, allowing them to make extreme amounts of money from the big fish (or little money from the school of sardines).
This also explains the large group of people not willing to pay up for a collective benefit in the form of taxes or why they aren't a fan of progressive taxation.. but this is off topic.
The problems arise when certain ethical grey area's are being brought into the equation and you get things like privatized health care, which is unaffordable for the median American.
Because I'm Belgian, and I've lived with health care all my life without being rich, I'm pro "Obamacare" and it's hard for me to understand the arguments against it.
Why wouldn't a nation care about the general well-being of its population? It's their duty to prevent mass mortality rates and mass disease. If a pandemic would strike in the US, with a high death rate, it will NOT be pretty.
|
On April 01 2012 12:29 Uldridge wrote:
I guess the US is just more focused on the individual rather than the collective. While this is not necessarily a bad thing, I just think it clears a path for companies and privatization to grow furiously, allowing them to make extreme amounts of money from the big fish (or little money from the school of sardines).
This also explains the large group of people not willing to pay up for a collective benefit in the form of taxes or why they aren't a fan of progressive taxation.. but this is off topic.
The problems arise when certain ethical grey area's are being brought into the equation and you get things like privatized health care, which is unaffordable for the median American.
Because I'm Belgian, and I've lived with health care all my life without being rich, I'm pro "Obamacare" and it's hard for me to understand the arguments against it.
Why wouldn't a nation care about the general well-being of its population? It's their duty to prevent mass mortality rates and mass disease. If a pandemic would strike in the US, with a high death rate, it will NOT be pretty.
That's totally unfair, and I'm am an extreme leftitst lol.
Maybe you don't understand the arguments against it, because you have a public healthcare system paid for by tax (which I believe is the right way to go). Imagine if your taxes instead went to a for-profit corporation, which was also anti trust exempt.
http://en.wikipedia.org/wiki/United_States_antitrust_law
|
On April 01 2012 12:12 FiWiFaKi wrote:Show nested quote +On April 01 2012 12:01 Sublimation wrote:On April 01 2012 11:33 liberal wrote:On April 01 2012 11:01 Defacer wrote:On April 01 2012 10:42 liberal wrote:On April 01 2012 10:16 Defacer wrote:+ Show Spoiler +On April 01 2012 07:03 liberal wrote:
The United State's rations care by cost, socialized medicine seems to ration care by waiting lists. Personally, I think it is better for an individual to have their life saved and yet be financially damaged than to have the care rationed to begin with. The time spent waiting is often worth more to a person than the price they would pay otherwise. Getting effective and timely treatment for a deadly condition is certainly worth the cost of declaring bankruptcy.
I understand and respect your position. However, specialized and timely treatment for real illness or injury is not the problem. It can be argued that people being prescribed non-essential drugs, or going for unnecessary diagnostic treatments and elective surgery that is contributing to the increasing the cost of health insurance. From the Wall Street Journal Blog: Mindful of concerns about health-care’s spiraling costs, the Health Blog was struck by some new research on what the investigators identified as wasteful practices by family doctors and general practitioners.
Not being doctors, we can’t vouch for the clinical appropriateness of the findings, but there’s no harm in triggering a discussion, right?
What did the researchers say was the No. 1 most over-used activity by primary care physicians? Prescribing a brand-name cholesterol-lowering drug without trying a less expensive generic first, according to the research posted online by the Archives of Internal Medicine.
Doctors’ prescribing a brand-name statin, without first checking to see if a lower-priced generic drug would cut a patient’s cholesterol sufficiently, results in $5.8 billion in excess health-care spending, according to the research letter published Oct. 1.
The authors found $6.76 billion in what they said was non-recommended health-care spending after analyzing surveys of patient visits to certain primary care doctors’ offices and hospital outpatient departments in 2009.
Other practices deemed inappropriate by the authors: bone density scans for women ages 40 to 64 years, costing $527.4 million; ordering CT Scans or MRI’s for lower back pain, amounting to $175.4 million; and prescribing antibiotics to children with sore throats caused by a virus, worth $116.3 million.
Although these sums aren’t chump change, the authors write that achieving affordable but high-quality health-care will really depend on finding ”‘high value’ targets” in specialty areas.
There is also the argument that American health care providers are simply overcharging for everything. For example, an appendectomy -- a common emergency medical procedure -- costs $13000 in the US, more than double the cost of next most expensive countries, Switzerland and Canada ($5000 to 5800). Here's a link to an interactive graphic comparing the cost of specific medical procedures across countries, via the Washington Post: http://www.washingtonpost.com/wp-srv/special/business/high-cost-of-medical-procedures-in-the-us/
There is another simple reason health care in the United States costs more than it does anywhere else: The prices are higher.
That may sound obvious. But it is, in fact, key to understanding one of the most pressing problems facing our economy. In 2009, Americans spent $7,960 per person on health care. Our neighbors in Canada spent $4,808. The Germans spent $4,218. The French, $3,978. If we had the per-person costs of any of those countries, America’s deficits would vanish. Workers would have much more money in their pockets. Our economy would grow more quickly, as our exports would be more competitive.
There are many possible explanations for why Americans pay so much more. It could be that we’re sicker. Or that we go to the doctor more frequently. But health researchers have largely discarded these theories. As Gerard Anderson, Uwe Reinhardt, Peter Hussey and Varduhi Petrosyan put it in the title of their influential 2003 study on international health-care costs, “it’s the prices, stupid.”
Prices don’t explain all of the difference between America and other countries. But they do explain a big chunk of it. The question, of course, is why Americans pay such high prices — and why we haven’t done anything about it.
“Other countries negotiate very aggressively with the providers and set rates that are much lower than we do,” Anderson says. They do this in one of two ways. In countries such as Canada and Britain, prices are set by the government. In others, such as Germany and Japan, they’re set by providers and insurers sitting in a room and coming to an agreement, with the government stepping in to set prices if they fail.
In America, Medicare and Medicaid negotiate prices on behalf of their tens of millions of members and, not coincidentally, purchase care at a substantial markdown from the commercial average. But outside that, it’s a free-for-all. Providers largely charge what they can get away with, often offering different prices to different insurers, and an even higher price to the uninsured.
Full Washington Post article about high US Healthcare CostsSo while you've convinced me that the individual mandate is not solution, I'm not sure what could be done to possibly reel in these costs, other than a socialized system. Yes, this is one of the factors I've been mentioning regarding higher costs. The normal system of supply and demand is breaking down because we have third and fourth parties acting as intermediaries in every transaction. The person consuming the service is not faced with the direct cost, except perhaps a small deductible, and so they have no incentive at all to seek cheaper doctors, to forego unnecessary visits or care, and most importantly, to hold the suppliers accountable for fraudulent charges or prices... It is far more expensive for a company to try and police all of these millions of transactions instead of having the individual consumer police their own behavior based upon prices. This is the brilliance of the concept of the "invisible hand" that probably serves as the butt of a joke for most people here. Millions of people being influenced by personal incentives as dictated by price will always be more effective than paying a third party to try and manage it for them. Could you imagine how expensive it would be for you to pay an adviser to tell you what to buy at the supermarket instead of just buying it yourself? The situation is exacerbated by the fact that most people are now getting their third party insurance through a fourth party, their employer, due of course to government regulation in the matter. The more middle men you insert in the equation and the more you separate the actual consumers and suppliers from the price mechanism, the more waste, inefficiency, and direct fraud and abuse will arise. I'm just so skeptical that general public would somehow, given the opportunity to select their own health care providers and insurers in a free market, be able to "force" them lowering the cost of health care in any meaningful way. Just look at what happened to amount of bad mortgages people bought that lead to the crisis in your country. This is absolutely cynical, but the average person is simply not objective enough or well-informed to challenge insurers or providers. Compound that with the fact that health care providers and insurers have your health to use as leverage. The individual mandate was a band aid solution that would give more people access to overpriced healthcare. It's a compromise, that's for sure. But I have no idea how you would approach the problem the other way, and force healthcare providers to charge less. I know you attribute that partially to wasteful bureaucracy, but the cynicism in me finds it hard to imagine that the health care industry wouldn't exploit less regulation for more profit. Edit: I might be misunderstanding what you're trying to say. Here's another way of looking at it, it might clarify what I mean. Personally, when I hear that a visit to the doctor costs upwards of $150, that an ambulance ride costs upwards of $1,200, that some minimally invasive surgery costs some ridiculous amount like $75,000.... it sounds absurd to me. After all, the costs should not be anywhere near any of those numbers. I know for a fact that I could get the education necessary to do any of these things and charge people significantly less for any of these services. So what's stopping me, or anyone else? Suppose I wanted to get in the health care market myself. Suppose I wanted to start an ambulance company and give people rides to the hospital with all the care of a normal ambulance. I know for a fact I could provide such a ride for much less than $1,200 a trip. So what's stopping me? What's stopping anyone from getting in these markets and undercutting costs? When a doctor in India can do the same surgery for $8,000 that we charge for $75,000, what's stopping him from moving to America and opening up shop? The answer can only be one thing: The myriad system of regulations we have in place. I'm not saying that aren't sometimes good or desired, but are the people willing to pay the costs that we are bearing now? No, we aren't. You can tell that just by the rising medical tourism, where people are willing to forego the safety of our system to simply save themselves from bankruptcy. On April 01 2012 11:25 DoubleReed wrote:On April 01 2012 11:03 liberal wrote:On April 01 2012 10:56 screamingpalm wrote:
@ liberal-
I'm not following your logic. Regulation is obviously not to blame here, as has already been stated. If this was the case, insurers would not be getting away with denying coverage to those with pre-existing conditions, for example. As has been stated, it is a case of crony capitalism. The greatest way to seperate consumers and suppliers from the "price mechanism" or free market, is to get rid of all of the middle men and reform the industry into a single payer system. Perhaps I am misunderstanding your point, but I am getting some contradictions from what you are suggesting. Your claim that regulation isn't to blame because insurers "get away" with denying coverage to those with pre existing conditions doesn't make sense... Insurance is designed to insure people who are healthy. You cannot insure someone who is already sick, anymore than you can insure a home that is already on fire. Forcing insurance companies to accept people with pre-existing conditions is effectively outlawing the insurance business. I agree with you that part of the problem is "crony capitalism," but it doesn't make sense that you then support greater regulation. Crony capitalism means businesses colluding with government through harmful regulation. So if you agree there is crony capitalism, then you agree with me that there must be much harmful regulation. So the first paragraph is a great example as to why health insurance does not make sense in the for-profit market. You are denying healthcare to the people that actually need it. No, we aren't denying health care to anyone. What's being denied is health INSURANCE. Those are very different things. If you want to claim that people simply aren't capable of paying for health care without insurance, then once again we are back at square one: the problem of high costs. Healthcare is incredibly expensive every where though. Its not like other places charge considerably less its just some or most of the cost gets covered by insurance in one way or another. Really that's the whole purpose of insurance, paying to be protected by things that might end up costing you colossal amounts of money. For example collision on your car, while a repair may cost upwards of fifteen grand because you have invested in the insurance you save yourself from having to pay for all of it. Really insurance is just a gamble of whether or not something might not happen. So really the problem is high costs, but there are high costs because of the lack of coverage. Please if I'm wrong about something explain. I don't claim to be an expert this is just my view from up North To an extent I'd agree, but I did find a statistic a while back that Canada spends 10% GDP on healthcare while the US spends 16%, which I found interesting... Using those numbers Canada does have cheaper healthcare; albeit there is no arguing that the US does have the best healthcare if you can afford it.
Whaaatttt are you serious?! Can you please link that if you don't mind or can, or atleast point me towards it? If that's really the case then there is something that's seriously wrong. Its not like doctors here don't make lots of money and I seriously doubt pharm. companies would sell us stuff cheaper (if anything it would be the other way around just like everything else!).
And yeah that really is kinda messed up about how the US has the best doctors and stuff but no one can use them. Really you'd be better off with the worst doctors in the world if it meant being able to use them, and really what's the point in having the best doctors anyway? I mean yeah obviously a good thing but it kind of just seems like those kinds of doctors and care cater to the extremely specific and rare cases no? I mean isn't having above average doctors or even average doctors enough for most people?
Ideally one day maybe we could have global healthcare system and anyone anywhere can get the best doctors if they need them...
|
On April 01 2012 12:18 screamingpalm wrote:
A silly fun fact you Canadians might (or not) enjoy:
Keifer Sutherland plays a right wing crusader on 24, and is touted on Fox & Friends as a hero (nevermind that it is a fictional character). Sutherland's grandfather was Tommy Douglas, who was dubbed "The Greatest Canadian" for bringing universal healthcare to Canada. I wonder if our Canadian posters can verify if this is the popular spin on this, or have I been subjected to bias?
Life's ironies are often funny.
True story. We like our healthcare 
|
On April 01 2012 12:23 liberal wrote:Show nested quote +On April 01 2012 12:01 Sublimation wrote:On April 01 2012 11:33 liberal wrote:On April 01 2012 11:01 Defacer wrote:On April 01 2012 10:42 liberal wrote:On April 01 2012 10:16 Defacer wrote:+ Show Spoiler +On April 01 2012 07:03 liberal wrote:
The United State's rations care by cost, socialized medicine seems to ration care by waiting lists. Personally, I think it is better for an individual to have their life saved and yet be financially damaged than to have the care rationed to begin with. The time spent waiting is often worth more to a person than the price they would pay otherwise. Getting effective and timely treatment for a deadly condition is certainly worth the cost of declaring bankruptcy.
I understand and respect your position. However, specialized and timely treatment for real illness or injury is not the problem. It can be argued that people being prescribed non-essential drugs, or going for unnecessary diagnostic treatments and elective surgery that is contributing to the increasing the cost of health insurance. From the Wall Street Journal Blog: Mindful of concerns about health-care’s spiraling costs, the Health Blog was struck by some new research on what the investigators identified as wasteful practices by family doctors and general practitioners.
Not being doctors, we can’t vouch for the clinical appropriateness of the findings, but there’s no harm in triggering a discussion, right?
What did the researchers say was the No. 1 most over-used activity by primary care physicians? Prescribing a brand-name cholesterol-lowering drug without trying a less expensive generic first, according to the research posted online by the Archives of Internal Medicine.
Doctors’ prescribing a brand-name statin, without first checking to see if a lower-priced generic drug would cut a patient’s cholesterol sufficiently, results in $5.8 billion in excess health-care spending, according to the research letter published Oct. 1.
The authors found $6.76 billion in what they said was non-recommended health-care spending after analyzing surveys of patient visits to certain primary care doctors’ offices and hospital outpatient departments in 2009.
Other practices deemed inappropriate by the authors: bone density scans for women ages 40 to 64 years, costing $527.4 million; ordering CT Scans or MRI’s for lower back pain, amounting to $175.4 million; and prescribing antibiotics to children with sore throats caused by a virus, worth $116.3 million.
Although these sums aren’t chump change, the authors write that achieving affordable but high-quality health-care will really depend on finding ”‘high value’ targets” in specialty areas.
There is also the argument that American health care providers are simply overcharging for everything. For example, an appendectomy -- a common emergency medical procedure -- costs $13000 in the US, more than double the cost of next most expensive countries, Switzerland and Canada ($5000 to 5800). Here's a link to an interactive graphic comparing the cost of specific medical procedures across countries, via the Washington Post: http://www.washingtonpost.com/wp-srv/special/business/high-cost-of-medical-procedures-in-the-us/
There is another simple reason health care in the United States costs more than it does anywhere else: The prices are higher.
That may sound obvious. But it is, in fact, key to understanding one of the most pressing problems facing our economy. In 2009, Americans spent $7,960 per person on health care. Our neighbors in Canada spent $4,808. The Germans spent $4,218. The French, $3,978. If we had the per-person costs of any of those countries, America’s deficits would vanish. Workers would have much more money in their pockets. Our economy would grow more quickly, as our exports would be more competitive.
There are many possible explanations for why Americans pay so much more. It could be that we’re sicker. Or that we go to the doctor more frequently. But health researchers have largely discarded these theories. As Gerard Anderson, Uwe Reinhardt, Peter Hussey and Varduhi Petrosyan put it in the title of their influential 2003 study on international health-care costs, “it’s the prices, stupid.”
Prices don’t explain all of the difference between America and other countries. But they do explain a big chunk of it. The question, of course, is why Americans pay such high prices — and why we haven’t done anything about it.
“Other countries negotiate very aggressively with the providers and set rates that are much lower than we do,” Anderson says. They do this in one of two ways. In countries such as Canada and Britain, prices are set by the government. In others, such as Germany and Japan, they’re set by providers and insurers sitting in a room and coming to an agreement, with the government stepping in to set prices if they fail.
In America, Medicare and Medicaid negotiate prices on behalf of their tens of millions of members and, not coincidentally, purchase care at a substantial markdown from the commercial average. But outside that, it’s a free-for-all. Providers largely charge what they can get away with, often offering different prices to different insurers, and an even higher price to the uninsured.
Full Washington Post article about high US Healthcare CostsSo while you've convinced me that the individual mandate is not solution, I'm not sure what could be done to possibly reel in these costs, other than a socialized system. Yes, this is one of the factors I've been mentioning regarding higher costs. The normal system of supply and demand is breaking down because we have third and fourth parties acting as intermediaries in every transaction. The person consuming the service is not faced with the direct cost, except perhaps a small deductible, and so they have no incentive at all to seek cheaper doctors, to forego unnecessary visits or care, and most importantly, to hold the suppliers accountable for fraudulent charges or prices... It is far more expensive for a company to try and police all of these millions of transactions instead of having the individual consumer police their own behavior based upon prices. This is the brilliance of the concept of the "invisible hand" that probably serves as the butt of a joke for most people here. Millions of people being influenced by personal incentives as dictated by price will always be more effective than paying a third party to try and manage it for them. Could you imagine how expensive it would be for you to pay an adviser to tell you what to buy at the supermarket instead of just buying it yourself? The situation is exacerbated by the fact that most people are now getting their third party insurance through a fourth party, their employer, due of course to government regulation in the matter. The more middle men you insert in the equation and the more you separate the actual consumers and suppliers from the price mechanism, the more waste, inefficiency, and direct fraud and abuse will arise. I'm just so skeptical that general public would somehow, given the opportunity to select their own health care providers and insurers in a free market, be able to "force" them lowering the cost of health care in any meaningful way. Just look at what happened to amount of bad mortgages people bought that lead to the crisis in your country. This is absolutely cynical, but the average person is simply not objective enough or well-informed to challenge insurers or providers. Compound that with the fact that health care providers and insurers have your health to use as leverage. The individual mandate was a band aid solution that would give more people access to overpriced healthcare. It's a compromise, that's for sure. But I have no idea how you would approach the problem the other way, and force healthcare providers to charge less. I know you attribute that partially to wasteful bureaucracy, but the cynicism in me finds it hard to imagine that the health care industry wouldn't exploit less regulation for more profit. Edit: I might be misunderstanding what you're trying to say. Here's another way of looking at it, it might clarify what I mean. Personally, when I hear that a visit to the doctor costs upwards of $150, that an ambulance ride costs upwards of $1,200, that some minimally invasive surgery costs some ridiculous amount like $75,000.... it sounds absurd to me. After all, the costs should not be anywhere near any of those numbers. I know for a fact that I could get the education necessary to do any of these things and charge people significantly less for any of these services. So what's stopping me, or anyone else? Suppose I wanted to get in the health care market myself. Suppose I wanted to start an ambulance company and give people rides to the hospital with all the care of a normal ambulance. I know for a fact I could provide such a ride for much less than $1,200 a trip. So what's stopping me? What's stopping anyone from getting in these markets and undercutting costs? When a doctor in India can do the same surgery for $8,000 that we charge for $75,000, what's stopping him from moving to America and opening up shop? The answer can only be one thing: The myriad system of regulations we have in place. I'm not saying that aren't sometimes good or desired, but are the people willing to pay the costs that we are bearing now? No, we aren't. You can tell that just by the rising medical tourism, where people are willing to forego the safety of our system to simply save themselves from bankruptcy. On April 01 2012 11:25 DoubleReed wrote:On April 01 2012 11:03 liberal wrote:On April 01 2012 10:56 screamingpalm wrote:
@ liberal-
I'm not following your logic. Regulation is obviously not to blame here, as has already been stated. If this was the case, insurers would not be getting away with denying coverage to those with pre-existing conditions, for example. As has been stated, it is a case of crony capitalism. The greatest way to seperate consumers and suppliers from the "price mechanism" or free market, is to get rid of all of the middle men and reform the industry into a single payer system. Perhaps I am misunderstanding your point, but I am getting some contradictions from what you are suggesting. Your claim that regulation isn't to blame because insurers "get away" with denying coverage to those with pre existing conditions doesn't make sense... Insurance is designed to insure people who are healthy. You cannot insure someone who is already sick, anymore than you can insure a home that is already on fire. Forcing insurance companies to accept people with pre-existing conditions is effectively outlawing the insurance business. I agree with you that part of the problem is "crony capitalism," but it doesn't make sense that you then support greater regulation. Crony capitalism means businesses colluding with government through harmful regulation. So if you agree there is crony capitalism, then you agree with me that there must be much harmful regulation. So the first paragraph is a great example as to why health insurance does not make sense in the for-profit market. You are denying healthcare to the people that actually need it. No, we aren't denying health care to anyone. What's being denied is health INSURANCE. Those are very different things. If you want to claim that people simply aren't capable of paying for health care without insurance, then once again we are back at square one: the problem of high costs. Healthcare is incredibly expensive every where though. Its not like other places charge considerably less its just some or most of the cost gets covered by insurance in one way or another. Really that's the whole purpose of insurance, paying to be protected by things that might end up costing you colossal amounts of money. For example collision on your car, while a repair may cost upwards of fifteen grand because you have invested in the insurance you save yourself from having to pay for all of it. Really insurance is just a gamble of whether or not something might not happen. So really the problem is high costs, but there are high costs because of the lack of coverage. Please if I'm wrong about something explain. I don't claim to be an expert this is just my view from up North One of the points I made is that health care is not incredibly expensive everywhere. Countries like Panama, Costa Rica, Brazil, and India can provide excellent care and some of the most difficult surgeries for amounts that people can afford without a dime of health insurance. For example, Apollo Hospital in New Delhi charges $4,000 for cardiac surgery, while the same procedure would cost about $30,000 in the U.S. It really is possible to provide people with medical care for all but the most extreme of conditions without health insurance, which is a point everyone seems to be missing when they suggest that mandated insurance coverage for those with pre-existing conditions is the only possible option.
So what exactly makes it so expensive in the states? Regulation? Personal greed? I mean for cardiac surgery you would at least have like two surgeons, an anesthesiologist, maybe even more doctors, all of which have years and years of intensive schooling and training, then maybe half a dozen nurses or possibly a couple technicians all working for 5+ hours straight... That right there seems like it should total more than four grand, even ten grand. Add on that equipment, extremely limited amount of operating space/time, plus whatever care came before and after and suddenly 30k doesn't really seem that far-fetched.
|
|
|
In the canadian constitution charter, the first article if I recall correctly allows a law to be unconstitutional if this law is conceivable in a free and democratic society among other conditions. Is there anything like that in the US one? OR if the constitution says its not part of federal legislation then too bad we break the law no matter the effects?
|
On April 01 2012 12:35 Sublimation wrote:Show nested quote +On April 01 2012 12:12 FiWiFaKi wrote:On April 01 2012 12:01 Sublimation wrote:On April 01 2012 11:33 liberal wrote:On April 01 2012 11:01 Defacer wrote:On April 01 2012 10:42 liberal wrote:On April 01 2012 10:16 Defacer wrote:+ Show Spoiler +On April 01 2012 07:03 liberal wrote:
The United State's rations care by cost, socialized medicine seems to ration care by waiting lists. Personally, I think it is better for an individual to have their life saved and yet be financially damaged than to have the care rationed to begin with. The time spent waiting is often worth more to a person than the price they would pay otherwise. Getting effective and timely treatment for a deadly condition is certainly worth the cost of declaring bankruptcy.
I understand and respect your position. However, specialized and timely treatment for real illness or injury is not the problem. It can be argued that people being prescribed non-essential drugs, or going for unnecessary diagnostic treatments and elective surgery that is contributing to the increasing the cost of health insurance. From the Wall Street Journal Blog: Mindful of concerns about health-care’s spiraling costs, the Health Blog was struck by some new research on what the investigators identified as wasteful practices by family doctors and general practitioners.
Not being doctors, we can’t vouch for the clinical appropriateness of the findings, but there’s no harm in triggering a discussion, right?
What did the researchers say was the No. 1 most over-used activity by primary care physicians? Prescribing a brand-name cholesterol-lowering drug without trying a less expensive generic first, according to the research posted online by the Archives of Internal Medicine.
Doctors’ prescribing a brand-name statin, without first checking to see if a lower-priced generic drug would cut a patient’s cholesterol sufficiently, results in $5.8 billion in excess health-care spending, according to the research letter published Oct. 1.
The authors found $6.76 billion in what they said was non-recommended health-care spending after analyzing surveys of patient visits to certain primary care doctors’ offices and hospital outpatient departments in 2009.
Other practices deemed inappropriate by the authors: bone density scans for women ages 40 to 64 years, costing $527.4 million; ordering CT Scans or MRI’s for lower back pain, amounting to $175.4 million; and prescribing antibiotics to children with sore throats caused by a virus, worth $116.3 million.
Although these sums aren’t chump change, the authors write that achieving affordable but high-quality health-care will really depend on finding ”‘high value’ targets” in specialty areas.
There is also the argument that American health care providers are simply overcharging for everything. For example, an appendectomy -- a common emergency medical procedure -- costs $13000 in the US, more than double the cost of next most expensive countries, Switzerland and Canada ($5000 to 5800). Here's a link to an interactive graphic comparing the cost of specific medical procedures across countries, via the Washington Post: http://www.washingtonpost.com/wp-srv/special/business/high-cost-of-medical-procedures-in-the-us/
There is another simple reason health care in the United States costs more than it does anywhere else: The prices are higher.
That may sound obvious. But it is, in fact, key to understanding one of the most pressing problems facing our economy. In 2009, Americans spent $7,960 per person on health care. Our neighbors in Canada spent $4,808. The Germans spent $4,218. The French, $3,978. If we had the per-person costs of any of those countries, America’s deficits would vanish. Workers would have much more money in their pockets. Our economy would grow more quickly, as our exports would be more competitive.
There are many possible explanations for why Americans pay so much more. It could be that we’re sicker. Or that we go to the doctor more frequently. But health researchers have largely discarded these theories. As Gerard Anderson, Uwe Reinhardt, Peter Hussey and Varduhi Petrosyan put it in the title of their influential 2003 study on international health-care costs, “it’s the prices, stupid.”
Prices don’t explain all of the difference between America and other countries. But they do explain a big chunk of it. The question, of course, is why Americans pay such high prices — and why we haven’t done anything about it.
“Other countries negotiate very aggressively with the providers and set rates that are much lower than we do,” Anderson says. They do this in one of two ways. In countries such as Canada and Britain, prices are set by the government. In others, such as Germany and Japan, they’re set by providers and insurers sitting in a room and coming to an agreement, with the government stepping in to set prices if they fail.
In America, Medicare and Medicaid negotiate prices on behalf of their tens of millions of members and, not coincidentally, purchase care at a substantial markdown from the commercial average. But outside that, it’s a free-for-all. Providers largely charge what they can get away with, often offering different prices to different insurers, and an even higher price to the uninsured.
Full Washington Post article about high US Healthcare CostsSo while you've convinced me that the individual mandate is not solution, I'm not sure what could be done to possibly reel in these costs, other than a socialized system. Yes, this is one of the factors I've been mentioning regarding higher costs. The normal system of supply and demand is breaking down because we have third and fourth parties acting as intermediaries in every transaction. The person consuming the service is not faced with the direct cost, except perhaps a small deductible, and so they have no incentive at all to seek cheaper doctors, to forego unnecessary visits or care, and most importantly, to hold the suppliers accountable for fraudulent charges or prices... It is far more expensive for a company to try and police all of these millions of transactions instead of having the individual consumer police their own behavior based upon prices. This is the brilliance of the concept of the "invisible hand" that probably serves as the butt of a joke for most people here. Millions of people being influenced by personal incentives as dictated by price will always be more effective than paying a third party to try and manage it for them. Could you imagine how expensive it would be for you to pay an adviser to tell you what to buy at the supermarket instead of just buying it yourself? The situation is exacerbated by the fact that most people are now getting their third party insurance through a fourth party, their employer, due of course to government regulation in the matter. The more middle men you insert in the equation and the more you separate the actual consumers and suppliers from the price mechanism, the more waste, inefficiency, and direct fraud and abuse will arise. I'm just so skeptical that general public would somehow, given the opportunity to select their own health care providers and insurers in a free market, be able to "force" them lowering the cost of health care in any meaningful way. Just look at what happened to amount of bad mortgages people bought that lead to the crisis in your country. This is absolutely cynical, but the average person is simply not objective enough or well-informed to challenge insurers or providers. Compound that with the fact that health care providers and insurers have your health to use as leverage. The individual mandate was a band aid solution that would give more people access to overpriced healthcare. It's a compromise, that's for sure. But I have no idea how you would approach the problem the other way, and force healthcare providers to charge less. I know you attribute that partially to wasteful bureaucracy, but the cynicism in me finds it hard to imagine that the health care industry wouldn't exploit less regulation for more profit. Edit: I might be misunderstanding what you're trying to say. Here's another way of looking at it, it might clarify what I mean. Personally, when I hear that a visit to the doctor costs upwards of $150, that an ambulance ride costs upwards of $1,200, that some minimally invasive surgery costs some ridiculous amount like $75,000.... it sounds absurd to me. After all, the costs should not be anywhere near any of those numbers. I know for a fact that I could get the education necessary to do any of these things and charge people significantly less for any of these services. So what's stopping me, or anyone else? Suppose I wanted to get in the health care market myself. Suppose I wanted to start an ambulance company and give people rides to the hospital with all the care of a normal ambulance. I know for a fact I could provide such a ride for much less than $1,200 a trip. So what's stopping me? What's stopping anyone from getting in these markets and undercutting costs? When a doctor in India can do the same surgery for $8,000 that we charge for $75,000, what's stopping him from moving to America and opening up shop? The answer can only be one thing: The myriad system of regulations we have in place. I'm not saying that aren't sometimes good or desired, but are the people willing to pay the costs that we are bearing now? No, we aren't. You can tell that just by the rising medical tourism, where people are willing to forego the safety of our system to simply save themselves from bankruptcy. On April 01 2012 11:25 DoubleReed wrote:On April 01 2012 11:03 liberal wrote:On April 01 2012 10:56 screamingpalm wrote:
@ liberal-
I'm not following your logic. Regulation is obviously not to blame here, as has already been stated. If this was the case, insurers would not be getting away with denying coverage to those with pre-existing conditions, for example. As has been stated, it is a case of crony capitalism. The greatest way to seperate consumers and suppliers from the "price mechanism" or free market, is to get rid of all of the middle men and reform the industry into a single payer system. Perhaps I am misunderstanding your point, but I am getting some contradictions from what you are suggesting. Your claim that regulation isn't to blame because insurers "get away" with denying coverage to those with pre existing conditions doesn't make sense... Insurance is designed to insure people who are healthy. You cannot insure someone who is already sick, anymore than you can insure a home that is already on fire. Forcing insurance companies to accept people with pre-existing conditions is effectively outlawing the insurance business. I agree with you that part of the problem is "crony capitalism," but it doesn't make sense that you then support greater regulation. Crony capitalism means businesses colluding with government through harmful regulation. So if you agree there is crony capitalism, then you agree with me that there must be much harmful regulation. So the first paragraph is a great example as to why health insurance does not make sense in the for-profit market. You are denying healthcare to the people that actually need it. No, we aren't denying health care to anyone. What's being denied is health INSURANCE. Those are very different things. If you want to claim that people simply aren't capable of paying for health care without insurance, then once again we are back at square one: the problem of high costs. Healthcare is incredibly expensive every where though. Its not like other places charge considerably less its just some or most of the cost gets covered by insurance in one way or another. Really that's the whole purpose of insurance, paying to be protected by things that might end up costing you colossal amounts of money. For example collision on your car, while a repair may cost upwards of fifteen grand because you have invested in the insurance you save yourself from having to pay for all of it. Really insurance is just a gamble of whether or not something might not happen. So really the problem is high costs, but there are high costs because of the lack of coverage. Please if I'm wrong about something explain. I don't claim to be an expert this is just my view from up North To an extent I'd agree, but I did find a statistic a while back that Canada spends 10% GDP on healthcare while the US spends 16%, which I found interesting... Using those numbers Canada does have cheaper healthcare; albeit there is no arguing that the US does have the best healthcare if you can afford it. Whaaatttt are you serious?! Can you please link that if you don't mind or can, or atleast point me towards it? If that's really the case then there is something that's seriously wrong. Its not like doctors here don't make lots of money and I seriously doubt pharm. companies would sell us stuff cheaper (if anything it would be the other way around just like everything else!). And yeah that really is kinda messed up about how the US has the best doctors and stuff but no one can use them. Really you'd be better off with the worst doctors in the world if it meant being able to use them, and really what's the point in having the best doctors anyway? I mean yeah obviously a good thing but it kind of just seems like those kinds of doctors and care cater to the extremely specific and rare cases no? I mean isn't having above average doctors or even average doctors enough for most people? Ideally one day maybe we could have global healthcare system and anyone anywhere can get the best doctors if they need them...
http://www.who.int/whosis/whostat/2009/en/index.html
Scroll down and check Table 7: Health expenditure
|
On April 01 2012 12:14 Defacer wrote:
The difference between health insurance and all other forms of insurance, for example car insurance, is simple.
Car insurance protects you against the risk of being in an accident. You can easily not own a car if you don't want to pay insurance.
Health insurance safeguards you against the certainty that you will get ill or injured at some point in your life.
You can certainly argue that insurers exist in a free market, and should have the right to deny insuring people with pre-existing conditions. But you should also be prepared to argue against forcing health care providers to give emergency medical care to the uninsured.
It's simply too low a moral standard for America, and a critical impairment to "the pursuit of happiness" for too many people.
Uhh... life insurance? I don't think you can get more certain than that...
I liked your argument before. This one isn't as strong.
"Pre-existing conditions" contains a lot of really serious diseases that cost a ton of money. The whole point is we need to cover people who actually need health insurance. Covering the costs of serious healthcare is what health insurance is for. It raises the question of the point of health insurance in the first place.
In fact, the moral guideline gets screwed up, because a self-imposed action like smoking would simply raise my rates, but it would still allow my lung cancer treatment to be covered. However a person with a genetic disorder through no fault of his own would not be covered. Pre-existing conditions are bullshit and should be thrown out.
|
On April 01 2012 01:28 JonnyBNoHo wrote:Show nested quote +On April 01 2012 00:25 Nottoo wrote:On April 01 2012 00:18 DeepElemBlues wrote:Because the slippery slope fallacy is a fallacy for a reason. You aren't having your life controlled by someone else, you're having one small area of your life controlled. Similar to the bits that are controlled to stop you killing/hurting/stealing. This must be why the government has been unable to articulate a limiting principle when it comes to the mandate. Usually when the slippery slope argument actually is a fallacy, those arguing that it is can point to a place where the buck stops. People allow this to happen because it ends up being better for everyone involved. Public-pooled costs for areas like health care help stop people being one accident or one disease away from poverty (or death). It's the mark of a civilised society. Implying that a society isn't civilized if it doesn't agree with your particular political opinion isn't going to win you many converts. Obamacare has been limited, its a fair bit smaller in scope than it was in its inception. I'm not looking for converts. I do consider it barbaric (and have no problem saying it) when a first world nation with more than enough wealth to cover all its citizens, applies a law of the jungle when it comes to basic needs. The law of the jungle belongs in the jungle - where you have to fight to barely survive. Not a plentiful land. It's not "law of the jungle" in the US. If you are sick you go to the hospital and they take care of you. Even if you don't have insurance and cannot pay. Basic needs ARE covered.
Aren't you supposed to sell your house afterwards because of it?
|
On April 01 2012 13:37 TanTzoR wrote:Show nested quote +On April 01 2012 01:28 JonnyBNoHo wrote:On April 01 2012 00:25 Nottoo wrote:On April 01 2012 00:18 DeepElemBlues wrote:Because the slippery slope fallacy is a fallacy for a reason. You aren't having your life controlled by someone else, you're having one small area of your life controlled. Similar to the bits that are controlled to stop you killing/hurting/stealing. This must be why the government has been unable to articulate a limiting principle when it comes to the mandate. Usually when the slippery slope argument actually is a fallacy, those arguing that it is can point to a place where the buck stops. People allow this to happen because it ends up being better for everyone involved. Public-pooled costs for areas like health care help stop people being one accident or one disease away from poverty (or death). It's the mark of a civilised society. Implying that a society isn't civilized if it doesn't agree with your particular political opinion isn't going to win you many converts. Obamacare has been limited, its a fair bit smaller in scope than it was in its inception. I'm not looking for converts. I do consider it barbaric (and have no problem saying it) when a first world nation with more than enough wealth to cover all its citizens, applies a law of the jungle when it comes to basic needs. The law of the jungle belongs in the jungle - where you have to fight to barely survive. Not a plentiful land. It's not "law of the jungle" in the US. If you are sick you go to the hospital and they take care of you. Even if you don't have insurance and cannot pay. Basic needs ARE covered. Aren't you supposed to sell your house afterwards because of it?
Yep. And for those saying, just declare bankruptcy... good luck with that (Biden threw down the hammer on that I believe). In other words, bankruptcy laws no longer protect consumers like they once did.
|
the only thing that ever happens when the government becomes involved in business is businesses make more money, and the citizens get less for it. when the u.s gov't finally gets its hands out of the pockets of their poorest people, maybe then things will change for the good, but while all these blind fucking sheep just nod their heads to whatever the tv tells them nothing will improve
edit: also, "morals" and "ethics" play absolutely zero role in the writing and signing of our laws, you need only look at what brings the most people to prison to see that, or maybe notice how corporations like Monsanto etc only get bigger and more powerful and the citizens get weaker and poorer. the idea that "just because im rich doesn't mean you can't be" only works in a 1 on 1 situation. when it comes to "just because we're billion/trillionaires doesn't mean you can't be" its a straight up fucking lie. there's a finite amount of money and value on this earth, and so only so much to go around. when 1% of the people own 99% of the wealth, the other 99% only have that 1% to work with, and its a straight up fact. money is only infinite in your dreams and those of democrats.
|
|
|
|
|
|
4124
2319
2013
EPT
