You know why health care is so expensive?  Because most don't pay for it.  And there are too many lawsuits.



If you work healtcare, you have seen the CYA BS, from stick-reduction needle programs (guards on needles etc) to disposable tools.  Then you have the people abusing the emergency departments, ambulance services and drug seekers.



People think health care is a right yet they don't take care of  themselves.



We could spend ourselves blind

       
 

STOP CALLING IT "SINGLE PAYER." THAT IS A PALATABLE EUPHEMISM.

CALL IT WHAT IT IS: SOCIALIST MEDICINE.

Even non-profits can make a profit - the difference is that all of it has to go back into the corporation.

People who are not in the industry do not understand the sheer amount of bullshit.

Bernie Sanders

OK, so how do we turn it around on them?

We can't wait until 2014.  Too much damage will be done by then.  We need to act now and get the ball rolling.

A lot of damage has been done already. It'd take years to "rework" insurance back to how it was, if it's even possible.

And many medical companies, including my own, are focusing more on overseas markets now. Not even bothering to try for FDA trials, because we can't make a profit here.

Lawsuits are only a tiny, tiny part of the equation. You could completely ban med mal suits - give docs complete immunity - and it would shift things only a few percent at best. In states (including mine) that enacted caps, pre-filing certification, etc. the effects on both med mal insurance premiums and overall costs have been negligible.

In addition to the first reason you state - that most people don't actually pay for it, so the "sticker" price for everyone else gets raised to cover the whole pie - the other factor that people seem to overlook is that medicine is far more advanced today than it was decades ago. Health care used to be cheap because things like MRIs didn't exist (or were rare), when you got old your knees/hips just hurt and that was part of being an old fart and replacement surgery wasn't an option, and so on. Oh, you have brain cancer? Today you have all kinds of sophisticated gamma knife procedures and such - 30 years ago it was "Sorry, put your affairs in order."

So, in sum, people today feel entitled to expensive and sophisticated levels of care but only a minority can actually pay the true cost. So now the government is attempting to force a redistributive system upon the entire population. They're just doing it piecemeal by starting off with mandatory "private insurance" as the vehicle.

When the high premiums, high deductibles, high copays, and limited access (no, you can't keep your doctor) start hitting everyone's wallet the screaming will start.

So basically they want the people who can pay to pay and those that cannot pay will get it free or subsidized.
Of course this means those that can pay will pay not only for themselves but for the free care and the subsidized care.
So it is Obamacare just scaled up

Been that way for a while. They're just restructuring and reorganizing that bargain now.

Yep. But combined with the 80/20 rule, it would mean that the bulk of the money has to be spent on patient care and not kept as profit. Which should mean that the cost to the individual goes down. But then, the healthcare system was never about caring for people as much as it was about making money.

Yes, well said.

I guess you don't realize that non-profit organizations can and do pay their staff. The non-profit status just means they don't have owners or stockholders and don't pay dividends, etc.

Even if he officially switched parties they would report him as the "one-time Republican, Colin Powell".

oh FUCK no.

I've been following this dude from Australia that made a short documentary about the fallacy of anthropogenic climate change, and he's commented on a lot of things. Including single-payer healthcare in Australia.

He said he realized a few years ago that he wasn't getting good rest while sleeping, so over a year ago he goes to see a doctor. Doc says he needs to have his tonsils out and that should clear him up. He just had the surgery last week after waiting for it since July. Of 2012. Almost a year and a half. He's had to deal with either sleep that isn't restful or using a second-hand machine.

In the US, you'd have that shit done inside two weeks.

And the incentive to innovate new products to be competitive is...?

You'll attract the best and brightest to the industry with...?

Calling Powell a republican is about like calling Rachael Maddow a fucking super model.

Exactly.

Taking risk and seeking profit is what drives innovation and is what made our country the greatest in the world. The socialists/marxists decided that's not how things should work. That experiment has been tried and failed, yet the brainwashing that continues in our education system has succeeded - we have a socialist in his second term and we will pay dearly for that.

Why do drugs cost so much more here and so little elsewhere?

Is it possible the other places have the screwed up systems and big pharma simply makes us (the U.S.) foot the bill?  If that's the case and you eliminate the ability to earn profits here, then you will simply put them out of business or socialize them.

That would be just great. People will of course just lineup in droves to invest (risk) millions of $'s in R&D costs on the front-end for the new American dream of not earning a profit when one of the projects yields fruit for the newly turned non-profit pharmaceutical company.

You can't maintain the same quality of care and drive for tech advancement if you take the profit incentive out of the equation.

Insurance has eliminated much of the price competition in the marketplace.  The consumer rarely looks at the economics of health care past the insurance premium or co-pay statement he gets in the mail.

So you have this mutually exclusive paradigm where people think they have the right to the labor of another person (healthcare providers - which must necessarily include the manufacturers of healthcare products) but then also say that those providers/laborers have the right to be paid.  So how can you guarantee the right to be receive and the right to be paid?  Only by government control of production, access and price.  There is no need for insurance under this scenario.  The government becomes the payer and forces everyone to adhere to its price structure.  The question is what does government do when people have options in terms of their vocation?  

When the smart people who could be doctors and scientists and researchers no longer choose to engage in the medical field because there is no profit motive for them, who fills the vacuum?  If you are lucky, the next tier down in terms of smart people.  So you have degradation in the quality of care and less advancement.  That's if you are lucky.  If that tier of people don't see enough personal gain opportunity, you might simply have vacancies...which means the right to healthcare is thwarted because the workers aren't in the fields anymore.  So then what does government do?

If it's serious about providing care, it starts to either attract or force people into the field.  But to attract means it would have to create a profit incentive.  Which it can't do without increasing payments, which means more tax dollars into healthcare.  And since we can always count on government to opt first for belt tightening in other areas before it raises taxes....

So government either raises taxes to pay more or it simply forces people into the field.  It could try to force people into it by regulating other industries as well and criminalizing the practice of medicine outside of it's approved regulatory price and payment plan.  And raising taxes really isn't that different because raising taxes simply forces the tax payer to give up on his profit incentive, he just does so on his net income statement after government withholds more and more of his earnings.

So in closing: you don't know the answer because there is no answer.  You cannot guarantee someone the right to the fruits of someone else's labor and also claim that the laborer has the right to be compensated for his.  At some point in that tug of war the government decides that someone actually isn't entitled to the fruit (via rationing and death panels) or someone actually isn't entitled to be paid (cost controls, criminalization of unapproved services and compulsory service).

These are glorious times we're living in.  Tribalism is beating the shit out of civilization.

The word don't mean what it used to.

I sit on the board of a non-profit.  It only pays those salaries because it gets grant money and donations.  So where does the investment money come from for non-profit medical service providers?  Who pays to build a new syringe factory?

Also, the NFL may be non-profit.  But that's actually a bit of a misleading argument as well.  Because the teams which comprise the NFL are not non-profit.  And they pay in to the NFL coffers to keep the NFL going.  The NFL would not and could not exist without for-profit teams propping it up.  So then what are the NFL team equivalent in this brave new healthcare system of non-profit pharmaceutical companies and medical clinics?

You are partially right in that non-profit regulation as currently formulated isn't exactly non-profit.  It's more about labeling those funds that would be considered profits in a for-profit venture.  The difference, from what I can gather as a non-accountant, is that the non-profit hangs on to the money to self-invest in itself rather than return those profits to owners/shareholders so they can re-invest that $ in other places in the marketplace.  So I suspect what you would want to "fix" in the non-profit regulatory scheme would be to truly make them non-profit.  But then that feeds right back into the same problem.  There is risk in the marketplace, even the non-profit marketplace.  And there is a limit to what people will voluntarily risk, particularly when there is no profit potential for them.  So then it still all falls back to government paying for it with tax dollars.  Which it can only do on such a large scale by socialization of the industry.

Allow health insurance plans to be sold across state lines, and make pre-tax HSAs easier to get.
Allow providers and facilities to deny all but life-critical care to the uninsured.

That solves about 87% of the "problem" right there.  Medical tort reform takes care of most of the rest.

So what's your solution? Let physicians kill people or cause them permanent harm because...well...they're doctors?

Tort reform is just as easy to toss around as a general idea as is healthcare reform.  The devil IS ALWAYS in the details.

Fuck these guys!  They never learn that everything they touch turns to complete and utter shit!

And not even the good kind that you could use as fertilizer...

Just utterly useless SHIT!

That is as much a strawman as the tired liberal canard of welfare reform entailing "children dying in the street". Don't do that. It's ridiculous.

As it is, sleazy trial lawyers are ready to help someone file suit against a doctor who saved their life because they'd not regained full use of their pinky.

I wouldn't get too excited about this bill. Bernie isn't in touch with the reality of THIS universe.
While I'm sure that the country will be subjected to government controlled medical treatment, the people who decide these things aren't going to use Bernie as the messenger boy.

Good posting!

Tort is extortion's middle name.

Did he talk to doctors?

And calling him a Republican, c'mom man!!!

I've made this argument here before I think:

Pell grants, heavily subsidized loans, and other government programs have very nearly created a de facto single payer system for higher education in the US.  Look at how much tuition costs have skyrocketed.

Exactly.  And your mistake is in assuming that it should be about other than making money.

If you don't think so, how soon can we expect you to re-sign from your own current for-profit job to work for free in a medical clinic?  How much money could they save if you would just donate your time and labor to the cause?  You don't have to be a doctor.  You could volunteer a day each weekend to do their janitorial work and help them reduce costs.

Why is it that everyone is an expert on how the other guy is too greedy?

"In single-payer systems, the government pays for most non-elective medical care. Supporters say adopting that tax-financed model would improve care and dramatically reduce costs by eliminating overhead and insurance company profits."




I had to audit and generate financial statements for governments. I could run a business with an 80% profit margins and still offer anything cheaper, higher quality, and more efficient than government could ever dream of.

LOL, reduce costs by eliminating profit. Profit driven gets shit done. You know all those jokes about the DMV? Want your medical care to operate like the DMV? Me either.

Is that how they do it in Portugal and Denmark?

This.

Know how I know you have zero experience in this realm?

If the doctor caused that loss through his negligence, why shouldn't he compensate his victim?

What you are trying to imply, perhaps, is that the guy's pinky really isn't hurt.

But then that's an issue of proof.  Is it not?  So do you really think you can micro-manage jury deliberations through some top-down regulatory structure?

Just like with the CYA diagnostic procedure argument, your argument sounds good, but it's a bit faulty in the details.  For there to be malpractice, there has to be a deviation from the accepted standard of care which caused injury to the victim.

The two big hurdles for the plaintiff are in proving that 1) the physician deviation from accepted practices for that type of procedure and 2) that deviation was the cause of injury.

So that CYA MRI isn't really a CYA MRI if 1) it should have been done by accepted medical standards and 2) the failure to have that MRI resulted in injury that would have been avoided had it been performed.

Think about it.  We're describing it as a CYA MRI that didn't really need to be done but yet had it been done, the doctor would have seen something that would have saved the patient from injury or harm.  If the MRI would have made a difference, then it wasn't a frivolous MRI, was it?

If the patient can't prove both those elements, the case won't even make it to trial in most states.

And if there is one field where insurance companies do fight tooth and nail, it's in medical malpractice.  So they don't really pay out thousands and millions of dollars in frivolous settlements.  They take cases to trial.  And they only get a verdict against their insured if a jury, by definition, determined that it wasn't a frivolous lawsuit.

Good posting.

Other than dealing with shithead sleazebag "law centers" all the time, making them take stolen IP off their shitty websites?

 

Like I said.

13er who has some peripheral connection to the world and thinks he know how it works.

You clearly do not have any clue how much it costs a plaintiff's lawyer to actually pursue a med mal case. Even the sleaziest of lawyers isn't going to spend the tens of thousands of dollars needed just to prepare a case, let alone the $100K+ to fully litigate one, over something trivial. They'd be out of business in a week.

We do a lot of OEM work for the larger companies. I have heard the same exact thing from  several other medical device companies. They are leaving the US due to US Govt over regulation,  taxations loss of profit. The liberals just dont get it.

Socialized medicine and total takeover of the economy is the plan.

Wow, you've been on this board longer. WOW! Not like I've been in this industry for well over a decade, dealing with that.  

And I'm guessing you're a lawyer of the very sort I'm mentioning, or associated with/working for a firm that deals with such things?

Yes. We have some amazing new stuff coming out. One uses natural materials to pretty much end the chance of postop organ adhesion.

We are not selling it in the US. Only overseas. Both due to the cost and snail-pace time of the FDA approvals that have nothing to do with safety, and due to the fact that it is subject to the device tax on sales before profit, and we're unwilling to take that kind of hit in the first few years of a new product's adoption. Americans will miss out on the latest and best tech that improves recovery and reduces complications. The profit is overseas, not in the US, thanks to government.

Now there's no more oak oppression, for they passed a noble law.  And the trees are all kept equal, by hatchet, axe and saw.