|
|
|
Dave W.
Info Junkie
USA
26020 Posts |
 Posted - 05/31/2011 : 14:41:14 [Permalink]
|
Originally posted by marfknox
Private health insurance is more expensive than that which you get through an employer (about twice as expensive)... |
Yes. Employers act a sort of collective bargainer when it comes to purchasing insurance to get lower prices than the individual employees could. And an insurance company acts as a collective bargainer when it comes to actually purchasing health care, to also negotiate lower prices than individuals. Logically, then, if the government were to do the work, it could accurately claim to be bargaining on behalf of 300 million people in this country, and so should wield much more power to get reduced prices than any single insurance company (not including the power to regulate prices by fiat). So even a plan as centrist as "single payer" should save all of us a lot of money, but now seems to be political suicide as it's been tainted by "socialism."
Oh, I missed this before:Originally posted by Valiant Dancer
So.... you want access to healthcare and don't care about how the people providing it are able to get a living wage. The providers have to get paid. The government is very slow about paying... |
The government isn't slow about its employee's paychecks. They get 'em every two weeks.| ...and do not pay as well as the insurance companies. |
Health care shouldn't be about making more money. Insurance companies should be non-profit. Hell, even companies that make gauze shouldn't be selling it at above cost to medical professionals for use in basic health care (if you're injured and in need of gauze, you shouldn't be the source of capital gains for Johnson&Johnson stockholders, for example). That's why I think the whole industry should be nationalized: it would eliminate profits and investors as motives for determining who gets how much care, and eliminate them as extra, unnecessary costs to those receiving health care. |
- Dave W. (Private Msg, EMail)
Evidently, I rock!
Why not question something for a change?
Visit Dave's Psoriasis Info, too. |
 |
|
|
Ebone4rock
SFN Regular
USA
894 Posts |
Posted - 05/31/2011 : 15:00:09 [Permalink]
|
originally posted by me, then marfknox,
I have told the story before about how my wife and I went uninsured for a number of months. During that time she required a CT scan. We were billed $2500 which we had to pay all on our own. A year or two later, now with insurance, my wife required another CT scan. We received our insurance statement. The retail price of the CT scan was still $2500 (same hospital, same exact machine) but with the discount the insurance company gets they only paid $650!
(marf)
Huh, I never heard of that sort of thing before.
|
Oh yes! Take a look at the next insurance statement you get. They (at least my insurance company anyway) shows in detail how much the retail price the original claim is for, then how much the discount is for the insurance company. It's all in black and white how much they are charging those with no insurance.
Lets take my example of the $2500 CT scan. The insurance company gets a discount which brings it to $650. Imagine if you didn't have all those people involved uselessly processing the paperwork. It would probably only cost me $200 if the hospital would just bill me directly and get the insurance company out of the way!
|
Haole with heart, thats all I'll ever be. I'm not a part of the North Shore society. Stuck on the shoulder, that's where you'll find me. Digging for scraps with the kooks in line. -Offspring |
|
|
|
marfknox
SFN Die Hard
USA
3739 Posts |
Posted - 05/31/2011 : 16:23:42 [Permalink]
|
Ebone wrote: | Oooh, I'm beginning to see clearly now! Health Insurance companies ARE a way to redistribute wealth. Give skilled people a complicated job, even though the job they do is completely unnecessary. |
LOL! Yeah. Except that lots of those people who work for the insurance companies are themselves underinsured. My mother-in-law works for an insurance company as a nurse and has what is relatively good health insurance for her and her husband. However, because of my father-in-law's age, the company wouldn't pay for his hearing aids, and they had to save for years before purchasing them out of pocket. It didn't matter that he worked full time himself and had to drive. When he finally got his hearing aids, at first he didn't recognize the sound of raindrops on windows because it had been so long since he had been able to hear that sound. Of course if he had been in his 30's they would have paid for his hearing aids. Yay, the logic of the market!
Sort of like the argument that Walmart undercutting everyone with their prices is a benefit to society because it lowers the cost of products for everyone. They just leave out the fact that they also depress wages enough that the benefits are canceled out. |
"Too much certainty and clarity could lead to cruel intolerance" -Karen Armstrong
Check out my art store: http://www.marfknox.etsy.com
|
|
|
|
Valiant Dancer
Forum Goalie
USA
4826 Posts |
Posted - 06/01/2011 : 06:42:39 [Permalink]
|
Originally posted by Kil
Okay Val. You seem to not like the new health care bill. And you seem to be against the creation of any new government health care law that covers everyone or the extension of any existing government health care programs. That suggests to me that you were also against the government option. I dunno. |
Nope. I'm all for a plan that makes healthcare insurance (specifically the healthcare exchanges that allows individuals to band together as a collective bargaining unit to get better prices on healthcare) more easily available to people. I object to any plan that does so at the expense of the Constitution. The individual mandate is a dangerous expansion of the commerce clause to force people to engage in a specific type of commerce.
I am against the government "single payer" option due to the manner in which it has been implemented in the past (Medicare, Medicaid) which has been at the expense of healthcare providers. Government is very slow in paying for healthcare. While they keep up on payment for their workforce, they are abysmal when it comes to reimbursement for medical care.
Here's what I do know. Like many millions of Americans ( I have heard estimates as high as 45 million now and growing.) I have lost my health insurance and there is no way back for me. Until I turn 65, I will be uninsured. And I'm not getting from what I'm reading here that you think that's much of a problem. After all, you did say that this country provides the best health care in the world. That's honky dory for those who have health insurance, but what about the rest of us? Whether it's 20, 30 or as high as 45 million, it's a failed system with those kinds of numbers of uninsured.
So what's the plan that you favor to get us all insured? I'd really like to know?
|
The plan that I favor is not one that either party has come up with. It is as complex as the issues facing the healthcare community.
1) Repeal portions of EIRSA which indemnified HMOs from malpractice suits.
2) Set up local collective bargaining units for the uninsured so that affordable healthcare insurance is provided.
3) Subsidize the units for the uninsured up to 150% of the poverty index.
4) Actually update the poverty index so that it is a far more meaningful number than it currently is.
5) Set MLR limits after seriously studying the amount of money it takes to administrate healthcare.
6) Tax non-profits the same as for-profit healthcare organizations.
7) Subject pharmecutecal companies to the same price controls that is inflicted on medical providers for Medicare.
8) Require arbitration for medical malpractice claims before access to the courts.
9) Place a profits percentage limit of 5% on healthcare insurers. (You'd be amazed at how few companies would have to worry about this) Add windfall taxes of 30% on overages.
10) Malpractice insurance reform. Causes the second most outlay of cash for service after drug expendatures. |
Cthulhu/Asmodeus when you're tired of voting for the lesser of two evils
Brother Cutlass of Reasoned Discussion |
| Edited by - Valiant Dancer on 06/01/2011 07:44:53 |
|
|
|
Valiant Dancer
Forum Goalie
USA
4826 Posts |
Posted - 06/01/2011 : 07:16:50 [Permalink]
|
Originally posted by Ebone4rock
This is just food for thought but everyone does realize that health insurance does not require employer sponsorship right? A person can purchase it on their own and there are quite a variety of plans to choose from. There is a plan out there that will work for everyone!
That being said I personally think that the insurance companies are a major cause of the bloated prices we see for health care.
I have told the story before about how my wife and I went uninsured for a number of months. During that time she required a CT scan. We were billed $2500 which we had to pay all on our own. A year or two later, now with insurance, my wife required another CT scan. We received our insurance statement. The retail price of the CT scan was still $2500 (same hospital, same exact machine) but with the discount the insurance company gets they only paid $650!
See, cut out the middle man. Bill me directly for the $650. I'll write a check. Easy, breezy, beautiful.
So, we get it taken care of so that those who can afford to pay for reasonably priced health care are actually able to do so. They carry insurance for major, unexpected things. At that point we can work on a plan so that all the rest of the people who cannot afford it get some sort of government assistance with it.
|
And you'd be wrong.
Healthcare providers contract with health insurers. The health insurers provide the providers with a large pool of potential customers (participating provider lists) and will tend to direct people in the area to the company for services. In response, the providers discount the procedures. Fee For Service is bloated due to bad debt caused by the must treat law (just pointing out root cause, not asking for it to be repealed). With the number of unemployed and working poor climbing, the ER has become the place to go for normal clinic services (with attendant additional cost) because community free clinics are overburdened and understaffed. This causes the bad debt for hospitals to soar. Add in the 20 million illegal aliens also getting service from ER's without paying and you get a greater debt.
You do identify where the bloat starts, but assign it to the wrong source.
EMTALA (Emergency Medical Treatment and Active Labor Act) was enacted in 1986. This is the Must treat law I have been talking about. Prior to this, hospitals could (and did) turn away people based on citizenship and ability to pay. It did not offer any reimbursement for healthcare providers. Health insurance companies provided large pools of patients that at least they could get some money for. (Like Medicaid and Medicare did for them)
In 2007, a study published in the Annals of Emergency Medicine points out that ERs are stiffed for 58% of all services they provide. Somebody has to pay for it. That somebody has been health insurance companies and the uninsured that actually pay for the services they get from healthcare providers. This same study broke down the percentage of charges that were paid by who was paying. Private insurance paid 56%, Medicare paid 38%, Uninsured paid 35%, and Medicaid paid 33%.
Add to that the malpractice insurance from $15,000 annually for an anesthesiologist in a state with tort reform law to $127,000 annually for an OB/GYN in Chicago. |
Cthulhu/Asmodeus when you're tired of voting for the lesser of two evils
Brother Cutlass of Reasoned Discussion |
|
|
|
Valiant Dancer
Forum Goalie
USA
4826 Posts |
Posted - 06/01/2011 : 07:33:36 [Permalink]
|
Originally posted by Dave W.
Originally posted by Valiant Dancer
Originally posted by Dave W.
Why? What do health insurance companies provide that the Federal government cannot? |
Better cost controls for care. |
Why can't the US just mandate price controls, like other nations? |
It's called Capitalism. The people getting paid won't want to play if there isn't any money in it for them. It's why healthcare is having a serious problem getting people to take jobs there.
| The VA is doing things the right way? |
I said, "closest to."I worked for the VA for a year. They are severely underfunded. They cannot attract competent providers because they don't pay anywhere near the going rate. They directly provide services but bill outside insurance now to cover their costs.
VA Lakeside in Chicago has serious infrastructure issues. Issues that have rendered the top three floors uninhabitable for over a decade. The VA has been pushing off building maintanance to be able to provide care. |
Yes, and all that is a horrible situation exacerbated by legislators who don't want "socialized" medicine to succeed. They need to be "reformed" if any serious effort is going to be made to make a working and cheap health care industry in this country.| But they help PAY for it. Something government does poorly. |
No, health insurance customers pay for it. The corporations don't get their money from nowhere, it all comes out of the wallets of the insured and the investors. Health insurance companies aren't being magnanimous when they pay for some procedure or other, they're using money that wasn't theirs to begin with. And health care in general would be less expensive if we didn't need to pay middlemen like them. |
They trade access to large pools of customers in exchange for discounts for services that would not normally be avaialable to Joe Consumer.
I don't want to pay for health insurance companies' executives salaries. I don't want to have to pay for a half-dozen doctors offices' different accountants. I don't want to have to pay for the tax preparation services my pharmacy uses. There are a zillion little things that I pay for, through premiums and copays that I really shouldn't need to pay for in order to get health care. Making the industry public could reduce all of this needless waste and redundancy by quite a large amount.
United Healthcare paid its CEO $102 million in 2009 and made nearly $5 billion profit. We could have paid over 30,000 GS-15/10 health care workers for the same amount. And that's just one insurance company out of many. |
Off of $87.1 Billion in revenue. 5.7% profit.
The CEO took a pay cut this year to $49 million.
(For comparison, the annual salary for the United States Secretary of Health and Human Services has been $199,700 since January, 2010.)
|
And what healthcare does he provide?
His position is regulatory. (and costs healthcare providers and insurance companies plenty when he changes his mind.) |
Cthulhu/Asmodeus when you're tired of voting for the lesser of two evils
Brother Cutlass of Reasoned Discussion |
|
|
|
Valiant Dancer
Forum Goalie
USA
4826 Posts |
Posted - 06/01/2011 : 07:42:18 [Permalink]
|
Originally posted by marfknox
Val wrote: | So.... you want access to healthcare and don't care about how the people providing it are able to get a living wage. The providers have to get paid. The government is very slow about paying and do not pay as well as the insurance companies. |
I don't find this convincing when I look at other countries that have MUCH MORE socialistic system than ours and yet they manage to continue to have people go into medical professions. There are doctor shortages, but the U.S. also has that problem in areas, and the overall health care per capita received by people in France, Britain, Germany, Canada, Hong Kong, Japan, and many other industrialized nations continues to be BETTER than in the United States and cheaper! So you explain to me how they manage to do that with so many more government controls? |
Because they limit malpractice awards and have price controls on pharmacutals which we don't have (and the US is paying for).
I think the answer is that each of those countries actually has system for distributing health care, while the United States doesn't. We have this weird mix of some government regulation and control and a lot of free market, and the result is that depending on what your job is, who you are married to, your age, and your current state of health, your health care could be managed in any number of ways, some of which offer the best care in the world and others which are identical to health care management in some third world nations. We need a system in this country. If we have a single system, then we can deal with the problems with that one system as they arise.
| And the list of items was to show you how far the legislation went. You claimed that it was modest. |
I do consider it to be modest relative to the problem and what sort of radical changes need to be made to adequately reform the health care system in America. The measure of how modest or not a plan is must be relative to something. The changes that have been made with the current legislation mostly shifts a lot of thing around; it doesn't make any fundamental changes to the way we do health care in America, which is a problem. |
As I am one of the poor bastards that have to change huge amounts of coding at short notice to comply with this, permit me to strenuously disagree. The legislation doesn't do anything to fix the root problem and only serves to punish the current bugaboo for political points.
| I do not agree that lack of adequate access is an issue. I posit that lack of focus on the major factors which cause health care to be so expensive is the issue. |
Why is it an issue that health care is so expensive? It is an issue because that problem has lead to inadequate health care for many Americans. That is what is at the heart of the issue. Who cares how expensive it is if everyone has access to good health care?
| Under the "must treat" rule in force for over 30 years, no emergency room may turn away people who are ill. They must be treated. This has saddled hospitals (private organizations) with a great deal of bad debt. This passes on the cost to everyone else. |
I agree. And what is your proposed solution? Are you actually arguing that the "must treat" rule is the cause of this problem? Also, emergency rooms can't turn away someone at the door, but they sure as hell do NOT have to treat non-life threatening illnesses. And most of the people going to emergency rooms wouldn't be there in the first place if they had regular checkups and health care access, which they don't because they are either underinsured or uninsured. What are you proposing? That "must treat" rule be eliminated? |
BUZZZZZZZZ!!! Tacky buzzer!!!!! ERs DO have to treat non-life threatening illnesses. I am identifying the "must treat" rule with the cause for medical care rising. It has to be paid for some way. The EMTALA's lack of reimbursement for this mandated care is the primary issue.
| Big Pharma cranks up their costs in the US because other nations put price controls on their product. (add in patent abuse, and big pharma gets quite a payday) |
Yes, that's a problem. I assume you are proposing that the U.S. use price controls, too, and if so, I agree with you.
| Health care insurance companies have been the ones paying for these services. There are no more fee-for-service options that are cost effective. With the government pushing Health Savings Accounts (which do nothing for major medical) and the malpractice insurance rates soaring, the cost of care continues to rise. As states turn to the insurance companies to inflict fees on for providing services, the cost of those plans will go up as well as responses to rising health care costs. |
Again, what are you proposing? Tort reform with regards to medical malpractice? If so, I agree. However, the estimates I've read from studies argue that about 10% of the increases in medical costs are the result of medical malpractice costs and defensive medicine done to avoid suits. That's a lot, but not the bulk of the problem, so fixing it alone won't be the bulk of the solution.
The only solutions you have seemed to suggest are tort reform and cost controls for Pharmaceuticals. And you complain that the new reforms don't do either of these, right? And that the things it does do will exacerbate the problem of high medical costs, right? If I'm reading you right, I really do see and agree with those points. However, I don't agree with you that insurance companies will run things better than a single payer government run system, and I don't see why you think the problem of high costs is a worse problem than the severely unequal distribution and access to health care across the American population.
|
|
Cthulhu/Asmodeus when you're tired of voting for the lesser of two evils
Brother Cutlass of Reasoned Discussion |
|
|
|
Dr. Mabuse
Septic Fiend
Sweden
9687 Posts |
Posted - 06/01/2011 : 10:49:57 [Permalink]
|
Originally posted by Valiant Dancer
Government is very slow in paying for healthcare. While they keep up on payment for their workforce, they are abysmal when it comes to reimbursement for medical care. |
That is a shortcoming which is easily rectified if some political will is applied to it. Right now, it is in the political interest of certain parties to see that reimbursement is a problem in order to destroy the credibility of such a system.
Slow payments aren't a problem inherent in the idea of a national single payer system. It's the problem caused by the current political climate.
Edit: spelling |
Dr. Mabuse - "When the going gets tough, the tough get Duct-tape..."
Dr. Mabuse whisper.mp3
"Equivocation is not just a job, for a creationist it's a way of life..." Dr. Mabuse
Support American Troops in Iraq:
Send them unarmed civilians for target practice..
Collateralmurder. |
| Edited by - Dr. Mabuse on 06/02/2011 01:20:26 |
|
|
|
marfknox
SFN Die Hard
USA
3739 Posts |
Posted - 06/01/2011 : 12:24:44 [Permalink]
|
Mab wrote: That is a shortcoming which is easily rectified if some political will is applied to it. Right now, it is in the political interest of certain parties to see that reimbursement is a problem in order to destroy the credimiliby of such a system.
Slow payments aren't a problem inherent in the idea of a national single payer system. It's the problem caused by the current political climate. |
Yeah, I've never understood the uber-small-government conservatives who vote for politicians who argue that government is evil and should be as small as possible. Why would people with such beliefs become a politician? The only motivation I can see is to try to destroy government from within, and one way to do that is to make government dysfunctional. |
"Too much certainty and clarity could lead to cruel intolerance" -Karen Armstrong
Check out my art store: http://www.marfknox.etsy.com
|
|
|
|
marfknox
SFN Die Hard
USA
3739 Posts |
Posted - 06/01/2011 : 13:28:10 [Permalink]
|
Val wrote: BUZZZZZZZZ!!! Tacky buzzer!!!!! ERs DO have to treat non-life threatening illnesses. I am identifying the "must treat" rule with the cause for medical care rising. It has to be paid for some way. The EMTALA's lack of reimbursement for this mandated care is the primary issue.
|
Okay, I apologize for my ignorance. ERs must treat "emergency medical situations", even if they are not life threatening. From here: http://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act
An emergency medical condition is defined as "a condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in placing the individual's health [or the health of an unborn child] in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of bodily organs. |
The criticisms of this law is that it is an unfunded mandate. That would be a good argument if the alternative wasn't going back to patient dumping being a legal practice. All this law really shows is the absurdity of not having universal health care. So I'm not sure what your point of bringing this law up is. Are you suggesting that we get rid of this law BEFORE we fix the other problems with our health care system? Because the only reason we need this law is because of those other problems.
| As I am one of the poor bastards that have to change huge amounts of coding at short notice to comply with this, permit me to strenuously disagree. The legislation doesn't do anything to fix the root problem and only serves to punish the current bugaboo for political points. |
So health insurance companies are merely a bugaboo, not even part of the problem?
| Because they limit malpractice awards and have price controls on pharmacutals which we don't have (and the US is paying for). |
According to this chart, USA health care costs per capita are about twice as high as in France, Japan, Germany, Canada, Australia and the U.K.  From what I've read, tort reform could at best reduce costs by 10%. So is it your contention that price controls on pharmacutals would bring it down the rest of the way? I am skeptical.
However, you have convinced me that tort reform and price controls on drugs would be huge steps in the right direction. But I sort of already believed that. |
"Too much certainty and clarity could lead to cruel intolerance" -Karen Armstrong
Check out my art store: http://www.marfknox.etsy.com
|
|
|
|
Dave W.
Info Junkie
USA
26020 Posts |
Posted - 06/01/2011 : 18:33:16 [Permalink]
|
Originally posted by Valiant Dancer
It's called Capitalism. |
Capitalism isn't the be-all, end-all governmental system. Which health interventions work best under which situations is an empirical question that need not wait for the "invisible hand" to scribble out an answer. Just how much competition is there between doctors for the creation of the next great surgical technique? Really, I see no need for health care to be subject to the whims of market forces.| The people getting paid won't want to play if there isn't any money in it for them. |
There are millions of civil servants who clearly didn't take their jobs in order to get rich. The cost savings of nationalizing health care would probably allow us to pay for the eduction of doctors and nurses, too - an encouragement to enter the field that many don't have today.| It's why healthcare is having a serious problem getting people to take jobs there. |
How much of a problem and where?| They trade access to large pools of customers in exchange for discounts for services that would not normally be avaialable to Joe Consumer. |
Nationalize the system and those considerations simply vanish.| The CEO took a pay cut this year to $49 million. |
Whoop-te-do. That's still over 300 GS-15/10 positions taken up by just one guy.| (For comparison, the annual salary for the United States Secretary of Health and Human Services has been $199,700 since January, 2010.) |
And what healthcare does he provide?
His position is regulatory. |
Insurance company CEOs don't provide any healthcare, either. Kathleen Sebelius' position as head of the DHHS would be analogous to an insurance company's CEO if we were to nationalize health care. We would get an instant cost reduction of nearly $48.8 million.| (and costs healthcare providers and insurance companies plenty when he changes his mind.) |
Not if we nationalized the system, she wouldn't. The healthcare providers would all be government employees, and the insurance companies would be begging for scraps among the very rich who only want insurance against their face-lifts sagging too soon. |
- Dave W. (Private Msg, EMail)
Evidently, I rock!
Why not question something for a change?
Visit Dave's Psoriasis Info, too. |
|
|
|
alienist
Skeptic Friend
USA
210 Posts |
Posted - 06/01/2011 : 18:50:01 [Permalink]
|
Ah, the healthcare debate.. I guess I will put my 2 cents in
US healthcare is a mess, to say the least.
As a physician, both private insurance and medicare are a pain in the ass to deal with. As a patient, I have to pay higher premiums because of "pre-existing condition." The difference between the two is that private insurance companies are only interested in making as much money as they can. so they try to find ways to deny care. A lot of them are trying to claim their plans are ERISA plans so they are not subject to the new health reform laws.
Medicare is focused on preventing fraud, which is important, but they tend to nitpick on everything. As a psychiatrist, to earn enough money under insurance and medicare, you have to see patients every 15 minutes.
Basically the fee for service system is not working. It just leads to doctors spending less time with patients. Then there is the paperwork and phone calls. You can put doctors on salary, but then government has to subsidize medical education. No one will want to go into primary care if they have a $200,000 debt from med school
I don't think a single payer system will solve all the problems. We have to take the profit motive out of medicine. Some doctors will of course order more tests if they own the x-ray machines or ultrasounds leading to increased cost. Ideally, I would want the government to really regulate the insurance industry, to make sure that they are spending money on patient care and not on overhead. They should also be required to justify any money they spend on overhead and salaries. This is highly unlikely to happen.
In terms of tort reform, I think we should have no-fault malpractice. That way the money will go to patients and improving healthcare rather than to lawyers. Usually state medical doctors weed out the bad doctors. it is an imperfect system but I don't think lawsuits are efficient ways of weeding out bad doctors.
I see taxes as the cost we pay for civilization. having everyone buy health insurance (as long as government regulates health insurance premiums) is a way of reducing cost of premiums for anyone. Otherwise, it will be tax dollars that pay for people who don't have insurance. I know my health costs are higher so as to cover people without insurance.
The only hope I see is that new healthcare reform law is making insurance put 80% of its money into direct patient care. Unfortunately, health insurances are already trying to find ways around this. THe law also has different pilot programs to reduce health care costs. Hopefully, these pilot projects will lead to bigger changes in health care.
Well, that was more than 2 cents. I will save the debate about prescription costs for another time |
The only normal people are the ones you don't know very well! - Joe Ancis |
|
|
|
Valiant Dancer
Forum Goalie
USA
4826 Posts |
Posted - 06/02/2011 : 06:46:15 [Permalink]
|
Originally posted by Dave W.
Originally posted by Valiant Dancer
It's called Capitalism. |
Capitalism isn't the be-all, end-all governmental system. Which health interventions work best under which situations is an empirical question that need not wait for the "invisible hand" to scribble out an answer. Just how much competition is there between doctors for the creation of the next great surgical technique? Really, I see no need for health care to be subject to the whims of market forces.| The people getting paid won't want to play if there isn't any money in it for them. |
There are millions of civil servants who clearly didn't take their jobs in order to get rich. |
They took the jobs because no one else would hire candidates with no experience. Some stuck with it after a year because they got permanent status and became nearly impossible to fire.
The cost savings of nationalizing health care would probably allow us to pay for the eduction of doctors and nurses, too - an encouragement to enter the field that many don't have today.| It's why healthcare is having a serious problem getting people to take jobs there. |
How much of a problem and where? |
Nursing is a biggie. There's no money in it to pay for the nursing schools that they attended. My own company has over 100 open positions that they cannot find qualified people for. Many don't know the programming language. Even more will not accept the mere pittance we pay (common for healthcare providers).
| They trade access to large pools of customers in exchange for discounts for services that would not normally be avaialable to Joe Consumer. |
Nationalize the system and those considerations simply vanish.| The CEO took a pay cut this year to $49 million. |
Whoop-te-do. That's still over 300 GS-15/10 positions taken up by just one guy. |
As his peers make quite a bit less, I think he is a poor example. In addition, what is $49 million compared to the revenue or profit from the company he runs? As it is a publicly traded company, the compensation is reviewed and voted on by the shareholders.
Should I worry about you looking at my job as so many government positions? I'm sure they could get a handful of GS-5 positions for mine.
| (For comparison, the annual salary for the United States Secretary of Health and Human Services has been $199,700 since January, 2010.) |
And what healthcare does he provide?
His position is regulatory. |
Insurance company CEOs don't provide any healthcare, either. Kathleen Sebelius' position as head of the DHHS would be analogous to an insurance company's CEO if we were to nationalize health care. {/quote]
No, the position wouldn't. DHHS makes rules for others that it doesn't have to follow. Likewise, they aren't subject to the state legislation that impacts insurance agencies.
| We would get an instant cost reduction of nearly $48.8 million. |
Out of a $2.6 trillion industry. There's savings for ya.
| [quote](and costs healthcare providers and insurance companies plenty when he changes his mind.) |
Not if we nationalized the system, she wouldn't. The healthcare providers would all be government employees, and the insurance companies would be begging for scraps among the very rich who only want insurance against their face-lifts sagging too soon.
|
|
Cthulhu/Asmodeus when you're tired of voting for the lesser of two evils
Brother Cutlass of Reasoned Discussion |
|
|
|
Valiant Dancer
Forum Goalie
USA
4826 Posts |
Posted - 06/02/2011 : 07:07:51 [Permalink]
|
Originally posted by marfknox
Val wrote: BUZZZZZZZZ!!! Tacky buzzer!!!!! ERs DO have to treat non-life threatening illnesses. I am identifying the "must treat" rule with the cause for medical care rising. It has to be paid for some way. The EMTALA's lack of reimbursement for this mandated care is the primary issue.
|
Okay, I apologize for my ignorance. ERs must treat "emergency medical situations", even if they are not life threatening. From here: http://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act
An emergency medical condition is defined as "a condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in placing the individual's health [or the health of an unborn child] in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of bodily organs. |
The criticisms of this law is that it is an unfunded mandate. That would be a good argument if the alternative wasn't going back to patient dumping being a legal practice. All this law really shows is the absurdity of not having universal health care. So I'm not sure what your point of bringing this law up is. Are you suggesting that we get rid of this law BEFORE we fix the other problems with our health care system? Because the only reason we need this law is because of those other problems. |
No. I am suggesting that we PAY FOR this law before trying to fix things. The law shows the market pressures on the system and instead of dealing with out of control costs, they just saddled the industry with an unfunded mandate.
| As I am one of the poor bastards that have to change huge amounts of coding at short notice to comply with this, permit me to strenuously disagree. The legislation doesn't do anything to fix the root problem and only serves to punish the current bugaboo for political points. |
So health insurance companies are merely a bugaboo, not even part of the problem? |
They are a very minor problem at best. Primarily with smaller health care insurers that jacked up their profits to the point that some government suit could cherry pick that data to try to paint the industry as a whole as fitting their mold.
| Because they limit malpractice awards and have price controls on pharmacutals which we don't have (and the US is paying for). |
According to this chart, USA health care costs per capita are about twice as high as in France, Japan, Germany, Canada, Australia and the U.K. From what I've read, tort reform could at best reduce costs by 10%. So is it your contention that price controls on pharmacutals would bring it down the rest of the way? I am skeptical.
However, you have convinced me that tort reform and price controls on drugs would be huge steps in the right direction. But I sort of already believed that.
|
Price controls on pharmaceuticals would have a significant impact. As the pharmeceutal companies operate at a much smaller profit in the price controlled nations, they have turned to the unregulated US market to make up for that lack of profit.
DME manufacturers have to keep up FDA filings on their products. They have to refile in the case of minor changes. For instance, a walker has blue handles. The company making the blue handles goes belly up or changes their color to red. The DME company must then refile with the FDA. The documents fill 30-40 banker's boxes worth of paper describing the walker to the finest detail and must have the handles updated everywhere it appears. This administrative burden drives up the cost of the item.
What I see being ignored hear is that the companies making medical supplies and equipment have to be able to buy raw materials. As those prices increase, the items have to be priced higher to pay for future raw material procurement. The government is the only corporation that can work differently because they can arbitrarily raise income by squeezing it out of the citizenry.
A government run, universal plan is an overkill solution to a problem that is still fixable. |
Cthulhu/Asmodeus when you're tired of voting for the lesser of two evils
Brother Cutlass of Reasoned Discussion |
|
|
|
Dave W.
Info Junkie
USA
26020 Posts |
Posted - 06/04/2011 : 19:32:52 [Permalink]
|
Originally posted by Valiant Dancer
Originally posted by Dave W.
There are millions of civil servants who clearly didn't take their jobs in order to get rich. |
They took the jobs because no one else would hire candidates with no experience. Some stuck with it after a year because they got permanent status and became nearly impossible to fire. |
Wow. How tremendously insulting.| Nursing is a biggie. There's no money in it to pay for the nursing schools that they attended. My own company has over 100 open positions that they cannot find qualified people for. Many don't know the programming language. Even more will not accept the mere pittance we pay (common for healthcare providers). |
Eliminating huge CEO salaries and ten-digit corporate profits and standardizing on a single national software system would go a long way towards fixing those problems.| As his peers make quite a bit less, I think he is a poor example. In addition, what is $49 million compared to the revenue or profit from the company he runs? As it is a publicly traded company, the compensation is reviewed and voted on by the shareholders. |
The shareholders are in it for the money, not for providing high-quality health care. If the two happen to coincide, that'd be fine with the investors, but if not, they want the money. Those are the wrong priorities for providing health care.| Should I worry about you looking at my job as so many government positions? I'm sure they could get a handful of GS-5 positions for mine. |
It's nothing personal, Val. So far as I know, the government doesn't actually directly hire any software developers, so I'm sure if my ideal health care system were to be implemented tomorrow, you could get a decent consulting contract with the Feds for helping to create the "next gen" network which would be required. Or, if you want job security, you could probably land a GS-13 or so as a COTR or project lead overseeing the contracting software developers. Those of us with insurance already pay your salary with our premiums, Val. None of us who are in favor of nationalizing the industry are going to whine about you doing a job you're good at with our tax dollars, either directly or indirectly. Given your obvious experience, your future would be bright and not at all uncertain.| No, the position wouldn't. DHHS makes rules for others that it doesn't have to follow. |
If health care were nationalized, the DHHS would be the logical executive-branch entity to run the whole system. That's why it's analogous.| Likewise, they aren't subject to the state legislation that impacts insurance agencies. |
If health care were nationalized, the state legislation and insurance companies become moot except for rich people who want extra coverage.| We would get an instant cost reduction of nearly $48.8 million. |
Out of a $2.6 trillion industry. There's savings for ya. |
It's just an example, and a good start. |
- Dave W. (Private Msg, EMail)
Evidently, I rock!
Why not question something for a change?
Visit Dave's Psoriasis Info, too. |
|
|
 |
|
|
|
The next black president?
