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

[Xavier434]

I am really not certain what the best direction is to take when it comes to Healthcare. All I know is that Healthcare and Education are two cornerstones in this country which are completely taken for granted when they should be bumped up amongst our top priorities in terms of quality and funding. Without our education and our health, this country has nothing. Everything else is pretty much meaningless.

 

[EagleKeeper]

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?

Is $40 worth it to you to feel better.

Why would you want to charge $4 for a cold beer as the owner of a bar when you can get it for $1 down at the corner store?

 

[fskimospy]

Originally posted by: 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!

I think you missed the point of my post. When your health care spending per capita is 6,800% of another country's you should damn well hope it is better. Attempting to discredit UHC by an experience in a fairly poor country that spends 1/68th what we do per person is a dishonest comparison.

 

[shiner]

Originally posted by: 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.

You can have one, but not both. So pick. Do you want it faster or do you want it cheaper?

 

[shiner]

Originally posted by: 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.

Well that and the fact that he's brain dead.

 

[EagleKeeper]

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?

Government is different than business.

Did you stay in business even if you could not make a profit

 

[ElFenix]

Originally posted by: tenshodo13

Originally posted by: XZeroII
Yea, I agree. In Japan, 50% of the hospitals there are in the red. It's what happens when introduce artificial control into a free market system.

Which is still why Japan has much better health care than the US?

the problem with using the term 'health' is that it brings in all sorts of societal issues that the medical industry simply can't correct. in this case, the typical japanese diet is well known to be very beneficial in terms of longevity. the typical american diet, not so much. i would argue that the effect of healthy living far outweighs the medical effect.

 

[ElFenix]

Originally posted by: 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.

this

(well, it could reduce paperwork, which is a huge cost, but i wouldn't place money on that bet)

 

[Hayabusa Rider]

Originally posted by: Common Courtesy

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?

Is $40 worth it to you to feel better.

Why would you want to charge $4 for a cold beer as the owner of a bar when you can get it for $1 down at the corner store?

Well, he won't believe it, but no I haven't sold a $1 pill for $40, but I have sold $100 medications for $90. All the time? Of course not, but selling a medication below it's actual purchase (to us) price is not uncommon. Contractually we have to accept that. We can't pick and choose. Such is life.

 

[RightIsWrong]

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

The answer you seek is two fold and the same target(s) is being aimed at both times: private healthcare insurance (PHI) and pharmaceuticals.

With the influence they have in the market ($$), they dictate that things are done as cheaply as possible for them. That in turn has some health care providers working for the PHI company instead of the healthcare facility or more importantly the patient. Tests that are not critical but recommended to obtain an accurate diagnosis are commonly not performed due to the PHI not approving it because it will cost them $$. Sometimes, these tests not being performed cause the patient to get worse or die. Malpractice time. Health care provider costs go up again due to higher insurance premiums.

Also, the PHIs only want the healthiest of the healthiest so that they improve their odds of not having to pay out, but still collect the premiums. This mindset has caused the US to incur an uninsured rate of 15.3% (24.1 here in TX -- Everything's bigger in TX). Along with this uninsured rate, people do not go to the hospitals for routine checkups. They do not catch conditions before they really get out of hand. What logically happens next is that the cost to treat now grows exponentially and a lot of times the health care provider is eating this cost due to the patient not having insurance or the PHI claiming it is pre-existing and not covering the cost.

The other target (sorry Hayabusa Rider) is the pharms. I completely understand and appreciate the costs associated with R&D and don't hold the inclusion of those costs into the price of their product. However, the price of their marketing is something that is way out of control and shouldn't be paid for by the consumer. In some cases, pharms are spending double the cost to produce and triple the R&D on marketing. Here's a study findings recap article that shows:

The researchers? estimate is based on the systematic collection of data directly from the industry and doctors during 2004, which shows the U.S. pharmaceutical industry spent 24.4% of the sales dollar on promotion, versus 13.4% for research and development, as a percentage of US domestic sales of US$235.4 billion.

...............

Thus, the study?s findings supports the position that the U.S. pharmaceutical industry is marketing-driven and challenges the perception of a research-driven, life-saving, pharmaceutical industry, while arguing in favour of a change in the industry?s priorities in the direction of less promotion, according to Gagnon and Lexchin.

 

[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.

 

[RightIsWrong]

Originally posted by: ElFenix

Originally posted by: 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.

this

(well, it could reduce paperwork, which is a huge cost, but i wouldn't place money on that bet)

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.

 

[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.

 

[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.

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.

anyone who chooses to go to medical school after government medical care is implemented is certainly not a 'slave.'

Originally posted by: RightIsWrong

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.

and every time one of those 'studies' shows that the quality of care in the US is dramatically lower that 'study' is ripped for the subjective piece of fluff that they always are.

 

[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.

 

[Nebor]

Originally posted by: ElFenix

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.

anyone who chooses to go to medical school after government medical care is implemented is certainly not a 'slave.'

And what you'll see is a dramatic reduction in the number of people trying to go to medical school, and those candidates who do go will not be the best and brightest as they are today in America. Just look at Canada. Recruiting for medical schools, and even then having to establish a complex system of laws to keep doctors from fleeing the country for the greener free market pastures to the south.

Disincentivizing a medical degree will result in a brain drain in the industry. There's no doubt about it. You'll still get a few great doctors with a mother teresa attitude, but you'll lose the thousands of guys that know that if they're a good, competent doctor they'll be able to buy a Ferrari when they're 35.

 

[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.

 

[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.

 

[Genx87]

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.

Great read.

 

[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).

 

[ElFenix]

Originally posted by: RightIsWrong

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).

you insist at grading the medical system by using health outcomes, which are a poor proxy for various reasons that i've illuminated from time to time (young black men shooting each other and thereby lowering the life expectancy statistic isn't something medicine can fix, for example). further, you use health outcomes whose definitions and measurement completeness are inconsistent from country to country and region to region (and which can appear worse due to medical advances, such as fertility treatments whereby the woman has a litter of babies and several of them die very early).


medical care is scarce and must be rationed in some form or fashion. you cannot legislate away that immutable truth.

 

[Xavier434]

Originally posted by: Genx87

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.

Great read.

From that article:

As to the question of how those who cannot afford medical care will receive it, we must bear in mind that government is not taking care of them now and is logically incapable of ever doing so, for the simple reason that government does not and cannot produce goods or services. Insofar as people who cannot afford medical care are receiving it, the care is being provided by productive American citizens, doctors, and hospitals. And we must bear in mind that, in the words of Philosopher Leonard Peikoff, Americans who cannot afford medical care ?are necessarily a small minority in a free or even semi-free country. If they were the majority, the country would be an utter bankrupt and could not even think of a national medical program.?63

Those unable to afford any particular medical services would have to rely on voluntary charity, not on the empty promises of government. Individually, Americans are the most generous people in the world, and they have always been so. For example, American individuals, corporations, and foundations gave $1.5 billion to aid victims of the December 26, 2004, Sumatra earthquake and tsunami, more than double the amount any government provided, including the United States.

Rely on charity? Rely on American generosity despite our knowledge of how greedy they are? I highly oppose this. There are too many really poor and elderly people in this country that work(ed) their fingers to the bone and can barely make ends meet let alone afford health insurance for themselves or their kids. These people along with the elderly deserve much more than having to rely on charity to be treated at hospitals that have the option of simply turning them away because they fear that they will not get paid. Correct me if I am mistaken, but this article sounds like it is shifting the problem on to the laps of these people more so than it is trying to ensure that everyone gets health care. I don't care how many of you want to pull the entitlement card on this matter. Without education and health care, everything else in this country means nothing. It is far more important than any kind of money or commodity and therefore it should not be treated as such. I am not proposing an alternative solution to this matter and I am not trying to state that our current system works or is better, but this whole idea of the health care system being a true free market just sounds like the only people who are going to the get the best health care are those with the most money. If I am wrong then I am wrong, but I would really like to hear more of an explaination as to why I am wrong rather than being flamed upon.

 

[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.

 

[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

 

[bamacre]

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.

Thanks for posting, Vic. :thumbsup: