affordable healthcare....

[blackangst1]

I'm generally a conservative type of person, however, this is one area where I'd break with my normal ideology.

Telling a poor person - who may or may not be poor because of their own deeds - to spend money they don't have, and will never have, just isn't going to work. Telling the same poor person they can't have a test they need to diagnose their issue, or not even telling them that and just not even bringing up the test, because it's too expensive, is just morally wrong. Out of all the values that America has stood for, that type of situation is not one of them.

The thing that needs to be figured out is, how do we drop the cost of providing services to everyone. How can we make the lithotripsy proceedure w/ stent placement not cost $16000 for 1 hour of work when someone has a kidney stone? Did it really cost $16k? Really? No, it didn't....not even remotely close.

It seems to me we have high demand for people with high qualifications, and equipment that for whatever reason costs a $$$$$$$$ amount of money (maybe it really costs that much, maybe those companies are marking it up to god and back because they can).

If we can alleviate the cost burden of obtaining these high qualifications, and at the same time get more of these people into the market, along with working with the equipment manufacturers to reduce the equipment costs, perhaps we can get costs much more in line with the salaries of those consuming the services.

It's not a problem for someone (whether that be the individual, company, county, state, fed, or a mix of those) to pay for health insurance if the insurance is low because it can be, because costs have been re-alinged.

Got to control the costs.....

Chuck

Agree 100%. And the thread title is incorrect. It should read "Affordable Healthcare Insurance". Otherwise it would be a different discussion.

 

[chucky2]

Why are insurance companies playing the game though? And is that the only reason why the amounts are so extreme?

 

[PeshakJang]

Ugh, you're all missing the point. Healthcare is ruined by insurance. Doctors know that they have to charge 10x the actual cost of a procedure because the insurance company will only cover 1/10th of the bill.

So why not charge 1/10 if the person pays in cash?

How much does medicaid/medicare pay out compared to for-profit companies?

The negotiators for BCBS and other such companies make millions of dollars per year by lowering the amount that's actually paid out by the health insurance company. If insurance companies weren't playing this game, then doctors wouldn't have to play it either.

Maybe doctors are raising their prices, forcing insurance to lower what is paid out.

Again, where are the profits going? The insurance industry averages just a few percent profit margin... where is all the money going?

 

[jhu]

So why not charge 1/10 if the person pays in cash?

How much does medicaid/medicare pay out compared to for-profit companies?

Medicare/medicaid doesn't pay enough to cover overhead. Any physician who just sees such patients really can't make enough to stay open.

Maybe doctors are raising their prices, forcing insurance to lower what is paid out.

Again, where are the profits going? The insurance industry averages just a few percent profit margin... where is all the money going?

Generally it doesn't matter what the physician bills because reimbursements are negotiated beforehand.

 

[ShawnD1]

I agree with the sliding scale for medical services. A person that makes less money gets less economic utility out of treatment so they should pay less. A rich person that is restored to health will end up producing a lot more for the economy and should be charged accordingly.

I like the idea of needing to haggle over prices. Doctor shopping would be like car shopping. You bring your brother or your father along to act like the service offered isn't that good. Taking your wife along would totally ruin everything because she slips up and says something about how much you "need" this heart surgery, and right there the doctor knows he has you by the balls and can charge a lot more.

 

[Modular]

So why not charge 1/10 if the person pays in cash?

How much does medicaid/medicare pay out compared to for-profit companies?



Maybe doctors are raising their prices, forcing insurance to lower what is paid out.

Again, where are the profits going? The insurance industry averages just a few percent profit margin... where is all the money going?

Even if they were charging 1/10th if you paid in cash, the cost would still be ridiculous. I had an ear surgery several years back that my insurance was billed over $40,000 for. They ended up settling for approximately 10k. That's not cost effective for anyone without insurance.

Also, you can negotiate prices. I had an MRI done on my knee this past summer that wasn't covered by my insurance. I got a bill for 900+ for the procedure, called them up and said, I can pay x amount over the next 3 months and they agreed.

Also, I don't know the specific numbers, but even if you're right and the profit margins are low, I'm sure that the execs and negotiators for the insurance companies aren't starving...

 

[manimal]

I like the idea of needing to haggle over prices. Doctor shopping would be like car shopping. You bring your brother or your father along to act like the service offered isn't that good. Taking your wife along would totally ruin everything because she slips up and says something about how much you "need" this heart surgery, and right there the doctor knows he has you by the balls and can charge a lot more.

you and Sue Louden need to hang out..you have lots in common..

 

[Hayabusa Rider]

These are awesome threads. Never have so many had such strong opinions about that which they have no concept yet produce numbers while completely unencumbered by data.

 

[Cerb]

So the OP feels that if a person pays a token amount, everything ought to be covered? How many doctors do you think will fall in line with that assessment? If someone is smart enough to go to medical school, what right do you have to demand their services at below-market rates? Are you going to hold a gun to the doctor's head and demand that he treat you? What if he says no?

Then, he doesn't practice, or he changes fields of practice. Both public and private insurance limit what they will pay. It's insane (in that it is putting patients, doctors, and the outsourced resources used by doctors and patients, all in a vice, and everyone is disconnected by several stages of obfuscation).

So why not charge 1/10 if the person pays in cash?

Some places, especially specialized clinics and labs, will do exactly that (IME, it's been more like 1/4-1/2). If you get referred somewhere, ask. The worst that can happen is that out-of-network billing to your insurance will be the cheapest option.

 

[exdeath]

Woah woah woah! Are we now admitting that rich people actually do more than just suck money away from the poor? I thought the rich were simply blood suckers feeding off the poor and hoarding their money?

They don't have to suck away anything when the poor just give it away. Gotta have those special edition remakes for the 15th time on BluRay discs and spinning rims and $30 t shirts with internet jokes on them.

I love how people who watch pay per view or are nuts about sports think athletes get paid too much, etc, etc. So if there was a pay cap on an athletes salary, who would they want their $150 to go to that they just spent on tickets?

 

[ShawnD1]

I love how people who watch pay per view or are nuts about sports think athletes get paid too much, etc, etc. So if there was a pay cap on an athletes salary, who would they want their $150 to go to that they just spent on tickets?

They foolishly assume that it would lower the ticket price.

Of course that would make absolutely no sense when you think about it. If a stadium sells out when the price is $100, why would anyone lower the price?

 

[child of wonder]

In a perfect utopia everyone would have top quality care available at no cost -- true universal healthcare.

However, we don't live in a utopia and either the individual must pay for their own care with their own money (and insurance) or the rest of us pay for it collectively through taxes and higher costs.

I wish I knew what the solution was so that everyone could be afforded very basic medical care free of charge if they need it while those that can pay for better care receive it without prices skyrocketing year after year.

 

[CycloWizard]

Then, he doesn't practice, or he changes fields of practice. Both public and private insurance limit what they will pay. It's insane (in that it is putting patients, doctors, and the outsourced resources used by doctors and patients, all in a vice, and everyone is disconnected by several stages of obfuscation).

The insanity is easily understood once you understand the root cause: it's the law. Congress is so keen on "reform" that they completely forgot how we got to this point in the first place - the previous wave of "reform." Reform nominally means to change something for the better, but government tends to stick that label on any arbitrary change, regardless of the end result.

 

[ericlp]

I think a lot of people that have jobs and are relatively healthy that they just don't need to go to the doctor. IE ... Young ones (you know your gonna live forever!) Smoke, Drink, Eat those french frys...

But....... I think there are an estimated 50 Million americans without health insurance and GROWING... Something is bound to break. It can't go on like this forever. Well, I suppose the people paying will just suck it up and pay even more to cover the growing number with out.

As for doctors getting paid for X amount. It's just a job... It's just money. I wouldn't want to be a doctor. Hell, I don't want to go to the hospital ... I take my Vit-c's. You can't put a price on health because when it's your time to go, no matter how much you got, if your going your going.

I don't know what the solution is, but for everyone that is 'comfortable' now with the way it is, I just see that when prices are going up more and more pretty soon we all could be just one step closer to joining the ranks of the 1 out of 6 of have not's.

It's not the doctors or the lawyers or the teachers, police, fireman, ambulance drivers that will determine the cost of health care. It's the insurance companies. How would you like it if you had to pay x amount of dollars for fire service and if you didn't pay the fire department would show up to just watch your house burn down? Oh, are you gonna hold up a gun to his head? How about cop? Getting mugged or robbed in your home, call the cops and they don't show up to your address because you didn't pay.

Where is you logic now? That's right in the toilet! What if it's the doctor ... not just a doctor but your doctor that didn't pay for the cops to show up to save his/her ass? I guess it's time for you find a new one. You could apply this logic to ALMOST any job. Doctors are worthless anyway. Half the time they can't figure out what's wrong with you. Then you end up on the table dead anyway. Now your dead and your family has to prove that it's malpractice to sue the hospital/doctor for killing someone because he was doing drugs right before he sliced you open.

Well, maybe you shouldn't have paid him so much... he wouldn't have been able to afford the drugs to get high to operate. oh well... I think we pay way too much ... Most of what we do pay doesn't even go to the doctor or hospital itself, but to INSURE him/her the doctor in case you decide to sue them. It's really nut's when you take a look at the big picture!

 

[Carmen813]

Another reason costs are high is because hospitals/doctors bill for each individual service. This creates an incentive to bill for any many individual services as possible, which creates more paperwork, which creates more inefficiency. This is particularly a problem for Medicare/Medicaid, but all insurers face it.

One thing we could start do is have programs like Medicare/Medicaid begin paying a lump sum amount for a service (like, $10,000 for a basic surgery), and then allowing the hospitals/providers decide how to split it up amongst themselves. That creates an incentive to be efficient.