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

[Hayabusa Rider]

Originally posted by: dmcowen674

Originally posted by: Hayabusa Rider

What Dave apparently does not see is that when costs exceed income, there is no profit. Where there is no profit, individuals or business must move to something else.

You cannot afford to make a negative income.

That's what the Bush Administration has been doing since 2001.

Do disagree with the domestic policy?

Bush is an idiot, but not exclusively so.

 

[heyheybooboo]

Originally posted by: Hayabusa Rider

Originally posted by: dmcowen674

Originally posted by: Hayabusa Rider
My personal physician has told me he figures he has two or three years, then he's out.

He's in his early 50s. His take home pay less close to net zero. He lives off of his investments and his kids are on their own. The reason he sticks around is because he likes what he does, and he provides jobs to people he likes. He can't run an office on his retirement though, so I'll have to go looking to see who's left. Most offices aren't taking new patients.

I have a bridge to sell you too.

You actually believe his bullshit?

What is he driving a 1980 Honda civic?

Why yes, I do believe him Dave. He and I both know far more than you do about it.

These were the good old days.

I can tell you that reimbursements have been cut drastically since 2003. I'm not a physician, but I am in health care, and I'm not stupid, nor gullible.

Apparently you don't know that much because this entire thread is misleading and full of sheet.

The proposed cuts are to Medicare Advantage plans which are government-funded medicare private health insurance plans.

 

[Hayabusa Rider]

Originally posted by: heyheybooboo

Originally posted by: Hayabusa Rider

Originally posted by: dmcowen674

Originally posted by: Hayabusa Rider
My personal physician has told me he figures he has two or three years, then he's out.

He's in his early 50s. His take home pay less close to net zero. He lives off of his investments and his kids are on their own. The reason he sticks around is because he likes what he does, and he provides jobs to people he likes. He can't run an office on his retirement though, so I'll have to go looking to see who's left. Most offices aren't taking new patients.

I have a bridge to sell you too.

You actually believe his bullshit?

What is he driving a 1980 Honda civic?

Why yes, I do believe him Dave. He and I both know far more than you do about it.

These were the good old days.

I can tell you that reimbursements have been cut drastically since 2003. I'm not a physician, but I am in health care, and I'm not stupid, nor gullible.

Apparently you don't know that much because this entire thread is misleading and full of sheet.

The proposed cuts are to Medicare Advantage plans which are government-funded medicare private health insurance plans.

It was an example to illustrate a problem. Medicaid which is a far larger program suffers from the same problem. Cut spending and reimbursements while at the same time expanding the program.

 

[soccerballtux]

Just get the government out of the picture.

Friend was telling me about free healthcare in Bulgaria.

If you are in a life threatening situation, you have to walk into the office with $10k or else you a). won't be seen now or b). will be seen now, but you might not wake up from the procedure. Oops.

Educated people know socialized healthcare won't work.

 

[Vic]

The biggest problem with govt-ran health care is that it doesn't do anything about the high cost, it just transfers the burden onto the taxpayers.

 

[palehorse]

Originally posted by: techs
A little less won't hurt them. Or us.

Is that the official battle cry of the US' far-left liberals?

😛

 

[fskimospy]

Originally posted by: soccerballtux
Just get the government out of the picture.

Friend was telling me about free healthcare in Bulgaria.

If you are in a life threatening situation, you have to walk into the office with $10k or else you a). won't be seen now or b). will be seen now, but you might not wake up from the procedure. Oops.

Educated people know socialized healthcare won't work.

Except for all those educated people who live in countries with socialized healthcare where it works better than our system here.

Oh, and dollars spent per capita on health care in Bulgaria: $62
Dollars spent per capita on health care in the United States: $4,271

 

[JSt0rm]

I don't work in health carte like some of you but I do have 2 friends in health care at different points in the system with very different views.

1st is my girlfriend - Stanford Grad, UCLA med school Grad (just this summer!!!) took 2 years off to do neurology/stroke research at the NIH in Washington, D.C. She is now working in San Fransisco doing her residency (UCSF only took 12 people from around the country for her residency). Her view - She would like to see a single payer system. I don't have this statistic but .30 of every dollar right now goes to some kind of paper work system then under a single payer could be virtually eliminated. She also feels that GP's aren't being focused on because the pay isn't as good as specialists. So most people don't go that route. She feels the insurance companies and pharma are putting the squeeze on the entire industry.

2nd is a friend from Ohio - She works in pharmaceuticals and the people she works with consistently vote republican to protect the status quote. Some of the drugs she sells cost $130 a pill and this would not survive is a single payer system. It's almost a joke for them to see how much of this stuff they can push. She actually wants to change her career trajectory because she sees the writing on the wall.

I've actually heard a insurance rep say that they try to keep the money out of the hands of the doctors. It was a tongue in cheek statement but I definitely took notice.

So I guess Hyabusa and others against the single payer system the question is- what part of the health care industry do you belong to exactly? I'm no where near as smart as my GF and i really respect and agree with her opinion on this one. As for my friend in Ohio I can tell she really doesn't like what she does. She is stuck and worried about her job and future. But sometimes things are more important then the individual. Sometimes a sacrifice has to be made for the greater good.

 

[Hayabusa Rider]

Originally posted by: JSt0rm01
I don't work in health carte like some of you but I do have 2 friends in health care at different points in the system with very different views.

1st is my girlfriend - Stanford Grad, UCLA med school Grad (just this summer!!!) took 2 years off to do neurology/stroke research at the NIH in Washington, D.C. She is now working in San Fransisco doing her residency (UCSF only took 12 people from around the country for her residency). Her view - She would like to see a single payer system. I don't have this statistic but .30 of every dollar right now goes to some kind of paper work system then under a single payer could be virtually eliminated. She also feels that GP's aren't being focused on because the pay isn't as good as specialists. So most people don't go that route. She feels the insurance companies and pharma are putting the squeeze on the entire industry.

2nd is a friend from Ohio - She works in pharmaceuticals and the people she works with consistently vote republican to protect the status quote. Some of the drugs she sells cost $130 a pill and this would not survive is a single payer system. It's almost a joke for them to see how much of this stuff they can push. She actually wants to change her career trajectory because she sees the writing on the wall.

I've actually heard a insurance rep say that they try to keep the money out of the hands of the doctors. It was a tongue in cheek statement but I definitely took notice.

So I guess Hyabusa and others against the single payer system the question is- what part of the health care industry do you belong to exactly? I'm no where near as smart as my GF and i really respect and agree with her opinion on this one. As for my friend in Ohio I can tell she really doesn't like what she does. She is stuck and worried about her job and future. But sometimes things are more important then the individual. Sometimes a sacrifice has to be made for the greater good.

Here's the problem with her thoughts. Paperwork is a tremendous waste. Unfortunately the government has requirements which promote that very thing. The cost of implementing HIPPA is enormous, and that's just one thing. Who sets the rules? With government looking to appease tax payers, they will almost certainly go for cost containment at the expense of medicine. Now this doesn't get private insurance entirely off the hook, but remember that government has the power to fine and imprison for not complying. A pharmacy I know recently got hit big time for not recording the time the call was taken from a doctor for a prescription. Thousands upon thousands of dollars. Apparently there is some stipulation that time must be recorded. NY state decided it could shake down pharmacies recently by looking at all the obscure requirements and went around to make sure everyone was complying with rules no one could reasonably know existed. A good faith effort to provide care (which was genuine, the prescription was indeed called in as recorded) was met with officials trying to make money for the public coffers.

That's what we have to look forward to on an even larger scale. It will be literally impossible to comply with all regulations all the time.

 

[JSt0rm]

The NIH is a government funded research institute but congress has no say on where the money goes just how much they get in total. I would imagine single payer working in a similar way.

Could you answer my question though?

what part of the health care industry do you belong to exactly?

 

[Hayabusa Rider]

Originally posted by: JSt0rm01
The NIH is a government funded research institute but congress has no say on where the money goes just how much they get in total. I would imagine single payer working in a similar way.

Could you answer my question though?

what part of the health care industry do you belong to exactly?

Sure, I'm a pharmacist.

 

[Fern]

Originally posted by: Common Courtesy
-snip-
How long would you stay in an industry where the costs go up but not the amount paid for services?

Why do costs continue to go up?

In other industries/professions, tools and methodologies are improved/developed to reduce costs and increase quality.

Among all others, is this profession unique in that there is no way to cost effectively increase service/quality, thus decreasing costs?

I suspect we have many, many poorly run medical practices. Physcians are hands down the worst business people I have run across as a CPA (lawyers are second).

As important as alt energy, we would do well IMO to also get togther some kind of Manhatten Project and address how to model our medical industry and it's practices. Efficeiency and quality should be the focus.

This formula we have of high costs+ lower quality care = financially poor physcians/health care workers makes no sense to me. Somethings's terribly wrong here; and forced HI purchases (the mis-named UHC) won't do a damn thing to correct it in any way.

Fern

 

[Hayabusa Rider]

Originally posted by: Fern

Originally posted by: Common Courtesy
-snip-
How long would you stay in an industry where the costs go up but not the amount paid for services?

Why do costs continue to go up?

In other industries/professions, tools and methodologies are improved/developed to reduce costs and increase quality.

Among all others, is this profession unique in that there is no way to cost effectively increase service/quality, thus decreasing costs?

I suspect we have many, many poorly run medical practices. Physcians are hands down the worst business people I have run across as a CPA (lawyers are second).

As important as alt energy, we would do well IMO to also get togther some kind of Manhatten Project and address how to model our medical industry and it's practices. Efficeiency and quality should be the focus.

This formula we have of high costs+ lower quality care = financially poor physcians/health care workers makes no sense to me. Somethings's terribly wrong here; and forced HI purchases (the mis-named UHC) won't do a damn thing to correct it in any way.

Fern

Remember that pediatrician I mentioned? Her husband was a paid business consultant for physicians and he was good at it. I have no doubt that there are some who are bad in business, but many offices are run quite efficiently. Now there is a way to get around this. Cut pay and benefits. People will adjust and go into other areas of work. When people are constantly occupied and work 10 or 12 hour days, what to you take from them?

Remember this is not a free market business. You cannot alter what you charge to offset the costs which you cannot control.

Imagine you produced automobiles. You must meet standards which are set. No price cutting on materials or construction. You are also allowed to charge 20K for a vehicle, no more. Your cost of insurance, energy, raw materials are determined by those who do not have those constraints. You cannot cut workers, because you have those down to the fewest needed to do the job. What now?

 

[Fern]

^ I repeat - Why do costs not come down?

Everybody else learns how to do things more efficiently and faster with ever increasing quality. Why not health care?

Fern

 

[EagleKeeper]

Originally posted by: Fern
^ I repeat - Why do costs not come down?

Everybody else learns how to do things more efficiently and faster with ever increasing quality. Why not health care?

Fern

If a GP has only so much time available. He can not be automated.
Many offices are moving more prelim work onto the nursing staff.
When he needs 30 minutes, he must take 30 minutes; cutting it to 25 will dimish quality.
And the planned 30 minutes in the schedule could expand to 45 depending on the situation.


Surgery can not be automated and people want the best.
When equipment is available to ensure better quality care, it is requested.

Because people demand the best (better), the medical profession will attempt to provide it; that increases the costs.

Equipment becomes expensive because it is not mass produced, expensive to design/develop/support along with cost of testing for FDA approval.

 

[ProfJohn]

Originally posted by: Fern
^ I repeat - Why do costs not come down?

Everybody else learns how to do things more efficiently and faster with ever increasing quality. Why not health care?

Fern

I think it has to do with the individualized service aspect of healthcare.

The cost of hiring a plumber to fix a leaking pipe has not come down.
The cost of hiring a electrician to wire a new room has not come down.
The cost of hiring a lawyer so you can divorce your wife has not come down.
The cost of hiring a CPA to balance your books has not come down.

The cost of a mass produced car has come down.
The cost of mass produced TVs have come down.

It seems simple, you can apply economies of scale and streamline operations for any type of industry that does not require one on one service.

 

[Vic]

Originally posted by: Fern
^ I repeat - Why do costs not come down?

Everybody else learns how to do things more efficiently and faster with ever increasing quality. Why not health care?

Fern

Text

It's worth the read.

 

[dmcowen674]

Originally posted by: Fern
Everybody else learns how to do things more efficiently and faster with ever increasing quality.

Why not health care?

Because as you saw in here Doctors are poor and getting poorer everyday.

When you get poorer you get less efficient obviously.

 

[dmcowen674]

Originally posted by: Hayabusa Rider

Originally posted by: JSt0rm01
The NIH is a government funded research institute but congress has no say on where the money goes just how much they get in total. I would imagine single payer working in a similar way.

Could you answer my question though?

what part of the health care industry do you belong to exactly?

Sure, I'm a pharmacist.

Charge $40 for a $1 pill?

 

[Craig234]

Originally posted by: dmcowen674

Originally posted by: Hayabusa Rider

Originally posted by: JSt0rm01
The NIH is a government funded research institute but congress has no say on where the money goes just how much they get in total. I would imagine single payer working in a similar way.

Could you answer my question though?

what part of the health care industry do you belong to exactly?

Sure, I'm a pharmacist.

Charge $40 for a $1 pill?

Dave, why are you attacking Hayabusa for no apparent reason?

 

[Hayabusa Rider]

Originally posted by: Craig234

Originally posted by: dmcowen674

Originally posted by: Hayabusa Rider

Originally posted by: JSt0rm01
The NIH is a government funded research institute but congress has no say on where the money goes just how much they get in total. I would imagine single payer working in a similar way.

Could you answer my question though?

what part of the health care industry do you belong to exactly?

Sure, I'm a pharmacist.

Charge $40 for a $1 pill?

Dave, why are you attacking Hayabusa for no apparent reason?

There is an old saying in law "If you have the facts, argue the facts. If you have the law, argue the law. If you have neither, just argue!"

Dave just argues a lot.

 

[Wheezer]

Originally posted by: Craig234

Originally posted by: dmcowen674

Originally posted by: Hayabusa Rider

Originally posted by: JSt0rm01
The NIH is a government funded research institute but congress has no say on where the money goes just how much they get in total. I would imagine single payer working in a similar way.

Could you answer my question though?

what part of the health care industry do you belong to exactly?

Sure, I'm a pharmacist.

Charge $40 for a $1 pill?

Dave, why are you attacking Hayabusa for no apparent reason?

jealousy....those that have not usually attack those that have simply because it is easier to attack than it is to get off their dead asses and do anything.

 

[Fern]

Originally posted by: ProfJohn

Originally posted by: Fern
^ I repeat - Why do costs not come down?

Everybody else learns how to do things more efficiently and faster with ever increasing quality. Why not health care?

Fern

I think it has to do with the individualized service aspect of healthcare.

The cost of hiring a plumber to fix a leaking pipe has not come down.
Plumbing used to require soldering etc. And the pipes didn't last as long. We now have PVC and PEK pipe, the later being especially easy to connect with a simple tool. I wouldn't be surprised if inflation were taken into account that they are less expensive.

The cost of hiring a electrician to wire a new room has not come down.
Can't comment here.
The cost of hiring a lawyer so you can divorce your wife has not come down.
Lawyers have made great use of computers. All their contracts and legal documents are on PC, one need only drop in the proper name and date. No more typing. Billing etc is also computerized. Documents are now filed electronically with most courts here. No more photocopying and walking/sending directly to the courthouse to be filed. Just click the button.

The cost of hiring a CPA to balance your books has not come down.
Again, PC's make a big difference here. E.g., we used to have complete all tax returns by hand, then have a secretary type up the forms. Same with spreadsheets & bookkeeping, we now have computer programs etc. Same with any doc's we generate. We used to have to write by hand, then get them typed.

The cost of a mass produced car has come down.
The cost of mass produced TVs have come down.

It seems simple, you can apply economies of scale and streamline operations for any type of industry that does not require one on one service.

I would think phycians would have equipment that would that help them become more efficient too. E.g., faster, cheaper x-rays, faster cheaper lab work for blood analysis etc

Fern.

 

[Fern]

Originally posted by: Vic

Originally posted by: Fern
^ I repeat - Why do costs not come down?

Everybody else learns how to do things more efficiently and faster with ever increasing quality. Why not health care?

Fern

Text

It's worth the read.

Book marked for later.

 

[Genx87]

Originally posted by: eskimospy

Originally posted by: soccerballtux
Just get the government out of the picture.

Friend was telling me about free healthcare in Bulgaria.

If you are in a life threatening situation, you have to walk into the office with $10k or else you a). won't be seen now or b). will be seen now, but you might not wake up from the procedure. Oops.

Educated people know socialized healthcare won't work.

Except for all those educated people who live in countries with socialized healthcare where it works better than our system here.

Oh, and dollars spent per capita on health care in Bulgaria: $62
Dollars spent per capita on health care in the United States: $4,271

Well that probably explains why if you walk into a hospital with a life threatening situation you need 10K, or you can hope your 62 bucks will provide a good enough procedure you dont die.

Sounds like a wonder system to me!