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Equality 7-2521 View Drop Down
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Points: 15784 		Direct Link To This Post Posted: March 25 2010 at 05:08
Originally posted by The T The T wrote:

Originally posted by Equality 7-2521 Equality 7-2521 wrote:

To answer your first unnumbered question before I go to sleep:

1) Allow health care to be purchased across state lines. This is one of the most obvious things.
2) Tort reform is overblown in what its effectiveness will be, but is still important.
3) End tax penalties levied against those who provide their own insurance.
4) Do away with government mandated liscencing requirements for med schools, hospitals, doctors etc. This will flood the market with supply and force downward pressure on costs.
5) Eliminate restrictions which prevent insurers from deeming certain personal activities as uninsurable risks.
6) (I'm for the abolition of the FDA but at least) relax FDA standards to allow quicker entry of legit care  and preventative medicine into the marketplace.
7) A general move towards individual, rather than business, provided healthcare. 

While all of this sounds ok, assuming the model to follow is an insurance, for-profit one (which I guess, sadly -in my view- it's the logical for the American view of things), do you agree with some regulation as in, for example, denying insurance for pre-existing conditions? And if you don't consider any kind of regulation acceptable, what is an alternative that this market would create for people who fall in that category (sick people, the ones who need health services the most)? 

I believe in no regulation at all. The problem of pre-existing conditions is a tricky one. The current solution of forcing companies to take people regardless of their conditions is rather absurd though. This will only force companies to take on people who cannot be insured without the company suffering negative profit. The costs will then be born by healthy individuals in the 20-30 range. Certainly this is not a just solution to the problem.

If the market were unregulated and government endorsed business provided health care was not the norm, then the problem of pre-existing conditions could be offset by buying longer term insurance policies. The way it works now is that you get very sick, and because so you cannot work and loose your job. Becuase your employer gives your insurance you are now uninsured, and because of your condition, cannot be accepted by another plan. Individual insurance does not have this problem. You can purchase long-term plans that are not dependent on your ability to work.
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Points: 15784 		Direct Link To This Post Posted: March 25 2010 at 05:10
Originally posted by Negoba Negoba wrote:

Originally posted by The T The T wrote:

Originally posted by Equality 7-2521 Equality 7-2521 wrote:

To answer your first unnumbered question before I go to sleep:

1) Allow health care to be purchased across state lines. This is one of the most obvious things.
2) Tort reform is overblown in what its effectiveness will be, but is still important.
3) End tax penalties levied against those who provide their own insurance.
4) Do away with government mandated liscencing requirements for med schools, hospitals, doctors etc. This will flood the market with supply and force downward pressure on costs.
5) Eliminate restrictions which prevent insurers from deeming certain personal activities as uninsurable risks.
6) (I'm for the abolition of the FDA but at least) relax FDA standards to allow quicker entry of legit care  and preventative medicine into the marketplace.
7) A general move towards individual, rather than business, provided healthcare. 

While all of this sounds ok, assuming the model to follow is an insurance, for-profit one (which I guess, sadly -in my view- it's the logical for the American view of things), do you agree with some regulation as in, for example, denying insurance for pre-existing conditions? And if you don't consider any kind of regulation acceptable, what is an alternative that this market would create for people who fall in that category (sick people, the ones who need health services the most)? 
 
Staying under an insurance model and then saying you can't choose who to insure is one of the wierdest ideas ever. But yet it's part of the system both before and after the reform bill. The market, like natural selection, works when non-viable entities die off.
 
The libertarian ideal, I think, is that those in need can be cared for only by the voluntary giving of those with resources. Forcing anyone to give up their resources involuntarily is essentially unacceptable.
 
I disagree with these ideas, but I am working as hard as I can to understand them.

This too. I believe that many of these cases should be picked up by public charity and voluntary groups. Forcing others to pay for someone else's problems is never right.
"One had to be a Newton to notice that the moon is falling, when everyone sees that it doesn't fall. "
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Points: 24429 		Direct Link To This Post Posted: March 25 2010 at 05:56
Originally posted by The T The T wrote:

 
I disagree with these ideas, but I am working as hard as I can to understand them.. I do understand where they come from. And it's sociological and psychological and  maybe even biological... This is the way here. Changing it will take a LOT of miracles to occur.... 

(Maybe in 2050 when the minorities are the majority this way of thinking will expire.... Tongue)
[/QUOTE]

Sorry for chopping off most of your post, Teo, but I'd like to reiterate that I'd rather avoid seeing references to 'biological' or 'genetic' attitudes in a given population. There are Americans who disagree profoundly with the whole for-profit mentality, and they are many more like that than one might expect.  I once saw a similar remark about Italians being genetically predisposed to cheating and dishonesty, and it didn't make me happy at all. This is a very slippery slope... Cultural conditioning can be extremely strong, and deeply rooted, but it has nothing whatsoever to do with biology.
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Points: 29630 		Direct Link To This Post Posted: March 25 2010 at 06:59
G.O.P. Forces New House Vote on Package of Health Bill Changes Based on Minor Parliamentary Challenges in the So-Called "Sidecar" Reconciliation HCR Alterations to the Now-Passed and Signed Senate Bill
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Edited by Slartibartfast - March 25 2010 at 06:59
Released date are often when it it impacted you but recorded dates are when it really happened...
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Points: 5208 		Direct Link To This Post Posted: March 25 2010 at 07:53
Instead of creating a bigger nested comment, I'll just make a few comments.
 
One of the big problems I see is negotiated pricing. Each insurance company pays a different amount for a given sevice (say one hospital day on the general medical floor). Often this is a negotiated "discount" between the company and a hospital (say 60%). Of course what happens is then the hospital inflates their pricing so that they get what they wanted in the first place. The sticking part is then that someone who has no bargaining power (self-insured, self-pay) are somehow expected to pay this artificially elevated price.
 
Similarly, what drugs are on an insurance's formulary is entirely based on negotiated pricing between the drug company and the insurance company. Merits of the drug are not always brought into consideration when making these choices.
 
The worst part of this is that the end-consumer (the patient) has no part of the free market dynamics, and often aren't even able to have knowledge of how these negotiations work. The insurance companies would argue that they are the consumer, not the patient, and therefore they deserve to be the ones negotiating. In addition, they would argue that getting a discount for buying in bulk is part of normal free market economics.
 
At minimum, transparency is needed.
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Points: 32530 		Direct Link To This Post Posted: March 25 2010 at 07:55
Originally posted by Negoba Negoba wrote:

Instead of creating a bigger nested comment, I'll just make a few comments.
 
One of the big problems I see is negotiated pricing. Each insurance company pays a different amount for a given sevice (say one hospital day on the general medical floor). Often this is a negotiated "discount" between the company and a hospital (say 60%). Of course what happens is then the hospital inflates their pricing so that they get what they wanted in the first place. The sticking part is then that someone who has no bargaining power (self-insured, self-pay) are somehow expected to pay this artificially elevated price.
 
Similarly, what drugs are on an insurance's formulary is entirely based on negotiated pricing between the drug company and the insurance company. Merits of the drug are not always brought into consideration when making these choices.
 
The worst part of this is that the end-consumer (the patient) has no part of the free market dynamics, and often aren't even able to have knowledge of how these negotiations work. The insurance companies would argue that they are the consumer, not the patient, and therefore they deserve to be the ones negotiating. In addition, they would argue that getting a discount for buying in bulk is part of normal free market economics.
 
At minimum, transparency is needed.


That's interesting.  Didn't know that.
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Points: 5208 		Direct Link To This Post Posted: March 25 2010 at 09:21
Another issue is cost shifting. For years hospitals have overcharged for simple services (the infamous $10 tylenol) to pay for uninsured patients up in the ICU eating thousands of dollars in resources the hospital will never get back. This is of course another defacto redistribution of wealth we don't acknowledge as such.
 
Anyway, recently, there has been a move to take the revenue generating services out of the hospital into stand alone facilities. (Radiology centers, surgery centers, endoscopy suites) This removes the losses, allows for lower prices, and for folks with insurance seems to make good sense. But then it removes the defacto pool of money for those ICU patients. And also cherry picks off the way that hospitals made their money. And by law they must still give at least life saving care to stabilization.
 
Finally, I must make a comment about doctors. There are alot of doctors who are in it for the money. My former employer did alot of work, but also provided probably more than necessary services to generate profit. He made over a million dollars a year in a specialty where my friends who work for group make about $200,000. I don't think he did things that were blatantly unethical, but he certainly stretched the envelope as a businessman. More importantly, this behavior is very common, and some of it must at least be addressed as part of a fix.
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Points: 6802 		Direct Link To This Post Posted: March 25 2010 at 09:28
Originally posted by Negoba Negoba wrote:

Instead of creating a bigger nested comment, I'll just make a few comments.
 
One of the big problems I see is negotiated pricing. Each insurance company pays a different amount for a given sevice (say one hospital day on the general medical floor). Often this is a negotiated "discount" between the company and a hospital (say 60%). Of course what happens is then the hospital inflates their pricing so that they get what they wanted in the first place. The sticking part is then that someone who has no bargaining power (self-insured, self-pay) are somehow expected to pay this artificially elevated price.
 
Similarly, what drugs are on an insurance's formulary is entirely based on negotiated pricing between the drug company and the insurance company. Merits of the drug are not always brought into consideration when making these choices.
 
The worst part of this is that the end-consumer (the patient) has no part of the free market dynamics, and often aren't even able to have knowledge of how these negotiations work. The insurance companies would argue that they are the consumer, not the patient, and therefore they deserve to be the ones negotiating. In addition, they would argue that getting a discount for buying in bulk is part of normal free market economics.
 
At minimum, transparency is needed.
 
this is a complete different approach man... interesting... I suppose that your point on this is that free market cannot regulate the health service....? Insuranse companies are gaining a lot of money while a lot of people is getting sick and not getting attention right? interesting...
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Points: 10651 		Direct Link To This Post Posted: March 25 2010 at 09:49
^ the insurance companies are the crux of the issue to me, yes I think they are overcharging and it has a wide spread crippling effect on all aspects of US life.
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Points: 6802 		Direct Link To This Post Posted: March 25 2010 at 10:11
Originally posted by Easy Money Easy Money wrote:

^ the insurance companies are the crux of the issue to me, yes I think they are overcharging and it has a wide spread crippling effect on all aspects of US life.
 
I don't have a point here... is really a doubt... if the government is not capable of giving the service and the insurance companies are just making money... who is the one who will fix this? The fact that medicine and all the related to health care is way too expensive is a huge problem... I don't know... the system is not working that way...
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Points: 10651 		Direct Link To This Post Posted: March 25 2010 at 10:29
^ read all the previous pages for everyone's possible solutions, ha ha. I think simple government regulation of insurance prices would be a nice first step.
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Points: 5208 		Direct Link To This Post Posted: March 25 2010 at 10:42

I personally don't think a viable health care system can be based on a for-profit formula. To me, this should be like education where public options are available to all and private options available to those who choose to spend their money on something other than a public option. I think using insurance companies as a middleman needs to be eliminated. 

A VA-type public medicine option for any who choose it appeals to me the most. You wait, you don't always get the prettiest rooms or treated like royalty, but you get cared for. If someone wants to pay for better, they can always do so. Lots of people have said "I've dealt with the VA. It stinks." Well that's what will pressure private providers to do a good job. In order to attract patients, they have to provide things the public option doesn't. In addition, there are some places where the VA is actually one of the most efficient systems in terms of information sharing, open-ness of formulary, etc.

This doesn't seem socialist or communist to me. It's what we already give our veterans.

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Points: 32530 		Direct Link To This Post Posted: March 25 2010 at 10:47
Originally posted by Negoba Negoba wrote:

I personally don't think a viable health care system can be based on a for-profit formula. To me, this should be like education where public options are available to all and private options available to those who choose to spend their money on something other than a public option. I think using insurance companies as a middleman needs to be eliminated. 

A VA-type public medicine option for any who choose it appeals to me the most. You wait, you don't always get the prettiest rooms or treated like royalty, but you get cared for. If someone wants to pay for better, they can always do so. Lots of people have said "I've dealt with the VA. It stinks." Well that's what will pressure private providers to do a good job. In order to attract patients, they have to provide things the public option doesn't. In addition, there are some places where the VA is actually one of the most efficient systems in terms of information sharing, open-ness of formulary, etc.

This doesn't seem socialist or communist to me. It's what we already give our veterans.



I think something like this is feasible and is an excellent middle ground.  However, public schools are not run by the federal government, but by local school districts.  This would (in theory) also promote a degree of competition and variety.
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Points: 6802 		Direct Link To This Post Posted: March 25 2010 at 10:51
Originally posted by Epignosis Epignosis wrote:

Originally posted by Negoba Negoba wrote:

I personally don't think a viable health care system can be based on a for-profit formula. To me, this should be like education where public options are available to all and private options available to those who choose to spend their money on something other than a public option. I think using insurance companies as a middleman needs to be eliminated. 

A VA-type public medicine option for any who choose it appeals to me the most. You wait, you don't always get the prettiest rooms or treated like royalty, but you get cared for. If someone wants to pay for better, they can always do so. Lots of people have said "I've dealt with the VA. It stinks." Well that's what will pressure private providers to do a good job. In order to attract patients, they have to provide things the public option doesn't. In addition, there are some places where the VA is actually one of the most efficient systems in terms of information sharing, open-ness of formulary, etc.

This doesn't seem socialist or communist to me. It's what we already give our veterans.



I think something like this is feasible and is an excellent middle ground.  However, public schools are not run by the federal government, but by local school districts.  This would (in theory) also promote a degree of competition and variety.


 
Yeah... at least in my country, that system of public school districts is the best, at least people is very up to that more than government charity... sounds logical really...
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Points: 8543 		Direct Link To This Post Posted: March 25 2010 at 10:53
I know.  Let's simply make it illegal to get ill unless you have the money to pay for it.  Problem solved.  End of thread.  Wacko
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Points: 6802 		Direct Link To This Post Posted: March 25 2010 at 11:00
Originally posted by The Doctor The Doctor wrote:

I know.  Let's simply make it illegal to get ill unless you have the money to pay for it.  Problem solved.  End of thread.  Wacko
 
LOL The Doc knows... end of thread...
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Points: 17493 		Direct Link To This Post Posted: March 25 2010 at 15:18
LOL
Originally posted by Qboyy007 Qboyy007 wrote:

Originally posted by The T The T wrote:

Originally posted by Qboyy007 Qboyy007 wrote:

Originally posted by Slartibartfast Slartibartfast wrote:

So I'm watching Countdown With Keith Olberman (on personal leave his Dad just died).  Barney Frank was just on to discuss all the threats that some Representatives and Senators are getting for voting for health reform.  He said the doesn't get many death threats, mostly after death threats.

If you haven't been following the news the teabaggers have become really sore losers. 

The Dems in the Senate have been smacking down Reps attempts at final derailment of reconciliation through amendment abuse.

Fox Noise, which spent so much time and effort smearing the legislation could only be bothered with a few seconds of coverage for the Presidential signing.

As people are getting the facts about what is actually in the legislation, public approval ratings are going up.

Watching MSNC and saying Fox News is bad makes you just as stupid as them. 

Not being able to make ONE comment without insults and with at least ONE idea makes you... a genius? An example? 

The fact that he complains about Fox News when he most likely watches MSNBC or ANY NEWS OUTLET, written or televised, is pathetic. You're an absolute moron if you disagree, sorry. 

LOLLOLClapClap
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Points: 29630 		Direct Link To This Post Posted: March 25 2010 at 16:06
Health care answer:
Released date are often when it it impacted you but recorded dates are when it really happened...
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Points: 15784 		Direct Link To This Post Posted: March 25 2010 at 16:11
Originally posted by Negoba Negoba wrote:

I personally don't think a viable health care system can be based on a for-profit formula. 


May I ask based on what?


Edited by Equality 7-2521 - March 25 2010 at 16:11
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Points: 17493 		Direct Link To This Post Posted: March 25 2010 at 19:51
Originally posted by Equality 7-2521 Equality 7-2521 wrote:

Originally posted by Negoba Negoba wrote:

I personally don't think a viable health care system can be based on a for-profit formula. 


May I ask based on what?

I would guess because a profit-based health care will always definitely leave out of the system those who need it the most. 

I would guess because in most of the rest of the world it is like that (even if it's private, the profit goal is not present, or is strongly regulated).

I would guess because profiting from health care in a way sounds like profiting from human beings' suffering and it doesn't sound  so right. 

I would guess... Though maybe, economically, there are other reasons... (for or against)
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