A real, but rarely addressed problem with government run health care

[Nebor]

Originally posted by: Excelsior

Originally posted by: Nebor

Originally posted by: RightIsWrong
The key phrase in your post was "just about". There are clear examples where the private sector can do and does a worse job than the government. Public utilities, roads, policing, space exploration, fire rescue services and the military for example.

As someone who takes a special interest in the economics of public goods, let me point out a simple fact: a doctor is not a public good. He is his own person, who gets to pick and choose his patients as he chooses, and go home at whatever time he pleases. He can only treat one person at a time, and makes a conscious decision between treating each successive patient and going home to do something else. A doctor is different from a police officer, or a road, a soldier or a space shuttle.

There are serious free rider problems associated with making health care a public good. And attempting to fix those problems creates serious problems concerning our personal liberties.

Like it's been said numerous times in this thread, health care is a scarce good, and thus it must be rationed. The most efficient way to ration it is in a free market. The least efficient way to ration it is through the inherent administrative inefficiencies of government intervention.

I used to think like this, but its simply untrue. Taiwan spends a fraction on the administrative costs that we have here in the US. I believe ours are around 15 percent:

By consolidating so much ? one government plan that covers everybody ? Taiwan achieves remarkable efficiency.

Everybody here has to have a smart card to go to the doctor. The doctor puts it in a reader and the patient's history and medications all show up on the screen. The bill goes directly to the government insurance office and is paid automatically.

So Taiwan has the lowest administrative costs in world: less than 2 percent.

http://www.npr.org/templates/s...y.php?storyId=89651916

It is remarkable how efficient it is, but you also have to consider the type of government in place in Taiwan. What do you think it entails when the "Bureau of National Health Insurance" comes to have a "little chat?"

That article serves to point out the unbridled consumption problem of UHC (solved by the Taiwanese with visits from scary state officials.) And also the fact that the system is too expensive for them to afford. They're borrowing money to keep it going.

I do admire their system overall though. Very efficient, high quality care, while still maintaining a private health care industry. Though I imagine prices for services must be dictated by the government.

 

[Xavier434]

Originally posted by: Nebor

It is remarkable how efficient it is, but you also have to consider the type of government in place in Taiwan. What do you think it entails when the "Bureau of National Health Insurance" comes to have a "little chat?"

That article serves to point out the unbridled consumption problem of UHC (solved by the Taiwanese with visits from scary state officials.) And also the fact that the system is too expensive for them to afford. They're borrowing money to keep it going.

I do admire their system overall though. Very efficient, high quality care, while still maintaining a private health care industry. Though I imagine prices for services must be dictated by the government.

Taiwan is having trouble affording it, but what I would like to know is what it would take for the US to be able to afford it and maintain the same kind of quality. That is one of many million dollar questions concerning this topic right? Does anyone really know who is also offering what seems to be an unbiased opinion?

 

[neodyn55]

Good article, but this disturbs me:

A first step in the right direction would be to repeal EMTALA, allowing doctors and hospitals to decide whom they will treat and on what terms, and whether they will treat a given patient at all. As a matter of moral fact, doctors have the same rights as plumbers, accountants, grocers, and lawyers?rights that include the right to decide which patients they will treat and to refuse patients who cannot afford them.

If you're unconscious in an accident, or are otherwise having a true emergency, what if the Hospital (for whatever reason) refuses to treat you (whether you can pay or not)? What if you're experiencing a high degree of pain? Will you have to go hobbling around to different hospitals for treatment?

I don't have an alternative solution to the problems of EMTALA, but it seems you will come across cases were denying someone treatment will simply be cruel and inhuman.

 

[Nebor]

Originally posted by: neodyn55
Good article, but this disturbs me:

A first step in the right direction would be to repeal EMTALA, allowing doctors and hospitals to decide whom they will treat and on what terms, and whether they will treat a given patient at all. As a matter of moral fact, doctors have the same rights as plumbers, accountants, grocers, and lawyers?rights that include the right to decide which patients they will treat and to refuse patients who cannot afford them.

If you're unconscious in an accident, or are otherwise having a true emergency, what if the Hospital (for whatever reason) refuses to treat you (whether you can pay or not)? What if you're experiencing a high degree of pain? Will you have to go hobbling around to different hospitals for treatment?

I don't have an alternative solution to the problems of EMTALA, but it seems you will come across cases were denying someone treatment will simply be cruel and inhuman.

Medical care is a commodity like anything else. You don't have a right to it. Just as someone who didn't properly budget for car maintenance is left to walk, someone who didn't properly prioritize and budget for health care is left to die.

I find it shocking that whoever wrote that quote above thinks that doctors shouldn't have the same right to free choice as any other professional.

 

[Xavier434]

Originally posted by: Nebor

Originally posted by: neodyn55
Good article, but this disturbs me:

A first step in the right direction would be to repeal EMTALA, allowing doctors and hospitals to decide whom they will treat and on what terms, and whether they will treat a given patient at all. As a matter of moral fact, doctors have the same rights as plumbers, accountants, grocers, and lawyers?rights that include the right to decide which patients they will treat and to refuse patients who cannot afford them.

If you're unconscious in an accident, or are otherwise having a true emergency, what if the Hospital (for whatever reason) refuses to treat you (whether you can pay or not)? What if you're experiencing a high degree of pain? Will you have to go hobbling around to different hospitals for treatment?

I don't have an alternative solution to the problems of EMTALA, but it seems you will come across cases were denying someone treatment will simply be cruel and inhuman.

Medical care is a commodity like anything else. You don't have a right to it. Just as someone who didn't properly budget for car maintenance is left to walk, someone who didn't properly prioritize and budget for health care is left to die.

I find it shocking that whoever wrote that quote above thinks that doctors shouldn't have the same right to free choice as any other professional.

That is complete bullshit considering how much certain kinds of emergency healthcare can cost. Some of it is upwards to being over 50k over the course of a week for christ's sake. How can you say that anyone who doesn't have that kind of money sitting around should just be left to die in their beds at home while in severe pain or on the street as they are kicked out of the hospital?

Sorry man, but what you are proposing will never become policy. Not in this country. We are above such nonsense. Too many Americans actually care about the well being of others and do not believe that money takes priority over everything. We do not believe that the lives of others are of equal value to that of cars.

Also, unlike other professionals, doctors are responsible for the lives of others on a regular basis. That is far more important than the vast majority of responsibilities that other professionals have. Most of America understands that. Why don't you?

 

[Nebor]

Originally posted by: Xavier434

Originally posted by: Nebor

Originally posted by: neodyn55
Good article, but this disturbs me:

A first step in the right direction would be to repeal EMTALA, allowing doctors and hospitals to decide whom they will treat and on what terms, and whether they will treat a given patient at all. As a matter of moral fact, doctors have the same rights as plumbers, accountants, grocers, and lawyers?rights that include the right to decide which patients they will treat and to refuse patients who cannot afford them.

If you're unconscious in an accident, or are otherwise having a true emergency, what if the Hospital (for whatever reason) refuses to treat you (whether you can pay or not)? What if you're experiencing a high degree of pain? Will you have to go hobbling around to different hospitals for treatment?

I don't have an alternative solution to the problems of EMTALA, but it seems you will come across cases were denying someone treatment will simply be cruel and inhuman.

Medical care is a commodity like anything else. You don't have a right to it. Just as someone who didn't properly budget for car maintenance is left to walk, someone who didn't properly prioritize and budget for health care is left to die.

I find it shocking that whoever wrote that quote above thinks that doctors shouldn't have the same right to free choice as any other professional.

That is complete bullshit considering how much certain kinds of emergency healthcare can cost. Some of it is upwards to being over 50k over the course of a week for christ's sake. How can you say that anyone who doesn't have that kind of money sitting around should just be left to die in their beds at home while in severe pain or on the street as they are kicked out of the hospital?

Sorry man, but what you are proposing will never become policy. Not in this country. We are above such nonsense. Too many Americans actually care about the well being of others and do not believe that money takes priority over everything.

Also, unlike other professionals, doctors are responsible for the lives of others on a regular basis. That is far more important than the vast majority of responsibilities that other professionals have. Most of America understands that. Why don't you?

You don't have to have $50k cash, you just have to have to have insurance. You have to budget for that every month. It's all about common sense and priority. If someone slams into a bridge support in their car at 100mph, you think that was a poor choice on their part, to drive recklessly. Why don't we have this concept of personal responsibility when it comes to health care? It's not my job to provide for your health care. It's just not. I provide for mine. You provide for yours, IF YOU WANT IT. By all means, die at home writhing in pain if you'd rather buy 24" wheels than pay your insurance premium every month.

 

[Nebor]

Originally posted by: Xavier434

Originally posted by: Nebor

It is remarkable how efficient it is, but you also have to consider the type of government in place in Taiwan. What do you think it entails when the "Bureau of National Health Insurance" comes to have a "little chat?"

That article serves to point out the unbridled consumption problem of UHC (solved by the Taiwanese with visits from scary state officials.) And also the fact that the system is too expensive for them to afford. They're borrowing money to keep it going.

I do admire their system overall though. Very efficient, high quality care, while still maintaining a private health care industry. Though I imagine prices for services must be dictated by the government.

Taiwan is having trouble affording it, but what I would like to know is what it would take for the US to be able to afford it and maintain the same kind of quality. That is one of many million dollar questions concerning this topic right? Does anyone really know who is also offering what seems to be an unbiased opinion?

Considering the costs involved when you get what amounts to unbridled consumption, I think it's pretty clearly unaffordable. Especially consider the elderly, and soon to be elderly population that would be utilizing it (often.) Also take into account the projected costs of current entitlement programs (Social security) and the cost of current (Iraq, Afghanistan) and imminent (Iran) conflicts.

America simply can't afford UHC, which is actually convenient, because even if we could, it would be a bad idea.

 

[Xavier434]

Originally posted by: Nebor

You don't have to have $50k cash, you just have to have to have insurance. You have to budget for that every month. It's all about common sense and priority. If someone slams into a bridge support in their car at 100mph, you think that was a poor choice on their part, to drive recklessly. Why don't we have this concept of personal responsibility when it comes to health care? It's not my job to provide for your health care. It's just not. I provide for mine. You provide for yours, IF YOU WANT IT. By all means, die at home writhing in pain if you'd rather buy 24" wheels than pay your insurance premium every month.

What if your income is at a state where you cannot afford insurance, your employer doesn't offer it as an option, and there is nothing else you can do to lower your standard of living that will result in a situation that even comes close to being able to pay for your own health insurance or that of anyone else in your family? This scenario is very common amongst the elderly and the lower class. What happens in those scenarios?

 

[Xavier434]

Originally posted by: Nebor

Originally posted by: Xavier434

Originally posted by: Nebor

It is remarkable how efficient it is, but you also have to consider the type of government in place in Taiwan. What do you think it entails when the "Bureau of National Health Insurance" comes to have a "little chat?"

That article serves to point out the unbridled consumption problem of UHC (solved by the Taiwanese with visits from scary state officials.) And also the fact that the system is too expensive for them to afford. They're borrowing money to keep it going.

I do admire their system overall though. Very efficient, high quality care, while still maintaining a private health care industry. Though I imagine prices for services must be dictated by the government.

Taiwan is having trouble affording it, but what I would like to know is what it would take for the US to be able to afford it and maintain the same kind of quality. That is one of many million dollar questions concerning this topic right? Does anyone really know who is also offering what seems to be an unbiased opinion?

Considering the costs involved when you get what amounts to unbridled consumption, I think it's pretty clearly unaffordable. Especially consider the elderly, and soon to be elderly population that would be utilizing it (often.) Also take into account the projected costs of current entitlement programs (Social security) and the cost of current (Iraq, Afghanistan) and imminent (Iran) conflicts.

America simply can't afford UHC, which is actually convenient, because even if we could, it would be a bad idea.

I don't know about that. I don't think it is necessarily a bad idea. I just think it boils down to proper management and priorities. I think that the biggest issue is that there are a lot of people out there who are well off and simply do not want their taxes going towards such quality healthcare for everyone and that it really doesn't have much to do with anything else. If that is the case, and I am open for correction, then it all boils down to a simple difference in opinion. Some place healthcare as a valued priority while others do not.

 

[neodyn55]

Originally posted by: Nebor

Originally posted by: Xavier434

Originally posted by: Nebor

Originally posted by: neodyn55
Good article, but this disturbs me:

A first step in the right direction would be to repeal EMTALA, allowing doctors and hospitals to decide whom they will treat and on what terms, and whether they will treat a given patient at all. As a matter of moral fact, doctors have the same rights as plumbers, accountants, grocers, and lawyers?rights that include the right to decide which patients they will treat and to refuse patients who cannot afford them.

If you're unconscious in an accident, or are otherwise having a true emergency, what if the Hospital (for whatever reason) refuses to treat you (whether you can pay or not)? What if you're experiencing a high degree of pain? Will you have to go hobbling around to different hospitals for treatment?

I don't have an alternative solution to the problems of EMTALA, but it seems you will come across cases were denying someone treatment will simply be cruel and inhuman.

Medical care is a commodity like anything else. You don't have a right to it. Just as someone who didn't properly budget for car maintenance is left to walk, someone who didn't properly prioritize and budget for health care is left to die.

I find it shocking that whoever wrote that quote above thinks that doctors shouldn't have the same right to free choice as any other professional.

That is complete bullshit considering how much certain kinds of emergency healthcare can cost. Some of it is upwards to being over 50k over the course of a week for christ's sake. How can you say that anyone who doesn't have that kind of money sitting around should just be left to die in their beds at home while in severe pain or on the street as they are kicked out of the hospital?

Sorry man, but what you are proposing will never become policy. Not in this country. We are above such nonsense. Too many Americans actually care about the well being of others and do not believe that money takes priority over everything.

Also, unlike other professionals, doctors are responsible for the lives of others on a regular basis. That is far more important than the vast majority of responsibilities that other professionals have. Most of America understands that. Why don't you?

You don't have to have $50k cash, you just have to have to have insurance. You have to budget for that every month. It's all about common sense and priority. If someone slams into a bridge support in their car at 100mph, you think that was a poor choice on their part, to drive recklessly. Why don't we have this concept of personal responsibility when it comes to health care? It's not my job to provide for your health care. It's just not. I provide for mine. You provide for yours, IF YOU WANT IT. By all means, die at home writhing in pain if you'd rather buy 24" wheels than pay your insurance premium every month.

Your scenario is oversimplified. Not everyone forgoes insurance for buying 24" wheels. What about those people? You can't deny that they don't exist.

Here's an example: What if you're in a strange town and beaten badly during a mugging? Lets say all your papers are stolen, and you're semi conscious. Will repealing the EMTALA cause denial of care of you because the hospital can't be assured of payment in this regard?

I see where you're coming from with your take on personal responsibility, but it isn't black-and-white like that.

Also, this is my personal opinion. I don't care if you're the dumbest person in the world, spending all your cash on stupid things and not insurance; if you're suffering from 9-level pain on a scale of 10, a civilized society shouldn't turn you away because you can't pay. And certainly not in the US, pretty much the most advanced society in the world. We just have to find the most efficient way of doing it (not necessarily UHC or the current system.)

 

[ElFenix]

Originally posted by: Nebor

Medical care is a commodity like anything else. You don't have a right to it. Just as someone who didn't properly budget for car maintenance is left to walk, someone who didn't properly prioritize and budget for health care is left to die.

I find it shocking that whoever wrote that quote above thinks that doctors shouldn't have the same right to free choice as any other professional.

no one puts a gun to a hospital's head and says they have to accept EMTALA.

Originally posted by: neodyn55

Also, this is my personal opinion. I don't care if you're the dumbest person in the world, spending all your cash on stupid things and not insurance; if you're suffering from 9-level pain on a scale of 10, a civilized society shouldn't turn you away because you can't pay. And certainly not in the US, pretty much the most advanced society in the world. We just have to find the most efficient way of doing it (not necessarily UHC or the current system.)

what if we're 'pretty much the most advanced society in the world' precisely because we tell people to f off after making dumb decisions?

 

[Nebor]

Originally posted by: neodyn55

Originally posted by: Nebor

Originally posted by: Xavier434

Originally posted by: Nebor

Originally posted by: neodyn55
Good article, but this disturbs me:

A first step in the right direction would be to repeal EMTALA, allowing doctors and hospitals to decide whom they will treat and on what terms, and whether they will treat a given patient at all. As a matter of moral fact, doctors have the same rights as plumbers, accountants, grocers, and lawyers?rights that include the right to decide which patients they will treat and to refuse patients who cannot afford them.

If you're unconscious in an accident, or are otherwise having a true emergency, what if the Hospital (for whatever reason) refuses to treat you (whether you can pay or not)? What if you're experiencing a high degree of pain? Will you have to go hobbling around to different hospitals for treatment?

I don't have an alternative solution to the problems of EMTALA, but it seems you will come across cases were denying someone treatment will simply be cruel and inhuman.

Medical care is a commodity like anything else. You don't have a right to it. Just as someone who didn't properly budget for car maintenance is left to walk, someone who didn't properly prioritize and budget for health care is left to die.

I find it shocking that whoever wrote that quote above thinks that doctors shouldn't have the same right to free choice as any other professional.

That is complete bullshit considering how much certain kinds of emergency healthcare can cost. Some of it is upwards to being over 50k over the course of a week for christ's sake. How can you say that anyone who doesn't have that kind of money sitting around should just be left to die in their beds at home while in severe pain or on the street as they are kicked out of the hospital?

Sorry man, but what you are proposing will never become policy. Not in this country. We are above such nonsense. Too many Americans actually care about the well being of others and do not believe that money takes priority over everything.

Also, unlike other professionals, doctors are responsible for the lives of others on a regular basis. That is far more important than the vast majority of responsibilities that other professionals have. Most of America understands that. Why don't you?

You don't have to have $50k cash, you just have to have to have insurance. You have to budget for that every month. It's all about common sense and priority. If someone slams into a bridge support in their car at 100mph, you think that was a poor choice on their part, to drive recklessly. Why don't we have this concept of personal responsibility when it comes to health care? It's not my job to provide for your health care. It's just not. I provide for mine. You provide for yours, IF YOU WANT IT. By all means, die at home writhing in pain if you'd rather buy 24" wheels than pay your insurance premium every month.

Your scenario is oversimplified. Not everyone forgoes insurance for buying 24" wheels. What about those people? You can't deny that they don't exist.

Here's an example: What if you're in a strange town and beaten badly during a mugging? Lets say all your papers are stolen, and you're semi conscious. Will repealing the EMTALA cause denial of care of you because the hospital can't be assured of payment in this regard?

I see where you're coming from with your take on personal responsibility, but it isn't black-and-white like that.

Also, this is my personal opinion. I don't care if you're the dumbest person in the world, spending all your cash on stupid things and not insurance; if you're suffering from 9-level pain on a scale of 10, a civilized society shouldn't turn you away because you can't pay. And certainly not in the US, pretty much the most advanced society in the world. We just have to find the most efficient way of doing it (not necessarily UHC or the current system.)

I don't get badly beaten down in muggings. Either I live and the other guy(s) don't, or I die. Introducing firearms into those situations narrows the possible outcomes.

While I agree it is a noble thing to help someone who is down and hurt, because that is charitable, I find it very objectionable to make it the law that you must help them. That's basically what you do when you compel doctors to help people regardless of their ability to pay.

And once you decide that health care is a human right, then no one can be excluded. Illegal immigrants who pay no taxes at all MUST be taken care of. It's a cluster fuck.

To me, the most agreeable system (if I were the type to compromise with you pinko-commie lib types ) would be a single payer national health insurance program. Everyone would pay in, and just like a social security card, you would get your insurance card. You absolutely have to have that card, or some way of proving your enrolled in the system (ie: a US citizen) in order to obtain care anywhere.

But there would also be a concurrent private medical services market. You would have the option of paying for your own care, or with your own private insurance. This would allow for certain clinics, hospitals and other facilities that do no accept the national insurance card (presumably because the prices that national insurance is willing to pay is too low to satisfy them.)

That way, everyone would have coverage (like you want) and people like me could still get their own private insurance to ensure a higher quality of care. While I strongly oppose the idea of paying for other people's health care by paying national health insurance premiums, I feel that this is the most likely outcome in America. We've turned the corner in our nations history, where the majority has realized that they can simply vote money right out of the pockets of the minority. So given a choice between being forced to use sub-standard care payed for by the national provider, and having my choice of "paying twice" to maintain my private, high level care, I'll choose the latter.

 

[JSt0rm]

I think Nebor is the guy who said he would fight to the death if a van pulled up with armed men in it.

Nebor while your right that doctors are not slaves they do have a requirement to work at hospitals for 2 years during med school with no pay and for 4 more years after they graduate with limited pay. If you want to be a surgeon add 3 more years on to that. So 12 years grade school 4 years collage 4 years med school 4 years resident and if you want to be a surgeon 3 more years resident = 24/27 years of "slave" as you say (these aren't drinking kegs at the frat house years either). The system already runs on the backs of low paid doctors (45k to 65k a year depending) and they work them 60 to 80 hours a week.

I don't expect to change your mind about health care, think what you want but don't think that doctors get to dictate their entire lives. Most of them made a choice to become a doctor because they want to help people, their community or do high end research, again to help people. You make them sound like lawyers but look at that commitment above and you will see that if money was the only option business school and those same years of hard work would payoff even more.

The doctors are getting the squeeze by the insurance companies and the hospitals. You think that by going single payer the doctors would suffer but that is wrong. They would flourish under those conditions of PEER review.

And there already are private hospitals. There are doctors that only accept cash for treatments in excess of 250k. Sorry but I'm pretty sure you would be left out of this group as well Nebor.

 

[JSt0rm]

and also why do you think that $1 going into a private for profit agency would have a better impact on your health then $1 going into a public health agency with one goal - keeping you healthy and well.

 

[Nebor]

Originally posted by: JSt0rm01
and also why do you think that $1 going into a private for profit agency would have a better impact on your health then $1 going into a public health agency with one goal - keeping you healthy and well.

Because the public health agency doesn't have one goal. It has 330 million goals, keeping everyone healthy. That runs contrary to every person's intuitive desire, to put themselves first, to keep themselves healthy and well.

 

[Hayabusa Rider]

Originally posted by: JSt0rm01
and also why do you think that $1 going into a private for profit agency would have a better impact on your health then $1 going into a public health agency with one goal - keeping you healthy and well.

Here's the thing. First, I can (and do regularly) swear at private insurers, however your comment with a public health agency having one goal is not how it really works.

Case in point. HIPPA. Health portability and privacy. Small goals compared to providing complete health care.

Mrs. Jones who is 85 and has been married to the Mr. for oh, some 50 years. They have been doing fine, but the Mrs. has been noticing some strange things and wonders if it's due to his medications. It used to be "Sure, Mrs Jones- Ahh, I see something which might be causing a problem. I can't be sure, and it isn't common, but it's worth checking with the doctor."

Now I am supposed to say.

"Mrs. Jones, do you have power of attorney?" She of course looks at me funny. I am supposed to say "I'm sorry, but there is a law called HIPPA which prevents me from discussing your concerns. If I violate HIPPA, I could be fined heavily. Sorry"

That is public health keeping Mr Jones healthy and well.

If there is one thing good about private insurance, it's that you are allowed to use your best professional judgement. By law and regulation the government often takes that away.

Trusting government on these issues is no better than trusting anyone else, and sometimes worse. The government can ruin your life.

 

[Nebor]

Originally posted by: JSt0rm01
I think Nebor is the guy who said he would fight to the death if a van pulled up with armed men in it.

Nebor while your right that doctors are not slaves they do have a requirement to work at hospitals for 2 years during med school with no pay and for 4 more years after they graduate with limited pay. If you want to be a surgeon add 3 more years on to that. So 12 years grade school 4 years collage 4 years med school 4 years resident and if you want to be a surgeon 3 more years resident = 24/27 years of "slave" as you say (these aren't drinking kegs at the frat house years either). The system already runs on the backs of low paid doctors (45k to 65k a year depending) and they work them 60 to 80 hours a week.

I don't expect to change your mind about health care, think what you want but don't think that doctors get to dictate their entire lives. Most of them made a choice to become a doctor because they want to help people, their community or do high end research, again to help people. You make them sound like lawyers but look at that commitment above and you will see that if money was the only option business school and those same years of hard work would payoff even more.

The doctors are getting the squeeze by the insurance companies and the hospitals. You think that by going single payer the doctors would suffer but that is wrong. They would flourish under those conditions of PEER review.

And there already are private hospitals. There are doctors that only accept cash for treatments in excess of 250k. Sorry but I'm pretty sure you would be left out of this group as well Nebor.

I don't remember the van with armed men conversation. But it is, generally speaking, better to fight to the death than be disarmed\captured. That seems irrelevant though.

I know (went to school with, fraternity brothers, family friends, etc.) a lot of medical doctors. They are regular people just like you and me. They drink, they smoke cigars, and do everything else that regular people do. They choose what to do with their time. They decide how much time they want to spend working, and how much time they want to spend playing video games, going out on dates, driving their car around, etc. And god help you if you ask them a medical question outside the office. Or if someone volunteers them as a doctor in the stereotypical "is there a doctor in the house" scenario. Just like a plumber or a lawyer, or anyone else, they don't want to do work when they aren't at work. They value their time at a certain dollar amount. When you start dictating by law how much they are allowed to charge, they are going to change professions (unlikely) or find a way to get the amount of money required to get them to give up their free time (by working privately or in another country.)

Everyone I know that's a doctor did it for money and prestige (women.) They've all done pretty well for themselves in that respect. None of the ones I know carry a pager, or give out their cell or home numbers to patients. They work regular office jobs just like you and me. Just because you think you're entitled to the service they provide gives you no right to take away their freedom to choose who to serve, and how much to charge them.

 

[Saga]

Originally posted by: techs
Let me get this straight. You want doctors to just put down a number and the insurance companies and Medicare should just pay it.
That's insane.

Isn't that what happens anyway?

Or is the $750 knee brace that sold for $9 at Walgreens my mother was charged for have an actual justification for that price premium?

 

[JohnnyGage]

Originally posted by: RightIsWrong

Originally posted by: JohnnyGage

Originally posted by: RightIsWrong

Originally posted by: Nebor
Doctors are people just like anyone else. They have the right to do as they please and charge what they please. UHC is centered around the idea of basically enslaving doctors by making health care a "right." It's not right, and it's not fair, and it will lead to a lower standard of care.

As you (or others that I'm confusing with you) have stated, you can always quit and go somewhere else.

This is what drives me nuts. Everyone (myself included) has viewpoints on topics that are diametrically opposed to their viewpoints in other topics.

Your argument is based on a fear/resentment of government and not reality. It has been shown in many different threads that the quality of care in the US is dramatically lower than in a multitude of other countries that have UHC.

There is no fear govt.--we just know that the private sector can do just about everything better than the govt. Especially in the health care area. The main reason that UHC appears cheaper in other countries is that the care is rationed, which is why there are 6 month and longer wait lists for elective surgeries. People have died in Canada waiting for open heart surgery. So if you think that the quality of care is bad now--just wait until the govt. takes over.

I would prefer that you could buy health care insurance across state lines and also be able to get an HSA and catastrophic coverage.

The key phrase in your post was "just about". There are clear examples where the private sector can do and does a worse job than the government. Public utilities, roads, policing, space exploration, fire rescue services and the military for example.

Please read this as a rebuttal to the Canadian wait list stance you have taken.

Originally posted by: JohnnyGage

Originally posted by: ElFenix

Originally posted by: RightIsWrong

You are both wrong. If government is the only provider, then the costs will go down because more people will utilize it for simple matters that can be "cured" before the costs become astronomical.

Giving someone Aldera for a patch on their skin in a benign state is exponentially cheaper than treating someone for melanoma.

everyone dies. you're merely putting off the cost, not lowering it.

You forgot to mention that UHC will get used at 10x the rate it is now--because it's "free"--thereby stressing the system and actually increase the cost of "free" healthcare.

And you are also forgetting to mention that in countries that have some form of UHC, they are rated higher in quality of care, lower in per capita costs, have a longer life span, lower infant mortality rate and EVERYONE has access to it.

I'm sorry, but the facts don't seem to validate your arguments against it (higher costs, worse care, etc).

So according to that link there were 141 deaths out ouf 29,293 CABG and valve procedures from 1991 to 1995, roughly 35 a year. Don't you think that is actually pretty appalling? And that is just four years of checking, what is it now? It's pretty routing procedure these days, and there aren't people waiting here for it. If there was a hospital or health system here that let 35 patients a year die because of waiting--they would probably be shut down. I would rather die being worked on, than at home sitting by the phone and wondering if I will see tomorrow. I know because I see these patients all the time.

I don't believe for a second that there is better quality care elsewhere, it's probably good and in some parts as good--but better I doubt it. As a matter of fact people in Canada are coming here to pay out of pocket for health care. And there are a lot of examples of high profile people coming here for health care. Heck, even El Jeffe Fidel had gastro surgeons flown down to Cuba for his procedure.

Finally, what is the final cost of going single payer going to cost? In Canada they paid about the same in taxes that we did and they have ten percent of the population of the US. The cost is going to be astronomical here. And what ever Hillary/Obama/hell any politician tells you it's going to cost. Multiply it times five and you will probably be warm.

Here is a linkage to the 20/20 special on health care--by far the fairest report on HC.
It's 7:24

http://www.youtube.com/watch?v...Kq9tZQ&feature=related

 

[JSt0rm]

Originally posted by: Nebor
Everyone I know that's a doctor did it for money and prestige (women.)

Then I feel sorry for you.

 

[JSt0rm]

Originally posted by: Hayabusa Rider
Case in point. HIPPA. Health portability and privacy. Small goals compared to providing complete health care.

If there are issues with individual little things then those can be fixed. Why was that law put in place to begin with? Was it to protect an individuals private health documents? and if so isn't this highly important when you can be turned down for insurance based on previous health concerns?

 

[RightIsWrong]

Originally posted by: JohnnyGage

Originally posted by: RightIsWrong

Originally posted by: JohnnyGage

Originally posted by: RightIsWrong

Originally posted by: Nebor
Doctors are people just like anyone else. They have the right to do as they please and charge what they please. UHC is centered around the idea of basically enslaving doctors by making health care a "right." It's not right, and it's not fair, and it will lead to a lower standard of care.

As you (or others that I'm confusing with you) have stated, you can always quit and go somewhere else.

This is what drives me nuts. Everyone (myself included) has viewpoints on topics that are diametrically opposed to their viewpoints in other topics.

Your argument is based on a fear/resentment of government and not reality. It has been shown in many different threads that the quality of care in the US is dramatically lower than in a multitude of other countries that have UHC.

There is no fear govt.--we just know that the private sector can do just about everything better than the govt. Especially in the health care area. The main reason that UHC appears cheaper in other countries is that the care is rationed, which is why there are 6 month and longer wait lists for elective surgeries. People have died in Canada waiting for open heart surgery. So if you think that the quality of care is bad now--just wait until the govt. takes over.

I would prefer that you could buy health care insurance across state lines and also be able to get an HSA and catastrophic coverage.

The key phrase in your post was "just about". There are clear examples where the private sector can do and does a worse job than the government. Public utilities, roads, policing, space exploration, fire rescue services and the military for example.

Please read this as a rebuttal to the Canadian wait list stance you have taken.

Originally posted by: JohnnyGage

Originally posted by: ElFenix

Originally posted by: RightIsWrong

You are both wrong. If government is the only provider, then the costs will go down because more people will utilize it for simple matters that can be "cured" before the costs become astronomical.

Giving someone Aldera for a patch on their skin in a benign state is exponentially cheaper than treating someone for melanoma.

everyone dies. you're merely putting off the cost, not lowering it.

You forgot to mention that UHC will get used at 10x the rate it is now--because it's "free"--thereby stressing the system and actually increase the cost of "free" healthcare.

And you are also forgetting to mention that in countries that have some form of UHC, they are rated higher in quality of care, lower in per capita costs, have a longer life span, lower infant mortality rate and EVERYONE has access to it.

I'm sorry, but the facts don't seem to validate your arguments against it (higher costs, worse care, etc).

So according to that link there were 141 deaths out ouf 29,293 CABG and valve procedures from 1991 to 1995, roughly 35 a year. Don't you think that is actually pretty appalling? And that is just four years of checking, what is it now? It's pretty routing procedure these days, and there aren't people waiting here for it. If there was a hospital or health system here that let 35 patients a year die because of waiting--they would probably be shut down. I would rather die being worked on, than at home sitting by the phone and wondering if I will see tomorrow. I know because I see these patients all the time.

I don't believe for a second that there is better quality care elsewhere, it's probably good and in some parts as good--but better I doubt it. As a matter of fact people in Canada are coming here to pay out of pocket for health care. And there are a lot of examples of high profile people coming here for health care. Heck, even El Jeffe Fidel had gastro surgeons flown down to Cuba for his procedure.

Finally, what is the final cost of going single payer going to cost? In Canada they paid about the same in taxes that we did and they have ten percent of the population of the US. The cost is going to be astronomical here. And what ever Hillary/Obama/hell any politician tells you it's going to cost. Multiply it times five and you will probably be warm.

Here is a linkage to the 20/20 special on health care--by far the fairest report on HC.
It's 7:24

http://www.youtube.com/watch?v...Kq9tZQ&feature=related

What you might have missed is that 35 was across the entire country and not just a single healthcare system.

How many die each year in the US due to a lack of availability to healthcare?

Source

Nearly nine Indiana residents die every week because they don't have health insurance, according to a report released Friday.

.........

In its 2002 report, the Institute of Medicine estimated that 18,000 adults nationwide died in 2000 because they did not have health insurance.

A 2006 update by the Urban Institute reported at least 22,000 U.S. adults died in 2006 because of a lack of health insurance, according to Families USA.

I think that I would take 35 nationally per year over 22,000. What about you?

 

[JohnnyGage]

No, it says 141. Results-There were 141 deaths (0.48%) among 29 293 patients.


Link isn't working for me, I tried multiple times--wish I could see it. There is no lack of health care. There is lack of insurance coverage (42 million is probably right, but there are lots of variables). If there that many people that die, it's more than likely they did so at their own volition for whatever reason. Because emergency services are always rendered until the patient is stable enough to transferred or released. I'm in the dialysis field, and I can tell you for sure that there are plenty of people on dialysis that have no coverage--both legal and illegal alike. That is mainly why I doubt the numbers.

The system here isn't that great, but it's better than rationed govt. care at the moment. Like I said before, if someone could buy insurance across state lines--i.e. a person in New York will pay more for the same coverage as someone in Connecticut. More HSA's and catastrophic coverage, not unlike car insurance.

Again, Canadians paid just about the same amount of total taxes as we did--and they are ten percent of our population. So it definitely costs more.

 

[Zebo]

Originally posted by: Hayabusa Rider
Government seeking to cut health care, led by the Democrats this time.

One of the biggest problems health care providers face is having to do more with less. Medicaid reimbursments have gone down ever since I can remember (Bush really hammered that) and now the Dems are trying to restrict access to medical care as well.

The costs to those who provide health care (and that includes physicians, nurses, pharmacies, dentists) is ever increasing. In the mean time government wants to offer reimbursments that are often less than what it takes to provide a service. Industry follows government, in that when reimbursements are cut by the feds or the states, they do likewise. The only thing to go is staffing, so there are fewer people to do the job. Then the insurance companies come up with these bizarre cost containment schemes, where health care providers now spend a significant portion of their time saving the insurance companies money. In essence they become unpaid labor. So hire someone to do it? No, there is less money now, and instead of hiring more staffing health care workers have to do more of it themselves. But there are patients to attend to, and more of them. So the time and attention each person gets decreases. Government's fix? Cut reimbursements more.

I know of many good physicians and other practitioners who have left health care because it's not worth it either financially or professionally. One of my wife's best friends left pediatrics a few years back to go teach. Her skyrocketing costs combined with decreasing income meant she was paying out of her own personal resources to keep adequate staff. Eventually that became too great a drain, and one of the best pediatricians I ever knew now teaches at a small private college making far less on paper, but bring far more home.

This is going to be an increasing problem. There is going to be an increasing shortage of nurses (and there is a real problem now), because there isn't going to be the money to pay new ones nor to replace ones approaching retirement.

One day we're going to have the best health care system on paper. The problem is there won't be people to make it a reality. If patients want to have working health care, gutting it won't get you there.

It's funny you mention this as I have an Oncologist buddy who is either going to quit or move to Costa Rica to private practice to expats. He says the same thing such as Medicaid pays 18% of what it costs on some procedures. Then again I know two anesthesiologists both making over 400k a year. None of them are going broke driving Porsche's and X5s and liv on multiple million dollar houses I think they the onco was just used to more and sees lots of geriatrics accounting for a disproportionate level of Medicaid discounting the others don't see. Nevertheless it still doesn't change the fact foreign Docs can't be placed as fast as they want in nor medical cartel which hasnt opened but 1 school in 20 years despite burgeoning populations. In sum I don't pity my friends for their cartel being stymied by the government payment cartel.

 

[Pliablemoose]

Originally posted by: Nebor

Originally posted by: RightIsWrong

Originally posted by: Nebor
Doctors are people just like anyone else. They have the right to do as they please and charge what they please. UHC is centered around the idea of basically enslaving doctors by making health care a "right." It's not right, and it's not fair, and it will lead to a lower standard of care.

As you (or others that I'm confusing with you) have stated, you can always quit and go somewhere else.

This is what drives me nuts. Everyone (myself included) has viewpoints on topics that are diametrically opposed to their viewpoints in other topics.

Your argument is based on a fear/resentment of government and not reality. It has been shown in many different threads that the quality of care in the US is dramatically lower than in a multitude of other countries that have UHC.

I simply don't believe that. The best medical care in the world is available here in the US. When I've had to go to the hospital, it's been Baylor Medical Center in Dallas, TX. The hospital is beautiful, clean, efficient, with great care, plenty of staff, hell even the food is wonderful. The fact is that the best health care in the world is available here in the US for those willing to work and pay for it, prioritize it above 24" wheels, etc.

My argument was based on doctors being people, not slaves. When you regulate the amount they get paid, then you will experience a brain drain in the industry. Quality of care will go down. You will likely raise quantity of care, but you'll only be helping those people who never prioritized health care to begin with.

Health care is a commodity, just like anything else. There is a market in place that deals with allocating health care to those willing to pay for it. It's basic economics, wants are unlimited, health care is scarce. Now you may argue that for whatever reason, the cost of health care is currently above what should be the market equilibrium (unfair insurance company practices, etc.) but arguing for massive government intervention, entirely destroying the market is ludicrous. It runs contrary to our entire way of life.

Cool, let's say I actually know more about Baylor than Nebor, but couldn't say exactly why...

Baylor loses money and the reason it provides nationally recognized quality health care is because it's a faith based hospital system with deep pockets, with a mission to not make money, but to provide the best care they possibly can, they have a mandate to provide better than the status quo in health care and to be an industry leader.

If I'm a trauma victim, take me to Parkland, anything else, take me to Baylor.

And HR is correct, the system is screwed, we are losing ground every year, as a good friend in hospital administration told me a few years ago, yes, we need a bigger ER so we can lose money faster.

I have a minimum of 10 years left till I can retire, and I'm out of the game, thank fucking god I've planned for my retirement.