[Jazzman]

At least she can be sure the Taliban won’t be trying to shoot her.

[Jazzman]

Apologies, I should have mentioned this is a full length documentary (also available on Netflix under the title Money and Medicine). What I like about it is that the medical profession has at last come out and added their vital input to this whole debate. Then you know it’s not politically skewed. It really is an eye-opener, not just from the point of view of waste and costs, but also from the perspective of life changing/threatening invasive, non-essential treatment. You don’t really get a sense of how much the debate rages within the medical profession, but one assumes it must since the problem is still there. Anyone getting long in the tooth needs to prepare not just for death itself, but also for the understandably difficult choices you may be faced with that lead up to it. Will or should health directives become mandatory?

Folks, if you have an opinion, any opinion on health care, then you NEED to watch this. It could save your life.

[Jazzman]

[quote=livinincali][quote]
Nobody is saying universal (single payer) systems are without their faults, but no one is denied health care. Budgets are trimmed, waste is slashed, and taxes go up, but health care still remains a fundamental right. Under a free market system, you are at the mercy of a corporation. You have no guarantees so it is the policy holders who get pushed out of the system.
[/quote]

In some cases you are denied health care in single payer system. See most elective surgeries in single payer countries. You could wait years to get a hip replacement and could die before received one. I suppose we can say you were in the queue so you weren’t denied but effectively you were. You didn’t get the surgery you wanted/needed for an improved quality of life before your life ended. The same is true under a capitalistic system if you don’t have the money for a hip replacement you don’t get one either.

Single payer is essentially a price control system. Since there is only one payer of services, the single payer sets the price for each service. You could implement price controls without single payer. We all know what tends to happen in price controlled systems. There usually ends up being shortages because the price is artificially lowered.[/quote]
In some cases, yes the system gets over-loaded and long waits are not unknown. As I said, national health care is not perfect. But the comparison is meaningless when you have 48 million without insurance. That is almost the whole population of single-payer country. Private healthcare is also the single biggest cause of personal bankruptcy. So it’s pretty clear where the biggest shortages are. Look, you can defend private health care, and berate public health care all you want, but the facts speak volumes. It is your choice whether to accept or reject them. I personally don’t care which system prevails as long as it provides a guarantee of affordable health care in times of need. That is what it is all about. Not who has the biggest dick.

[Jazzman]

[quote=livinincali]
There’s a limited number of medical services available to everybody. Whether you decide to provide those services on the ability to pay, or waiting in line you still have a selective process in who gets the services when they want them.
Not sure if you are referring to all health care systems of just universal. Whatever, that holds true for most things.

The current medical system isn’t a free market. there’s plenty of anti competitive laws passed by congress to limit competition in providing medical services. Go try to open a MRI center in San Deigo and charge $500 a patient. You’ll never make it through the licensing and regulation process because those with existing MRI center lobbied to put up those barriers to entry in the name of safety. Go try to buy cheaper prescription drugs in Mexico and import them to the US. That still makes it a free market. It may wield more power than some of us would like, but the lobbying isn’t done in the name of socialism.

All of these things make health care more expensive and single payer doesn’t do anything to solve those problems of higher costs here than anywhere else. Who opens a new hospital or clinic if the single payer doesn’t pay enough to keep the doors open. Do medical services providers open more facilities or less facilities under a single payer system. I see single payer pushing more providers out of the system and fewer services available to those in the single payer system. The next step will be to create government providers of services and/or forcing providers of medical services to accept single payer no matter what. Nobody is saying universal (single payer) systems are without their faults, but no one is denied health care. Budgets are trimmed, waste is slashed, and taxes go up, but health care still remains a fundamental right. Under a free market system, you are at the mercy of a corporation. You have no guarantees so it is the policy holders who get pushed out of the system.

Why not focus of the problem of cost by encouraging more supply of medical services via competition. Why not force users of medical services to shop around for better prices and/or decide that some test/treatment isn’t worth it. That’s the way you address the cost problem.
I agree that costs are the core of the problem, but the current system encourages escalating costs, so it is time for the system to change.[/quote]

[Jazzman]

[quote=livinincali]
The fundamental issue is there’s virtually unlimited demand for medical services and tests if you don’t have to pay for it.
Under a universal system everyone contributes. If everyone abuses or over-uses, they’ll soon tire of the long lines.

Single payer solves the rising costs of infinite demand problem via rationing.
What rationing is that? It is the opposite; giving greater access to care as opposed to discriminatory, selective care.

A free market system would solve that problem via competition of providers.
Yes? Look where it has led.

Of course single payer does have the problem that you don’t necessarily attract the best and the brightest to become doctors because your single payer system has limited their compensation package. The best and brightest still might become doctors but they won’t be available to the users of the single payer system. They’ll exist outside of the system treating those that can afford to pay supplemental coverage.
This is a large assumption. Doctors in other countries are well remunerated and the profession does not attract the money-grubbing type. The extent to which it does, makes no commensurate guarantee of better care. No lines and slicker service maybe.

Placing healthcare systems under a theoretical framework comes unstuck pretty quickly. Far better to experience it for yourself to understand it.

[/quote]

[Jazzman]

^^^The calculations and comparisons are going to difficult, but the money to pay for health care still has to come from the same place, whether it’s taxes or insurance premiums, so I don’t see how costs per capita increase under a universal system.

[Jazzman]

Good find CAR, ditto OCR. Here’s my take on the email:

Socialized (whatever that is supposed to mean) healthcare is not without its problems. I too lived under one for many years. They are a constant political bone of contention.

Obamacare is possibly not working as well as it could, because it’s a half-baked compromise that came about as a result of the usual legislative political deal-making.

I was very happy to see costs have been mentioned as “one of the biggest problems.” They are, I believe, the main problem.

I can confirm the exchanges are poorly represented by insurers here in Hawaii. But there are very few insurers anyway. Healthcare cover, however, is already mandated for employers for every employee.

Very interesting cost statistic regarding the last year of one’s life. I have a health care directive. It says. “If you find me injured and bleeding, kick me perfunctorily (hard) in the head. If you call an ambulance, don’t forget to leave your address so I can forward you the bill.”

[Jazzman]

[quote=ocrenter][quote=joec]

Companies are also getting fleeced if you see how much COBRA is when you switch jobs. I think that’s what your company pays for you actually.

[/quote]

This is why it is to our competitive advantage to move the health care burden away from the companies and put it under a single payer monopoly that can regulate cost.

Btw, all of the East Asian developed countries (Japan, S.Korea, Taiwan) enacted universal single payer health coverage under Conservative, Right Wing, Pro-business parties.[/quote]
I have been to Taiwanese hospitals a couple of times. Once for a two day stay for a complete, top-to-toe body check. I don’t remember exactly how much it cost, but I do remember it was a fraction of the cost here. The second time I used a hospital dentist. Excellent service, very effective, and much cheaper. They issue you with an electronic card that has all the data about your visits, health, etc. Fantastic! How did they achieve this? They were not too proud to admit their system was creaky and so went around the world taking the best parts of other healthcare systems to create their own unique system. The result is probably one of the best healthcare systems in the world. A very rational approach.

[Jazzman]

[quote=all][quote=EconProf]You need to look at the quality of doctors, not just the quantity. Would you rather be treated by an Uzbekistani doctor in a hospital in Uzbekistan, or an American doctor in America?[/quote]

I don’t think primary care physicians in Uzbekistan are lesser doctors than their US counterparts. They likely cannot order an MRI for you, though. But I was thinking about the cost and ease of access. Having more trained professionals would help with both.[/quote]

You may be right EconProf. Central Asian man with sexually transmitted diseases possibly due to incestuous relationship seeks health care in the US. http://www.youtube.com/watch?v=YCAubW1g7vQ

[Jazzman]

I can’t even get catastrophic cover at the moment. I’m healthy and have no pre-existing conditions. Not only that but I had to go through very extensive tests. They just didn’t want to cover me from the start so decided to waste my time and money instead. I’m glad they didn’t offer me cover because I see now a claim would have been a nightmare.

[Jazzman]

[quote=no_such_reality][quote=ocrenter]Bottomline, we need to figure something out before the Baby Boomer generation hits 80+. The first of that generation are already in their late 60’s. So we got about ten years before the bomb explodes.[/quote]

The biggest health savings we’ll get is by getting people covered and into care instead of spiraling until they cannot be ignored.

And we need seriously change our end of life care expectations. AKA death panels.[/quote]

That is only half the equation. Just finding revenue will mean healthcare costs will remain high. The reason the current system is failing is because of out-of-control costs, not because of the uninsured, or insurance companies, or any other scapegoats. Look at the OECD figures. It says is all.

[Jazzman]

[quote=all]Single payer + H1B for MD’s and DDS/DMD’s?
But what do you do with all the doctors, dentists and back office people who can’t pay back the loans they took to acquire skills?[/quote]
As I mentioned in an earlier post, training/education is a major cost. When you see why it is so expensive, the words escape you. The biggest problem is, without question, a complete denial and inability to see spiraling, out-of-control costs as the problem. You have seen it in housing, education, health care and yet the popular fix is to find extra money from somewhere. The problem with that is it just pushes the costs to somewhere else. Nobody wants money taken from them, but I find it impossible to believe that many of the costs cannot be reduced significantly without too much hurt. In plain English, it is quite insane and worrying that the issue is sidestepped.

[Jazzman]

This is an insurer’s (Aetna) report, but the principle that costs are the problem is, I believe, correct. Merely finding ways to meet those costs encourages escalating them.

Compared to other Organization of Economic Cooperation and Development (OECD) nations, hospital spending in the U.S. is more than 60 percent higher. Spending on physicians, specialists and dentists is almost 2 ½-times higher than in other OECD countries.

[img_assist|nid=17716|title=Graph|desc=|link=node|align=left|width=515|height=423]

Reasons:

Hospital mergers and acquisitions jumped by 33 percent between 2009 and 2010. Research shows that hospital market concentration leads to increases in the price of hospital care.

Wow! Now aren’t M&As supposed to have the opposite effect?

Higher levels of obesity and greater access to advanced medical technology, is a primary driver of higher spending levels.

Don’t just blame the fatties. This is the food industry targeting poorer people.

After hospital spending the next biggest contributor to overall spending growth … was the increase in physician and clinical service costs.

Apparently, doctors pay up 30% of their income on liability insurance. Obama clearly needs to find other sources of campaign funds.

The implementation of new medical technology accounts for between 38 percent and 65 percent of health care spending increases.

That’s huge. Ends justifies the means looks more like a corporate slogan here.

Half of all health care spending, is the result of waste. The biggest area of excess is defensive medicine, including redundant, inappropriate or unnecessary tests and procedures.

Another huge and seemingly, easily solved problem. How many CPAs do hospitals have on their boards. Clearly not enough.

The growing burden of chronic diseases adds significantly to escalating health care costs. Obesity accounts for an estimated 12 percent of the health spending growth in recent years.

Now this is an interesting one. Were are, by all accounts, becoming healthier since we are living longer. It seems we are living longer so we can enjoy longer poor health.

Major drug manufacturers have an average profit margin of 16.7 percent; medical instrument and supply companies, 13.6 percent; biotechnology, 11.9 percent; and medical appliance and equipment companies, 13.7 percent.

This is just Aetna’s gripe about insurers being blamed for the costs. They state their profit margins are significantly less. In some senses, they do occupy the end of the soup line so their gripe is somewhat justified.

Source: http://www.aetna.com/health-reform-connection/aetnas-vision/facts-about-costs.html#spending

[Jazzman]

Do you work in healthcare OCR?

[Jazzman]

[quote=EconProf]My son is a single, healthy 30-year old. He has always bought inexpensive health insurance on his own with a high deductible. He pays the first $2000 per year of any medical expenses and 20% of anything over that amount. Very cheap because at his age the insurance company has little risk and competition with other insurance companies forces them to price it low. Also, he shops around when he needs medical service, offers to pay up front, and gets huge discounts when the provider realizes they don’t have to deal with insurance paperwork. In other words, he is dealing in the private sector he has found the right solution for his situation, and puts no burden on others to subsidize his medical needs.
Now, under Obamacare, he will see his costs double or triple because he will have to pay for older, less healthy people. The government is imposing a one-size-fits-all plan upon us rather than letting us pick and chose what best fits our situation. The result is hidden subsidies to some and hidden costs to others. For all you Piggs under 40, and especially those under 30, the coming rate shock will be a wakeup call. Interestingly, the under 30 year olds were those who most likely voted for Obama.[/quote]
Supposing your son falls ill (God forbid) when he is older. Won’t he be thankful the next generation is subsidizing him?

[Author]

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