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Posted: 8/28/2015 2:26:40 AM EDT
[#1]
Quote HistoryQuoted:
I think the government should be severely restricted in what it can tax. The employer is subsidizing what you are paying for income maybe. Are you going to tax the parking space where you work at? Companies pay for many things to attract an employee. Oh you used the company counselor taxed, you used the company washing machine taxed, you used the company computer for your Facebook tax. Thats why the power to tax is the power to destroy. Yet one of those things we give preferential treatment to in a way that forces up the cost of healthcare and damages the productivity of businesses. |
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Posted: 8/28/2015 2:51:20 AM EDT
[#2]
also, op inferrs health care is a right that everyone gets
mighty sneaky progressive of you, commrade! always move the people to the left! |
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Posted: 8/28/2015 3:09:50 AM EDT
[#3]
Quoted:
...for sick people. This is an interesting question. Because it seems that we've pretty much accepted that it can only be handled by some sort of private (insurance) or public collectivism. The current business model relies on some form of collectivism. Is this the only solution? Thoughts? |
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Posted: 8/28/2015 3:17:18 AM EDT
[#4]
0bama care with their employer mandate just helped big business to start hiring part time and temporary workers with low wages so the gov will pay for it thru subsidies and Medicaid. They profit not contributing to employee health care if you don't get 40 hours. The individual mandate makes sure your the burden of paying for it on a sliding scale.
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Posted: 8/28/2015 3:39:03 AM EDT
[#5]
No, sick poor people die, humanity wins.
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Posted: 8/28/2015 5:30:58 AM EDT
[#6]
Only liberals can get it backwards.
Think about it if for auto insurance for instance. If good drivers (who never collect) paid way more than bad drivers (who are collecting) does that even make sense? How millions of years of evolution can result in a brain that could even think like this is beyond me. But then again I look around in today's society, and have to question if we really have evolved much anyway. |
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Posted: 8/28/2015 7:22:05 AM EDT
[#7]
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Only liberals can get it backwards. Think about it if for auto insurance for instance. If good drivers (who never collect) paid way more than bad drivers (who are collecting) does that even make sense? How millions of years of evolution can result in a brain that could even think like this is beyond me. But then again I look around in today's society, and have to question if we really have evolved much anyway. Individualism is a liberal value. What we call a liberal in the US is a left wing collectivist of one type or another. On the right wing you have collectivism as well, often under the banner of nationalism or religion. |
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Posted: 8/28/2015 7:33:01 AM EDT
[#8]
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Found the Statist! Quote HistoryQuoted:
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I think we are going to end up with a dual payer system like Australia, and we are going to be damn glad to have it. Basically you basic medical costs would be covered by a Medicare/Medicaid type program and higher levels of care are provided through private insurance. It would also be a good time to start taxing employer health care plans. Found the Statist! No. This guy is probably self employed, like me. |
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Posted: 8/28/2015 7:42:19 AM EDT
[#9]
Quoted:
...for sick people. This is an interesting question. Because it seems that we've pretty much accepted that it can only be handled by some sort of private (insurance) or public collectivism. The current business model relies on some form of collectivism. Is this the only solution? Thoughts? you might see single payer as the only solution if you didn't realize the current system was designed to eventually make people to beg for it its a textbook fabian socialist maneuver eta theres nothing wrong with collectivism if its voluntary |
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Posted: 8/28/2015 9:30:03 AM EDT
[#10]
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No. This guy is probably self employed, like me. Quote HistoryQuoted:
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I think we are going to end up with a dual payer system like Australia, and we are going to be damn glad to have it. Basically you basic medical costs would be covered by a Medicare/Medicaid type program and higher levels of care are provided through private insurance. It would also be a good time to start taxing employer health care plans. Found the Statist! No. This guy is probably self employed, like me. Turd world has that kind of system, 36 hours in the waiting room for free health care, coffee and donuts and quick service for those who pay |
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Posted: 8/28/2015 9:33:52 AM EDT
[#11]
When does FBHOcare start to collect on the amount on form W-2, Box 12, code DD? "Cost of employer-sponsored health coverage" is the official IRS definition, and they say it is for information only
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Posted: 8/28/2015 9:36:15 AM EDT
[#12]
Quote HistoryQuoted:
When does FBHOcare start to collect on the amount on form W-2, Box 12, code DD? "Cost of employer-sponsored health coverage" is the official IRS definition, and they say it is for information only
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Posted: 8/28/2015 9:57:35 AM EDT
[#13]
Here is the basic problem:
a) health care industry wants to absorb 22%-25% of GDP b) people are willing to only pay 15% of GDP for health care c) the grieving families of the dead have access to lawyers. |
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Posted: 8/28/2015 10:17:18 AM EDT
[#14]
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Healthcare costs surge when Government becomes involved. No one has a Constitutional Right to healthcare. period. People over consume when there are subsidies. Insurance is a big impediment to lower costs. Plus, we need tort reform. |
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Posted: 8/28/2015 10:35:54 AM EDT
[#15]
A couple of thoughts:
Everyone DOES have a 'right' to health care....but don't confuse that right to access with a right to have someone else pay for that access. You could run the system one of several ways: User pays. Pay out of pocket for small stuff, and for big stuff have 'real' insurance with limited government regulation (pooled risk, but your insurance doesn't kick in until a $10k deductible is met....). User pays. Pay a whole lot more for private insurance that covers everything (pooled risk, but with better benefits...no, or low deductible, etc.). Government Pays. One Health Insurance Provider (could be run either of the ways above...high or low deductible plan, then the Fed.Gov kicks in when the deductible is met), much greater cost overall in taxes. Government Controls. All medicine is a government agency...Docs, Nurses, etc. etc. are paid by the government, and are salaried employees (highest overall cost). Any one of which would be economically viable. But they must be discrete. In the first two cases...you don't pay, you don't get service....you can't hybridize (some people have to buy insurance...but then let people without insurance show up and get treated...or have some funded by the government and some by private insurance, then pay providers at different rates). Allow insurance to be sold nationwide...more competition to drive prices down. Eliminate a lot of paperwork not directly related to patient care....a 5 minute test shouldn't take 30+ minutes to get authorized, paperwork filled out, etc. Unfortunately, we've got some kind of bastardized/hybrid system... Some people have to buy their insurance...some get 'free' (Medicaid) insurance from the government...but that costs a lot to the taxpayer (the same people who have to actually buy insurance)...some get subsidized by the government (Obamacare exchanges with subsidies...the taxpayer also foots the bill for that)...and finally, you have Medicare...which sets the guidelines for everything, and controls prices for everyone.... AFARR |
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Posted: 8/28/2015 8:43:37 PM EDT
[#16]
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True insurance is not bad.Car insurance, for example. Pays for catastrophes, not oil changes. Health 'insurance' in the US is more like prepaid care for the sick, subsidized by the healthy. And made worse when the recipient doesn't have their own $$$ in the mix. The West has decided that healthcare, at some level, should be a perk of citizenship, and all are equal in that system. And that works when you ration care and set a budget. When the money is gone, it is gone and everything stops until the new fiscal cycle kicks in. I see the US going to a two tiered system, similar to the UK or Australia. You can see a public doc in a public hospital for 'free'. Of course, that is subject to .gov funding and staffing. Break a leg or have appendicitis? You will cared for rather promptly. Want your tonsils out or your knee replaced? Get on a list and wait. But if you don't want to wait, you pay out of pocket for a private doc at a private hospital. With the dumbing down of medicine, esp primary care, with NPs and PAs, such cheap care will be 'free' and the .gov all to happy to tell you how lucky you are. Want to see a trained physician or surgeon that does more than give a steroid shot or Z-pak? Get out your checkbook. +1 I keep thinking we're not going to have a two-tiered system like many people here postulate, but you guys are probably right. I grew up in Canada where until recently there was no medical care outside the government system except for some rare exceptions. As a doc, I'm going to work every day and I'll adjust to whatever system the people and government come up with. You can't fight the system. Posted Via AR15.Com Mobile |
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Posted: 8/28/2015 8:47:41 PM EDT
[#17]
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Ah ha! The typical Lib jab. Good one ol'boy. We will see how will that 40% or so tax on "Cadillac" health care plans work out, when they start getting canceled. Taxing meaning more government intervention only causes problems small, big, or medium but still problems. Our healthcare system is huge and massively regulated and no surprise it's a monster. There are many cogs in the wheel that need to be addressed but ultimately any system that mandates or oppressively taxes crushes freedom and the very foundation of liberty. Quote HistoryQuoted:
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So taxing my employer on my benefits would cause them increase my wages? Interesting concept. Except I don't see how that would work. The market is the most efficient in deciding where money goes not the government. The market did not decide to give preferential tax treatment to health insurance. The government did. Do try to keep up. Ah ha! The typical Lib jab. Good one ol'boy. We will see how will that 40% or so tax on "Cadillac" health care plans work out, when they start getting canceled. Taxing meaning more government intervention only causes problems small, big, or medium but still problems. Our healthcare system is huge and massively regulated and no surprise it's a monster. There are many cogs in the wheel that need to be addressed but ultimately any system that mandates or oppressively taxes crushes freedom and the very foundation of liberty. I was elected to the town budget committee and that's likely at the top of the agenda this year. Posted Via AR15.Com Mobile |
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Posted: 8/28/2015 8:50:54 PM EDT
[#18]
Quote HistoryQuoted:
In this case it was a long existing medication that was changed slightly to maintain a patent. I'm currently exploring my options for long term use, and I think I can just take the old stuff instead. Will ask the doctor next time. If we all paid out of pocket for it they wouldn't be able to get away with this bullshit. Quote HistoryQuoted:
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As someone who just got some serious sticker shock on new meds, I think I can see whats going on here. If I couldn't afford it, I'm sure some government program would cover all or a portion or the cost. My other option is to not buy it. Which of the two solutions will lower the cost of the medication? Thats the problem the situation is tricky. Eliminating all patents on medication could lower costs but that would significantly hinder innovation. The other would be where insurance companies would negotiate with pharm companies to lower costs. The latter is how european countries with single payer systems get their meds and other med tech, mostly. There are systems that people smarter than I would conceive of. In this case it was a long existing medication that was changed slightly to maintain a patent. I'm currently exploring my options for long term use, and I think I can just take the old stuff instead. Will ask the doctor next time. If we all paid out of pocket for it they wouldn't be able to get away with this bullshit. Wait . . . are you proposing a capitalist solution? 
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Posted: 8/28/2015 8:57:08 PM EDT
[#19]
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Or the confluence of two industries, like health care and insurance. Quote HistoryQuoted:
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"We want you to have more money to spend on healthcare by taxing it!" "We want you to have more guns by taxing it!" "We want you to drive your car more by taxing it!" You seem to be addressing the symptom not the disease. Healthcare costs have been on a steady rise due to further restrictions and regulations by the federal government. No cross state competition, federal healthcare plans that cost hospitals. Looking at healthcare one dimensionally though the lens of cost is a not a good way. Hyperbole, saying that the iron fist of government dealing with one of the most personal issues a person can have is wrong? Also many republicans are liberals but don't know it just like how many democrats are conservative. Nothing you have posted in this thread has availed your republicanism. I suppose you think things like tax breaks for solar panels are a great idea too, then. Thats a perfect example of why you don't try to manipulate the market with a tax policy that targets individual industries. Or the confluence of two industries, like health care and insurance. Or using insurance for what it was originally intended: catastrophic events. Posted Via AR15.Com Mobile |
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Posted: 8/28/2015 9:02:39 PM EDT
[#20]
Quote HistoryQuoted:
When the patient is the one paying for it, the market will quickly discover there is no need for a $1000 per month heart med that is 4% better than a $50 per month med. When there is a deep pocket willing to pay, why would a company sell it on the cheap? Quote HistoryQuoted:
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As someone who just got some serious sticker shock on new meds, I think I can see whats going on here. If I couldn't afford it, I'm sure some government program would cover all or a portion or the cost. My other option is to not buy it. Which of the two solutions will lower the cost of the medication? When there is a deep pocket willing to pay, why would a company sell it on the cheap? I deal with patients all the time who have no health insurance. It's actually fun trying to find the cheapest way to treat them. Like you point out, a newer drug may have less side effects but at 10 times the cost than an older drug. I already try to limit testing as much as I can, but with an out-of-pocket patient, I cut it down to the absolute bare bones. Posted Via AR15.Com Mobile |
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Posted: 8/28/2015 9:15:39 PM EDT
[#21]
Quote HistoryQuoted:
I deal with patients all the time who have no health insurance. It's actually fun trying to find the cheapest way to treat them. Like you point out, a newer drug may have less side effects but at 10 times the cost than an older drug. I already try to limit testing as much as I can, but with an out-of-pocket patient, I cut it down to the absolute bare bones. Posted Via AR15.Com Mobile Quote HistoryQuoted:
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As someone who just got some serious sticker shock on new meds, I think I can see whats going on here. If I couldn't afford it, I'm sure some government program would cover all or a portion or the cost. My other option is to not buy it. Which of the two solutions will lower the cost of the medication? When there is a deep pocket willing to pay, why would a company sell it on the cheap? I deal with patients all the time who have no health insurance. It's actually fun trying to find the cheapest way to treat them. Like you point out, a newer drug may have less side effects but at 10 times the cost than an older drug. I already try to limit testing as much as I can, but with an out-of-pocket patient, I cut it down to the absolute bare bones. Posted Via AR15.Com Mobile Walmart is opening cash clinics in stores. Fucking WIN. |
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Posted: 8/28/2015 9:17:48 PM EDT
[#22]
It should be simple - if you can afford treatment (at a price decided by an open competitive market) you get treatment. If you can't afford treatment then that's life (or not).
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Posted: 8/28/2015 9:19:15 PM EDT
[#23]
Quote HistoryQuoted:
A couple of thoughts: Everyone DOES have a 'right' to health care....but don't confuse that right to access with a right to have someone else pay for that access. You could run the system one of several ways: User pays. Pay out of pocket for small stuff, and for big stuff have 'real' insurance with limited government regulation (pooled risk, but your insurance doesn't kick in until a $10k deductible is met....). User pays. Pay a whole lot more for private insurance that covers everything (pooled risk, but with better benefits...no, or low deductible, etc.). Government Pays. One Health Insurance Provider (could be run either of the ways above...high or low deductible plan, then the Fed.Gov kicks in when the deductible is met), much greater cost overall in taxes. Government Controls. All medicine is a government agency...Docs, Nurses, etc. etc. are paid by the government, and are salaried employees (highest overall cost). Any one of which would be economically viable. But they must be discrete. In the first two cases...you don't pay, you don't get service....you can't hybridize (some people have to buy insurance...but then let people without insurance show up and get treated...or have some funded by the government and some by private insurance, then pay providers at different rates). Allow insurance to be sold nationwide...more competition to drive prices down. Eliminate a lot of paperwork not directly related to patient care....a 5 minute test shouldn't take 30+ minutes to get authorized, paperwork filled out, etc. Unfortunately, we've got some kind of bastardized/hybrid system... Some people have to buy their insurance...some get 'free' (Medicaid) insurance from the government...but that costs a lot to the taxpayer (the same people who have to actually buy insurance)...some get subsidized by the government (Obamacare exchanges with subsidies...the taxpayer also foots the bill for that)...and finally, you have Medicare...which sets the guidelines for everything, and controls prices for everyone.... AFARR http://volunteersinmedicine.org/volunteers-in-medicine-clinic-directory/ We need to maximize and incentivize volunteers in the medical field like this. As i understood the original clinics in S. Carolina the legislature devised special malpractice insurance limits. This is similar to how drugs get to places like Egypt. They license and Egypt manufactures with no liability to US drug company. If people are getting care for free I'd think limiting liability is a fair trade. Can't have it all. |
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Posted: 8/28/2015 9:29:59 PM EDT
[#24]
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http://volunteersinmedicine.org/volunteers-in-medicine-clinic-directory/ We need to maximize and incentivize volunteers in the medical field like this. As i understood the original clinics in S. Carolina the legislature devised special malpractice insurance limits. This is similar to how drugs get to places like Egypt. They license and Egypt manufactures with no liability to US drug company. If people are getting care for free I'd think limiting liability is a fair trade. Can't have it all. That makes sense with a lot of things. Our problem is our litigious culture. We've become "law" crazy, and it's killed personal responsibility. A general plain english disclosure that there are no guarantees should be enough. Unless a person can prove that fraud, or a malicious act was committed they shouldn't have a leg to stand on. People aren't perfect, doctors can make mistakes, the human body isn't a model T, results can vary. Our legal system is nuts, and it has completely fucked up our society. |
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Posted: 8/28/2015 9:33:21 PM EDT
[#25]
Quote HistoryQuoted: Not at all. People who pay for their own healthcare, either because they don't have insurance or have insurance with a very large deductible, just skip treatment. That's one reason why Americans die from things that are easily treated in other countries; people put off care because of the cost. When HMOs held the line on healthcare costs in the '90s, people hated them and doctors and hospitals banded together into conglomerates to gain market power and force the costs back up again. Many medical corporations now have effective monopolies in some areas, and monopolies are not much affected by consumer sentiment. Just look at Comcast. Anyone see them scrambling to lower prices and improve service? There's a fundamental flaw in a for-profit medical system; the goals of the provider and customer are diametrically opposed, and with their very lives at stake most people have little option but to pay. People want to live and be healthy, but doctors and hospitals only make money when they're NOT healthy. Profit motivates healthcare providers to want a sick population, not a healthy one. (Just as the security industry benefits from a frightened population.) And for the 'No one has a Constitutional right to healthcare/water/air' crowd, how is it that socialized healthcare is bad, but socialized police, fire, emergency services, and national defense are good? Quote HistoryQuoted: Quoted: I think if people just paid for health care, like they do other services, the prices would decline. They'd have to. Not at all. People who pay for their own healthcare, either because they don't have insurance or have insurance with a very large deductible, just skip treatment. That's one reason why Americans die from things that are easily treated in other countries; people put off care because of the cost. When HMOs held the line on healthcare costs in the '90s, people hated them and doctors and hospitals banded together into conglomerates to gain market power and force the costs back up again. Many medical corporations now have effective monopolies in some areas, and monopolies are not much affected by consumer sentiment. Just look at Comcast. Anyone see them scrambling to lower prices and improve service? There's a fundamental flaw in a for-profit medical system; the goals of the provider and customer are diametrically opposed, and with their very lives at stake most people have little option but to pay. People want to live and be healthy, but doctors and hospitals only make money when they're NOT healthy. Profit motivates healthcare providers to want a sick population, not a healthy one. (Just as the security industry benefits from a frightened population.) And for the 'No one has a Constitutional right to healthcare/water/air' crowd, how is it that socialized healthcare is bad, but socialized police, fire, emergency services, and national defense are good?  |
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Posted: 8/28/2015 9:33:24 PM EDT
[#26]
The collectivist model is not about healthcare. It is about advancing socialism and the need we all suffer together.
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Posted: 8/28/2015 9:35:58 PM EDT
[#27]
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Walmart is opening cash clinics in stores. Fucking WIN. Quote HistoryQuoted:
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As someone who just got some serious sticker shock on new meds, I think I can see whats going on here. If I couldn't afford it, I'm sure some government program would cover all or a portion or the cost. My other option is to not buy it. Which of the two solutions will lower the cost of the medication? When there is a deep pocket willing to pay, why would a company sell it on the cheap? I deal with patients all the time who have no health insurance. It's actually fun trying to find the cheapest way to treat them. Like you point out, a newer drug may have less side effects but at 10 times the cost than an older drug. I already try to limit testing as much as I can, but with an out-of-pocket patient, I cut it down to the absolute bare bones. Posted Via AR15.Com Mobile Walmart is opening cash clinics in stores. Fucking WIN. You could actually live inside a Walmart. 
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Posted: 8/28/2015 9:37:35 PM EDT
[#28]
Great idea...subsidize unhealthy habits... This can only end well.
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Posted: 8/28/2015 10:06:15 PM EDT
[#29]
So many who are against the collective healthcare payment system seem fine with how K-12 is paid for though.
I do not have kids and never will, but I am forced to contribute to educate your rug rats via my property taxes. BS!!!!! |
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Posted: 8/28/2015 10:08:41 PM EDT
[#30]
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So many who are against the collective healthcare payment system seem fine with how K-12 are paid for though.
I do not have kids and never will, but I am forced to contribute to educate your rug rats via my property taxes. BS!!!!! The brainwashing of the next generation is supposed to provide you some nebulous benefit, even though the average retard churned out by public schools can barely read, write, or do mental math. |
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Posted: 8/28/2015 10:09:53 PM EDT
[#31]
Quote HistoryQuoted:
I think we are going to end up with a dual payer system like Australia, and we are going to be damn glad to have it. Basically you basic medical costs would be covered by a Medicare/Medicaid type program and higher levels of care are provided through private insurance. It would also be a good time to start taxing employer health care plans really, really hoping you don't get sick. |
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Posted: 8/28/2015 10:16:47 PM EDT
[#32]
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So many who are against the collective healthcare payment system seem fine with how K-12 are paid for though.
I do not have kids and never will, but I am forced to contribute to educate your rug rats via my property taxes. BS!!!!! Read for yourself, it's historic. Nearly all states mandated education and found virtue in implmenting it through legislation and taxation of some sort. A few states don't have property taxes so obviously you'd be safe there. http://pabarcrc.org/pdf/Molly%20Hunter%20Article.pdf |
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Posted: 8/28/2015 11:42:17 PM EDT
[#33]
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The brainwashing of the next generation is supposed to provide you some nebulous benefit, even though the average retard churned out by public schools can barely read, write, or do mental math. Quote HistoryQuoted:
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So many who are against the collective healthcare payment system seem fine with how K-12 are paid for though.
I do not have kids and never will, but I am forced to contribute to educate your rug rats via my property taxes. BS!!!!! The brainwashing of the next generation is supposed to provide you some nebulous benefit, even though the average retard churned out by public schools can barely read, write, or do mental math. They really do seem more of an indoctrination camp. A place where children are taught to obey, and follow direction from authority. The amount of real education covered in these mills could probably be taught in 2-3 hours per day. But the kids must pass through this "factory" to make them ready to fit society. They must be taught what to think. In Georgia the curriculum is at least 50% propaganda. New generations of kids are taught about the sins of their fathers. I'm floored how much time is spent on black history. Not that there is anything wrong with it, it's part of history. But they spend a lot of time on a subject, seemingly trying to keep something going. They spend much time on the civil rights movement than the revolution. About the civil war more is taught about Harriet Tubman, the underground railroad, and slavery than any other aspect. That's just one obvious example but there are many. Some obvious some subtle. Like word problems with africanized first names (not african mind you, made up ghetto names), or they use third-world names. It seems that they go to great lengths to...change things. My wife's cousin is a public school teacher, and she's talked about it at great length. |
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Posted: 8/29/2015 11:05:25 AM EDT
[#34]
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Snip... http://volunteersinmedicine.org/volunteers-in-medicine-clinic-directory/ We need to maximize and incentivize volunteers in the medical field like this. As i understood the original clinics in S. Carolina the legislature devised special malpractice insurance limits. This is similar to how drugs get to places like Egypt. They license and Egypt manufactures with no liability to US drug company. If people are getting care for free I'd think limiting liability is a fair trade. Can't have it all. Might help. However, Physician salaries are only about 8% of the health care dollar....tests, equipment, etc. is very, very expensive. Even volunteers can't cut too much off the top at that rate. Oh, and it's a great deal more complicated than just licensing to Egypt. Other countries will refuse patents and then allow their domestic makers to produce 'generics' (and, as the patent info covers most of the 'recipe' to develop the drug, very easy for them to do). So if that (say) Sovaldi pill costs $80,000 for a course of treatment in the US (almost $1k per pill)...and the US Maker goes to Egypt and says 'here's our research and patent application..'...and the Egyptian government says 'sorry, no patent...that's not a 'new drug'...but if you sell it to us for $300 for the course of treatment we'll let you sell it here and not allow our manufacturers to make the generic version. |
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Posted: 8/29/2015 1:41:54 PM EDT
[#35]
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Might help. However, Physician salaries are only about 8% of the health care dollar....tests, equipment, etc. is very, very expensive. Even volunteers can't cut too much off the top at that rate. Quote HistoryQuoted:
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Snip... http://volunteersinmedicine.org/volunteers-in-medicine-clinic-directory/ We need to maximize and incentivize volunteers in the medical field like this. As i understood the original clinics in S. Carolina the legislature devised special malpractice insurance limits. This is similar to how drugs get to places like Egypt. They license and Egypt manufactures with no liability to US drug company. If people are getting care for free I'd think limiting liability is a fair trade. Can't have it all. Might help. However, Physician salaries are only about 8% of the health care dollar....tests, equipment, etc. is very, very expensive. Even volunteers can't cut too much off the top at that rate. The malpractice limits would have to be tiny to non-existent, otherwise it would be hard to get enough on board to volunteer enough to take care of the patient load. I am careful about ordering tests as it is, and I would be even more so when the patient had no insurance, but as you point out, the cost of health care is almost all pills, testing, etc. What causes so much testing is the fear of lawsuits. There is no disincentive to ordering tests as of now, so many docs order them without regard to cost. I see about 2/3 of the number of patients my partner does but he orders 7 times more tests. I don't know if you know more about the new HMO type of initiatives going on? I'm hearing a lot of grumblings about it from the hospital administrators. Supposedly there are big cuts coming with this new model. |
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Posted: 8/29/2015 1:44:22 PM EDT
[#36]
Quote HistoryQuoted: Healthcare costs surge when Government becomes involved. No one has a Constitutional Right to healthcare, provided by money taken from someone else. period. |
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Posted: 8/29/2015 1:52:21 PM EDT
[#37]
Just a rant, but calling it "insurance" is something that annoys the fuck out of me.
I can't call State Farm the day after my cabin burns down and buy fire insurance. That, however, is exactly what forcing "insurance" companies to cover "pre-existing conditions" is. Only a fucking moron thinks it is reasonable to make State Farm sell insurance to someone after the fire, then pay for rebuilding after the "pre-existing" fire, yet we still act like health care is insurance. It isn't insurance. It is a scam to get healthy people to pay for the sick people, while the insurance companies skim a few billion off the top. If it was insurance, my healthy BMI 45 year-old self wouldn't pay nearly what I do, as I would be in an appropriate insurance pool with other healthy people and pay an appropriately low premium, similar to a preferred driver who hasn't had any tickets or accidents for years. [/rant] |
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Posted: 8/29/2015 1:57:02 PM EDT
[#38]
Healthy people are already paying and subsiding the poor and the sick.
We have been for a long time. The way our health care is structured, the healthy are picking up the tab (paying higher premiums, higher bills when they get medical services) to offset the costs of those that don't pay. We already are doing it. We have been for awhile. to think otherwise is foolish. |
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Posted: 8/29/2015 2:11:17 PM EDT
[#39]
Look, it's all right here. Medicine will become affordable again when both patients and physicians embrace the following formula. High deductible plan + cash medical practices. Just one example of many- Kids $10/month Adults $50/month Unlimited care https://m.youtube.com/watch?v=kJHgm72LeU4 https://m.youtube.com/watch?v=cXBUZ9yFu6w |
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Posted: 8/31/2015 7:43:27 AM EDT
[#40]
Quote HistoryQuoted:
Snip..... I don't know if you know more about the new HMO type of initiatives going on? I'm hearing a lot of grumblings about it from the hospital administrators. Supposedly there are big cuts coming with this new model. You mean the new GCF (Giant Cluster-Fuck) Model...aka the Accountable Care Organizations (ACO)? In my limited understanding... Despite the repeated failures of the HMO models, Medicare has decided it's the best way to go... So, eventually everyone (presumably within a geo-political boundary) on Medicare will have to become part of an ACO...that's hospitals, doctors, etc. etc...you could remain outside the system but that would likely have very, very deleterious effects on practice income (*****more on that in a minute). So...all Medicare patients have to join an ACO. Medicare funds the ACO based on the patients diagnosis (and presumably age, etc.). The ACO is then responsible to manage that pool of $$...if they spend less on care, then a profit is made. Spend more...then money is lost. The ACOs will be based around Primary Cares, and specialists/hospitals/testing centers have to join to get referrals (or keep the patients in the 'in house' facilities to save $$). Medicare likes it because it's flat fee...1000 Diabetic Patients...we'll pay $$$$. 1000 Healthy Patients, we'll pay $$....oh, you had 100 of those healthy patients suddenly need liver transplants....well tough shit...you got your money already.... The deficiencies should be pretty glaring..avoid tests/specialists to save $$, exclude or dump patients who have severe conditions (or any 'heavy user' in the system). If you're a specialist and don't join...you probably won't get many referrals.... The ACO test runs apparently worked...for limited patient numbers and with healthy patients. A good summary: http://khn.org/news/aco-accountable-care-organization-faq/ Some of the pioneer participants are dropping out...because they're going to lose money: http://www.healthcare-informatics.com/article/breaking-news-medicare-s-pioneer-aco-program-loses-three-more-participants |
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Posted: 8/31/2015 7:49:44 AM EDT
[#41]
Quote HistoryQuoted:
I don't think the medical inflation is only due to government. But I agree that's an aggravating factor. I believe it doesn't respond to normal economic pressures because of third-party payers isolating the consumer from the full financial impact of their choices. I think if people just paid for health care, like they do other services, the prices would decline. They'd have to. Because healthcare providers are paid by "pooled" payers, they can charge a much higher price then they'd otherwise be able to charge. Young healthy people pay for sick older people. I'm closing in on 50, and I'm healthy. I've not had any health problems, or needed any major medical procedures, nothing I couldn't have paid for out of pocket at the point of service at fraction of the cost of my annual insurance premium. No I realize I might be a little more healthy then many. But I have to believe most people are still in the same boat. Especially younger people in their 20 and 30's. Most of the really expensive healthcare occurs in the last decades, or years of life ...for most people. The system depends on most people just paying very expensive premiums, and not costing that much. So even private insurance is collectivism. Quote HistoryQuoted:
Quoted:
Healthcare costs surge when Government becomes involved. No one has a Constitutional Right to healthcare. period. I don't think the medical inflation is only due to government. But I agree that's an aggravating factor. I believe it doesn't respond to normal economic pressures because of third-party payers isolating the consumer from the full financial impact of their choices. I think if people just paid for health care, like they do other services, the prices would decline. They'd have to. Because healthcare providers are paid by "pooled" payers, they can charge a much higher price then they'd otherwise be able to charge. Young healthy people pay for sick older people. I'm closing in on 50, and I'm healthy. I've not had any health problems, or needed any major medical procedures, nothing I couldn't have paid for out of pocket at the point of service at fraction of the cost of my annual insurance premium. No I realize I might be a little more healthy then many. But I have to believe most people are still in the same boat. Especially younger people in their 20 and 30's. Most of the really expensive healthcare occurs in the last decades, or years of life ...for most people. The system depends on most people just paying very expensive premiums, and not costing that much. So even private insurance is collectivism. First off, there is a maximum providers can charge, and it is based off Medicare/Medicaid reimbursement rates. Second, the gov reimbursement rates are a joke. My wife charges $130 for a followup visit and if someone is on public healthcare she'll be lucky to see about $70. Private insurers pay a little more. btw, gov reimbursement is absolutely the worst to work with, too. Lowest reimbursement rates, take the longest to pay, will reject a claim if you literally did not cross a t or dot an I. It's ridiculous. |
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Posted: 8/31/2015 10:18:19 AM EDT
[#42]
Quote HistoryQuoted:
First off, there is a maximum providers can charge, and it is based off Medicare/Medicaid reimbursement rates. Second, the gov reimbursement rates are a joke. My wife charges $130 for a followup visit and if someone is on public healthcare she'll be lucky to see about $70. Private insurers pay a little more. btw, gov reimbursement is absolutely the worst to work with, too. Lowest reimbursement rates, take the longest to pay, will reject a claim if you literally did not cross a t or dot an I. It's ridiculous. Quote HistoryQuoted:
Quoted:
Quoted:
Healthcare costs surge when Government becomes involved. No one has a Constitutional Right to healthcare. period. I don't think the medical inflation is only due to government. But I agree that's an aggravating factor. I believe it doesn't respond to normal economic pressures because of third-party payers isolating the consumer from the full financial impact of their choices. I think if people just paid for health care, like they do other services, the prices would decline. They'd have to. Because healthcare providers are paid by "pooled" payers, they can charge a much higher price then they'd otherwise be able to charge. Young healthy people pay for sick older people. I'm closing in on 50, and I'm healthy. I've not had any health problems, or needed any major medical procedures, nothing I couldn't have paid for out of pocket at the point of service at fraction of the cost of my annual insurance premium. No I realize I might be a little more healthy then many. But I have to believe most people are still in the same boat. Especially younger people in their 20 and 30's. Most of the really expensive healthcare occurs in the last decades, or years of life ...for most people. The system depends on most people just paying very expensive premiums, and not costing that much. So even private insurance is collectivism. First off, there is a maximum providers can charge, and it is based off Medicare/Medicaid reimbursement rates. Second, the gov reimbursement rates are a joke. My wife charges $130 for a followup visit and if someone is on public healthcare she'll be lucky to see about $70. Private insurers pay a little more. btw, gov reimbursement is absolutely the worst to work with, too. Lowest reimbursement rates, take the longest to pay, will reject a claim if you literally did not cross a t or dot an I. It's ridiculous. Yep...try $35 from the State Medicaid programs (privately run now...Amerihealth Northeast, Geisinger Family, Coventry Cares) for a 99213 ('office visit'...low to moderate complexity). Government sets price controls. Qweevox isn't entirely wrong that if the government (and insurance companies) got out of the system, prices would come down...and probably substantially. If you figure that the new Obamacare requirements allow the insurance companies to keep 20% for their administration and profits (i.e...80% of what they take in has to go out in claims)...and then figure that the Doctors office, Hospital, etc. has a substantial cost in paperwork to get paid...prices would likely drop by about 40% or 50% just due to the reduction in paperwork requirements. AFARR |
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Posted: 8/31/2015 10:20:36 AM EDT
[#43]
Well, by its very nature, health insurance is the definition of collectivism.
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Posted: 8/31/2015 10:27:48 AM EDT
[#44]
Quote HistoryQuoted:
Insurance was invented by ship owners who new that a certain percentage of their ships would founder in heavy seas, and that by socializing the risk they could survive the otherwise unsurvivable. So insurance is supposed to be for catastrophes, not for things like regular maintenance? Got it. Why isn't health insurance more like that? |
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Posted: 8/31/2015 10:33:40 AM EDT
[#45]
Quote HistoryQuoted:
Found the Statist! Quote HistoryQuoted:
Quoted:
I think we are going to end up with a dual payer system like Australia, and we are going to be damn glad to have it. Basically you basic medical costs would be covered by a Medicare/Medicaid type program and higher levels of care are provided through private insurance. It would also be a good time to start taxing employer health care plans. Found the Statist! Not really. If compensation in the form of wages/salary is taxed, why shouldn't compensation in the form of other benefits like health insurance? If you agree with the first premise (income tax is the right thing to do) then why not the second (tax health insurance as income)? |
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Posted: 8/31/2015 10:38:24 AM EDT
[#46]
Quote HistoryQuoted:
The other would be where insurance companies would negotiate with pharm companies to lower costs. The latter is how european countries with single payer systems get their meds and other med tech, mostly. Isn't this why we are where we are? If a procedure would/should cost about $200 and the insurance companies have negotiated a $100 rate (while medicaid has decided to only pay $50), what happens to the "cash" price? They guy that walks in without the backing of insurance or the government gets stuck paying much more than a "fair market" price would be and many, many times more than other entities have negotiated down. |
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Posted: 8/31/2015 10:40:46 AM EDT
[#47]
Solution? Tort reform.
HMOs are a burden to society. |
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Posted: 8/31/2015 10:45:31 AM EDT
[#48]
I came across a study out of MIT that concluded that health care costs really took off in the 60's,
after the advent of Medicare and Medicaid. Shocking, right? |
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Posted: 8/31/2015 10:58:47 AM EDT
[#49]
Quote HistoryQuoted:
Solution? Tort reform. HMOs are a burden to society. Does nothing, empirically speaking. They put caps and pre-filing expert certification requirements for med mal cases in place in my state years ago. Hasn't changed malpractice insurance premiums or prevailing community rates for charges one bit. Malpractice is decimal dust compared to the much larger forces at work in this equation. And no, I don't do med mal (on either side) and have no dog in that fight. I do represent a number of physician groups and surgery centers in a very specific area of billing disputes though. |
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Posted: 8/31/2015 11:07:18 AM EDT
[#50]
Quote HistoryQuoted:
Just a rant, but calling it "insurance" is something that annoys the fuck out of me. I can't call State Farm the day after my cabin burns down and buy fire insurance. That, however, is exactly what forcing "insurance" companies to cover "pre-existing conditions" is. Only a fucking moron thinks it is reasonable to make State Farm sell insurance to someone after the fire, then pay for rebuilding after the "pre-existing" fire, yet we still act like health care is insurance. It isn't insurance. It is a scam to get healthy people to pay for the sick people, while the insurance companies skim a few billion off the top. If it was insurance, my healthy BMI 45 year-old self wouldn't pay nearly what I do, as I would be in an appropriate insurance pool with other healthy people and pay an appropriately low premium, similar to a preferred driver who hasn't had any tickets or accidents for years. [/rant] A policy is like a winning lottery ticket, especially when subsidized. And advocates are not shy about promoting it that way. it's not unlike selling an auto policy to a serial car wrecker or life insurance to a 2pack a day smoker for the same price as any other customer. |
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