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Padraic View Drop Down
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Points: 31169 		Direct Link To This Post Posted: October 04 2013 at 12:10
Originally posted by JJLehto JJLehto wrote:

Originally posted by Padraic Padraic wrote:

Originally posted by JJLehto JJLehto wrote:

Maybe someone can enlighten me...before ACA what exactly was the deal with the uninsured? Lets say they went to a doctor or hopsital, some were turned away I'm sure, but was it up to the doctor? I also once heard that it was illegal to be denied care, at least basic, even if you couldn't pay. That could be flat out wrong IDK


You could be thinking of EMTALA.

People who can't pay get treated, the hospital "eats" the cost, but in reality passes it on to the rest of us.

So we're "forced" to pay for these poor bums anyway.  Wink
Ah but that was my point!
I get the sentiment of people not wanting to do so, but they blast universal coverage as "paying for bums" but I thoght this already was the case, which as you say yes, it is.
  

Right - we don't let people just die in the street, we pay for them to get better - just in probably the most horribly inefficient way possible.
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Points: 9869 		Direct Link To This Post Posted: October 04 2013 at 12:24
Originally posted by JJLehto JJLehto wrote:


Doesn't mean we should halt medicine and let people dieLOL but basically we can keep people alive longer, but how? I cant think of how to put it...we live longer but how much of it is "good" living or basically just reliant on technologies? Id imagine the only way to boost longer quality living is by living a life of good habits. I think it kind of goes along with what your saying?
The painful question being how much of this extending life should be done at who's cost?
 
IDK, it may be one of the most complex issues out there.
 

I absolutely support the idea that people should live as long as possible and it is great that we have so much technology to help us prolong our lives.  But we must also discuss the cost involved in doing so and we have to be accountable for it too, not lean on govt to subsidise it all the time.   As much as I hate talking about lives in terms of money, medicines and consultations do cost a lot of money, there's no getting away from it.  If the medical fraternity itself was so impossibly noble as to voluntarily waive fees for those who cannot afford it, it would be a different issue.  And that used to happen earlier but I am not sure how much it still does because doctors have to pay so much by way of education fees and they need to maximise their ROI as well.   The buck has got to stop somewhere, maximum return at minimum cost doesn't exist except as an illusion promised by govts to get votes.
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Points: 17493 		Direct Link To This Post Posted: October 04 2013 at 14:44
Originally posted by rogerthat rogerthat wrote:

  If the medical fraternity itself was so impossibly noble as to voluntarily waive fees for those who cannot afford it, it would be a different issue.  And that used to happen earlier but I am not sure how much it still does because doctors have to pay so much by way of education fees and they need to maximise their ROI as well.  

Which is one reason why I don't believe in the traditional "charity will take care of the rest" or "doctors can negotiate with their patients like in the old times" anymore. Sadly, we are not in the old times. 
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Points: 34550 		Direct Link To This Post Posted: October 04 2013 at 14:44
Originally posted by Padraic Padraic wrote:

Originally posted by JJLehto JJLehto wrote:

Originally posted by Padraic Padraic wrote:

Originally posted by JJLehto JJLehto wrote:

Maybe someone can enlighten me...before ACA what exactly was the deal with the uninsured? Lets say they went to a doctor or hopsital, some were turned away I'm sure, but was it up to the doctor? I also once heard that it was illegal to be denied care, at least basic, even if you couldn't pay. That could be flat out wrong IDK


You could be thinking of EMTALA.

People who can't pay get treated, the hospital "eats" the cost, but in reality passes it on to the rest of us.

So we're "forced" to pay for these poor bums anyway.  Wink
Ah but that was my point!
I get the sentiment of people not wanting to do so, but they blast universal coverage as "paying for bums" but I thoght this already was the case, which as you say yes, it is.
  

Right - we don't let people just die in the street, we pay for them to get better - just in probably the most horribly inefficient way possible.
Quite, but that seems to be how we roll!
 
 
Originally posted by rogerthat rogerthat wrote:

Originally posted by JJLehto JJLehto wrote:


Doesn't mean we should halt medicine and let people dieLOL but basically we can keep people alive longer, but how? I cant think of how to put it...we live longer but how much of it is "good" living or basically just reliant on technologies? Id imagine the only way to boost longer quality living is by living a life of good habits. I think it kind of goes along with what your saying?
The painful question being how much of this extending life should be done at who's cost?
 
IDK, it may be one of the most complex issues out there.
 

I absolutely support the idea that people should live as long as possible and it is great that we have so much technology to help us prolong our lives.  But we must also discuss the cost involved in doing so and we have to be accountable for it too, not lean on govt to subsidise it all the time.   As much as I hate talking about lives in terms of money, medicines and consultations do cost a lot of money, there's no getting away from it.  If the medical fraternity itself was so impossibly noble as to voluntarily waive fees for those who cannot afford it, it would be a different issue.  And that used to happen earlier but I am not sure how much it still does because doctors have to pay so much by way of education fees and they need to maximise their ROI as well.   The buck has got to stop somewhere, maximum return at minimum cost doesn't exist except as an illusion promised by govts to get votes.
 
mhm well said.  
 


Edited by JJLehto - October 04 2013 at 14:48
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Points: 32552 		Direct Link To This Post Posted: October 04 2013 at 16:47
Originally posted by dr wu23 dr wu23 wrote:

Originally posted by JJLehto JJLehto wrote:

Originally posted by Epignosis Epignosis wrote:

All of the ideas presented assume that healthcare is inherently expensive.  I contend that it need not be.
 
It's possible, could you elaborate why?
By studying a history of healthcare, it certainly seems to be inherently expensive. Driven by technology.
 
Before the 1920s hopsitals were places to die. Then things got better, and they got more expensive. I believe many Americans couldn't really afford it, thus various insurance plans/blue cross orgs/communal groups and etc started popping up. Can't really say this is due to gov intervention since there wasn't any.
 
Yes, gov has made things worse by creating the tax incentives for businesses (which should be ended) and creating HMOs and all types of laws and sh*t, this cant be denied. Ending employer provided insurance would open up competition and help business, I feel this is necessary (and Im not sure ACA will accomplish it). Should a universal health plan thus pick up the slack or leave it solely to markets? I just feel too many would be unable to afford it with the latter.
 
I mean, when my mother had a major surgery and hopstial stay, it took 2 or 3 years for us to finally get back to normal financially from that. This was WITH insurance paying 80% of it. Sure, gov has made things worse, but I can't believe it's not inherently expensive.
 
I agree and I'd also like to hear how costs can be lowered by using a 'free market system'. Ain't gonna happen.
Pharmaceuticals, hospitals, and doctors have some of the highest fees out there and that has steadily gone up the way it currently is. They will not police themselves and help make healthcare more affordable nor help provide it for those who don't even have it  since they like the big bucks. If some govt regulation or something similar doesn't step in to help those who need healthcare it will only get worse. The ACA might not be a good answer but leaving it the way it is, the GOP answer, will make it even worse in time.


I've discussed this many times before.  Medical insurance itself is the greatest reason health care in the US is so expensive.  When costs are paid for by a group and not an individual, it invites waste.
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Points: 32552 		Direct Link To This Post Posted: October 04 2013 at 16:51
Originally posted by Padraic Padraic wrote:

Originally posted by JJLehto JJLehto wrote:

Originally posted by Padraic Padraic wrote:

Originally posted by JJLehto JJLehto wrote:

Maybe someone can enlighten me...before ACA what exactly was the deal with the uninsured? Lets say they went to a doctor or hopsital, some were turned away I'm sure, but was it up to the doctor? I also once heard that it was illegal to be denied care, at least basic, even if you couldn't pay. That could be flat out wrong IDK


You could be thinking of EMTALA.

People who can't pay get treated, the hospital "eats" the cost, but in reality passes it on to the rest of us.

So we're "forced" to pay for these poor bums anyway.  Wink
Ah but that was my point!
I get the sentiment of people not wanting to do so, but they blast universal coverage as "paying for bums" but I thoght this already was the case, which as you say yes, it is.
  

Right - we don't let people just die in the street, we pay for them to get better - just in probably the most horribly inefficient way possible.


And I don't see how the ACA is preferable to this- it is increasing bureaucracy (read: administrative costs and waste) and is merely shuffling the costs around, not actually making anything affordable.
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Points: 20649 		Direct Link To This Post Posted: October 04 2013 at 18:02
Originally posted by Epignosis Epignosis wrote:

Originally posted by dr wu23 dr wu23 wrote:

Originally posted by JJLehto JJLehto wrote:

Originally posted by Epignosis Epignosis wrote:

All of the ideas presented assume that healthcare is inherently expensive.  I contend that it need not be.
 
It's possible, could you elaborate why?
By studying a history of healthcare, it certainly seems to be inherently expensive. Driven by technology.
 
Before the 1920s hopsitals were places to die. Then things got better, and they got more expensive. I believe many Americans couldn't really afford it, thus various insurance plans/blue cross orgs/communal groups and etc started popping up. Can't really say this is due to gov intervention since there wasn't any.
 
Yes, gov has made things worse by creating the tax incentives for businesses (which should be ended) and creating HMOs and all types of laws and sh*t, this cant be denied. Ending employer provided insurance would open up competition and help business, I feel this is necessary (and Im not sure ACA will accomplish it). Should a universal health plan thus pick up the slack or leave it solely to markets? I just feel too many would be unable to afford it with the latter.
 
I mean, when my mother had a major surgery and hopstial stay, it took 2 or 3 years for us to finally get back to normal financially from that. This was WITH insurance paying 80% of it. Sure, gov has made things worse, but I can't believe it's not inherently expensive.
 
I agree and I'd also like to hear how costs can be lowered by using a 'free market system'. Ain't gonna happen.
Pharmaceuticals, hospitals, and doctors have some of the highest fees out there and that has steadily gone up the way it currently is. They will not police themselves and help make healthcare more affordable nor help provide it for those who don't even have it  since they like the big bucks. If some govt regulation or something similar doesn't step in to help those who need healthcare it will only get worse. The ACA might not be a good answer but leaving it the way it is, the GOP answer, will make it even worse in time.


I've discussed this many times before.  Medical insurance itself is the greatest reason health care in the US is so expensive.  When costs are paid for by a group and not an individual, it invites waste.
Gee..then all we need do is get rid of the Insurance monopolies....let me know how that works out with the Libertarian platform..
LOL
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Points: 20649 		Direct Link To This Post Posted: October 04 2013 at 18:07
Originally posted by Epignosis Epignosis wrote:

Originally posted by Padraic Padraic wrote:

Originally posted by JJLehto JJLehto wrote:

Originally posted by Padraic Padraic wrote:

Originally posted by JJLehto JJLehto wrote:

Maybe someone can enlighten me...before ACA what exactly was the deal with the uninsured? Lets say they went to a doctor or hopsital, some were turned away I'm sure, but was it up to the doctor? I also once heard that it was illegal to be denied care, at least basic, even if you couldn't pay. That could be flat out wrong IDK


You could be thinking of EMTALA.

People who can't pay get treated, the hospital "eats" the cost, but in reality passes it on to the rest of us.

So we're "forced" to pay for these poor bums anyway.  Wink
Ah but that was my point!
I get the sentiment of people not wanting to do so, but they blast universal coverage as "paying for bums" but I thoght this already was the case, which as you say yes, it is.
  

Right - we don't let people just die in the street, we pay for them to get better - just in probably the most horribly inefficient way possible.


And I don't see how the ACA is preferable to this- it is increasing bureaucracy (read: administrative costs and waste) and is merely shuffling the costs around, not actually making anything affordable.
That might be the case but it has not been shown in practice yet since no one has even given it a chance yet ..so then we should leave healthcare the way it is, broken,  so the richer get richer and many don't get healthcare and the GOP will continue to have no plan at all that helps either.
Yeah...that's the ticket we'll call it the Libertarian solution.
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Points: 32552 		Direct Link To This Post Posted: October 04 2013 at 18:37
You're clearly not interested in what I have to say.
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Points: 20649 		Direct Link To This Post Posted: October 04 2013 at 19:44
Originally posted by Epignosis Epignosis wrote:

You're clearly not interested in what I have to say.
Perhaps you are not making yourself clear......what exactly are you trying to say?

Edited by dr wu23 - October 04 2013 at 19:45
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Points: 32552 		Direct Link To This Post Posted: October 04 2013 at 19:52
Originally posted by dr wu23 dr wu23 wrote:

Originally posted by Epignosis Epignosis wrote:

You're clearly not interested in what I have to say.
Perhaps you are not making yourself clear......what exactly are you trying to say?


All I meant was that you're not exactly responding with any degree of curiosity or humility.  I have no interest with that type anymore.
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Points: 20649 		Direct Link To This Post Posted: October 04 2013 at 22:52
Originally posted by Epignosis Epignosis wrote:

Originally posted by dr wu23 dr wu23 wrote:

Originally posted by Epignosis Epignosis wrote:

You're clearly not interested in what I have to say.
Perhaps you are not making yourself clear......what exactly are you trying to say?


All I meant was that you're not exactly responding with any degree of curiosity or humility.  I have no interest with that type anymore.
 
Yeah....I think I just lost my interest also.
Disapprove
 
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Points: 34550 		Direct Link To This Post Posted: October 05 2013 at 12:43
I am honestly confused, Rob. You are saying insurance itself is why costs are so high?
Can you elaborate?
I thought insurance came around due to costs, and isn't pooling good?
 
I could be missing something, please tell me your thoughts. Sounds like you are saying government isn't even THE problem (though it is one) but that insurance itself is, and if we go to a system were individuals are responsible it'd drive cost down.
I'm not disagreeing just never heard this...try to win me overWink


Edited by JJLehto - October 05 2013 at 12:49
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I do gotta say, while I can totally get disagreeing...most flak libertarians get are people just assuming they are Republicans. See it all the time in this thread in fact, the two are basically just interchangable to many and this is pretty damn wrong.

It was actually the Cato Institute and libertarian writers who showed me how monopolistic healthcare is, and of course should be ended. As well as things like subsidies, corporate handouts etc etc   also stuff like drastically reducing our military, war on drugs stuff GOP would never dream of touching.
It's misinformation or bias, and it upsets me even though I wouldnt say Im a US "libertarian"    its what I see as wrong in this country. All these words are thrown around and it dumbs down talk.
GOP and libertarians really aren't the same at all, Reps just use the words and etc to win people over .

But yeah this whole GOP=Libertarian thing really has to stop. It's maddening in how false it is, like how people think Dems = crazy populist socialists...its so untrue it's comical.
But yeah, GOP (and dems) love monopolies, libertarians don't. The question is just how can maintaining a free market happen? Is gov needed, or should it be left unhampered with, that is what the debate should be.

Instead its name calling and lies LOLCry
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Points: 17493 		Direct Link To This Post Posted: October 05 2013 at 13:09
The fact that the healthcare system here is for-profit is also a problem. When the mentality is that this is an industry like all other ones and you need to make a profit regardless of how you do it, no matter how it is operated it will be a system where healthcare providers only interest is not curing or preventing disease but maintaining it, just controlling it and keeping "customers" coming back.
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Points: 17493 		Direct Link To This Post Posted: October 05 2013 at 13:52
I just finished watching a pretty good health care documentary called "Escape fire". Maybe nothing we don't already know but good for the general public, and no, it's not overly Government-loving. It's quite fair.
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Points: 32552 		Direct Link To This Post Posted: October 05 2013 at 13:55
Originally posted by JJLehto JJLehto wrote:

I am honestly confused, Rob. You are saying insurance itself is why costs are so high?
Can you elaborate?
I thought insurance came around due to costs, and isn't pooling good?
 
I could be missing something, please tell me your thoughts. Sounds like you are saying government isn't even THE problem (though it is one) but that insurance itself is, and if we go to a system were individuals are responsible it'd drive cost down.
I'm not disagreeing just never heard this...try to win me overWink


We've talked about it before.  Wink

http://www.progarchives.com/forum/forum_posts.asp?TID=85372&PID=4555945#4555945

Here's the direct link to the article.

There's been much talk about hospitals and people who don't pay their medical bills, but none of that explains why it costs $135+ for a 15 minute visit to the doctor (perhaps they charge you for the ridiculous wait).

Originally posted by </font></font><font size=3><font face=Times New Roman, Times, serif>Stan Liebowitz Stan Liebowitz wrote:



The excessive costs of our current medical system can be classified into three major categories:

• The first, and by far the largest excess cost, is due to the current overuse of medical resources by patients. Overuse is the rational response of consumers who do not have to pay the entire cost of the medical services they use. The causes of those excess costs are Medicaid, Medicare, and tax laws that provide incentives for individuals to have their employers purchase their medical care in the form of private health insurance.

• The second category of excess cost consists of administrative and paperwork costs that are unnecessary for the provision of health care, but that have come into existence because of the current patchwork of third-party payers and their attempts to control their increasing costs by closely monitoring the behavior of doctors and patients. Even worse is the fact that those cost-containment activities do not seem to have contained costs very well.

• The third excess cost is associated with the fear of malpractice suits. Administering medically unnecessary tests and procedures helps to insulate doctors and hospitals from the potential wrath of patients or their families when inevitable accidents occur in medical treatment or when treatments just do not work.




In a nutshell, medical insurance that covers almost everything (as opposed to covering catastrophes only as all other forms of insurance do) sharply increases demand, which thus increases prices.

Let's consider an entirely different market: Suppose automotive insurance began covering maintenance expenses rather than just collisions.  What would happen?  First, mechanics would need to hire some administrative personnel to handle the insurance filing, increasing their overhead.  Second, with such low out-of-pocket expenses, motorists will have fewer reservations about "taking care" of that $1,700 worth of problems the mechanic found when conducting the oil change.  Third, because of this increase in demand, mechanics will have fewer reservations about increasing the markup of parts and the cost of labor.  Fourth, in order to stay profitable, Allstate, Progressive, et al. will need to increase premiums.  Fifth (assume for a moment auto insurance is not mandatory), this will result in exorbitant out-of-pocket expenses for those who do not have auto insurance- if their cars break down, they will be hit with a massive bill.

And the bill would be even more staggering if regulations required mechanics to get 10-12 years of post-secondary education.
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Points: 17493 		Direct Link To This Post Posted: October 05 2013 at 14:01
"• The first, and by far the largest excess cost, is due to the current overuse of medical resources by patients. Overuse is the rational response of consumers who do not have to pay the entire cost of the medical services they use. The causes of those excess costs are Medicaid, Medicare, and tax laws that provide incentives for individuals to have their employers purchase their medical care in the form of private health insurance."

I would say patients usually do what doctors presceibe to them. As far as I know a patient can't go and do an MRI on himself. Therefore, what's the incentive for doctors and providers to overuse the system?
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Originally posted by The T The T wrote:

The fact that the healthcare system here is for-profit is also a problem. When the mentality is that this is an industry like all other ones and you need to make a profit regardless of how you do it, no matter how it is operated it will be a system where healthcare providers only interest is not curing or preventing disease but maintaining it, just controlling it and keeping "customers" coming back.
 
The fact that it's for profit is the one and only main problem....period. As long as that is the case there will never be any fair pricing or way to get everyone on it because it's simply not in the best interest of the capitalists that control it to change to a more equitable system.
The GOP don't seem to care about that or the people and the Dems have come up with what many consider to be a bad answer to the problem.
And I have yet to hear any actual solution from 'Libertarians' either.
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Points: 34550 		Direct Link To This Post Posted: October 05 2013 at 20:44
Sorry Rob but bro, 3 threads with prob near 1000 pages of content where we've covered every topic under the sun and often in depth, man I can't keep track of everything said!
I'll start perusing the info, Im a bit drunk sooooooooo



Untrue, you may disagree (I cant say I really buy it myself) but libertarians have indeed provided a solution, the usual: eliminate government from healthcare. I have seen this include ending state monopolies and boosting competition but ironically I think this requires gov. Like I said, you may not like it but the libertarian answer is their answer to most thingsLOL I mean....shouldn't this be obvious?
Edit: if you want concrete answers and will actually care to read it, here is the Cato Institute take on their ideal healthcare system http://www.cato.org/sites/cato.org/files/serials/files/cato-journal/2011/1/cj31n1-2.pdf


Edited by JJLehto - October 05 2013 at 20:46
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